The effect of toe-tap exercise on abductor hallucis activity and medial longitudinal arch angle in individuals with pes planus

2020 ◽  
Vol 28 (4) ◽  
pp. 415-422
Author(s):  
Min-Hyeok Kang ◽  
Sang-Min Cha ◽  
Jae-Seop Oh
Keyword(s):  
Repeated Measures ◽  
Plantar Flexion ◽  
Surface Emg ◽  
Rehabilitation Program ◽  
Emg Activity ◽  
Electromyographic Activity ◽  
Medial Longitudinal Arch ◽  
Abductor Hallucis ◽  
Pes Planus ◽  
Longitudinal Arch

BACKGROUND: Active interventions for pes planus, including short-foot exercises (SF) and toe-spread-out exercises (TSO), aim to continuously support the medial longitudinal arch (MLA) by activating the abductor hallucis (AbdH) muscle. However, compensatory movements, such as ankle supination and/or plantar flexion, often occur during these exercises. OBJECTIVE: To examine the effects of a novel exercise, i.e., the toe-tap (TT) exercise on AbdH activity and MLA angle. METHODS: A total of 16 participants with pes planus participated in this study. Participants performed SF, TSO, and TT exercises. Electromyographic activity of the AbdH and MLA angle during three AbdH contraction exercises were recorded using surface EMG system and digital image analysis program, respectively. The differences in outcome measures among the three exercises were analyzed using one-way repeated-measures analysis of variance. RESULTS: The EMG activity of the AbdH was significantly greater during the TT exercise compared to the SF and TSO exercises. The MLA angle was significantly smaller during the TT exercise compared with the SF and TSO exercises. CONCLUSIONS: These findings suggest that the TT exercise could be effective in activating the AbdH and increasing height of the MLA, as part of a sports rehabilitation program for individuals with pes planus.

scholarly journals Effect of Isometric Hip Abduction on Foot and Ankle Muscle Activity and Medial Longitudinal Arch During Short-Foot Exercise in Individuals With Pes Planus

2020 ◽  
pp. 1-7
Author(s):  
Jung-Hoon Choi ◽  
Heon-Seock Cynn ◽  
Chung-Hwi Yi ◽  
Tae-Lim Yoon ◽  
Seung-Min Baik
Keyword(s):  
Muscle Activity ◽  
Statistical Significance ◽  
Standing Position ◽  
Medial Longitudinal Arch ◽  
Joint Stability ◽  
Abductor Hallucis ◽  
Pes Planus ◽  
Longitudinal Arch ◽  
Significant Difference ◽  
Hip Abduction

Context: The improvement of hip joint stability can significantly impact knee and rearfoot mechanics. Individuals with pes planus have a weak abductor hallucis (AbdH), and the tibialis anterior (TA) may activate to compensate for this. As yet, no studies have applied isometric hip abduction (IHA) for hip stability during short-foot exercise (SFE). Objective: To compare the effects of IHA on the muscle activity of the AbdH, TA, peroneus longus (PL), and gluteus medius (Gmed), as well as the medial longitudinal arch (MLA) angle during sitting and standing SFE. Design: Two-way repeated analyses of variance were used to determine the statistical significance of AbdH, TA, PL, and Gmed electromyography activity, as well as the change in MLA angle. Setting: University research laboratory. Participants: Thirty-two participants with pes planus. Intervention(s): The participants performed SFE with and without isometric hip abduction in sitting and standing positions. Main Outcome Measures: Surface electromyography was used to measure the activity of the AbdH, TA, PL, and Gmed muscles, and Image J was used to measure the MLA angle. Results: Significant interactions between exercise type and position were observed in terms of the PL muscle activity and in the change in MLA angle only, while other muscles showed significant main effects. The IHA during SFE significantly increased the AbdH muscle activity, while the TA muscle activity was significantly lower. The muscle activity of Gmed and PL was significantly increased in the standing position compared with sitting, but there was no significant difference with or without IHA. The change in the MLA angle was significantly greater in SFE with IHA in a standing position than in the other SFE conditions. Conclusions: IHA may be an effective method for reducing compensatory TA activity and increasing AbdH muscle activity during SFE for individuals with pes planus.

scholarly journals Effect of Peroneus Longus Muscle Release on Abductor Hallucis Muscle Activity and Medial Longitudinal Arch before Toe-Tap Exercise in Participants with Flexible Pes Planus

