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Comparison of Foot Muscle Activity During Short Foot and Toe Spread-out Exercises in Different Weight Bearing Conditions in Individuals With Pes Planus

  • Hyun-ji Lee (Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Sae-hwa Kim (Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Seung-min Baik (Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Heon-seock Cynn (Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University)
  • Received : 2024.03.24
  • Accepted : 2024.04.03
  • Published : 2024.04.20

Abstract

Background: Individuals with pes planus tend to overuse the extrinsic foot muscles, such as the tibialis anterior (TA) and peroneus longus (PL), to compensate for the weakened intrinsic foot muscles, such as the abductor hallucis (AbdH). Furthermore, differences in weight-bearing can affect the activity of muscles in both the intrinsic and extrinsic foot muscles. To date, no study has compared the effects of the short foot exercise (SFE) and toe spread-out exercise (TSO) on intrinsic and extrinsic foot muscle activity and the corresponding ratios in different weight-bearing positions. Objects: To compare the effects of the SFE and TSO on AbdH, TA, and PL activity and the AbdH/TA and AbdH/PL activity ratios in the sitting and standing positions in individuals with pes planus. Methods: Twenty participants with pes planus were recruited. Surface electromyography was used to assess the amplitudes of AbdH, TA, and PL activity. Participants performed both exercises while adopting both the sitting and standing positions. Results: No significant interaction between exercise and position was found regarding the activity of any muscle or ratio of the activity, except for PL activity. We observed a significant increase in AbdH activity during the TSO compared to the SFE, and no significant difference in TA and PL activity between the two exercises. AbdH, TA, and PL activity were significantly higher in the standing position than in the sitting position. Furthermore, the AbdH/PL activity ratio significantly increased in the sitting position, although there was a significant increase in AbdH activity in the standing position. Conclusion: In individuals with pes planus, we recommend performing the TSO in the sitting position, which may increase the activity of the AbdH while concurrently decreasing the activity of the TA and PL, thus strengthening the AbdH.

