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Wang J, Wang Y, Zhou B, Wang L, Lai Z. Age-Related Reduction of Foot Intrinsic Muscle Function and the Relationship with Postural Stability in Old Adults. Clin Interv Aging 2024; 19:1005-1015. [PMID: 38855030 PMCID: PMC11162186 DOI: 10.2147/cia.s454068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 05/11/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction The risk of falls among the elderly significantly increases, which has become a serious public health concern. Falls can not only lead to serious complications such as fractures and brain injuries but also limit their mobility function, reducing quality of life. Foot intrinsic muscles (FIMs) are an essential part of foot core stability even overall postural stability. This study aimed to investigate the effects of aging on the function of FIMs and to explore the influence of FIMs on postural control in the elderly. Materials and Methods 56 healthy old participants (60-75 years) and 57 healthy young participants (18-29 years) joined this study. An ergoFet dynamometer was used to determine foot muscle strength (Doming, T1, T23 and T2345), and ankle muscle strength (plantarflexion and dorsiflexion). The morphology of FIMs and extrinsic foot muscle was determined using a Doppler ultrasound system, whereas the postural stability was assessed through Limits of Stability test. Independent samples t-test was used to determine the differences in strength and morphological parameters and Spearman correlation analysis was used to determine whether an association existed between muscle strength and postural stability parameters in the elderly. Results Compared with young adults, foot muscle strength and ankle muscle strength (Doming, T1, T23, T2345, dorsiflexion, and plantarflexion, all p <0.05) and the morphology of foot muscles (all p <0.05) were significantly reduced in the elderly. The strength of FIMs and the limit of stability (r = 0.302-0.424, all p <0.05) were significantly correlated in the elderly. Conclusion Compared with young adults, the weakness of strength as well as the morphological decline of the intrinsic and extrinsic foot muscles were found in the elderly. In addition, a correlation was observed between FIM's strength and postural stability in the elderly, suggesting their potential role in posture stability.
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Affiliation(s)
- Jiayi Wang
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Yuanyuan Wang
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Bangguo Zhou
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Shanghai, People’s Republic of China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, People’s Republic of China
| | - Zhangqi Lai
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
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Matsumoto Y, Ogihara N. Direct visualization and measurement of the plantar aponeurosis behavior in foot arch deformation via the windlass mechanism. Clin Anat 2024. [PMID: 38642017 DOI: 10.1002/ca.24171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/28/2024] [Accepted: 04/11/2024] [Indexed: 04/22/2024]
Abstract
The plantar aponeurosis (PA) is an elastic longitudinal band that contributes to the generation of a propulsive force in the push-off phase during walking and running through the windlass mechanism. However, the dynamic behavior of the PA remains unclear owing to the lack of direct measurement of the strain it generates. Therefore, this study aimed to visualize and quantify the PA behavior during two distinct foot postures: (i) neutral posture and (ii) windlass posture with midtarsal joint plantarflexion and metatarsophalangeal joint dorsiflexion, using computed tomography scans. Six healthy adult males participated in the experiment, and three-dimensional reconstruction of the PA was conducted to calculate its path length, width, thickness, and cross-sectional area. This study successfully visualized and quantified the morphological changes in the PA induced by the windlass mechanism, providing a precise reference for biomechanical modeling. This study also highlighted the interindividual variability in the PA morphology and stretching patterns. Although the windlass posture was not identical to that observed in the push-off phase during walking, the observed PA behavior provides valuable insights into its mechanics and potential implications for foot disorders.
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Affiliation(s)
- Yuka Matsumoto
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
- Graduate Course of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Naomichi Ogihara
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
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Wang S, Xu X, Cao S, Cheng J, Wang Y, Dong Y. Sonographic methods to predict type 2 diabetes patients with sarcopenia: B mode ultrasound and shear wave elastography. Clin Hemorheol Microcirc 2024:CH231822. [PMID: 38393892 DOI: 10.3233/ch-231822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
BACKGROUND Type 2 diabetes accelerates the loss of muscle mass and strength. Sarcopenia is also one of the chronic complications of diabetes. OBJECTIVE To investigate the clinical value of B mode ultrasound (BMUS) and shear wave elastography (SWE) for predicting type 2 diabetic sarcopenia. METHODS We recorded Skeletal Muscle Mass Index (ASMI), grip strength, muscle thickness (MT), pinna angle (PA), fascicle length (FL), and the difference of Young's modulus in the relaxed states and tense states (ΔSWE). The correlations between clinical indicators and ultrasound characteristics were compared. A diagnostic model of sarcopenia was developed to assess the independent correlates and evaluate the diagnostic efficacy of sarcopenia. RESULTS ASMI was significantly and positively correlated with MT and ΔSWE (r = 0.826, 0.765, P < 0.01), and grip strength was significantly and positively correlated with MT and ΔSWE (r = 0.797, 0.818, P < 0.01). MT was the most significant predictor of sarcopenia (OR = 4.576, P < 0.001), and the cut-off value of MT was 11.4 mm (AUC: 0.952). CONCLUSION BMUS and SWE can quantitatively assess muscle mass and strength, and are effective methods to predict the occurrence of sarcopenia in elderly patients with type 2 diabetes.
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Affiliation(s)
- Shengqiao Wang
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinliang Xu
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Siqi Cao
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juan Cheng
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Wang
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Dong
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Hirota K, Watanabe K, Miyamoto H, Negishi K, Watase M, Teramoto A. Comparison by ultrasound shear wave elastography of toe flexor muscle contraction during MTP flexion exercise and short-foot exercise. J Back Musculoskelet Rehabil 2024:BMR230282. [PMID: 38427465 DOI: 10.3233/bmr-230282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
BACKGROUND The intrinsic foot muscles play an important role in medial longitudinal arch support, as well as several extrinsic foot muscles. While various strength training methods specific to intrinsic foot muscles have been conducted, these exercises are associated with certain concerns regarding their effectiveness and difficulty. We developed a new exercise for the intrinsic muscles (MTP flexion exercise). OBJECTIVE The aim was to compare the shear modulus of the toe flexors as the muscle contraction activity during MTP flexion and short-foot exercises using ultrasound shear wave elastography. METHODS Eleven healthy participants were included in this study. The shear modulus of the toe flexor muscles was measured during MTP flexion and short-foot exercises using ultrasound shear wave elastography. The muscle shear modulus was statistically compared between the resting phase, and during the two exercises. RESULTS The shear modulus during MTP flexion exercise was significantly greater than in the resting phase in the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis, quadratus plantae, and flexor digitorum longus. The flexor digitorum longus showed greater shear modulus during MTP flexion exercise than during short-foot exercise. CONCLUSION MTP flexion exercise showed equivalent or greater contraction activity in certain intrinsic and extrinsic foot muscles when compared with short-foot exercise. This exercise is considered one of the training options for strengthening the intrinsic muscles of the foot.
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Affiliation(s)
- Kento Hirota
- Department of Physical Therapy, Sapporo Medical University, School of Health Sciences, Sapporo, Japan
- Tokachi Physical Lab, Obihiro, Japan
| | - Kota Watanabe
- Department of Physical Therapy, Sapporo Medical University, School of Health Sciences, Sapporo, Japan
| | - Hiroki Miyamoto
- Department of Physical Therapy, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan
| | - Keisuke Negishi
- Department of Rehabilitation, Hitsujigaoka Hospital, Sapporo, Japan
| | - Mako Watase
- Department of Physical Therapy, Sapporo Medical University, School of Health Sciences, Sapporo, Japan
| | - Atsushi Teramoto
- Department of Orthopaedic Surgery, Sapporo Medical University, School of Medicine, Sapporo, Japan
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Okamura K, Hamaguchi M, Ueno Y, Kida T. Effect of Neuromuscular Electrostimulation With Blood Flow Restriction on Acute Muscle Swelling of the Abductor Hallucis. J Sport Rehabil 2024; 33:121-127. [PMID: 38154017 DOI: 10.1123/jsr.2023-0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 12/30/2023]
Abstract
CONTEXT Plantar intrinsic foot muscle strength training is difficult to master to a degree sufficient to elicit muscle hypertrophy in most individuals. It is possible that combining neuromuscular electrostimulation (NMES) and blood flow restriction (BFR) can elicit plantar intrinsic foot muscle hypertrophy regardless of the individual's technique. This study aimed to determine the effects of NMES training with BFR on acute muscle swelling in the abductor hallucis. DESIGN Randomized, controlled, single-blind trial design. METHODS Forty-eight participants were randomly allocated to the NMES + BFR, NMES, or Sham NMES + BFR groups. All participants received abductor hallucis NMES for 15 minutes. Participants in the NMES + BFR and Sham NMES + BFR groups received NMES with BFR. The intensity of NMES was the sensory threshold in the Sham NMES + BFR group. The cross-sectional area of the abductor hallucis was measured pretraining and posttraining using ultrasonography by a single investigator blinded to the participants' allocations. RESULTS After 15 minutes of training, the cross-sectional area of the abductor hallucis was significantly increased in the NMES + BFR (P < .001) and the Sham NMES + BFR (P = .004) groups. Moreover, the rate of increase was significantly higher in the NMES + BFR group than in the NMES or the Sham NMES + BFR groups (P < .001 and P = .001, respectively). CONCLUSIONS Since it is possible that the amount of muscle swelling immediately after training correlates with muscle hypertrophy when training is continued, the results of this study suggest that NMES training with BFR is a training method that can be expected to produce plantar intrinsic foot muscle hypertrophy. Further studies are needed to confirm the long-term effects of NMES training with BFR.
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Affiliation(s)
- Kazunori Okamura
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Manami Hamaguchi
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Yuna Ueno
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Taira Kida
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, Japan
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Kobayashi T, Hirota K, Otsuki R, Onodera J, Kodesho T, Taniguchi K. Morphological and mechanical characteristics of the intrinsic and extrinsic foot muscles under loading in individuals with flat feet. Gait Posture 2024; 108:15-21. [PMID: 37976604 DOI: 10.1016/j.gaitpost.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 10/04/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND The intrinsic and extrinsic foot softtissue structures that apply force and support the medial longitudinal arch (MLA) have been implicated in the development of flat feet. However, the relationship between the changes in MLA height under increasing load and the morphological and mechanical properties of individual intrinsic and extrinsic foot soft tissue structures is not fully understood. RESEARCH QUESTION To examine the morphological and mechanical characteristics of the foot soft tissue structures in flat feet when subjected to loading. METHODS This study consisted of two studies focusing on the extrinsic foot muscles (10 normal feet/11 flat feet) and intrinsic foot muscles (14 normal feet/13 flat feet). Images of the extrinsic and intrinsic foot muscles and plantar fascia (PF) under 10%, 50%, and 90% body weight conditions were obtained using ultrasound-based shear-wave elastography. RESULTS The cross-sectional area (CSA) of the peroneus brevis was larger in the flat-foot group than in the normal-foot group under all loading conditions. The CSAs of the intrinsic foot muscles (abductor hallucis, flexor digitorum brevis, and quadratus plantae) and thickness of the PF in the flat-foot group decreased significantly with increasing load. As for mechanical characteristics, the stiffness of the flexor digitorum longus and abductor hallucis was higher in the flat-foot group than in the normal group under high loading conditions. In addition, flat feet with greater flexibility tended to exhibit a greater decrease in PF thickness and smaller increase in stiffness. SIGNIFICANCE Excessive stretching of the intrinsic foot muscles and PF occurs in flat feet, and excessive contraction of the flexor digitorum longus may counteract the excessive lowering of the foot arch. Therefore, it is necessary to promote the contraction of the intrinsic foot musculature in feet with greater flexibility of the MLA during loading.
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Affiliation(s)
- Takumi Kobayashi
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan; Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan.
| | - Kento Hirota
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan; Tokachi Physical Lab, Obihiro, Japan
| | - Ryo Otsuki
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan
| | - Juri Onodera
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan
| | - Taiki Kodesho
- Department of Sport Science and Research, Japan Institute of Sports Sciences (JISS), Tokyo, Japan
| | - Keigo Taniguchi
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
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7
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Lai J, Ye Y, Huang D, Zhang X. Age-related differences in the capacity and neuromuscular control of the foot core system during quiet standing. Scand J Med Sci Sports 2024; 34:e14522. [PMID: 37872662 DOI: 10.1111/sms.14522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 09/08/2023] [Accepted: 09/29/2023] [Indexed: 10/25/2023]
Abstract
The foot core system is essential for upright stability. However, aging-induced changes in the foot core function remain poorly understood. The present study aimed to examine age-related differences in postural stability from the perspective of foot core capacity and neuromuscular control during quiet standing. Thirty-six older and 25 young adults completed foot core capacity tests including toe flexion strength, muscle ultrasonography, and plantar cutaneous sensitivity. The center of pressure (COP) and electromyography (EMG) of abductor hallucis (ABH), peroneus longus (PL), tibialis anterior (TA) and medial gastrocnemius (GM) were simultaneously recorded during double-leg and single-leg standing (SLS). EMG data were used to calculate muscle synergy and intermuscular coherence across three frequency bands. Compared to young adults, older adults exhibited thinner hallucis flexors, weaker toe strength, and lower plantar cutaneous sensitivity. The ABH thickness and plantar cutaneous sensitivity were negatively associated with the COP mean peak velocity in older adults, but not in young adults. Besides, older adults had higher cocontraction of muscles spanning the arch (ABH-PL) and ankle (TA-GM), and had lower beta- and gamma-band coherence of the ABH-PL and TA-PL during SLS. Foot core capacities became compromised with advancing age, and the balance control of older adults was susceptible to foot core than young adults in balance tasks. To compensate for the weakened foot core, older adults may adopt arch and ankle stiffening strategies via increasing muscle cocontraction. Furthermore, coherence analysis indicated that aging may increase the demand for cortical brain resources during SLS.