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 44
Author(s):  
Youngkyu Choi ◽  
Jihyun Lee
Keyword(s):  
Muscle Activity ◽  
Medial Longitudinal Arch ◽  
Abductor Hallucis ◽  
Pes Planus ◽  
Myofascial Release ◽  
Peroneus Longus ◽  
Medial Side ◽  
Longitudinal Arch ◽  
Longus Muscle ◽  
Abductor Hallucis Muscle

Pes planus is a medical condition of the foot wherein there is a flattening or lowering of the medial longitudinal arch. The abductor hallucis muscle starts at the heel bone and attaches to the medial side of the first toe. Whenever it contracts, it plays a key role in elevating the medial longitudinal arch. Hence, the abductor hallucis muscle should be strong enough to control the depression on the medial longitudinal arch. The peroneus longus muscle plantarflexes the ankle and everts the ankle and subtalar joint. If this muscle contracts more than the abductor hallucis muscle does, the medial longitudinal arch of the foot is depressed. This study aimed to investigate the effect of myofascial release of the peroneus longus before performing the toe-tap exercise for strengthening the abductor hallucis muscle in participants with flexible pes planus. This cross-over study included 16 volunteers with flexible pes planus. The participants performed a toe-tap exercise before and after the myofascial release of the peroneus longus. During the toe-tap exercise, the muscle activity of the abductor hallucis and peroneus longus were measured using a Delsys Trigno Wireless Electromyography System. The angle of the medial longitudinal arch was measured using Image J software. Photos in the sagittal plane were used. The peroneus longus activity and medial longitudinal arch angles were significantly decreased. On the other hand, the activity of the abductor hallucis significantly increased after the myofascial release of the peroneus longus before performing the toe-tap exercise (p < 0.05). Individuals with flexible pes planus should be encouraged to perform myofascial release of the peroneus longus before the toe-tap exercise to improve the abductor hallucis activity and to elevate the medial longitudinal arch.

scholarly journals MORPHOMETRIC STUDY OF PLANTAR ARCH INDEX AND THE PREVALENCE OF FLATFOOT AMONG TRIBES

2020 ◽  
Vol 8 (4.1) ◽  
pp. 7782-7787
Author(s):  
Adjei-Antwi Collins ◽  
◽  
Chrissie Stansie Abaidoo ◽  
Nketsiah James ◽  
Joshua Tetteh ◽  
...  
Keyword(s):  
Prevalence Rate ◽  
The Other ◽  
Morphometric Study ◽  
Medial Longitudinal Arch ◽  
Foot Deformity ◽  
Pes Planus ◽  
Longitudinal Arch ◽  
Ethical Approval ◽  
Foot Arch ◽  
Arch Index

Flatfoot (pes planus), commonest foot deformity caused by the absence or collapse of the medial longitudinal arch. Flatfoot results in serious health problems and postural defects. It is highly variable in different populations with many factors associated. This study was conducted to find the plantar arch index and the prevalence of flatfoot and its relationship with tribes in Ghana. A total of 278 participants (172 males and 106 females) with ages ranging from 16 to 34 years were recruited for the study. Ethical approval and participants’ informed consent were sought prior to the study. Participants were drawn from the Akan, Ewe, Ga-Dangbe and other tribes (Dagomba, Dagabaa, Frafra, Gonja, Wale Wale etc). Foot imprints were taken from each participant using the ink method. The plantar arch index was calculated using the ratio of the width of the central and the heel region of the footprint. The mean right plantar arch index was higher than the left. The prevalence of flatfoot was 15.1% (6.1% unilateral left, 5.8% unilateral right and 3.2% bilateral). The prevalence rate was 15.7% in males and 14.1% in females. The prevalence rates reported for the Ga-Dangbes and Ewes were 30.8% and 23.6% respectively. On the other hand, both Akans and individuals belonging to the other tribes recorded the same prevalence rate of 13.7%. Flatfoot was found to be high among the Ga-Dangbes. Ethnicity as an external factor has a great role in influencing foot arch structure. Also, sex has an influence on the morphology of an individual’s foot. KEY WORDS: Flatfoot, Pes planus, Foot deformity, Medial Longitudinal Arch.

