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The Impact of PNF Leg Patterns Hallux Abduction on the Intrinsic Foot Muscles of Participants with Hallux Valgus

엄지발가락 벌림을 강조한 PNF 하지 패턴이 엄지발가락가쪽휨증을 지닌 대상자의 발의 내재근 근활성도에 미치는 영향

  • Kim, Byeong-Jo (Department of Physical Therapy, Dongeui University) ;
  • Park, Du-Jin (Department of Physical Therapy, Kaya University)
  • 김병조 (동의대학교 물리치료학과) ;
  • 박두진 (가야대학교 물리치료학과)
  • Received : 2018.11.07
  • Accepted : 2018.11.12
  • Published : 2018.12.31

Abstract

Purpose: This study aimed to compare the impact of proprioceptive neuromuscular facilitation leg patterns emphasizing hallux abduction (PNF-LPHA) on the intrinsic foot muscles of participants with hallux valgus (HV) using the toe-spread-out exercise (TSO). Methods: The present study recruited 12 individuals with HV. All the participants voluntarily agreed to participate in the study after hearing explanations of its purpose and process. All participants performed the TSO, PNF-LPHA 1, and PNF-LPHA 2. The participants' abductor hallucis (AbH), adductor hallucis (AdH), extensor hallucis longus (EHL), and flexor hallucis brevis (FHB) activity was measured, and the ratio of AbH:AdH was measured during the three interventions using electromyography. Additionally, the participants' AbH thickness was measured by ultrasonography. An intraclass correlation coefficient (ICC) was used to verify the intra-rater reliability of ultrasonography at rest and during contraction. Results: The intra-rater reliability was excellent at rest and during contraction ($ICC_{3,1}=0.90$ and $ICC_{3,1}=0.83$, respectively). There were no statistically significant differences in the activity of the AbH, the ratio of AbH: AdH, and the thickness of AbH between the TSO and PNF-LPHA2 groups. Additionally, EHL activity was significantly higher in the PNF-LPHA2 group than in the TSOgroup. Conclusion: PNF-LPHA 2 can be recommended as a method to optimize AbH and EHL activity, the ratio of AbH:AdH, and the thickness of AbH in individuals with HV.

Keywords

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Fig. 1. Foot print.

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Fig. 2. Placements of surface electrodes on foot. EHL: extensor hallucis longus, AbH: abductor hallucis, AdH: adductor hallucis, FHB: flexor hallucis brevis.

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Fig. 3. Ultrasonography for abductor hallucis.

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Fig. 4. Toe spread out exercise. (A) Start position, (B)End position.

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Fig. 5. PNF leg pattern emphasized hallux abduction 1.(A) Start position, (B) End position.

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Fig. 6. PNF leg pattern emphasized hallux abduction 2.(A) Start position, (B) End position.

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Fig. 7. Ratio of muscle activity among interventions.

Table 1. Comparison of activity of foot intrinsic muscles among exercises (n=12)

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Table 2. Comparison of thickness of abductor hallucis and ratio of muscle activity among exercises (n=12)

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Table 3. Intra-rater reliability of thickness measurement of abductor hallucis (n=6)

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