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Affiliation(s)
- Jiaqi Lai
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Yinyan Ye
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Dongfeng Huang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
- Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, Guangdong, China
| | - Xianyi Zhang
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
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8
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Maeda N, Tsutsumi S, Arima S, Ikuta Y, Ushio K, Komiya M, Tashiro T, Nishikawa Y, Kobayashi T, Nakasa T, Adachi N, Urabe Y. Relationship between foot morphologic characteristic and postural control after jump-landing in youth competitive athletes. J Back Musculoskelet Rehabil 2024; 37:419-426. [PMID: 38073371 DOI: 10.3233/bmr-230122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
BACKGROUND Foot arch dynamics play an important role in dynamic postural control. Association between foot arch dynamics and postural control among adolescent athletes remains poorly explored. OBJECTIVE To examine the relationship between foot arch dynamics, intrinsic foot muscle (IFM) morphology, and toe flexor strength and dynamic postural stability after jump landing and repetitive rebound jump performance in competitive adolescent athletes. METHODS Based on foot arch dynamics, evaluated from relative change in the foot arch height in sitting and standing positions, 50 adolescent athletes were classified as stiff, normal, or flexible. IFM morphology was evaluated by ultrasonography. Dynamic postural stability index (DPSI) was measured as participants jumped and landed with the right leg onto a force plate, whereas repetitive rebound jumping performance was assessed using the jump height and reactive jump index. RESULTS The stiff group had a significantly worse DPSI and vertical stability index than the normal group (p= 0.26, p= 0.44, respectively), and worse anteroposterior stability index (APSI) values than the flexible group (p= 0.005). Multivariate regression models of the relationship between the APSI and foot arch dynamics showed adequate power (probability of error = 0.912). CONCLUSIONS Increased foot arch stiffness negatively affects dynamic balance during jump-landing, which may deteriorate their performance.
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Affiliation(s)
- Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shogo Tsutsumi
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Satoshi Arima
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasunari Ikuta
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Kai Ushio
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Makoto Komiya
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsubasa Tashiro
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science and Engineering, Kanazawa University, Kanazawa, Japan
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Tomoyuki Nakasa
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Hirota K, Watanabe K, Negishi K, Miyamoto H, Taniguchi T, Teramoto A. Evaluation of the activities of the intrinsic and extrinsic muscles of the foot during toe flexion with or without interphalangeal joint flexion using ultrasound shear wave elastography. Foot (Edinb) 2023; 57:101945. [PMID: 37898055 DOI: 10.1016/j.foot.2022.101945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/17/2022] [Accepted: 10/04/2022] [Indexed: 10/30/2023]
Abstract
The intrinsic muscles of the foot are important to maintain the arch of the foot and to participate in sports activities. Using ultrasound shear wave elastography, we investigated the effect of different toe flexion methods on the activity of the intrinsic and extrinsic muscles of the foot. The study included 15 healthy adults who performed toe flexion under 2 conditions: with interphalangeal (IP) joint flexion and without IP joint flexion. The applied load during flexion was 500 g. Muscle stiffness was measured in the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis, quadratus plantae, flexor hallucis longus, and flexor digitorum longus muscles using ultrasound shear wave elastography. Muscle stiffness was statistically compared with IP flexion and without IP flexion (P < 0.05). The stiffness of the abductor hallucis (P < 0.0005), flexor hallucis brevis (P = 0.022), and flexor digitorum brevis muscles (P < 0.0005) was significantly greater without IP flexion than with IP flexion. In contrast, the muscle stiffness of the flexor hallucis longus (P = 0.001) and the flexor digitorum longus (P = 0.004) was significantly greater during with IP flexion than without IP flexion. This study shows that the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis muscles are more active during toe flexion without IP flexion. These results suggest that the toe flexion method is important for more effective training of the intrinsic muscles of the foot.
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Affiliation(s)
- Kento Hirota
- Graduate School of Health Science, Sapporo Medical University, Sapporo, Japan.
| | - Kota Watanabe
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Keisuke Negishi
- Graduate School of Health Science, Sapporo Medical University, Sapporo, Japan
| | - Hiroki Miyamoto
- Department of Physical Therapy, Sendai Seiyo Gakuin College, Sendai, Japan
| | - Tatsuya Taniguchi
- Department of Rehabilitation, Sapporo Tokushukai Hospital, Sapporo, Japan
| | - Atsushi Teramoto
- Department of Orthopaedic Surgery, School of Medicine, Sapporo Medical University, Sapporo, Japan
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10
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Xu J, Goss DD, Saliba SA. A Novel Intrinsic Foot Muscle Strength Dynamometer Demonstrates Moderate-To-Excellent Reliability and Validity. Int J Sports Phys Ther 2023; 18:997-1008. [PMID: 37547834 PMCID: PMC10399096 DOI: 10.26603/001c.84310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Background Intrinsic foot muscle (IFM) weakness can result in reduced foot function, making it crucial for clinicians to track IFM strength changes accurately. However, assessing IFM strength can be challenging for clinicians, as there is no clinically applicable direct measure of IFM strength that has been shown to be reliable and valid with the foot on the ground. Purpose The purpose was to investigate the intra-rater and inter-rater reliability of a novel, budget-friendly IFM dynamometer and determine its agreement with a handheld dynamometer (HHD). The researchers also examined correlations of foot morphology and activity level to IFM strength. Study design Descriptive Laboratory Study. Methods Two assessors measured IFM strength of 34 healthy volunteers (4 male, 30 female; age=21.14±2.57, height=164.66 ±7.62 cm, mass=64.45±11.93 kg) on two occasions 6.62±0.78 days apart with the novel dynamometer to assess intra- and inter-rater reliability. The HHD was used to measure IFM in the first session in order to assess validity. Results For the novel dynamometer, intra- and inter-rater reliability was moderate-to-excellent (ICC = 0.73 - 0.95), and the majority of the strength tests were within the 95% limits of agreement with the HHD. Wider foot morphology and a higher number of days walking over the prior seven days had small but significant correlations with IFM strength (dominant foot r = 0.34, non-dominant foot r = 0.39; r = -0.33, -0.39 respectively). Conclusion This novel IFM dynamometer is a budget-friendly ($75) tool that was shown to be reliable and valid in a healthy population. Levels of evidence Level 3©The Author(s).
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Haelewijn N, Peters Dickie JL, Staes F, Vereecke E, Deschamps K. Current evidence regarding 2D ultrasonography monitoring of intrinsic foot muscle properties: A systematic review. Heliyon 2023; 9:e18252. [PMID: 37520980 PMCID: PMC10374929 DOI: 10.1016/j.heliyon.2023.e18252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
Background Ultrasonography can discriminate between intrinsic and extrinsic foot muscle properties and has therefore gained considerable popularity as an indirect strength evaluation. However, an overview on the use of ultrasound for assessing intrinsic foot musculature (IFM) is currently lacking. Research question What is the current evidence regarding (1) 2D ultrasonography protocols and its reliability? (2) Reference values for cross-sectional area and dorso-plantar thickness evaluation in asymptomatic and symptomatic persons? Methods The PRISMA guidelines were used to conduct this systematic review. Eight databases (PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, SPORTDiscus and EuropePMC) were searched up to November 1, 2021. Studies reporting quantitative 2D ultrasound findings of the intrinsic foot muscles with no limitation to sex, BMI, ethnicity or physical activity were included. Studies were assessed for methodological quality using the Downs and Black checklist. Results Fifty-three studies were retained. Protocols showed an overall good to great reliability, suggesting limits of agreement between 8 and 30% of relative muscle size with minimal detectable changes varying from 0.10 to 0.29 cm2 for cross-sectional area and 0.03-0.23 cm for thickness. Reference values are proposed for both cross-sectional area and thickness measurements of the abductor hallucis, flexor digitorum brevis, flexor hallucis brevis and quadratus plantae in asymptomatic persons. This could not be performed in the symptomatic studies due to a limited number of relevant studies addressing the symptomatic population, therefore a clinical overview is outlined. Clinically, IFM properties have been studied in ten distinct pathological conditions, predominantly pointing towards decreased muscle properties of the abductor hallucis. Significance We provide a clear and comprehensive overview of the literature regarding 2D ultrasonography of the IFM, making the available evidence more accessible to decision makers and researchers.
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Affiliation(s)
- Nicolas Haelewijn
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Spoorwegstraat 12, 8200 Brugge, Belgium
| | - Jean-Louis Peters Dickie
- Neuromusculoskeletal Lab (NMSK), Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Filip Staes
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Tervuursevest 101, 3000 Leuven, Belgium
| | - Evie Vereecke
- Department of Development & Regeneration, Muscles & Movement Group, KU Leuven, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium
| | - Kevin Deschamps
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, Spoorwegstraat 12, 8200 Brugge, Belgium
- Haute Ecole Leonard De Vinci, Division of Podiatry, Avenue E. Mounier 84, 1200 Sint-Lambrechts-Woluwe, Belgium
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12
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Kaneda K, Maeda N, Ikuta Y, Tashiro T, Tsutsumi S, Arima S, Sasadai J, Suzuki Y, Morikawa M, Komiya M, Adachi N, Urabe Y. The Features of Foot Morphology and Intrinsic Foot Muscle Property in Adolescent Swimmers: An Ultrasound-Based Study. J Hum Kinet 2023; 87:95-103. [PMID: 37559776 PMCID: PMC10407327 DOI: 10.5114/jhk/163148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/30/2022] [Indexed: 08/11/2023] Open
Abstract
This cross-sectional study aimed to investigate the relationship between foot shape and intrinsic foot muscles (IFMs) in adolescent swimmers compared with other athletes. Foot morphology of swimmers was compared with other athletes of comparable age and a competition level (n = 32 [64 feet]; a total of 64 feet; 128 feet in two groups). Foot morphology and variables of IFMs were measured using a three-dimensional foot scanner and an ultrasound imaging system, respectively. Multiple linear regression analysis with forced entry was performed to clarify the association of the thickness and the cross-sectional area (CSA) of IMFs with the navicular height in both sitting and standing positions. Navicular height in a standing position, the thickness of the abductor hallucis (AbH) and the flexor digitorum brevis (FDB), as well as the CSA were significantly lower in swimmers compared with other athletes (p < 0.05). A larger CSA for the flexor hallucis brevis (FHB) was observed in swimmers than in other athletes (p < 0.01). The navicular height of swimmers in sitting and standing positions was positively correlated with the thickness and the CSA of the FHB and the FDB (p < 0.05). Multiple regression analysis showed that navicular height was associated with the CSA of the FDB in both sitting and standing positions (β = 0.395; p < 0.002, β = 0.201; p < 0.018). This study showed that the navicular height of elite adolescent swimmers was lower than that of other athletes. Furthermore, the swimmers' high navicular height was associated with the CSA of the FDB, suggesting that the FDB might be more involved in the formation of the medial longitudinal arch than the AbH.
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Affiliation(s)
- Kazuki Kaneda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasunari Ikuta
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Tsubasa Tashiro
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shogo Tsutsumi
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Satoshi Arima
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Junpei Sasadai
- Sports Medical Center, Japan Institute of Sports Sciences, Japan Sport Council, Tokyo, Japan
| | - Yuta Suzuki
- Department of Physical Therapy, Faculty of Rehabilitation, Kyusyu Nutrition Welfare University, Fukuoka, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Makoto Komiya
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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13
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Wei Z, Liao J, Hu X, Li P, Wang L. Comparison of intrinsic foot muscle morphology and isometric strength among runners with different strike patterns. PLoS One 2023; 18:e0286645. [PMID: 37267296 DOI: 10.1371/journal.pone.0286645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/22/2023] [Indexed: 06/04/2023] Open
Abstract
This study aimed to compare the intrinsic foot muscle (IFM) morphology and isometric strength among runners with habitual rearfoot strike (RFS) and non-rearfoot strike (NRFS) patterns. A total of 70 recreational male runners were included in this study (32 RFS and 38 NRFS), an ultrasound device and hand-held dynamometry were used to measure IFM morphology and isometric strength. Results indicated that the RFS runners had significantly thicker tibialis anterior (P = 0.01, ES = 0.64, 95% CI [0.01-0.07]) in IFMs morphology and higher Toe2345 flexion strength in IFMs strength (P = 0.04, ES = 0.50, 95% CI [0.01-0.27]) than NRFS runners, the cross-sectional area of flexor digitorum brevis was positively correlated with T2345 flexion strength (r = 0.33, p = 0.04), T12345 (r = 0.37, p = 0.02) and Doming (r = 0.36, p = 0.03) for runners with NRFS. IFMs morphology and isometric strength were associated with foot strike pattern, preliminary findings provide new perspectives for NRFS runners through the simple measurement of IFMs morphological characteristics predicting IFMs strength, future studies could adopt IFMs training to compensate the muscle strength defects and prevent foot-related injuries.