An Anatomic Study of the Naviculocuneiform Ligament and Its Possible Role Maintaining the Medial Longitudinal Arch

2018 ◽  
Vol 40 (3) ◽  
pp. 352-355 ◽  
Author(s):  
Eric Swanton ◽  
Lauren Fisher ◽  
Andrew Fisher ◽  
Andrew Molloy ◽  
Lyndon Mason
Keyword(s):  
Weight Bearing ◽  
Lower Limbs ◽  
Tibialis Posterior ◽  
Medial Longitudinal Arch ◽  
Pes Planus ◽  
Average Width ◽  
Tibialis Posterior Tendon ◽  
Longitudinal Arch ◽  
Medial Cuneiform ◽  
Distal Aspect

Background: Weight-bearing radiographic analysis of pes planus deformities show, with varying degree of severity, a break in the Meary line. The break in the Meary line occurs not only at the talonavicular joint but also distal to the spring ligament and reported tibialis posterior insertion. Our aim in this study was to investigate the distal plantar ligaments of the medial longitudinal arch, to try to identify other areas where deformity correction could be affected. Methods: We examined 11 cadaveric lower limbs that had been preserved for dissection in a solution of formaldehyde. The lower limbs were carefully dissected to identify the plantar aspect of the medial longitudinal arch. Results: In all specimens, the tibialis posterior tendon inserted into the plantar medial aspect of the navicular with separate slips to the intermediate and lateral cuneiform. The navicular cuneiform ligament extended from the navicular to medial cuneiform. This structure was statically inserted between the navicular and medial cuneiform, which would allow the pull of the tibialis posterior to act on the navicular and medial cuneiform in tandem. The average width of the naviculocuneiform ligament was 15.2 mm (range 12.4-18.0) compared to 9.5 mm (range 7.6-11.4) for the tibialis posterior tendon. Conclusion: The tibialis posterior tendon inserted into the navicular and continued onto the medial cuneiform to provide a static restraint between 2 bony insertions, thus supporting the distal aspect of the medial longitudinal arch. Clinical Relevance: We are confident that it is a structure of importance in maintaining the distal aspect of the medial longitudinal arch and may therefore have significant clinical and surgical implications when treating the pes planus deformity.

scholarly journals Ankle Bracing, Plantar-Flexion Angle, and Ankle Muscle Latencies During Inversion Stress in Healthy Participants

2008 ◽  
Vol 43 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Thomas Kernozek ◽  
Christopher J. Durall ◽  
Allison Friske ◽  
Matthew Mussallem
Keyword(s):  
Repeated Measures ◽  
Plantar Flexion ◽  
Ankle Injuries ◽  
Flexion Angle ◽  
Electromyographic Activity ◽  
Custom Made ◽  
Ankle Muscle ◽  
Main Effects ◽  
And Inversion ◽  
Healthy Females

Abstract Context: Ankle braces may enhance ankle joint proprioception, which in turn may affect reflexive ankle muscle activity during a perturbation. Despite the common occurrence of plantar-flexion inversion ankle injuries, authors of previous studies of ankle muscle latencies have focused on inversion stresses only. Objective: To examine the latency of the peroneus longus (PL), peroneus brevis (PB), and tibialis anterior (TA) muscles in response to various degrees of combined plantar-flexion and inversion stresses in braced and unbraced asymptomatic ankles. Design: Repeated measures. Setting: University biomechanics laboratory. Patients or Other Participants: Twenty-eight healthy females and 12 healthy males (n = 40: mean age = 23.63 years, range = 19 to 30 years; height = 172.75 ± 7.96 cm; mass = 65.53 ± 12.0 kg). Intervention(s): Participants were tested under 2 conditions: wearing and not wearing an Active Ankle T1 brace while dropping from a custom-made platform into 10°, 20°, and 30° of plantar flexion and 30° of inversion. Main Outcome Measure(s): The time between platform drop and the onset of PL, PB, and TA electromyographic activity was measured to determine latencies. We calculated a series of 2-way analyses of variance to determine if latencies were different between the conditions (braced and unbraced) and among the plantar-flexion angles (α = .05). Results: No interaction was found between condition and plantar-flexion angle. No significant main effects were found for condition or plantar-flexion angle. Overall means for braced and unbraced conditions were not significantly different for each muscle tested. Overall means for angle for the PL, PB, and TA were not significantly different. Conclusions: Reflexive activity of the PL, PB, or TA was unaffected by the amount of plantar flexion or by wearing an Active Ankle T1 brace during an unanticipated plantar-flexion inversion perturbation.

