Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
권호 표지
DOI QR코드

DOI QR Code

Peroneal Muscle and Biceps Femoris Muscle Activation During Eversion With and Without Plantarflexion in Sitting and Side-lying Postures

  • Do-eun Lee (Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Jun-hee Kim (Kinetic Ergocise Based on Movement Analysis Laboratory) ;
  • Seung-yoon Han (Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Oh-yun Kwon (Kinetic Ergocise Based on Movement Analysis Laboratory)
  • Received : 2023.11.26
  • Accepted : 2024.01.15
  • Published : 2024.04.20
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Lateral instability of the ankle is one of the most common causes of musculoskeletal ankle injuries. The peroneus longus (PL) and peroneus brevis (PB) contribute to ankle stability. In early rehabilitation, isometric exercises have been selected for improvement of ankle stability. To effectively train the peroneal muscles during eversion, it is important to consider ankle and body posture. Objects: This study aimed to compare activation of the PL, PB, and biceps femoris (BF) muscles during eversion in different ankle postures (neutral [N], plantarflexed [PF]) and body postures (sitting and side-lying). Methods: Thirty healthy individuals with no history of lateral ankle sprains within the last 6 months were included in the study. Maximal isometric strength of eversion and muscle activation were measured simultaneously. Muscle activation at submaximal eversion was divided by the highest value obtained from maximal isometric eversion among the four postures (percent maximal voluntary isometric contraction [%MVIC]). To examine the differences in muscle activation depending on posture, a 2 × 2 repeated measures analysis of variance (ANOVA) was conducted. Results: There were significant interaction effects of ankle and body postures on PL muscle activation and evertor strength (p < 0.05). The PL muscle activation showed a significantly greater difference in the side-lying and PF conditions than in the sitting and N conditions (p < 0.05). Evertor strength was greater in the N compared to the PF condition regardless of body posture (p < 0.05). In the case of PB and BF muscle activation, only the main effects of ankle and body posture were observed (p < 0.05). Conclusion: Among the four postures, the side-lying-PF posture produced the highest muscle activation. The side-lying-PF posture may be preferred for effective peroneal muscle exercises, even when considering the BF muscle.