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Affiliation(s)
- Zhen Wei
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Shanghai, China
| | - Jingjing Liao
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Shanghai, China
| | - Xiaomei Hu
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Shanghai, China
| | - Pan Li
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Shanghai, China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Shanghai, China
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14
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Özgül B, Starbuck C, Polat MG, Abdeen R, Nester C. Inter and intra-examiner reliability of musculoskeletal ultrasound scanning of Anterior Talofibular Ligament and ankle muscles. J Ultrasound 2023; 26:137-146. [PMID: 36048331 PMCID: PMC10063751 DOI: 10.1007/s40477-022-00699-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/13/2022] [Indexed: 10/14/2022] Open
Abstract
PURPOSE Although the function of subjects with chronic ankle instability (CAI) has been examined, structural analysis by ultrasound scanning of the structures surrounding the ankle is limited. Before such structural comparisons between injured and uninjured people can be made it is important to investigate a reliable measurement protocol of structures possibly related to CAI. The aim of this study was to investigate the inter-intra examiner reliability of ultrasonic characteristics of selected structures in healthy subjects. METHODS Eleven healthy participants were assessed by an experienced sonographer and inexperienced certificated examiner. Ultrasound images were collected of the ATFL length and ankle muscles of gastrocnemius medialis (GM), tibialis anterior (TA) and peroneals. Thickness was measured for the muscles, whilst cross-sectional area (CSA) was measured for the peroneals. Inexperienced examiner repeated the measurements a week later. RESULTS Inter-examiner reliability was excellent for all structures (ICC3,1 = 0.91-0.98). Intra-examiner reliability shows excellent agreement for all structures (ICC3,1 = 0.92-0.98) except GM (good agreement) (ICC3,1 = 0.82). LoA, relative to structure size, ranged from 1.38 to 6.88% for inter-reliability and from 0.07 to 5.79% for intra-reliability. CONCLUSION This study shows a high level of inter-intra examiner reliability in measuring the structures possibly related to CAI. Future research has been planned to investigate the structural analysis in CAI by using applied MSUS protocol.
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Affiliation(s)
- Bahar Özgül
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Marmara University, Istanbul, Turkey.
| | - Chelsea Starbuck
- Applied Sports, Technology, Exercise, and Medicine Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - Mine Gülden Polat
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Marmara University, Istanbul, Turkey
| | - Rawan Abdeen
- Faculty of Applied Medical Sciences, Diagnostic Radiology Technology Department, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Christopher Nester
- School of Health Sciences and Society, University of Salford, Manchester, UK
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15
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Positional and dimensional relation of tendons around the first metatarsal bone with hallux valgus. SURGICAL AND RADIOLOGIC ANATOMY : SRA 2023; 45:183-192. [PMID: 36581705 DOI: 10.1007/s00276-022-03066-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/20/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE It was aimed to reveal whether the positions and dimensions of the extrinsic and intrinsic muscle tendons related to the hallux around the first metatarsal bone are affected by the severity of hallux valgus (HV) and whether tendon positional changes and tendon sizes affect each other. METHODS In formalin-fixed 46 feet, three HV angle subgroups (normal, mild, and moderate/severe) were defined. Width, thickness, and cross-sectional area (CSA) of tendons of the extensor hallucis longus (EHL) and brevis (EHB), abductor hallucis (AH), and flexor hallucis longus (FHL) were measured. On the clock model created in coronal plane, positional variations of each tendon were determined. RESULTS In the moderate/severe HV group, thickness and CSA of the EHB, width and CSA of the AH were smaller, compared to mild HV. Width and CSA of the FHL were smaller in moderate/severe HV than in the normal. Regardless of HV, the width and CSA of the FHL were greater in cases where the FHL was located more lateral, and the width of both FHL and AT were greater in cases where AH located was more plantar. CONCLUSION The smaller tendon size of two intrinsic (one plantar and one dorsal) and one extrinsic muscle in the moderate/severe HV group indicates that changes in the tendons are evident in cases of high severity of HV but not in cases of mild HV. Accordingly, the changes do not appear to be due to a factor limited to only one aspect of the foot. It is recommended to consider the possible biomechanical effects of AH, FHL, and EHB tendon dimensional weakness in surgical planning in moderate/severe HV cases.
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16
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Arima S, Maeda N, Tsutsumi S, Ishihara H, Ikuta Y, Ushio K, Fujishita H, Kobayashi T, Komiya M, Morikawa M, Adachi N, Urabe Y. Association of the intrinsic foot muscles and plantar fascia with repetitive rebound jumping and jump landing in adolescent athletes: An ultrasound-based study. Gait Posture 2023; 99:146-151. [PMID: 36436441 DOI: 10.1016/j.gaitpost.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 10/17/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The characteristics of foot structure in adolescents and adults are different, affecting sports performance and leading to the progression of foot and lower extremity disorders. RESEARCH QUESTION This study aimed to investigate the relationship between the intrinsic foot muscles (IFM) and plantar fascia morphology and the repetitive rebound jumping and jump landing ability in adolescent athletes. METHODS A total of 60 adolescent athletes (35 boys and 25 girls) participated in this study. B-mode ultrasonography was used to obtain images of the IFM and plantar fascia morphology [thickness and cross-sectional area (CSA) of the abductor hallucis (AbH), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), and thickness of the plantar fascia]. The repetitive rebound jump performance was evaluated using the Optojump™ system. Participants were instructed to jump five times continuously with one leg, jumping as high as possible with minimal ground contact time. The jump landing was assessed by measuring the dynamic posture stability index (DPSI) using forward one-legged jump landings. RESULTS The thickness and CSA of the AbH and FDB were positively correlated with the jump height and reactive jump index. The DPSI score was significantly correlated with the thickness of the AbH, but not with other IFMs or plantar fascia. In the multiple regression analysis, only the thickness of the FDB was associated with the jump height and reactive jump index, indicating that FDB thickness might facilitate adolescent athletes to jump higher with minimal contact time in repetitive rebounding movements. SIGNIFICANCE The IFM (especially FDB) should be focused on when examining sports performance in adolescent athletes.
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Affiliation(s)
- Satoshi Arima
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Shogo Tsutsumi
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Honoka Ishihara
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Yasunari Ikuta
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kai Ushio
- Sports Medical Center, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Hironori Fujishita
- Sports Medical Center, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, China
| | - Makoto Komiya
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Masanori Morikawa
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan.
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17
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Mei Q, Kim HK, Xiang L, Shim V, Wang A, Baker JS, Gu Y, Fernandez J. Toward improved understanding of foot shape, foot posture, and foot biomechanics during running: A narrative review. Front Physiol 2022; 13:1062598. [PMID: 36569759 PMCID: PMC9773215 DOI: 10.3389/fphys.2022.1062598] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
The current narrative review has explored known associations between foot shape, foot posture, and foot conditions during running. The artificial intelligence was found to be a useful metric of foot posture but was less useful in developing and obese individuals. Care should be taken when using the foot posture index to associate pronation with injury risk, and the Achilles tendon and longitudinal arch angles are required to elucidate the risk. The statistical shape modeling (SSM) may derive learnt information from population-based inference and fill in missing data from personalized information. Bone shapes and tissue morphology have been associated with pathology, gender, age, and height and may develop rapid population-specific foot classifiers. Based on this review, future studies are suggested for 1) tracking the internal multi-segmental foot motion and mapping the biplanar 2D motion to 3D shape motion using the SSM; 2) implementing multivariate machine learning or convolutional neural network to address nonlinear correlations in foot mechanics with shape or posture; 3) standardizing wearable data for rapid prediction of instant mechanics, load accumulation, injury risks and adaptation in foot tissue and bones, and correlation with shapes; 4) analyzing dynamic shape and posture via marker-less and real-time techniques under real-life scenarios for precise evaluation of clinical foot conditions and performance-fit footwear development.
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Affiliation(s)
- Qichang Mei
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,*Correspondence: Qichang Mei, , ; Yaodong Gu, ,
| | - Hyun Kyung Kim
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Liangliang Xiang
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Vickie Shim
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Alan Wang
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,*Correspondence: Qichang Mei, , ; Yaodong Gu, ,
| | - Justin Fernandez
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,Department of Engineering Science, The University of Auckland, Auckland, New Zealand
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Zurong Y, Yuandong L, Xiankui T, Fuhao M, Tang L, Junkun Z. Morphological and Mechanical Properties of Lower-Limb Muscles in Type 2 Diabetes: New Potential Imaging Indicators for Monitoring the Progress of DPN. Diabetes 2022; 71:2751-2763. [PMID: 36125913 DOI: 10.2337/db22-0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 09/14/2022] [Indexed: 01/11/2023]
Abstract
The aim of this study was to explore changes in morphological and mechanical properties of lower-limb skeletal muscles in patients with diabetes with and without diabetic peripheral neuropathy (DPN) and seek to find a potential image indicator for monitoring the progress of DPN in patients with type 2 diabetes mellitus (T2DM). A total of 203 patients with T2DM, with and without DPN, were included in this study. Ultrasonography and ultrasound shear wave imaging (USWI) of the abductor hallux (AbH), tibialis anterior (TA), and peroneal longus (PER) muscles were performed for each subject, and the shear wave velocity (SWV) and cross-sectional area (CSA) of each AbH, TA, and PER were measured. The clinical factors influencing AbH_CSA and AbH_SWV were analyzed, and the risk factors for DPN complications were investigated. AbH_CSA and AbH_SWV in the T2DM group with DPN decreased significantly (P < 0.05), but no significant differences were found in the SWV and CSA of the TA and PER between the two groups. Toronto Clinical Scoring System (CSS) score and glycosylated hemoglobin (HbA1c) were independent predictors of AbH_CSA and AbH_SWV. As AbH_SWV and AbH_CSA decreased, Toronto CSS score and HbA1c increased and incidence of DPN increased significantly. In conclusion, the AbH muscle of T2DM patients with DPN became smaller and softer, while its morphological and mechanical properties were associated with the clinical indicators related to the progression of DPN. Thus, they could be potential imaging indicators for monitoring the progress of DPN in T2DM patients.
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Affiliation(s)
- Yang Zurong
- Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Li Yuandong
- College of Mechanical and Vehicle Engineering, Hunan University, Changsha, Hunan, China
| | - Tan Xiankui
- Department of Ultrasound Diagnosis, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Mo Fuhao
- College of Mechanical and Vehicle Engineering, Hunan University, Changsha, Hunan, China
| | - Liu Tang
- Department of Orthopaedics, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zhan Junkun
- Department of Geriatric, Institute of Aging and Geriatrics, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Hikawa K, Tsutsui T, Ueyama T, Yang J, Hara Y, Torii S. Effects of a 9-weeks arch support intervention on foot morphology in young soccer players: a crossover study. BMC Sports Sci Med Rehabil 2022; 14:193. [PMID: 36376907 PMCID: PMC9664602 DOI: 10.1186/s13102-022-00590-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022]
Abstract
Background A flat foot is a common cause of chronic sports injuries and therefore many opportunities for arch support interventions exist. However, young athletes change their foot morphology due to developmental influences even without intervention. Therefore, developmental influences need to be considered when examining the effects of arch support, but there have not been sufficient longitudinal studies to date. This study aimed to determine the effect of the arch support intervention by performing a 9-weeks arch support intervention on the foot morphology and cross-sectional area of the foot muscles in flat-footed young athletes. Thirty-one elementary school boys (Age 11.4 ± 0.5 years, Height 145.2 ± 7.4 cm, Weight 38.8 ± 8.3 kg, BMI 18.2 ± 2.2 kg/m2) with a decreased medial longitudinal arch in the foot posture index were selected as participants from a local soccer club and randomly divided into two groups. Methods In one group, in the intervention period, an existing arch supporter was used to provide arch support, while in the other group, no special intervention was provided in the observation period. To account for developmental effects, the intervention study was conducted as an 18-weeks crossover study in which the intervention and observational phases were switched at 9 weeks after the intervention. Foot morphology was assessed using a three-dimensional foot measuring machine, and the cross-sectional area (CSA) of the internal and external muscles of the foot was assessed using an ultrasound imaging device. We examined the effect of the intervention by comparing the amount of change in the measurement results between the intervention and observation periods using corresponding t-tests and Wilcoxon signed-rank sum test, analysis of covariance methods. Results After adapting the exclusion criteria, 14 patients (28 feet) were included in the final analysis. The CSA of the abductor hallucis muscle (ABH) increased 9.7% during the intervention period and 3.0% during the observation period (p = 0.01). The CSA of the flexor digitorum longus muscle (FDL) increased 7.7% during the intervention period and 4.2% during the observation period (p = 0.02). Conclusion A 9-weeks arch supporter intervention may promote the development of the ABH and FDL CSA in young flat-footed soccer players.