The Relationship Between Surface Electromyographic Activity and Torque Production of the Infraspinatus Muscle in Shoulder Rehabilitation Exercises

2020 ◽  
Vol 36 (3) ◽  
pp. 141-147
Author(s):  
Bill Stodart ◽  
Maria Cup ◽  
Curtis Kindel
Keyword(s):  
Inverse Relationship ◽  
External Rotation ◽  
Surface Emg ◽  
Joint Torque ◽  
Emg Activity ◽  
Electromyographic Activity ◽  
Maximum Voluntary Isometric Contraction ◽  
Relative Value ◽  
Torque Values ◽  
The Relationship

In current rehabilitation practice, exercise selection is commonly based on the amount of muscle recruitment demonstrated by electromyographic (EMG) analysis. A preponderance of evidence supports the concept that EMG of a muscle and torque output are positively correlated. This study was designed to investigate the relationship between surface EMG activity of the infraspinatus and torque production during exercises involving shoulder external rotation (ER). A total of 30 participants (average age = 24.6 y) performed maximum voluntary isometric contraction of ER at 5 points within the range of motion of 3 shoulder exercise positions with concomitant surface EMG recording. As a maximal internally rotated position was approached, maximum ER torque and minimum or near-minimum EMG recruitment were demonstrated. Conversely, at maximally externally rotated positions, EMG activity was greatest and torque values were lowest. An inverse relationship between joint torque output and EMG activity was established in each of the 3 exercises. The inverse relationship between EMG activity and torque output during Shoulder ER suggests that there may be additional factors warranting consideration during exercise selection. Further research may be needed to determine the relative value of electrical activity versus torque output to optimize the selection of rehabilitative exercises.

Minimally Invasive Calcaneo-Stop Method for Idiopathic, Flexible Pes Planovalgus in Children

2007 ◽  
Vol 28 (9) ◽  
pp. 991-995 ◽  
Author(s):  
Sandor Roth ◽  
Branko Sestan ◽  
Anton Tudor ◽  
Zdenko Ostojic ◽  
Anton Sasso ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pediatric Patients ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Medial Longitudinal Arch ◽  
Pes Planovalgus ◽  
Loss Of Function ◽  
Cancellous Screw ◽  
Pes Planus ◽  
Longitudinal Arch

Background: The aim of this study was to correct heel valgus in children and to lift the longitudinal arch of the foot using a temporary cancellous screw placed percutaneously across the talocalcaneal articulation. Methods: From April, 1997, to June, 2003, 94 procedures were done on 48 children between the ages of 8 and 14 years. The Meary angle to determine the degree of collapse of the medial longitudinal arch was 170 degrees or less, and the weightbearing hindfoot was in valgus. Presumably, the screw achieves correction by stimulating the proprioceptive foot receptors allowing active inversion of the foot. Results: At 5 years followup, no serious complications occurred. The correction of the Meary angle on average was 17.10 ± 5.51 degrees. In every foot, heel valgus and the longitudinal arch of the foot were improved radiographically and clinically without the loss of function. We removed the screws in all patients. In 91 feet, the arch of the foot and heel valgus remained in the corrected position. Conclusions: The ‘calcaneo-stop’ method is a simple, effective, minimally invasive technique for the treatment of idiopathic, flexible pes planus in carefully selected pediatric patients.

scholarly journals Early Outcomes of Pes Planus Reconstruction Using Either Hamstring Allograft or Synthetic Ligament

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0021
Author(s):  
Gavin Heyes ◽  
Amir Vosoughi ◽  
Lyndon W Mason ◽  
Andrew P. Molloy
Keyword(s):  
Ligament Reconstruction ◽  
T Test ◽  
Medial Gastrocnemius ◽  
Medial Longitudinal Arch ◽  
Pes Planus ◽  
Hindfoot Alignment ◽  
Longitudinal Arch ◽  
Medial Cuneiform ◽  
Functional Scores ◽  
Synthetic Ligament