Keywords

References

  1. Freeman MA. Instability of the foot after injuries to the lateral ligament of the ankle. J Bone Joint Surg Br 1965;47(4):669-77.  https://doi.org/10.1302/0301-620X.47B4.669
  2. Konradsen L, Olesen S, Hansen HM. Ankle sensorimotor control and eversion strength after acute ankle inversion injuries. Am J Sports Med 1998;26(1):72-7.  https://doi.org/10.1177/03635465980260013001
  3. Richie DH Jr. Functional instability of the ankle and the role of neuromuscular control: a comprehensive review. J Foot Ankle Surg 2001;40(4):240-51.  https://doi.org/10.1016/S1067-2516(01)80025-9
  4. Ashton-Miller JA, Ottaviani RA, Hutchinson C, Wojtys EM. What best protects the inverted weightbearing ankle against further inversion? Evertor muscle strength compares favorably with shoe height, athletic tape, and three orthoses. Am J Sports Med 1996;24(6):800-9.  https://doi.org/10.1177/036354659602400616
  5. Klein P, Mattys S, Rooze M. Moment arm length variations of selected muscles acting on talocrural and subtalar joints during movement: an in vitro study. J Biomech 1996;29(1):21-30.  https://doi.org/10.1016/0021-9290(95)00025-9
  6. Mattacola CG, Dwyer MK. Rehabilitation of the ankle after acute sprain or chronic instability. J Athl Train 2002;37(4):413-29. 
  7. Muscolino JE. The muscular system manual: the skeletal muscles of the human body. 4th ed. Mosby; 2016. 
  8. Mendez-Rebolledo G, Guzman-Venegas R, Valencia O, Watanabe K. Contribution of the peroneus longus neuromuscular compartments to eversion and plantarflexion of the ankle. PLoS One 2021;16(4):e0250159. 
  9. Johnson CH, Christensen JC. Biomechanics of the first ray. Part I. The effects of peroneus longus function: a three-dimensional kinematic study on a cadaver model. J Foot Ankle Surg 1999;38(5):313-21.  https://doi.org/10.1016/S1067-2516(99)80002-7
  10. Otis JC, Deland JT, Lee S, Gordon J. Peroneus brevis is a more effective evertor than peroneus longus. Foot Ankle Int 2004;25(4):242-6.  https://doi.org/10.1177/107110070402500408
  11. Donnelly L, Donovan L, Hart JM, Hertel J. Eversion strength and surface electromyography measures with and without chronic ankle instability measured in 2 positions. Foot Ankle Int 2017;38(7):769-78.  https://doi.org/10.1177/1071100717701231
  12. Kernozek T, Durall CJ, Friske A, Mussallem M. Ankle bracing, plantar-flexion angle, and ankle muscle latencies during inversion stress in healthy participants. J Athl Train 2008;43(1):37-43.  https://doi.org/10.4085/1062-6050-43.1.37
  13. Keles SB, Sekir U, Gur H, Akova B. Eccentric/concentric training of ankle evertor and dorsiflexors in recreational athletes: muscle latency and strength. Scand J Med Sci Sports 2014;24(1):e29-38.  https://doi.org/10.1111/sms.12105
  14. Cram JR, Kasman GS, Holtz J. Introduction to surface electromyography. Aspen Publishers; 1998;xiv, 408. 
  15. Ahn SH, Kim HA, Kim JH, Kwak KT, Kwon OY. Ankle evertor strength of healthy subjects in different ankle and toe positions. Phys ther Korea 2019;26(3):84-90.  https://doi.org/10.12674/ptk.2019.26.3.084
  16. Ahn SH, Hwang UJ, Gwak GT, Yoo HI, Kwon OY. Comparison of the strength and electromyography of the evertor muscles with and without toe flexion in patients with chronic ankle instability. Foot Ankle Int 2020;41(4):479-85.  https://doi.org/10.1177/1071100719898464
  17. Wikstrom EA, Fournier KA, McKeon PO. Postural control differs between those with and without chronic ankle instability. Gait Posture 2010;32(1):82-6.  https://doi.org/10.1016/j.gaitpost.2010.03.015
  18. Webster CA, Nussbaum MA. Localized ankle fatigue development and fatigue perception in adults with or without chronic ankle instability. J Athl Train 2016;51(6):491-7.  https://doi.org/10.4085/1062-6050-51.9.02
  19. Gribble PA, Delahunt E, Bleakley C, Caulfield B, Docherty CL, Fourchet F, et al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the international ankle consortium. J Orthop Sports Phys Ther 2013;43(8):585-91.  https://doi.org/10.2519/jospt.2013.0303
  20. Ahn SH, Hwang UJ, Jung SH, Kim HA, Kim JH, Kwon OY. Hip external rotator strength and compensatory movement in three different positions. Health 2018;10(1):132-44.  https://doi.org/10.4236/health.2018.101011
  21. Kim HA, Hwang UJ, Jung SH, Ahn SH, Kim JH, Kwon OY. Comparison of shoulder strength in males with and without myofascial trigger points in the upper trapezius. Clin Biomech (Bristol, Avon) 2017;49:134-8.  https://doi.org/10.1016/j.clinbiomech.2017.09.001
  22. Kim YW, Kim TH, Yang MN, Yon YS, Lee JH. Comparison of activities of tibialis anterior, peroneus longus, and tibialis posterior muscles according to lunge squats and bulgarian split squats in a healthy population. J Msculoskelet Sci Technol 2017;1(1):26-30.  https://doi.org/10.29273/jkema.2017.1.1.26
  23. Feger MA, Donovan L, Hart JM, Hertel J. Lower extremity muscle activation during functional exercises in patients with and without chronic ankle instability. PM R 2014;6(7):602-11; quiz 611.  https://doi.org/10.1016/j.pmrj.2013.12.013
  24. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1(8476):307-10.  https://doi.org/10.1016/S0140-6736(86)90837-8
  25. Neumann DA. Kinesiology of the musculoskeletal system - ebook: foundations for rehabilitation. 3rd ed. Mosby; 2016. 
  26. Butler JE, Hudson AL, Gandevia SC. The neural control of human inspiratory muscles. Prog Brain Res 2014;209:295-308.  https://doi.org/10.1016/B978-0-444-63274-6.00015-1
  27. Nakazawa K, Kawakami Y, Fukunaga T, Yano H, Miyashita M. Differences in activation patterns in elbow flexor muscles during isometric, concentric and eccentric contractions. Eur J Appl Physiol Occup Physiol 1993;66(3):214-20.  https://doi.org/10.1007/BF00235096
  28. van Zuylen EJ, Gielen CC, Denier van der Gon JJ. Coordination and inhomogeneous activation of human arm muscles during isometric torques. J Neurophysiol 1988;60(5):1523-48.  https://doi.org/10.1152/jn.1988.60.5.1523
  29. Al-Himdani S, Talbot C, Kurdy N, Pillai A. Accessory muscles around the foot and ankle presenting as chronic undiagnosed pain. An illustrative case report and review of the literature. Foot (Edinb) 2013;23(4):154-61.  https://doi.org/10.1016/j.foot.2013.08.002
  30. Olewnik L, Podgorski M, Ruzik K, Polguj M, Topol M. New classification of the distal attachment of the fibularis brevis - anatomical variations and potential clinical implications. Foot Ankle Surg 2020;26(3):308-13.  https://doi.org/10.1016/j.fas.2019.04.002
  31. Andersen LL, Magnusson SP, Nielsen M, Haleem J, Poulsen K, Aagaard P. Neuromuscular activation in conventional therapeutic exercises and heavy resistance exercises: implications for rehabilitation. Phys Ther 2006;86(5):683-97.  https://doi.org/10.1093/ptj/86.5.683
  32. Bavdek R, Zdolsek A, Strojnik V, Dolenec A. Peroneal muscle activity during different types of walking. J Foot Ankle Res 2018;11:50. 
  33. Calhoun JH, Li F, Ledbetter BR, Viegas SF. A comprehensive study of pressure distribution in the ankle joint with inversion and eversion. Foot Ankle Int 1994;15(3):125-33.  https://doi.org/10.1177/107110079401500307
  34. Ayotte NW, Stetts DM, Keenan G, Greenway EH. Electromyographical analysis of selected lower extremity muscles during 5 unilateral weight-bearing exercises. J Orthop Sports Phys Ther 2007;37(2):48-55.  https://doi.org/10.2519/jospt.2007.2354
  35. Digiovine NM, Jobe FW, Pink M, Perry J. An electromyographic analysis of the upper extremity in pitching. J Shoulder Elbow Surg 1992;1(1):15-25.  https://doi.org/10.1016/S1058-2746(09)80011-6
  36. Cardillo T, Dresden S, Solem J. Crosstalk: surface versus intramuscular electrodes for the peroneus brevis and peroneus longus. Michigan, Grand Valley State University, Masters Thesis. 1998.