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Intra- and Inter-rater Reliability of a Magnetic Resonance Imaging-Based Volumetric Analysis of the Abductor Hallucis Muscle. IRANIAN JOURNAL OF RADIOLOGY 2022. [DOI: 10.5812/iranjradiol-128725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: The muscle volume considerably changes with aging, pathologies, mechanical loading and exercise, and immobilization. It is recognized as an important parameter that can be measured by various methods to evaluate the effectiveness of interventions focusing on muscle strengthening and function. However, before the application of any measurement method, their reliability needs to be investigated and established. Objectives: This study aimed to evaluate the inter- and intra-rater reliability of the manual measurement method of the abductor hallucis muscle volume in feet with hallux valgus deformities using magnetic resonance imaging (MRI). Patients and Methods: The MRI images of the feet of 15 samples with a hallux valgus deformity were selected in this study. The cross-sectional areas of the abductor hallucis muscle were measured in the cuts along the entire length of the foot and multiplied by slice thickness. Two trained raters performed the measurements. The second rater repeated the measurements after five days to eliminate the memory effect. The intra-rater reliability and inter-rater reliability were assessed based on the intraclass correlation coefficient [ICC (2, 1)] to evaluate the extent of agreement between the raters at a 95% confidence interval. Results: The between- and within-rater ICCs were 0.92 (0.79 - 0.97) and 0.99 (0.97 - 0.99), respectively. The standard error of measurements was also small in both inter-rater (6.2%) and intra-rater (2.1%) reliability analyses. Conclusion: The manually outlined slice-by-slice volume measurement of the abductor hallucis muscle based on MRI images showed excellent inter- and intra-rater reliability. The excellent intra-rater reliability, besides the lower standard error percentage of measurements, indicates the superiority of measurements by a single person. However, further studies with a larger sample size are recommended.
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KOYAMA K. Effects of a 12-week barefoot exercise training on foot muscle functions and arch height. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.20.04356-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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22
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Matsumoto Y, Ogihara N, Hanawa H, Kokubun T, Kanemura N. Novel Multi-Segment Foot Model Incorporating Plantar Aponeurosis for Detailed Kinematic and Kinetic Analyses of the Foot With Application to Gait Studies. Front Bioeng Biotechnol 2022; 10:894731. [PMID: 35814002 PMCID: PMC9265906 DOI: 10.3389/fbioe.2022.894731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Kinetic multi-segment foot models have been proposed to evaluate the forces and moments generated in the foot during walking based on inverse dynamics calculations. However, these models did not consider the plantar aponeurosis (PA) despite its potential importance in generation of the ground reaction forces and storage and release of mechanical energy. This study aimed to develop a novel multi-segment foot model incorporating the PA to better elucidate foot kinetics. The foot model comprised three segments: the phalanx, forefoot, and hindfoot. The PA was modeled using five linear springs connecting the origins and the insertions via intermediate points. To demonstrate the efficacy of the foot model, an inverse dynamic analysis of human gait was performed and how the inclusion of the PA model altered the estimated joint moments was examined. Ten healthy men walked along a walkway with two force plates placed in series close together. The attempts in which the participant placed his fore- and hindfoot on the front and rear force plates, respectively, were selected for inverse dynamic analysis. The stiffness and the natural length of each PA spring remain largely uncertain. Therefore, a sensitivity analysis was conducted to evaluate how the estimated joint moments were altered by the changes in the two parameters within a range reported by previous studies. The present model incorporating the PA predicted that 13%–45% of plantarflexion in the metatarsophalangeal (MTP) joint and 8%–29% of plantarflexion in the midtarsal joints were generated by the PA at the time of push-off during walking. The midtarsal joint generated positive work, whereas the MTP joint generated negative work in the late stance phase. The positive and negative work done by the two joints decreased, indicating that the PA contributed towards transfer of the energy absorbed at the MTP joint to generate positive work at the midtarsal joint during walking. Although validation is limited due to the difficulty associated with direct measurement of the PA force in vivo, the proposed novel foot model may serve as a useful tool to clarify the function and mechanical effects of the PA and the foot during dynamic movements.
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Affiliation(s)
- Yuka Matsumoto
- Graduate School of Saitama Prefectural University, Graduate Course of Health and Social Services, Saitama, Japan
| | - Naomichi Ogihara
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
| | - Hiroki Hanawa
- Department of Health Science, University of Human Arts and Sciences, Saitama, Japan
| | - Takanori Kokubun
- Department of Health and Social Services, Saitama Prefectural University, Saitama, Japan
| | - Naohiko Kanemura
- Department of Health and Social Services, Saitama Prefectural University, Saitama, Japan
- *Correspondence: Naohiko Kanemura,
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Features of Extrinsic Plantar Muscles in Patients with Plantar Fasciitis by Ultrasound Imaging: A Retrospective Case Control Research. Diagnostics (Basel) 2022; 12:diagnostics12040897. [PMID: 35453945 PMCID: PMC9026851 DOI: 10.3390/diagnostics12040897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/28/2022] [Accepted: 04/02/2022] [Indexed: 11/17/2022] Open
Abstract
The present study aimed to compare by ultrasound imaging (USI) the tibial posterior (TP), medial gastrocnemius (MG) and soleus muscle in patients with and without plantar fasciitis (PF). A sample of 42 individuals was recruited and divided into two groups: PF and a healthy group. The thickness, cross-sectional area (CSA), echointensity and echovariation were assessed in both groups by USI. TP, soleus and MG variables did not report differences (p > 0.05) for thickness and CSA. For the echotexture parameters significant differences were found for MG echointensity (p = 0.002), MG echovariation (p = 0.002) and soleus echointensity (p = 0.012). Non-significant differences (p > 0.05) were reported for soleus echovariation, TP echointensity and TP echovariation variables. The thickness and CSA of the TP, GM and soleus muscle did not show significant differences between individuals with and without PF measured by USI. Muscle quality assessment reported an increase of the MG echointensity and echovariation, as well as a decrease of echointensity of the soleus muscle in the PF group with respect to the healthy group. Therefore, the evaluation of the structure and muscle quality of the extrinsic foot muscles may be beneficial for the diagnosis and monitoring the physical therapy interventions.
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Test-Retest Reliability of Ultrasonographic Measurements from the Rectus Femoris Muscle 1-5 Years after Anterior Cruciate Ligament Reconstruction in the Ipsilateral and Contralateral Legs: An Observational, Case-Control Study. J Clin Med 2022; 11:jcm11071867. [PMID: 35407473 PMCID: PMC8999881 DOI: 10.3390/jcm11071867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 02/04/2023] Open
Abstract
About 40% of traumatic injuries in sports are related to the knee. Of these, 33% require arthroscopic surgery. The rehabilitative ultrasound imaging technique is a simple method to obtain objective real-time results on the state and measurement of the musculoskeletal tissue and its use can represent an important change in the process of functional diagnosis and recovery of these injuries. The aim was to quantify the differences in the thickness, muscle contraction time, and muscle relaxation time of the rectus femoris muscle between individuals with knee arthroscopy and healthy individuals and to verify the reliability of the inter-examiner measurements in these ultrasound variables. An observational case-control study with individuals (18−60 years aged) who underwent surgery for anterior cruciate ligament through knee arthroscopy a year or more before. A total of 38 subjects were divided into 2 groups, case and control. Ultrasound measurements were taken of the following outcomes: thickness at rest and contraction, muscle contraction time, and muscle relaxation time of the rectus femoris muscle. Excellent inter-examiner reliability was obtained for all ultrasound measurements (ICC3.3 > 0.90). No significant changes were found in the rate of contraction or rest of the rectus femoris muscle. On the other hand, if significant changes in the thickness of the rectus femoris muscle were found between control and case group. Arthroscopic surgery for anterior cruciate ligament reconstruction does not appear to modify function but does modify the thickness of the rectus femoris muscle on ultrasound examination. Ultrasound appears to be a reliable tool for the study of these measurements in the rectus femoris muscle.
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Okamura K, Hasegawa M, Ikeda T, Fukuda K, Egawa K, Kanai S. Classification of medial longitudinal arch kinematics during running and characteristics of foot muscle morphology in novice runners with pronated foot. Gait Posture 2022; 93:20-25. [PMID: 35051713 DOI: 10.1016/j.gaitpost.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/21/2021] [Accepted: 01/12/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Novice runners with pronated feet are at an increased risk of running-related injuries. However, not all runners with pronated feet have increased foot pronation during running. Moreover, although foot muscle morphology is related to static foot alignment, the relationship between foot muscle morphology and foot kinematics during running remains unclear. We aimed to determine foot kinematic patterns during running among novice runners with pronated feet and the presence of a relationship between these foot kinematic patterns and foot muscle morphology. METHODS Twenty-one novice runners with pronated feet participated in this study, and data on 39 lower limbs were collected. Data on foot kinematics during running (rearfoot strike) were collected using a three-dimensional motion capture system in terms of navicular height (NH) at initial contact and dynamic navicular drop (DND). A hierarchical cluster analysis method was used to identify the optimal number of clusters based on these two foot-related kinematic variables. Following identification of the clusters, differences in cluster variables and cross-sectional areas of selected foot muscles assessed using ultrasonography in each cluster were examined. The muscles of interest included the abductor hallucis, flexor hallucis brevis and longus, flexor digitorum brevis and longus, and peroneus longus. RESULTS Three subgroups were identified based on foot kinematics during running: cluster 1, lowest NH at initial contact and larger DND; cluster 2, moderate NH at initial contact and smaller DND; and cluster 3, highest NH at initial contact and larger DND. Clusters 1 and 3 had a larger abductor hallucis compared with cluster 2, and cluster 3 had a larger flexor hallucis brevis compared with cluster 2. SIGNIFICANCE These subgroups may differ in terms of resistance to and type of running-related injury. Moreover, foot kinematics during running is possibly impacted by the morphology and function of medial intrinsic foot muscles.
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Affiliation(s)
- Kazunori Okamura
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Masaki Hasegawa
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Tomohiro Ikeda
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Kengo Fukuda
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Kohei Egawa
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
| | - Shusaku Kanai
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima 723-0053, Japan.
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The Role of Diffusion Weighted MR Imaging in the Diagnosis of Tendon Injuries of the Ankle and Foot. Medicina (B Aires) 2022; 58:medicina58020321. [PMID: 35208644 PMCID: PMC8879388 DOI: 10.3390/medicina58020321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/27/2022] [Accepted: 02/03/2022] [Indexed: 12/03/2022] Open
Abstract
Background and objectives: Our aim is to determine the diagnostic performance and utility of Diffusion Weighted MR Imaging (DWI) against the routine Magnetic Resonance Imaging (MRI) for the evaluation of patients with tendon injuries of the ankle and foot. Materials and Method: After institutional review board approval and informed consent taken from all the patients, ankle and foot MR imaging and DWI-Apparent Diffusion Coefficient (ADC) mapping were performed on the 81 injured tendons of 50 patients. All tendon injuries were named as Rupture (R), Partial tear (PT), and Tenosynovitis (T). Diagnostic interpretation was based on the MRI-DWI and ADC mapping, verified by either open surgery, diagnostic arthroscopy, or conservative procedures-splint application. Statistical analysis of this research was assessed by Fischer’s exact test, variance analysis test between dependent groups, Receiver Operating Characteristics (ROC) curve, and Pearson chi square statistics. Results: MRI depicted all tendon injuries with 70% sensitivity and 100% specificity, and showed a significant statistical relationship to surgical and arthroscopic references with high agreement (p < 0.05, k: 0.609). DWI had 100% sensitivity and 83–90% specificity for the visualization of tendon injuries with certain agreement and a significant statistical relationship to the gold standard (p < 0.05, k: 0.890–0.899). For all those injured tendons, DWI had 100% sensitivity for the diagnosis of R, and 92–97% sensitivity corresponding to PT and T over routine ankle MR imaging. The specificity of DWI to MRI ranged from 75 to 44% for all the injured tendons. DWI had significant statistical superiority over MRI for the visualization of R, PT, and T of all tendons included in this research (p < 0.05). Conclusions: DWI is a good imaging modality for the visualization of ankles with tendon injuries, possibly further improving the sensitivity of the classical ankle and foot MRI, and supplying more beneficial and diagnostic information than routine MR imaging on the basis of R, PT, and T of tendons at the ankle and foot.
