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Weakness of the intrinsic foot muscles is thought to produce deformity, disability and pain. Assessing intrinsic foot muscles in isolation is a challenge; however ultrasound might provide a solution. The aims of this study were to assess the reproducibility of assessing the size of abductor halluces (AbH) and the medial belly of flexor hallucis brevis (FHBM) muscles, and identify their relationship with toe strength, foot morphology and balance.
Twenty one participants aged 26–64 years were measured on two occasions for muscle cross-sectional area using a Siemens Acuson X300 Ultrasound System with 5-13 MHz linear array transducer. Great toe flexor strength was measured by pedobarography, the paper grip test and hand-held dynamometry. Foot morphology was assessed by foot length, truncated foot length, Foot Posture Index (FPI) and dorsal arch height. Balance was measured by the maximal step test. Intra-class correlation coefficients (ICC3,1) were used to evaluate intra-rater reliability. Pearson’s correlation coefficients were performed to assess associations between muscle size and strength, morphology and balance measures. To account for the influence of physical body size, partial correlations were also performed controlling for truncated foot length.
Intra-rater reliability was excellent for AbH (ICC3,1 = 0.97) and FHBM (ICC3,1 = 0.96). Significant associations were found between cross-sectional area of AbH and great toe flexion force measured standing by pedobarography (r = .623, p = .003),), arch height measured sitting (r = .597, p = .004) and standing (r = .590, p = .005), foot length (r = .582, p = 006), truncated foot length (r = .580, p = .006), balance (r = .443, p = .044), weight (r = .662, p = .001), height (r = .559, p = .008), and BMI (r = .502, p = .020). Significant associations were found between cross-sectional area of FHBM and FPI (r = .544, p = .011), truncated foot length (r = .483, p = .027) and foot length (r = .451, p = .040). Significant partial associations were found between AbH and great toe flexion force in standing by pedobarography (r = .562, p = .012) and FHBM and the FPI (r = .631, p = .003).
Measuring the cross-sectional area of AbH and FHBM with ultrasound is reproducible. Measures of strength, morphology and balance appear to relate more to the size of AbH than FHBM. After controlling for physical body size, cross-sectional area of AbH remained a significant correlate of great toe flexor strength and might be a useful biomarker to measure early therapeutic response to exercise.
Chang R, Kent-Braun JA, Hamill J. Use of MRI for volume estimation of tibialis posterior and plantar intrinsic foot muscles in healthy and chronic plantar fasciitis limbs. Clin Biomech. 2012;27:500–5. CrossRef
Sullivan J, Burns J, Adams R, Pappas E, Crosbie J. Musculoskeletal and activity-related factors associated with plantar heel pain. Foot Ankle Int. 2015;36:37–45.
Menz HB, Morris ME, Lord SR. Foot and ankle risk factors for falls in older people: a prospective study. J Gerontol Ser A Biol Med Sci. 2006;61:866–70. CrossRef
Mickle KJ, Munro B, Lord S, Menz H, Steele J. ISB clinical biomechanics award 2009: toe weakness and deformity increase the risk of falls in older people. Clin Biomech. 2009;24:787–91. CrossRef
Yue SW. Influence of the abductor hallucis muscle on the medial arch of the foot: a kinematic and anatomical cadaver study. Foot Ankle Int. 2007;28:617–20. CrossRef
Kelly LA, Kuitunen S, Racinais S, Cresswell AG. Recruitment of the plantar intrinsic foot muscles with increasing postural demand. Clin Biomech. 2012;27:46–51. CrossRef
de Win MM, Theuvenet WJ, Roche PW, de Bie RA, van Mameren H. The paper grip test for screening on intrinsic muscle paralysis in the foot of leprosy patients. Int J Lepr Other Mycobact Dis. 2002;70:16–24. PubMed
Visser M, Goodpaster BH, Kritchevsky SB, Newman AB, Nevitt M, Rubin SM, Simonsick EM, Harris TB. Study ft HA: muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci. 2005;60:324–33. CrossRefPubMed
Mickle K, Nester C, Crofts G, Steele J. Reliability of ultrasound to measure morphology of the toe flexor muscles. J Foot Ankle Res. 2012;5:1–2. CrossRef
Mijnarends DM, Meijers JMM, Halfens RJG, Ter Borg S, Luiking YC, Verlaan S, Schoberer D, Cruz Jentoft AJ, Van Loon LJC, Schols JMGA. Validity and reliability of tools to measure muscle mass, strength, and physical performance in community-dwelling older people: a systematic review. J Am Med Dir Assoc. 2013;14:170–8. CrossRefPubMed
Crofts G, Angin S, Mickle KJ, Hill S, Nester CJ. Reliability of ultrasound for measurement of selected foot structures. Gait Posture. 2014;39:35–9.