Keywords

References

  1. Gooding TM, Feger MA, Hart JM, Hertel J. Intrinsic foot muscle activation during specific exercises: a T2 time magnetic resonance imaging study. J Athl Train 2016;51(8):644-50.  https://doi.org/10.4085/1062-6050-51.10.07
  2. Neumann DA. Kinesiology of the musculoskeletal system. 3rd ed. Elsevier; 2016. 
  3. Lynn SK, Padilla RA, Tsang KK. Differences in static- and dynamic-balance task performance after 4 weeks of intrinsic-foot-muscle training: the short-foot exercise versus the towelcurl exercise. J Sport Rehabil 2012;21(4):327-33.  https://doi.org/10.1123/jsr.21.4.327
  4. Lees A, Lake M, Klenerman L. Shock absorption during forefoot running and its relationship to medial longitudinal arch height. Foot Ankle Int 2005;26(12):1081-8.  https://doi.org/10.1177/107110070502601214
  5. Mann R, Inman VT. Phasic activity of intrinsic muscles of the foot. J Bone Joint Surg Am 1964;46:469-81.  https://doi.org/10.2106/00004623-196446030-00001
  6. Chen YC, Lou SZ, Huang CY, Su FC. Effects of foot orthoses on gait patterns of flat feet patients. Clin Biomech (Bristol, Avon) 2010;25(3):265-70.  https://doi.org/10.1016/j.clinbiomech.2009.11.007
  7. Lee JH, Cynn HS, Yoon TL, Choi SA, Kang TW. Differences in the angle of the medial longitudinal arch and muscle activity of the abductor hallucis and tibialis anterior during sitting short-foot exercises between subjects with pes planus and subjects with neutral foot. J Back Musculoskelet Rehabil 2016;29(4):809-15.  https://doi.org/10.3233/BMR-160693
  8. Yoon H, Kim J, Park J, Jeon H. Comparison of the foot muscle EMG and medial longitudinal arch angle during short foot exercises at different ankle position. Phys Ther Korea 2017;24(4):46-53.  https://doi.org/10.12674/ptk.2017.24.4.046
  9. Jung DY, Kim MH, Koh EK, Kwon OY, Cynn HS, Lee WH. A comparison in the muscle activity of the abductor hallucis and the medial longitudinal arch angle during toe curl and short foot exercises. Phys Ther Sport 2011;12(1):30-5.  https://doi.org/10.1016/j.ptsp.2010.08.001
  10. Headlee DL, Leonard JL, Hart JM, Ingersoll CD, Hertel J. Fatigue of the plantar intrinsic foot muscles increases navicular drop. J Electromyogr Kinesiol 2008;18(3):420-5.  https://doi.org/10.1016/j.jelekin.2006.11.004
  11. Kim JS, Moon DC. A comparison of selective muscle activity in the abductor hallucis between flat feet and normal feet during single mini-squat exercise. Isokinet Exerc Sci 2021;29(3):233-8.  https://doi.org/10.3233/IES-203202
  12. Lurati AR. Flat feet and a diagnosis of plantar fasciitis in a marine corps recruit. Workplace Health Saf 2015;63(4):136-8.  https://doi.org/10.1177/2165079915576923
  13. Kamiya T, Uchiyama E, Watanabe K, Suzuki D, Fujimiya M, Yamashita T. Dynamic effect of the tibialis posterior muscle on the arch of the foot during cyclic axial loading. Clin Biomech (Bristol, Avon) 2012;27(9):962-6.  https://doi.org/10.1016/j.clinbiomech.2012.06.006
  14. Jeon I, Kim K. Effect of the arch support on the strength of the abductor hallucis during the toe spread out exercise in standing position in individuals with pes planus. Phys Ther Korea 2020;27(3):206-11.  https://doi.org/10.12674/ptk.2020.27.3.206
  15. Barton CJ, Lack S, Hemmings S, Tufail S, Morrissey D. The 'best practice guide to conservative management of patellofemoral pain': incorporating level 1 evidence with expert clinical reasoning. Br J Sports Med 2015;49(14):923-34.  https://doi.org/10.1136/bjsports-2014-093637
  16. Kisacik P, Tunay VB, Bek N, Atay OA, Selfe J, Karaduman AA. Short foot exercises have additional effects on knee pain, foot biomechanics, and lower extremity muscle strength in patients with patellofemoral pain. J Back Musculoskelet Rehabil 2021;34(6):1093-104.  https://doi.org/10.3233/BMR-200255
  17. Noh H, Jung J, Lee S. Effect on squatting with short foot exercise on muscle activation and onset of contraction in the quadriceps femoris. Phys Ther Rehabil Sci 2021;10(3):367-73.  https://doi.org/10.14474/ptrs.2021.10.3.367
  18. Kim MH, Kwon OY, Kim SH, Jung DY. Comparison of muscle activities of abductor hallucis and adductor hallucis between the short foot and toe-spread-out exercises in subjects with mild hallux valgus. J Back Musculoskelet Rehabil 2013;26(2):163-8.  https://doi.org/10.3233/BMR-2012-00363
  19. Kim MH, Yi CH, Weon JH, Cynn HS, Jung DY, Kwon OY. Effect of toe-spread-out exercise on hallux valgus angle and cross-sectional area of abductor hallucis muscle in subjects with hallux valgus. J Phys Ther Sci 2015;27(4):1019-22.  https://doi.org/10.1589/jpts.27.1019
  20. Kang MH, Cha SM, Oh JS. The effect of toe-tap exercise on abductor hallucis activity and medial longitudinal arch angle in individuals with pes planus. Isokinet Exerc Sci 2020;28(4):415-22.  https://doi.org/10.3233/IES-202107
  21. Cote KP, Brunet ME, Gansneder BM, Shultz SJ. Effects of pronated and supinated foot postures on static and dynamic postural stability. J Athl Train 2005;40(1):41-6. 
  22. Choi JH, Cynn HS, Yi CH, Yoon TL, Baik SM. Effect of isometric hip abduction on foot and ankle muscle activity and medial longitudinal arch during short-foot exercise in individuals with pes planus. J Sport Rehabil 2020;30(3):368-74.  https://doi.org/10.1123/jsr.2019-0310
  23. Fiolkowski P, Brunt D, Bishop M, Woo R, Horodyski M. Intrinsic pedal musculature support of the medial longitudinal arch: an electromyography study. J Foot Ankle Surg 2003;42(6):327-33.  https://doi.org/10.1053/j.jfas.2003.10.003
  24. Criswell E. Cram's introduction to surface electromyography. Jones & Bartlett Publishers; 2011. 
  25. Vera-Garcia FJ, Moreside JM, McGill SM. MVC techniques to normalize trunk muscle EMG in healthy women. J Electromyogr Kinesiol 2010;20(1):10-6.  https://doi.org/10.1016/j.jelekin.2009.03.010
  26. Kendall FP, McCreary EK, Provance PG, Rodgers MM, Romani WA. Muscles: testing and function with posture and pain. 5th ed. Lippincott Williams & Wilkins; 2005. 
  27. Houtz SJ, Walsh FP. Electromyographic analysis of the functions of the muscles acting on the ankle during weightbearing with special reference to the triceps surae. J Bone Joint Surg Am 1959;41-A:1469-81.  https://doi.org/10.2106/00004623-195941080-00008
  28. Masani K, Sayenko DG, Vette AH. What triggers the continuous muscle activity during upright standing? Gait Posture 2013;37(1):72-7.  https://doi.org/10.1016/j.gaitpost.2012.06.006
  29. Bellew JW, Frilot CF, Busch SC, Lamothe TV, Ozane CJ. Facilitating activation of the peroneus longus: electromyographic analysis of exercises consistent with biomechanical function. J Strength Cond Res 2010;24(2):442-6.  https://doi.org/10.1519/JSC.0b013e3181c088bc
  30. Louwerens JW, van Linge B, de Klerk LW, Mulder PG, Snijders CJ. Peroneus longus and tibialis anterior muscle activity in the stance phase. A quantified electromyographic study of 10 controls and 25 patients with chronic ankle instability. Acta Orthop Scand 1995;66(6):517-23.  https://doi.org/10.3109/17453679509002306
  31. Day JT, Lichtwark GA, Cresswell AG. Tibialis anterior muscle fascicle dynamics adequately represent postural sway during standing balance. J Appl Physiol (1985) 2013;115(12):1742-50.  https://doi.org/10.1152/japplphysiol.00517.2013
  32. Peterka RJ. Sensorimotor integration in human postural control. J Neurophysiol 2002;88(3):1097-118. https://doi.org/10.1152/jn.2002.88.3.1097