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Meza-Valderrama D, Sánchez-Rodríguez D, Perkisas S, Duran X, Bastijns S, Dávalos-Yerovi V, Da Costa E, Marco E. The feasibility and reliability of measuring forearm muscle thickness by ultrasound in a geriatric inpatient setting: a cross-sectional pilot study. BMC Geriatr 2022; 22:137. [PMID: 35177006 PMCID: PMC8855585 DOI: 10.1186/s12877-022-02811-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 02/02/2022] [Indexed: 12/16/2022] Open
Abstract
Background Given the potential benefits of introducing ultrasound in the clinical assessment of muscle disorders, this study aimed to assess the feasibility and reliability of measuring forearm muscle thickness by ultrasound in a geriatric clinical setting. Methods Cross-sectional pilot study in 25 participants (12 patients aged ≥ 70 years in an acute geriatric ward and 13 healthy volunteers aged 25–50 years), assessed by three raters. Muscle thickness measurement was estimated as the distance between the subcutaneous adipose tissue-muscle interface and muscle-bone interface of the radius at 30% proximal of the distance between the styloid process and distal insertion of the biceps brachii muscle of the dominant forearm. Examinations were repeated three times by each rater and intra- and inter-rater reliability was calculated. Feasibility analysis included consideration of technological, economic, legal, operational, and scheduling (TELOS) components. Results Mean muscle-thickness measurement difference between groups was 4.4 mm (95% confidence interval [CI] 2.4 mm to 6.3 mm], p < 0.001). Intra-rater reliability of muscle-thickness assessment was excellent, with intraclass correlation coefficient (ICC) of 0.947 (95%CI 0.902 to 0.974), 0.969 (95%CI 0.942 to 0.985), and 0.950 (95%CI 0.907 to 0.975) for observer A, B, and C, respectively. Inter-rater comparison showed good agreement (ICC of 0.873 [95%CI 0.73 to 0.94]). Four of the 17 TELOS components considered led to specific recommendations to improve the procedure’s feasibility in clinical practice. Conclusion Our findings suggest that US is a feasible tool to assess the thickness of the forearm muscles with good inter-rater and excellent intra-rater reliability in a sample of hospitalized geriatric patients, making it a promising option for use in clinical practice.
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Affiliation(s)
- Delky Meza-Valderrama
- Rehabilitation Research Group, Hospital Del Mar Medical Research Institute (IMIM), Carrer de Llull, 410, 08019, Barcelona, Catalonia, Spain. .,Physical Medicine and Rehabilitation Department, National Institute of Physical Medicine and Rehabilitation (INMFRE), Panama City, Panama. .,Physical Medicine and Rehabilitation Department, Caja de Seguro Social (C.S.S.), Panama City, Panama.
| | - Dolores Sánchez-Rodríguez
- Rehabilitation Research Group, Hospital Del Mar Medical Research Institute (IMIM), Carrer de Llull, 410, 08019, Barcelona, Catalonia, Spain.,Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium.,WHO Collaborating Centre for Public Health Aspects of Musculo‑Skeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Stany Perkisas
- University Center of Geriatrics, Antwerp University, Leopoldstraat 26, 2000, Antwerp, Belgium.,First Line and Interdisciplinary Care Medicine, ELIZA, University of Antwerp, 2650, Edegem, Belgium
| | - Xavi Duran
- Methodological and Biostatistical Advisory Service. Hospital del Mar Research Institute, Barcelona, Catalonia, Spain
| | - Sophie Bastijns
- University Center of Geriatrics, Antwerp University, Leopoldstraat 26, 2000, Antwerp, Belgium
| | - Vanesa Dávalos-Yerovi
- Rehabilitation Research Group, Hospital Del Mar Medical Research Institute (IMIM), Carrer de Llull, 410, 08019, Barcelona, Catalonia, Spain.,Physical Medicine and Rehabilitation Department, Vall d'Hebron University Hospital, Catalonia, Barcelona, Spain
| | - Elizabeth Da Costa
- Physical Medicine and Rehabilitation Department, Hospital Del Mar - Hospital de L´Esperança, Parc de Salut Mar, Barcelona, Catalonia, Spain
| | - Ester Marco
- Rehabilitation Research Group, Hospital Del Mar Medical Research Institute (IMIM), Carrer de Llull, 410, 08019, Barcelona, Catalonia, Spain.,Geriatric Department, Centre Fòrum-Hospital del Mar, Parc de Salut Mar, Barcelona, Catalonia, Spain.,School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.,School of Medicine, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Catalonia, Spain
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Swanson DC, Sponbeck JK, Swanson DA, Stevens CD, Allen SP, Mitchell UH, George JD, Johnson AW. Validity of ultrasound imaging for intrinsic foot muscle cross-sectional area measurements demonstrated by strong agreement with MRI. BMC Musculoskelet Disord 2022; 23:146. [PMID: 35164718 PMCID: PMC8842549 DOI: 10.1186/s12891-022-05090-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/02/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Intrinsic foot muscles maintain foot structural integrity and contribute to functional movement, posture and balance. Thus, assessing intrinsic foot muscle size and strength are important. Magnetic resonance imaging (MRI) has been shown to accurately image the individual muscles but is costly and time consuming. Ultrasound (US) imaging may provide an alternative that is less costly and more readily available. The purpose of this study was to investigate the validity and intratester reliability of US imaging in measuring intrinsic foot muscle size in comparison to MRI. METHODS US and MRI were employed to measure the intrinsic foot muscle size involving 35 participants (females = 13; males = 22). The scanned intrinsic foot muscles included the flexor hallucis brevis (FHB), abductor hallucis (ABDH), flexor digitorum brevis (FDB), quadratus plantae (QP) and abductor digiti minimi (ADM). Pearson product correlation (r), intraclass correlation coefficients (ICC), standard error of the measurement (SEm) and minimal detectable difference (MDD) were calculated. RESULTS High correlations were detected between the US and MRI cross-sectional area (CSA) measurements (r = .971 to 0.995). Test reliability was excellent for both MRI and US (ICC = 0.994 to 0.999). Limits of agreement between MRI and US measurements from ranged from 5.7 to 12.2% of muscle size. SEm values for US ranged from 0.026 to 0.044 cm2, while the SEm for MRI ranged from 0.018 to 0.023 cm2. MDD values for US ranged from 0.073 to 0.122 cm2, while MRI ranged from 0.045 to 0.064 cm2. CONCLUSIONS US appears to be a valid and reliable alternative to MRI when measuring intrinsic foot muscle CSA. While US is less costly and more readily available, the MRI results were shown to be slightly more precise.
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Affiliation(s)
- Dallin C Swanson
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Joshua K Sponbeck
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Derek A Swanson
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Conner D Stevens
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Steven P Allen
- Electrical and Computer Engineering, Ira A. Fulton College of Engineering, Brigham Young University, Provo, UT, USA
| | - Ulrike H Mitchell
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - James D George
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA
| | - Aaron Wayne Johnson
- Department of Exercise Sciences, Brigham Young University, 84602, Provo, UT, USA.
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Willemse L, Wouters EJM, Pisters MF, Vanwanseele B. Intra-assessor reliability and measurement error of ultrasound measures for foot muscle morphology in older adults using a tablet-based ultrasound machine. J Foot Ankle Res 2022; 15:6. [PMID: 35078499 PMCID: PMC8788121 DOI: 10.1186/s13047-022-00510-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/07/2022] [Indexed: 12/25/2022] Open
Abstract
Background To gain insight into the role of plantar intrinsic foot muscles in fall-related gait parameters in older adults, it is fundamental to assess foot muscles separately. Ultrasonography is considered a promising instrument to quantify the strength capacity of individual muscles by assessing their morphology. The main goal of this study was to investigate the intra-assessor reliability and measurement error for ultrasound measures for the morphology of selected foot muscles and the plantar fascia in older adults using a tablet-based device. The secondary aim was to compare the measurement error between older and younger adults and between two different ultrasound machines. Methods Ultrasound images of selected foot muscles and the plantar fascia were collected in younger and older adults by a single operator, intensively trained in scanning the foot muscles, on two occasions, 1–8 days apart, using a tablet-based and a mainframe system. The intra-assessor reliability and standard error of measurement for the cross-sectional area and/or thickness were assessed by analysis of variance. The error variance was statistically compared across age groups and machines. Results Eighteen physically active older adults (mean age 73.8 (SD: 4.9) years) and ten younger adults (mean age 21.9 (SD: 1.8) years) participated in the study. In older adults, the standard error of measurement ranged from 2.8 to 11.9%. The ICC ranged from 0.57 to 0.97, but was excellent in most cases. The error variance for six morphology measures was statistically smaller in younger adults, but was small in older adults as well. When different error variances were observed across machines, overall, the tablet-based device showed superior repeatability. Conclusions This intra-assessor reliability study showed that a tablet-based ultrasound machine can be reliably used to assess the morphology of selected foot muscles in older adults, with the exception of plantar fascia thickness. Although the measurement errors were sometimes smaller in younger adults, they seem adequate in older adults to detect group mean hypertrophy as a response to training. A tablet-based ultrasound device seems to be a reliable alternative to a mainframe system. This advocates its use when foot muscle morphology in older adults is of interest. Supplementary Information The online version contains supplementary material available at 10.1186/s13047-022-00510-1.
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Ichikawa S, Kumai T, Okunuki T, Maemichi T, Matsumoto M, Yabiku H, Liu Z, Yamaguchi R, Iwayama A, Ayukawa G, Akiyama Y, Mitsui H, Niki H. Comparison of foot posture and foot muscle morphology between lifesaver athletes and healthy adults. Res Sports Med 2021:1-11. [PMID: 34802357 DOI: 10.1080/15438627.2021.2002330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed to compare the foot muscle morphology and foot posture between healthy adults and lifesavers in sandy beach sports. The participants included 15 lifesaver athletes and 15 healthy adults. Using a non-contact three-dimensional foot measurement device, the foot length, width, and arch height of the right foot were measured while standing and sitting without back support, and the transverse arch length ratio and arch height index were subsequently calculated. Muscle cross-sectional area was measured using an ultrasound imaging device. Muscle cross-sectional areas, arch height, foot width, arch height index, and transverse arch length ratio were larger in the lifesaver than in the healthy adult group. Lifesavers had higher arches and more developed intrinsic and extrinsic muscles than healthy adults. Performing physical activity while barefoot on sandy beaches may effectively develop the foot intrinsic and extrinsic muscles and raise the arch.
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Affiliation(s)
- Shota Ichikawa
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan.,Department of Orthopaedic Surgery, St. Marianna University Graduate School of Medicine, Kawasaki, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Takumi Okunuki
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | | | - Masatomo Matsumoto
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan.,Department of Rehabilitation, Kuwana City Medicine Center, Mie, Japan
| | - Hiroki Yabiku
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Zijian Liu
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Ryusei Yamaguchi
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Arina Iwayama
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Goro Ayukawa
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Yui Akiyama
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hiroyuki Mitsui
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hisateru Niki
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
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Reeves J, Jones R, Liu A, Bent L, Martinez-Santos A, Nester C. No change in foot soft tissue morphology and skin sensitivity after three months of using foot orthoses that alter plantar pressure. FOOTWEAR SCIENCE 2021. [DOI: 10.1080/19424280.2021.1961880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Joanna Reeves
- School of Health Sciences, University of Salford, Salford, United Kingdom
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Richard Jones
- School of Health Sciences, University of Salford, Salford, United Kingdom
| | - Anmin Liu
- School of Health Sciences, University of Salford, Salford, United Kingdom
| | - Leah Bent
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada
| | | | - Christopher Nester
- School of Health Sciences, University of Salford, Salford, United Kingdom
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Feng Y, Shen S, Song Y. Ultrasound Comparison of the Abductor Hallucis Muscle Between Normal and Hallux Valgus Feet After Long-Distance Running: A Pilot Study. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: Previous research has indicated that the structure and function of abductor hallucis muscle (AbdH) would be adversely affected by hallux valgus (HV). However, the influence of long-distance running on AbdH in HV feet has not been explored. Therefore, this pilot study
aimed to compare the imaging differences of AbdH between normal and HV feet after long-distance running. Methods: A total of 14 male adults were divided into two groups (Normal Foot Group (NFG), Hallux Valgus Group (HVG)) based on their foot morphology. A B-mode ultrasonic scanner was
utilized for measuring AbdH thickness, cross-sectional area, and pennation angle before and after 5-km running test. Perceived soreness was monitored simultaneously using the visual analogue scale. Results: AbdH showed significantly differences between groups before and after the running
test. Compared with NFG, HVG exhibited smaller value before the test while greater changes in all parameters although pennation angle failed to reach the significant level. Conclusions: These results further confirmed that HV could lead to the morphological alterations of AbdH. Also,
AbdH of people with HV would endure more fatigue and soreness when performed the same long-distance running test with normal counterparts. Nevertheless, more studies are much needed for further verification.
