Comparison of the Muscle Activity Ratio of Tibialis Anterior and Extensor Digitorum Longus in Subjects with the Normal Toe and the Hammer Toe during the Active Ankle Dorsiflexion

발목관절의 능동적 배측굴곡 시 정상과 망치 발가락 대상자의 전경골근과 장지신근의 근 활성도 비의 비교

  • Koh, Eun-Kyung (Department of Physical Therapy, Masan College) ;
  • Jung, Do-Young (Department of Physical Therapy, Jungbu University) ;
  • Kim, Tae-Ho (Department of Physical Therapy, Daegu Health College)
  • 고은경 (마산대학 물리치료과) ;
  • 정도영 (중부대학교 물리치료학과) ;
  • 김태호 (대구보건대학 물리치료과)
  • Received : 2011.02.05
  • Accepted : 2011.02.19
  • Published : 2011.02.28

Abstract

Purpose : The purposes of this study were to compare the muscle activity ratio of tibialis anterior (TA) / extensor digitorum longus (EDL) during the active ankle dorsiflexion in subjects with the normal toe (NT) and the hammer toe (HT). Methods : Nineteen subjects with the NT group and nineteen subjects with the HT group were recruited for this study. The muscle activities of TA and EDL were measured by using surface electromyography (EMG) and the angles of ankle dorsiflexion and eversion of the subtalar joint were measured by using 3-dementional motion analysis during the active ankle dorsiflexion in prone position. Results : The muscle activity ratio of TA / EDL was significantly lower in the HT group compared to the NT group (p<.05). The angle of ankle dorsiflexion was significantly lower in the HT group compared to the NT group (p<.05). Conclusions : These results suggest that muscle imbalance between TA and EDL muscle and decreased ankle dorsiflexion range of motion may contribute to hammer toe deformity. Further studies are needed to confirm that the correcting of this imbalance and the increasing ankle dorsiflexion could improve toe alignment in the subjects with HT.

Keywords

References

  1. Bhatia D, Myerson MS, Curtis MJ et al. Anatomical restraints to dislocation of the second metatarsophalangeal joint and assessment of a repair technique. J Bone Joint Surg Am. 1994;76(9):1371-5. https://doi.org/10.2106/00004623-199409000-00012
  2. Boulton AJ. The diabetic foot. Med Clin North Am. 1988;72(6):1513-30. https://doi.org/10.1016/S0025-7125(16)30719-2
  3. Coughlin MJ. Mallet toes, hammer toes, claw toes, and corns. Causes and treatment of lesser-toe deformities. Postgrad Med. 1984;75(5):191-8.
  4. Coughlin MJ, Dorris J, Polk E. Operative repair of the fixed hammer toe deformity. Foot Ankle Int. 2000;21(2):94-104.
  5. Dhukaram V, Hossain S, Sampath J et al. Correction of hammer toe with an extended release of the metatarsophalangeal joint. J Bone Joint Surg Br. 2002;84(7):986-90. https://doi.org/10.1302/0301-620X.84B7.12811
  6. Greenman RL, Khaodhiar L, Lima C et al. Foot small muscle atrophy is present before the detection of clinical neuropathy. Diabetes Care. 2005;28(6):1425-30. https://doi.org/10.2337/diacare.28.6.1425
  7. Hansen ST. Functional reconstruction of the foot and ankle. Philadephia. Lippincott Williams & Wilkins. 2000.
  8. Kendall FP, McCreary EK, Provance PG. Muscles: Testing and Function. 4th ed. Philadephia. Lippincott Williams & Wilkins. 1993.
  9. Kwon OY, Tuttle LJ, Johnson JE et al. Muscle imbalance and reduced ankle joint motion in people with hammer toe deformity. Clin Biomech (Bristol, Avon). 2009;24(8):670-5. https://doi.org/10.1016/j.clinbiomech.2009.05.010
  10. Mueller MJ, Hastings M, Commean PK et al. Forefoot structural predictors of plantar pressures during walking in people with diabetes and peripheral neuropathy. J Biomech. 2003;36(7): 1009-17. https://doi.org/10.1016/S0021-9290(03)00078-2
  11. Parrish TF. Dynamic correction of clawtoes. Orthop Clin North Am. 1973;4(1):97-102.
  12. Perry J. Gait analysis: Normal and pathological function. SLACK: Thorofare; 1992.
  13. Reynard F, Deriaz O, Bergeau J. Foot varus in stroke patients: muscular activity of extensor digitorum longus during the swing phase of gait. Foot (Edinb). 2009;19(2):69-74. https://doi.org/10.1016/j.foot.2008.11.012
  14. Scheck M.. Etiology of acquired hammertoe deformity. Clin Orthop Relat Res. 1977;(123):63-9.
  15. Sharmann SA. Diagnosis and treatment of movement impairment syndrome. Mosby. St. Louis. 2002.
  16. Tollafild DR, Merriman LM. Assessment of the lower limb. In: Merriman LM, Tollafild DR. Assessment of the locomotor system. Churchill Livingstone. 1995.