Verhulst FV, Leeuwesteijn AEEPM, Louwerens JW, Geurts ACH, van Alfen N, Pillen S. Quantitative ultrasound of lower leg and foot muscles: feasibility and reference values. J Foot Ankle Surg. 2011;17:145–9.
Aiyer A, Stewart S, Rome K. The effect of age on muscle characteristics of the abductor hallucis in people with hallux valgus: a cross-sectional observational study. J Foot Ankle Res. 2015;8
Mickle KJ, Caputi P, Potter JM, Steele JR. Efficacy of a progressive resistance exercise program to increase toe flexor strength in older people. Clin Biomech. 2016;40:14–9. CrossRef
Menz H, Morris M, Lord S. Foot and ankle characteristics associated with impaired balance and functional ability in older people. J Gerontol A Biol Sci Med Sci. 2005;60A:1546–52. CrossRef
Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR. Cross-sectional analysis of foot function, functional ability, and health-related quality of life in older people with disabling foot pain. Arthritis Care Res (Hoboken). 2011;63:1592–8. CrossRef
Mickle K, Chambers S, Steele J, Munro B. A novel and reliable method to measure toe flexor strength. Clin Biomech. 2008;23:683.
Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the foot posture index. Clin Biomech. 2006;21:89–98. CrossRef
McPoil TG, Cornwall MW, Medoff L, Vicenzino B, Forsberg K, Hilz D. Arch height change during sit-to-stand: an alternative for the navicular drop test. J Foot Ankle Res. 2008;1
McPoil TG, Cornwall MW, Vicenzino B, Teyhen DS, Molloy JM, Christie DS, Collins N. Effect of using truncated versus total foot length to calculate the arch height ratio. Foot (Edinb). 2008;18:220–7. CrossRef
Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960;20:37–46. CrossRef
McHugh ML. Interrater reliability: the kappa statistic. Biochem Med. 2012;22:276. CrossRef
Kelikian AS, Sarrafian SK, Sarrafian SK, Ovid Technologies I. Sarrafian’s anatomy of the foot and ankle: descriptive, topographical, functional. 3rd ed. Philadelphia: LWW; 2011.
Williams DS, McClay IS. Measurements used to characterize the foot and the medial longitudinal arch: reliability and validity. Phys Ther. 2000;80:864–71. PubMed
Mickle KJ, Angin S, Crofts G, Nester CJ. Effects of age on strength and morphology of toe flexor muscles. J Orthop Sports Phys Ther. 2016:1–30.
Lobo CC, Marin AG, Sanz DR, Lopez DL, Lopez PP, Morales CR, Corbalan IS. Ultrasound evaluation of intrinsic plantar muscles and fascia in hallux valgus A case-control study. Medicine. 2016;95:Se5243. CrossRef
Cheung R, Sze L, Mok N, Ng G. Intrinsic foot muscle volume in runners with and without chronic bilateral plantar fasciitis. Physiotherapy. 2015;101:e238. CrossRef
Cheung RTH, Sze LKY, Mok NW, GYF N. Intrinsic foot muscle volume in experienced runners with and without chronic plantar fasciitis. J Sci Med Sport. 2016;19:713–15
Kanehisa H, Ikegawa S, Fukunaga T. Comparison of muscle cross-sectional area and strength between untrained women and men. Eur J Appl Physiol. 1994;68:148–54. CrossRef
Battaglia PJ, Mattox R, Winchester B, Kettner NW. Non–weight-bearing and weight-bearing ultrasonography of select foot muscles in young, asymptomatic participants: a descriptive and reliability study. J Manip Physiol Ther. 2016;39:655–61. CrossRef
Nilwik R, Snijders T, Leenders M, Groen BBL, van Kranenburg J, Verdijk LB, Van Loon LJC. The decline in skeletal muscle mass with aging is mainly attributed to a reduction in type II muscle fiber size. Exp Gerontol. 2013;48:492–8.
Green SM, Briggs PJ. Flexion strength of the toes in the normal foot. An evaluation using magnetic resonance imaging. Foot (Edinb). 2013;23:115-9.
- Reliability and correlates of cross-sectional area of abductor hallucis and the medial belly of the flexor hallucis brevis measured by ultrasound
Penelope J. Latey
Elizabeth J. Nightingale
Jillian L. Clarke
Claire E. Hiller
- BioMed Central