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Affiliation(s)
- Yong Feng
- Department of Physical Education, Ningbo University of Finance and Economics, Ningbo, 315211, China
| | - Siqin Shen
- Faculty of Engineering, University of Pannonia, Veszprem, 8200, Hungary
| | - Yang Song
- Doctoral School of Safety and Security Sciences, Obuda University, Budapest, 1034, Hungary
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Mattock J, Steele JR, Mickle KJ. Lower leg muscle structure and function are altered in long-distance runners with medial tibial stress syndrome: a case control study. J Foot Ankle Res 2021; 14:47. [PMID: 34233725 PMCID: PMC8262020 DOI: 10.1186/s13047-021-00485-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Medial tibial stress syndrome (MTSS) is a common lower leg injury experienced by runners. Although numerous risk factors are reported in the literature, many are non-modifiable and management of the injury remains difficult. Lower leg muscle structure and function are modifiable characteristics that influence tibial loading during foot-ground contact. Therefore, this study aimed to determine whether long-distance runners with MTSS displayed differences in in vivo lower leg muscle structure and function than matched asymptomatic runners. Methods Lower leg structure was assessed using ultrasound and a measure of lower leg circumference to quantify muscle cross-sectional area, thickness and lean lower leg girth. Lower leg function was assessed using a hand-held dynamometer to quantify maximal voluntary isometric contraction strength and a single leg heel raise protocol was used to measure ankle plantar flexor endurance. Outcome variables were compared between the limbs of long-distance runners suffering MTSS (n = 20) and matched asymptomatic controls (n = 20). Means, standard deviations, 95 % confidence intervals, mean differences and Cohen’s d values were calculated for each variable for the MTSS symptomatic and control limbs. Results MTSS symptomatic limbs displayed a significantly smaller flexor hallucis longus cross-sectional area, a smaller soleus thickness but a larger lateral gastrocnemius thickness than the control limbs. However, there was no statistical difference in lean lower leg girth. Compared to the matched control limbs, MTSS symptomatic limbs displayed deficits in maximal voluntary isometric contraction strength of the flexor hallucis longus, soleus, tibialis anterior and peroneal muscles, and reduced ankle plantar flexor endurance capacity. Conclusions Differences in lower leg muscle structure and function likely render MTSS symptomatic individuals less able to withstand the negative tibial bending moment generated during midstance, potentially contributing to the development of MTSS. The clinical implications of these findings suggest that rehabilitation protocols for MTSS symptomatic individuals should aim to improve strength of the flexor hallucis longus, soleus, tibialis anterior and peroneal muscles along with ankle plantar flexor endurance. However, the cross-sectional study design prevents us determining whether between group differences were a cause or effect of MTSS. Therefore, future prospective studies are required to substantiate the study findings.
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Affiliation(s)
- Joshua Mattock
- Biomechanics Research Laboratory, University of Wollongong, NSW, Wollongong, Australia.
| | - Julie R Steele
- Biomechanics Research Laboratory, University of Wollongong, NSW, Wollongong, Australia
| | - Karen J Mickle
- School of Allied Health, Human Services and Sport, La Trobe University, VIC, Melbourne, Australia
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Tashiro T, Maeda N, Sasadai J, Kotoshiba S, Sakai S, Suzuki Y, Fujishita H, Urabe Y. Tensiomyographic Neuromuscular Response of the Peroneus Longus and Tibialis Anterior with Chronic Ankle Instability. Healthcare (Basel) 2021; 9:healthcare9060707. [PMID: 34200684 PMCID: PMC8230383 DOI: 10.3390/healthcare9060707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/01/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the muscle contractile response of the peroneus longus (PL) and tibialis anterior (TA) in groups with and without chronic ankle instability (CAI) using tensiomyography. Twenty-three adults, 12 with CAI and 11 healthy participants, participated in this study. All subjects underwent a tensiomyographic assessment of the PL and TA to measure delay time, contraction time and maximal displacement. The ankle evertor and invertor normalized peak torques, maximum work done and muscle thickness of the PL and TA were calculated. The delay time and contraction time of the PL in the CAI side were significantly higher than those in the healthy group (p < 0.05); however, no significant difference could be detected in the TA between groups. Furthermore, there was no significant difference in the normalized peak torques, maximum work done and muscle thickness of the PL and TA between groups. The CAI side demonstrated a delayed muscle contractile response of the PL when compared with the healthy group although there was no difference in muscle strength and muscle size. Clinicians should consider the muscle contractile response of the PL for rehabilitation of the ankle evertor with CAI.
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Affiliation(s)
- Tsubasa Tashiro
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (T.T.); (N.M.); (S.K.); (S.S.)
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (T.T.); (N.M.); (S.K.); (S.S.)
| | - Junpei Sasadai
- Sports Medical Center, Japan Institute of Sports Sciences, Tokyo 115-0056, Japan;
| | - Somu Kotoshiba
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (T.T.); (N.M.); (S.K.); (S.S.)
| | - Shogo Sakai
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (T.T.); (N.M.); (S.K.); (S.S.)
| | - Yuta Suzuki
- Department of Rehabilitation, Matterhorn Rehabilitation Hospital, Hiroshima 737-0046, Japan;
| | - Hironori Fujishita
- Sports Medical Center, Hiroshima University Hospital, Hiroshima University, Hiroshima 734-8551, Japan;
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; (T.T.); (N.M.); (S.K.); (S.S.)
- Correspondence:
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Kazemi K, Saadi F, Javanshir K, Goharpey S, Shaterzadeh Yazdi MJ, Miraali SS, Nassadj G. Reliability of musculoskeletal ultrasonography for peri-ankle muscles in subjects with unilateral chronic ankle instability. J Bodyw Mov Ther 2021; 27:565-572. [PMID: 34391288 DOI: 10.1016/j.jbmt.2021.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 03/12/2021] [Accepted: 04/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Ankle sprain is a common problem among active people and athletes. It causes reduces their activity of daily living and quality of life. Because of the impaired muscle strength and neuromuscular and postural control, it seems that the morphological criteria of peri-ankle muscles are changed. OBJECTIVE This study aimed to develop a reliable method for measuring tibialis anterior (TA) and peroneus longus (PL) muscles in the injured and intact side of lower limbs in people with unilateral chronic ankle instability (CAI). STUDY DESIGN Cross-sectional study. METHOD This study was intra-tester reliability by ultrasound imaging to measure ultrasonography characteristics contains thickness, width, fiber length, pennation angle, and cross-sectional area (CSA) of TA, and PL in both limbs of 25 subjects at three separate times. Intra-class correlation coefficients (ICC), limits of agreement (LOA), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated to analyzed relative and absolute intra-tester reliability, respectively. RESULTS The present study showed good to excellent relative reliability for both injured and intact sides (ICC 0.88-0.98), less proportional measurement error (β coefficient of LOA≈ 0), and suitable absolute reliability. CONCLUSION Musculoskeletal ultrasonography is a reliable method for the measurement of peri-ankle muscle morphology such as thickness, width, CSA, fiber length, and pennation angle.
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Affiliation(s)
- Khadijeh Kazemi
- Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Feryal Saadi
- Department of Radiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Khodabakhsh Javanshir
- Mobility Impairment Research Center, Department of Physiotherapy, Babol University of Medical Sciences, Babol, Iran
| | - Shahin Goharpey
- Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Jafar Shaterzadeh Yazdi
- Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Gholamhossein Nassadj
- Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Maeda N, Hirota A, Komiya M, Morikawa M, Mizuta R, Fujishita H, Nishikawa Y, Kobayashi T, Urabe Y. Intrinsic foot muscle hardness is related to dynamic postural stability after landing in healthy young men. Gait Posture 2021; 86:192-198. [PMID: 33756408 DOI: 10.1016/j.gaitpost.2021.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/28/2021] [Accepted: 03/03/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The human foot has competent mechanisms for supporting weight and adapting movement to various surfaces; in particular, the toe flexor muscles aid in supporting the foot arches and may be important contributors to postural stability. However, the role of intrinsic foot muscle morphology and structure in the postural control system remains unclear, and the relationship between them is not well known. RESEARCH QUESTION Are intrinsic foot muscle morphology and toe flexor strength related to static and dynamic postural stability in healthy young men?. METHODS A total of 27 healthy men aged 19-27 years participated in this study. intrinsic foot muscle morphology included muscle hardness and thickness. Cross-sectional area was measured by ultrasonography at an ankle dorsiflexion angle of 0°. The hardness of the abductor hallucis (AbH), flexor hallucis brevis, and flexor digitorum brevis (FDB) muscles was measured using ultrasound real-time tissue elastography. Static postural stability during single-leg standing on a single force platform with closed eyes was assessed for the right leg. In the assessment of dynamic postural stability, the subjects jumped and landed on single-leg onto a force platform and the dynamic postural stability index (DPSI) was measured. RESULTS FDB muscle thickness showed a positive correlation with anteroposterior stability index (APSI) (r = 0.398, p = 0.040). AbH muscle hardness was negatively correlated with APSI (r = -0.407, p = 0.035); whereas FDB muscle hardness was positively correlated with DPSI (r = 0.534, p = 0.004), vertical stability index (r = 0.545, p = 0.003), and maximum vertical ground reaction force (r = 0.447, p = 0.020). Multiple regression with forced entry revealed that only DPSI was significantly correlated with FDB muscle hardness (p = 0.003). SIGNIFICANCE The results indicated that intrinsic foot muscle hardness plays an important role in dynamic postural control among healthy young men, which may enable a more rapid muscular response to changes in condition during jump landing and better performance in balance tasks.
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Affiliation(s)
- Noriaki Maeda
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Arisu Hirota
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Makoto Komiya
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Masanori Morikawa
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Rami Mizuta
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Hironori Fujishita
- Sports Medical Center, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kanazawa, Japan
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, China
| | - Yukio Urabe
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
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Okamura K, Egawa K, Ikeda T, Fukuda K, Kanai S. Relationship between foot muscle morphology and severity of pronated foot deformity and foot kinematics during gait: A preliminary study. Gait Posture 2021; 86:273-277. [PMID: 33831742 DOI: 10.1016/j.gaitpost.2021.03.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/12/2021] [Accepted: 03/25/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The morphology of foot muscles that support the medial longitudinal arch differs between normal and pronated feet. The degree to which the difference depends on the severity of the pronated foot deformity is unclear. In the clinical setting, however, to reduce the pronated deformity, muscle-strengthening exercises are performed. RESEARCH QUESTION Does a relationship exist between foot muscle morphology and severity of the pronated foot deformity and foot kinematics during gait? METHODS Using the six-item foot posture index (FPI-6), 26 study participants were assessed for their foot posture and divided into two groups of 13 participants each based on the FPI-6 score: pronated foot group (with a score of 6-9) and highly pronated foot group (with a score of 10-12). Select foot muscles were scanned with ultrasonography, and muscle thicknesses were measured. The following were the muscles of interest: abductor hallucis, flexor hallucis brevis and longus, flexor digitorum brevis and longus, and peroneus longus. Foot kinematic data during gait was collected using a three-dimensional motion capture system as a dynamic navicular drop. RESULTS No between-group differences were noted for muscle thickness and dynamic navicular drop. However, the abductor hallucis and flexor hallucis brevis thicknesses were correlated with the dynamic navicular drop, but not with the severity of the pronated foot deformity. SIGNIFICANCE In individuals with pronated foot deformity, more developed abductor hallucis and flexor hallucis brevis muscles may reduce the dynamic navicular drop that represents the degree of medial longitudinal arch deformation during the stance phase of gait.
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Affiliation(s)
- Kazunori Okamura
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
| | - Kohei Egawa
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
| | - Tomohiro Ikeda
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
| | - Kengo Fukuda
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
| | - Shusaku Kanai
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi, Hiroshima, 723-0053, Japan.
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Morikawa M, Maeda N, Komiya M, Hirota A, Mizuta R, Kobayashi T, Kaneda K, Nishikawa Y, Urabe Y. Contribution of Plantar Fascia and Intrinsic Foot Muscles in a Single-Leg Drop Landing and Repetitive Rebound Jumps: An Ultrasound-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094511. [PMID: 33922807 PMCID: PMC8123000 DOI: 10.3390/ijerph18094511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/10/2021] [Accepted: 04/19/2021] [Indexed: 11/16/2022]
Abstract
The plantar fascia and intrinsic foot muscles (IFM) modulate foot stiffness. However, it is unclear whether the corresponding ultrasonography findings reflect it. This study aimed to examine the effect of the plantar fascia and IFM morphologies on force attenuation during landing and reactivity when jumping in healthy adults (n = 21; age, 21-27 years). Thickness, cross-sectional area (CSA), and hardness of the plantar fascia, abductor hallucis (AbH), and flexor hallucis brevis (FHB) muscles were measured using ultrasonography. Single-leg drop landing and repetitive rebound jumping tests assessed the ground reaction force (GRF) and reactive jump index (RJI), respectively. The CSA of FHB was negatively correlated with maximum vertical GRF (r = -0.472, p = 0.031) in the single-leg drop landing test. The CSA of AbH was negatively correlated with contact time (r = -0.478, p = 0.028), and the plantar fascia thickness was positively correlated with jump height (r = 0.615, p = 0.003) and RJI (r = 0.645, p = 0.002) in the repetitive bound jump test. In multivariate regression analysis, only the plantar fascia thickness was associated with RJI (β = 0.152, 95% confidence interval: 7.219-38.743, p = 0.007). The CSA of FHB may contribute to force attenuation during landing. The thickness of the plantar fascia and CSA of AbH may facilitate jumping high with minimal contact time.
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Affiliation(s)
- Masanori Morikawa
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Noriaki Maeda
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Makoto Komiya
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Arisu Hirota
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Rami Mizuta
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, China;
| | - Kazuki Kaneda
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
| | - Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kanazawa 076-264-5111, Japan;
| | - Yukio Urabe
- Division of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan; (M.M.); (N.M.); (M.K.); (A.H.); (R.M.); (K.K.)