Category: Hindfoot, Midfoot/Forefoot Introduction/Purpose: Maintenance of the medial longitudinal arch is crucial to efficient kinematics in gait. It is supported by as complex interplay of osseous structures, ligaments, extrinsic tendons and plantar fascia. Two ligaments critical to stabilising the medial longitudinal arch are the Spring (Calcaneofibular) and Naviculocuneiform ligaments. The Spring Ligament serves as a sling within the “Acetabulum Pedis” to orientate the Talus relative to the Calcaneus and Navicular. The Naviculocuneiform ligament is an important plantar tension band and a separate entity to the Posterior Tibial Tendon (PTT) insertion. Attenuation of these ligaments leads to Pes Planus deformity and subsequent defunctioning of the PTT. This study evaluates the functional and radiological outcomes of Spring and Naviculocuneiform ligament reconstruction using Hamstring (Semitendinosis) Allograft and Synthetic ligament (Internal BraceTM, Arthrex). Methods: 33 consecutive Pes Planus reconstructions were performed between 11/11/2013 and 06/03/2018. All patients were followed up prospectively with serial radiographs and functional scores including; MOXFQ, EQF5D and VAS. Minimum follow up was six months. At the midpoint during the study there was transition to using Synthetic Ligament instead of allograft. This was due to availability and ease of use. Surgical technique for both reconstructions included a proximal medial gastrocnemius recession and medialising calcaneal osteotomy. For allograft reconstructions, a pre-tensioned Semitendinosis allograft was fixed proximally to Talar neck using a tenodesis screw and passed plantar to PTT and through a bone tunnel in the medial cuneiform. Synthetic ligaments were inserted from the Sustentaculum Tali to the medial cuneiform in a hammock fashion. In both reconstructions tendinopathic PTTs were excised and a Flexor Digitorum Longus transfer used. Results: There were 17 synthetic ligament reconstructions (6 male, 11 female) and 16 allograft reconstructions (6 male, 10 female). Groups were matched pre-operatively for age, functional scores and radiological markers (T test P values >0.05). At six months significantly better improvements were observed in the synthetic ligament group compared to allograft group with regards to VAS, MOXFQ pain score, Meary’s line, 1st metatarsal Talus angle, Talonavicular uncoverage angle and Hindfoot alignment (T test P < 0.05). Statistical significance was maintained at 12 months with the synthetic ligament providing a significantly better reduction of Meary’s line 1st Metatarsal Talar angle, Talonavicular uncoverage and hindfoot alignment. 2 patients were revised to double fusions in the allograft group and 1 patient revised in the synthetic ligament group. Conclusion: Statistically significant improved functional scores and radiological appearance can be found up to 1 year following Synthetic ligament reconstruction of the Spring and Naviculocuneiform ligaments when compared to Hamstring allograft.

Effect of Humeral-Elevation Angle on Electromyographic Activity in the Serratus Anterior During the Push-Up-Plus Exercise

2017 ◽  
Vol 26 (1) ◽  
pp. 57-64 ◽  
Author(s):  
Ui-jae Hwang ◽  
Oh-yun Kwon ◽  
In-cheol Jeon ◽  
Si-hyun Kim ◽  
Jong-hyuck Weon
Keyword(s):  
Outcome Measures ◽  
Muscle Activity ◽  
Repeated Measures ◽  
Elevation Angle ◽  
Emg Activity ◽  
Electromyographic Activity ◽  
Serratus Anterior ◽  
Repeated Measures Design ◽  
Activity Ratios ◽  
Push Up

Context:The push-up-plus (PP) exercise has been recommended for strengthening of the serratus anterior (SA). Previous studies have investigated the effect of different stability properties of the base of support to adjust the difficulty level of SA muscle-strengthening exercises in the PP position. However, the optimal humeral-elevation angle (HEA) for selective activation and maximum contraction of the SA during PP has not been investigated.Objectives:To assess the effects of HEA during PP on electromyographic (EMG) activity in the SA, upper trapezius (UT), and pectoralis major (PM) and on the UT:SA and PM:SA activity ratios.Design:Comparative, repeated-measures design.Setting:University research laboratory.Participants:29 healthy men.Main Outcome Measures:The subjects performed PP at 3 different HEAs (60°, 90°, and 120°); EMG activity in the SA, UT, and PM was measured, and the UT:SA and PM:SA activity ratios were calculated. Differences in muscle activity and ratios between the 60°, 90°, and 120° HEAs were assessed using 1-way repeated-measures analysis of variance; the Bonferroni correction was applied.Results:SA muscle activity was significantly increased, in order of magnitude, at the 120°, 90°, and 60° HEAs. UT:SA and PM:SA activity ratios were significantly greater during performance of the PP at an HEA of 60° than at HEAs of 120° and 90°.Conclusion:The results suggest that an HEA of 120° should be used during performance of the PP because it produces greater SA activation than HEAs of 60° and 90°.

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