- Correspondence:
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Morphological Characteristics of Passive and Active Structures of the Foot Across Populations With Different Levels of Physical Activity. J Sport Rehabil 2021; 30:935-941. [PMID: 33662932 DOI: 10.1123/jsr.2020-0423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Imaging diagnosis plays a fundamental role in the evaluation and management of injuries suffered in sports activities. OBJECTIVE To analyze the differences in the thickness of the Achilles tendon, patellar tendon, plantar fascia, and posterior tibial tendon in the following levels of physical activity: persons who run regularly, persons otherwise physically active, and persons with a sedentary lifestyle. DESIGN Cross-sectional and observational. PARTICIPANTS The 91 volunteers recruited from students at the university and the Triathlon Club from December 2016 to June 2019. The data were obtained (age, body mass index, and visual analog scale for quality of life together with the ultrasound measurements). RESULTS Tendon and ligament thickness was greater in the runners group than in the sedentary and active groups with the exception of the posterior tibial tendon. The thickness of the Achilles tendon was greater in the runners than in the other groups for both limbs (P = .007 and P = .005). This was also the case for the cross-sectional area (P < .01) and the plantar fascia at the heel insertion in both limbs (P = .034 and P = .026) and for patellar tendon thickness for the longitudinal measurement (P < .01). At the transversal level, however, the differences were only significant in the right limb (P = .040). CONCLUSION The thickness of the Achilles tendon, plantar fascia, and patellar tendon is greater in runners than in persons who are otherwise active or who are sedentary.
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Heinen EH, Lima KMME, Correia R, Diefenthaeler F, de Brito Fontana H. Reliability in ultrasound measurements of plantar aponeurosis thickness. Foot (Edinb) 2021; 46:101749. [PMID: 33285494 DOI: 10.1016/j.foot.2020.101749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 09/21/2020] [Accepted: 11/11/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE Given the increasing research interest in ultrasound plantar aponeurosis (PA) thickness measurements, this study aimed to analyze the inter and intra-rater reliability of independent sonograms and to identify the error related to the image analysis procedure. METHODS Twenty-one healthy men participated in this study. Imaging of PA consisted of two independent sonograms per subject. Two raters (R1 and R2) evaluated each sonogram twice using standardized steps. Precision of the image analysis procedure was analyzed using the Bland and Altman plot and Intraclass Correlation Coefficient (ICC). Agreement estimates and ICC were used to assess absolute and relative inter and intra-rater reliability. RESULTS Reliability of PA thickness was found to depend strongly on the number of images acquired per subject. Intra-rater agreement for single measurements were 0.696 (R1) and 0.495 (R2), whereas average measurements yielded values of 0.821 (R1) and 0.662 (R2), respectively. Precision within a sonogram varied from ICC values of 0.873 to 0.960 (intra-rater) and 0.670 to 0.822 (inter-rater). CONCLUSION Most part of the error in PA thickness measurements seems to be related to the sonogram acquisition process and not to the visual inspection of the image. To minimize error, average values of a minimum of two images per subject should be used. The moderate agreement between raters found in this study ratifies the need of all measurements being made by the same rater or group of raters. If a single rater evaluates all subjects, performing multiple measurements over one image does not seem to affect ICC as much as acquiring multiple images.
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Affiliation(s)
- Eduarda Heydt Heinen
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianópolis, 88.040-900, Brazil.
| | - Kelly Mônica Marinho E Lima
- Health Sciences Department, School of Science, Technology and Health, Federal University of Santa Catarina, Araranguá, 88.906-072, Brazil.
| | - Raissa Correia
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianópolis, 88.040-900, Brazil.
| | - Fernando Diefenthaeler
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianópolis, 88.040-900, Brazil; Physical Eduaction Department, School of Sports, Federal University of Santa Catarina, Florianópolis, 88.040-900, Brazil.
| | - Heiliane de Brito Fontana
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianópolis, 88.040-900, Brazil; Morphological Sciences Department, School of Biological Sciences, Federal University of Santa Catarina, Florianópolis, 88.040-900, Brazil.
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Sponbeck JK, Frandsen CR, Ridge ST, Swanson DA, Swanson DC, Johnson AW. Leg muscle cross-sectional area measured by ultrasound is highly correlated with MRI. J Foot Ankle Res 2021; 14:5. [PMID: 33436029 PMCID: PMC7802339 DOI: 10.1186/s13047-021-00446-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/02/2021] [Indexed: 01/04/2023] Open
Abstract
Background The leg muscles are important for balance, posture, and movement during static and dynamic activity. Obtaining cross-sectional area measurements (CSA) of the leg muscles helps researchers understand the health and force production capability of individual leg muscles. Therefore, having an easy to use and readily available method to assess leg muscle CSA is needed. Thus, the purpose of this study was to compare the magnitude, repeatability, and validity of CSA measurements of select leg muscles from ultrasound (US) and the current gold standard, magnetic resonance imaging (MRI). Methods 20 healthy volunteers participated in this study. Each participant was imaged via US and MRI. The muscles of interest obtained on each participant consisted of the tibialis anterior at both 30 and 50% of the shank length, tibialis posterior at both 30 and 50% of the shank length, the flexor digitorum longus, the fibularis (peroneus) longus, and the fibularis (peroneus) brevis. Results Strong Pearson correlations were seen for all of the muscles when comparing US to MRI with a range from .7840 to .9676. For all measurements, standard error of the measurement ranged from .003 to 0.260 cm2. Minimum detectable difference for muscle measurements ranged from .008 cm2 for MRI fibularis longus and fibularis brevis to .693 cm2 for MRI of tibialis anterior at 30%. US minimum detectable difference ranged from .125 cm2 for the tibialis posterior muscle at 30% to .449 cm2 for the tibialis anterior muscle at 50%. Conclusions Based on these results ultrasound is a valid method to obtain CSA of muscles of the leg when compared with MRI.
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Affiliation(s)
- Joshua K Sponbeck
- Exercise Sciences Department, Brigham Young University, 1000 N University Ave, Provo, UT, 84604, USA
| | - Clint R Frandsen
- Exercise Sciences Department, Brigham Young University, 1000 N University Ave, Provo, UT, 84604, USA
| | - Sarah T Ridge
- Exercise Sciences Department, Brigham Young University, 1000 N University Ave, Provo, UT, 84604, USA
| | - Derek A Swanson
- Exercise Sciences Department, Brigham Young University, 1000 N University Ave, Provo, UT, 84604, USA
| | - Dallin C Swanson
- Exercise Sciences Department, Brigham Young University, 1000 N University Ave, Provo, UT, 84604, USA
| | - A Wayne Johnson
- Exercise Sciences Department, Brigham Young University, 1000 N University Ave, Provo, UT, 84604, USA.
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Johnson AW, Bruening DA, Violette VA, Perkins KV, Thompson CL, Ridge ST. Ultrasound Imaging Is Reliable for Tibialis Posterior Size Measurements. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:2305-2312. [PMID: 32412115 DOI: 10.1002/jum.15340] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/09/2020] [Accepted: 04/26/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The tibialis posterior (TP) is a vital muscle for controlling the medial longitudinal arch of the foot during weight-bearing activities. Dysfunction of this muscle is associated with a variety of pathologic conditions; thus, it is important to reliably assess its morphologic characteristics. Ultrasound (US) has been used to assess characteristics of TP tendons but not the muscle cross-sectional area (CSA). The purpose of this study was to establish a reliable US technique to measure the TP CSA and thickness. METHODS Twenty-three healthy volunteers participated. We evaluated the CSA and thickness at 4 measurement locations (anterior and posterior views at both 30% and 50% of the shank length). RESULTS The participants included 12 female and 11 male volunteers (mean age ± SD, 31.23 ± 14.93 years). Excellent reliability was seen for the CSA and thickness at all locations (intraclass correlation coefficients, 0.988-0.998). Limits of agreement (LoA) and standard errors of the measurement (SEMs) were slightly lower at the 30% locations (LoA at 30%, 4.6-9.2; LoA at 50%, 6.4-9.7; SEM at 30%, 0.03-0.05; SEM at 50%, 0.04-0.07). Strong correlations were seen between anterior and posterior measurements of the CSA (30%, r = 0.99; P < .0001; 50%, r = 0.94; P < .0001) and thickness (30%, r = 0.98; P < .0001; 50%, r = 0.95; P = .0001). CONCLUSIONS Based on these results, the TP can be measured accurately with US at any of the tested locations. Due to the ease of collection and the quality of the data, we recommend the anterior view at 30% of the shank length to measure the CSA. The ability to assess muscle size of the TP will aid in a variety of medical and research applications.
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Affiliation(s)
- A Wayne Johnson
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - Dustin A Bruening
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | | | - Keisha V Perkins
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | | | - Sarah T Ridge
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
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Protopapas K, Perry SD. The effect of a 12-week custom foot orthotic intervention on muscle size and muscle activity of the intrinsic foot muscle of young adults during gait termination. Clin Biomech (Bristol, Avon) 2020; 78:105063. [PMID: 32521283 DOI: 10.1016/j.clinbiomech.2020.105063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 05/08/2020] [Accepted: 05/26/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The tissue stress theory is commonly used to prescribe foot orthoses, however the mechanisms of foot orthoses are not understood well. The effect foot orthotics have on the plantar intrinsic muscles remains unclear. The study was designed to assess changes in muscle size and activity of the intrinsic muscles of individuals with pes planus after wearing custom-made foot orthotics for 12-weeks. METHODS Eighteen young adults with pes planus were allocated by stratified sampling into the orthotic group (n = 9) or control group (n = 9). Ultrasonography measured the cross-sectional area of the flexor digitorum brevis, abductor digiti minimi, and abductor hallucis at baseline, 6 and 12-weeks. Subsequently, participants completed an unexpected gait termination protocol (12 of 50 trials unexpected) and average electromyography magnitude was recorded. FINDINGS After 12-weeks the orthotic group cross-sectional area significantly decreased by 9.6% (P < .001) for the flexor digitorum brevis, 17.1% for abductor digiti minimi (P < .001) and 17.4% for abductor hallucis (P < .001). There were no significant differences of muscle activity magnitude for the intrinsic muscles. INTERPRETATION The short-term use of custom-made foot orthoses created a decrease in muscle size of the flexor digitorium brevis, abductor digiti minimi and abductor hallucis plantar intrinsic muscles but had no effect on muscle activity. Clinically, these results help to understand the adaptations that are created when foot orthoses are supporting a pes planus foot structure when reducing plantar pressures. These findings may help enhance the prescription of foot orthoses by adding a strength program to prevent disuse atrophy of these muscles.
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Affiliation(s)
- Katrina Protopapas
- Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada.
| | - Stephen D Perry
- Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada; Toronto Rehabilitation Institute, University of Toronto, Toronto, Canada
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Romero-Morales C, López-López S, Bravo-Aguilar M, Cerezo-Téllez E, Benito-de Pedro M, López López D, Lobo CC. Ultrasonography Comparison of the Plantar Fascia and Tibialis Anterior in People With and Without Lateral Ankle Sprain: A Case-Control Study. J Manipulative Physiol Ther 2020; 43:799-805. [PMID: 32709515 DOI: 10.1016/j.jmpt.2019.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 11/16/2019] [Accepted: 11/22/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The purpose of the present study was to evaluate the thickness of the plantar fascia (PF) at the insertion of the calcaneus and the midfoot and forefoot fascial locations, in addition to the thickness of the tibialis anterior, by ultrasound imaging in individuals with and without lateral ankle sprain (LAS). METHODS A sample of 44 participants was recruited and divided in 2 groups: 22 feet with a prior diagnosis of grade 1 or 2 LAS (case group) and 22 feet without this condition (healthy group). The thickness and cross-sectional area were evaluated by ultrasound imaging in both groups. RESULTS Ultrasound measurements of the PF at the calcaneus, midfoot, and forefoot showed statistically significant differences (P < .05), with a decrease in thickness in the LAS group relative to the healthy group. For the thickness and cross-sectional area of the tibialis anterior, no significant differences (P < .05) were observed between groups. CONCLUSION The thickness of the PF at the calcaneus, midfoot, and forefoot is reduced in individuals with LAS relative to the healthy group.
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Affiliation(s)
| | - Sergio López-López
- Faculty of Sports Sciences, European University of Madrid, Madrid, Spain
| | | | | | | | - Daniel López López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, University of Coruña, Ferrol, Spain
| | - César Calvo Lobo
- Faculty of Nursing, Physiotherapy and Podiatry, Complutence University of Madrid, Madrid, Spain
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Johnson AW, Stoneman P, McClung MS, Van Wagoner N, Corey TE, Bruening DA, Hunter TD, Myrer JW, Ridge ST. Use of Cine Loops and Structural Landmarks in Ultrasound Image Processing Improves Reliability and Reduces Error in the Assessment of Foot and Leg Muscles. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:1107-1116. [PMID: 31837060 DOI: 10.1002/jum.15192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Foot and leg muscle strength and size are crucial to proper function. It is important to assess these characteristics reliably. Our primary objective was to compare the measurement of still images to cine loops. The secondary purpose was to determine interoperator and intraoperator reliability between operators of different experience levels using video clips and internal and external landmarks. METHODS Twelve healthy volunteers participated in our study. Internal (navicular tuberosity) and external (lateral leg length at 30% and 50% from the knee joint line) landmarks were used. Two operators each captured and later measured still and cine loop images of selected foot and leg muscles. RESULTS The 12 participants included 8 male and 4 female volunteers (mean age ± SD, 23.5 ± 1.9 years). Good to excellent intraoperator and interoperator reliability was seen (intraclass correlation coefficient range of 0.946-0.998). The use of cine loops improved the intraclass correlation coefficients for both intraoperator and interoperator reliability (0.5%-4% increases). The use of cine loops decreased the intraoperator standard error of the measurement and limits of agreement of the novice operator (decreases of 45%-73% and 24%-51%, respectively), and these became comparable to those of experienced operators using still images. The interoperator standard errors of the measurement dropped by 42% to 53%, whereas the limits of agreement dropped by 27% to 40%. No substantial changes were noted in the tibialis anterior across reliability metrics. CONCLUSIONS Improved protocols that take advantage of using internal bony landmarks and cine loops during both the image-gathering and measurement processes improve the reliability of research examining muscle size changes in the lower leg or foot associated with muscle changes due to exercise, injury, disuse, or disease.
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Affiliation(s)
- A Wayne Johnson
- Departments of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - Paul Stoneman
- Department of Physical Therapy, Rocky Mountain University of Health Professions, Provo, Utah, USA
| | - Matthew S McClung
- Departments of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | | | - Taryn E Corey
- Departments of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - Dustin A Bruening
- Departments of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | | | - J William Myrer
- Departments of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - Sarah T Ridge
- Departments of Exercise Sciences, Brigham Young University, Provo, Utah, USA
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Navicular drop is negatively associated with flexor hallucis brevis thickness in community-dwelling older adults. Gait Posture 2020; 78:30-34. [PMID: 32199231 DOI: 10.1016/j.gaitpost.2020.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 02/04/2020] [Accepted: 03/09/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Flatfoot is characterized as a lower longitudinal arch and is a common foot deformity in older adults. Foot intrinsic muscle dysfunction has been considered as one of the factors for a lower medial longitudinal arch. The objective of this study was to investigate the association of the navicular drop with the thickness of foot intrinsic muscles in older adults. RESEARCH QUESTION Which intrinsic muscle contributes most to support the medial longitudinal arch in older adults? METHODS We studied 88 community-dwelling older adults (mean age 74.2 ± 6.2 years). We measured the navicular height, the calcaneus inclination, and hallux valgus angle on the right foot in the sitting and standing positions using a 3D foot scanner. Then, we calculated the navicular drop and changes in the calcaneus inclination from the sitting to the standing position. The muscle thickness of the flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), and abductor hallucis (AbH) was measured on the right foot using Bmode ultrasonography. RESULTS Multiple regression analysis demonstrated that FHB thickness was significantly associated with navicular height in the standing positions (β = 8.568, P = 0.016) as well as navicular drop (β = -9.495, P = 0.037) after adjusting for age, sex, height, weight, and hallux valgus angle. There was no association with FDB or AbH. The thickness of any intrinsic muscle was not associated with the calcaneus inclination or changes in the calcaneus inclination. SIGNIFICANCE Our data suggest that FHB plays an important role in preventing navicular drop and that intrinsic muscles likely do not contribute to the rearfoot angle in older adults.
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Takakura Y, Yamaguchi S, Akagi R, Kamegaya M, Kimura S, Tanaka H, Yasui T. Diagnosis of avulsion fractures of the distal fibula after lateral ankle sprain in children: a diagnostic accuracy study comparing ultrasonography with radiography. BMC Musculoskelet Disord 2020; 21:276. [PMID: 32345266 PMCID: PMC7189593 DOI: 10.1186/s12891-020-03287-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 04/13/2020] [Indexed: 12/26/2022] Open
Abstract
Background The purpose of this study was to determine the diagnostic accuracy of ultrasonography for the diagnosis of avulsion fractures of the distal fibula for lateral ankle sprain in children and compare it to that of radiography. Methods Children who sustained lateral ankle sprain were prospectively surveyed. They underwent both ultrasonography and radiography at the first clinic visit to diagnose any concomitant avulsion fractures of the distal fibula. The patients underwent follow-up radiography 4 weeks later to obtain the reference standard diagnosis. The measures of diagnostic accuracy (i.e., sensitivity, specificity, positive predictive value, and negative predictive value) of the initial ultrasonography and radiography were calculated; they were then compared using the McNemar test. Totally, 52 patients (with a median age of 9 years) were analyzed. Results On the reference standard (follow-up) radiographs, 32 patients (62%) were found to have avulsion fractures of the distal fibula. The sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography were 94, 85, 91, and 89% respectively; and 81, 100, 100, and 77% respectively for radiography at the first visit. There were no significant differences in sensitivity and specificity between the two diagnostic methods (P = 0.22, 0.25). Conclusions Ultrasonography has a high diagnostic accuracy, which is comparable to that of radiography, for the diagnosis of avulsion fracture of the distal fibula. Ultrasonography may be used as an option of imaging modality for lateral ankle sprain in children.
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Affiliation(s)
- Yoshiyuki Takakura
- Takakura Orthopaedic & Sports Clinic, 5-4-21 Tokui-cho, Nada-ku, Kobe-shi, Hyogo, 657-0033, Japan
| | - Satoshi Yamaguchi
- Collage of Liberal Arts and Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan. .,Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan.
| | - Ryuichiro Akagi
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Makoto Kamegaya
- Chiba C & A Orthopaedic Clinic, 3-24-2 Oyumino-minami, Midori-ku, Chiba-shi, Chiba, 266-0033, Japan
| | - Seiji Kimura
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Hirofumi Tanaka
- Hyakutake Orthopedic Surgery and Sports Clinic, 4-2-15 Mizugae, Saga-shi, Saga, 840-0054, Japan
| | - Tetsuro Yasui
- Department of Orthopaedic Surgery, Teikyo University Mizonokuchi Hospital, 5-1-1 Futako, Takatsu-ku, Kawasaki-shi, Kanagawa, 213-8507, Japan
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De-la-Cruz-Torres B, Barrera-García-Martín I, De la Cueva-Reguera M, Bravo-Aguilar M, Blanco-Morales M, Navarro-Flores E, Romero-Morales C, Abuín-Porras V. Does Function Determine the Structure? Changes in Flexor Hallucis Longus Muscle and the Associated Performance Related to Dance Modality: A Cross-Sectional Study. ACTA ACUST UNITED AC 2020; 56:medicina56040186. [PMID: 32316305 PMCID: PMC7230629 DOI: 10.3390/medicina56040186] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 12/16/2022]
Abstract
Background and Objectives: Flexor hallucis longus pathology is one of the most common conditions of the ankle and foot in dancers, due to the high demand of dance movements performed in an extreme plantar flexion and dorsiflexion range of motion. The objectives of this study were to determine the bilateral differences between the thickness and cross-sectional area of the flexor hallucis longus muscle in dancers, to establish possible differences between dance modalities, and to analyze whether there is a correlation between ultrasonographic parameters or performance variables and the dance modality. Material and Methods: A sample of 50 (29 classical and 21 contemporary) full-time pre-professional female dancers were included in the study. The thickness and cross-sectional area of the flexor hallucis longus muscle were evaluated for both limbs using ultrasound imaging. The range of movement of the first metatarsophalangeal joint was measured using functional extension with maximal ankle plantarflexion, balance was measured in a unilateral stance with the heel raised, endurance was evaluated through a modified heel rise fatigue test, and a counter movement jump to assess the vertical jump performance was measured bilaterally. Results: There were no significant differences recorded between the dominant and non-dominant limbs for each variable, within both groups. Contemporary dancers showed a greater thickness and cross-sectional area of the flexor hallucis longus muscle than classical dancers. However, classical dancers showed an increase of balance, endurance, range of movement of the first metatarsophalangeal joint, and counter movement jump with respect to contemporary dancers. Conclusion: Bilateral symmetry was identified in all variables for both groups. The size and performance of the flexor hallucis longus muscle may be influenced by the specific nature of dance modality.
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Affiliation(s)
- Blanca De-la-Cruz-Torres
- Department of Physiotherapy, University of Seville, Avicena Street, 41009 Sevilla, Spain; (B.D.-l.-C.-T.); (I.B.-G.-M.)
| | - Irene Barrera-García-Martín
- Department of Physiotherapy, University of Seville, Avicena Street, 41009 Sevilla, Spain; (B.D.-l.-C.-T.); (I.B.-G.-M.)
| | - Mónica De la Cueva-Reguera
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.D.l.C.-R.); (M.B.-A.); (M.B.-M.); (V.A.-P.)
| | - María Bravo-Aguilar
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.D.l.C.-R.); (M.B.-A.); (M.B.-M.); (V.A.-P.)
| | - María Blanco-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.D.l.C.-R.); (M.B.-A.); (M.B.-M.); (V.A.-P.)
| | - Emmanuel Navarro-Flores
- Frailty Research Organized Group (FROG), Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, 46010 Valencia, Spain;
| | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.D.l.C.-R.); (M.B.-A.); (M.B.-M.); (V.A.-P.)
- Correspondence:
| | - Vanesa Abuín-Porras
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (M.D.l.C.-R.); (M.B.-A.); (M.B.-M.); (V.A.-P.)
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de-la-Cruz-Torres B, Barrera-García-Martín I, Cueva-Reguera MDL, Bravo-Aguilar M, Abuin-Porras V, Romero-Morales C. Ultrasound imaging features of the Achilles tendon in dancers. Is there a correlation between the imaging and clinical findings? A cross-sectional study. Phys Ther Sport 2020; 43:181-187. [PMID: 32203702 DOI: 10.1016/j.ptsp.2020.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/13/2020] [Accepted: 03/14/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To analyze the prevalence of tendon pathology and performance associated in pre-professional classic dancers with no history of Achilles tendon (AT) pain. DESIGN A cross-sectional study was conducted. PARTICIPANTS Twenty-nine classic ballet dancers without AT pain (58 tendons) were recruited. The tendons were classified (normal, abnormal) using ultrasound imaging (USI). Cross-sectional area (CSA) and thickness of flexor hallucis longus (FHL) muscle were measured using USI. Range of movement (ROM) of the first metatarsophalangeal join, balance test, endurance test and vertical jump were measured (bilaterally) as performance variables. RESULTS More than a half (62%) of the participants had at least one abnormal tendon, with 45% of the dancers in the abnormal group having bilateral abnormalities. Dancers with AT pathology had significantly more years of dancing and number of weekly pointe hours than those with no pathology on US imaging. No significant differences between the groups were identified for the rest of the variables. Dancing years were moderately correlated with AT thickness. CONCLUSIONS Asymptomatic classic dancers had a high incidence of tendon pathology. Increased dancing years was associated with pathology in the AT. Nevertheless, these abnormalities may not affect dance performance.
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Affiliation(s)
| | | | - Mónica de la Cueva-Reguera
- Faculty of Sport Sciences, Universidad Europea de Madrid, C/ Tajo s/n, Villaviciosa de Odón, 28670, Madrid, Spain
| | - Maria Bravo-Aguilar
- Faculty of Sport Sciences, Universidad Europea de Madrid, C/ Tajo s/n, Villaviciosa de Odón, 28670, Madrid, Spain
| | - Vanesa Abuin-Porras
- Faculty of Sport Sciences, Universidad Europea de Madrid, C/ Tajo s/n, Villaviciosa de Odón, 28670, Madrid, Spain.
| | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, C/ Tajo s/n, Villaviciosa de Odón, 28670, Madrid, Spain
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Instruments of Choice for Assessment and Monitoring Diabetic Foot: A Systematic Review. J Clin Med 2020; 9:jcm9020602. [PMID: 32102313 PMCID: PMC7074122 DOI: 10.3390/jcm9020602] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 02/06/2023] Open
Abstract
Diabetic foot is the most frequent disorder among the chronic complications of diabetes, happening in 25% of patients. Objective clinical outcome measures are tests or clinical instruments that provide objective values for result measurement. The aim of this study was to carry out a systematic review of specific objective clinical outcome measures focused on the assessment and monitoring of diabetic foot disorders. The databases used were PubMed, CINAHL, Scopus, PEDro, Cochrane, SciELO and EMBASE. Search terms used were foot, ankle, diabet*, diabetic foot, assessment, tools, instruments, objective outcome measures, valid*, reliab*. Because of the current published evidence, diabetic neuropathy assessment via sudomotor analysis, cardiovascular autonomic neuropathy and peripheral vascular disease detection by non-invasive electronic devices, wound 3D dimensional measurement, hyperspectral imaging for ulcer prediction and the probe-to-bone test for osteomyelitis diagnosis were highlighted in this study.
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