• The Journal of Korean Physical Therapy
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• v.31 no.4
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• pp.222-227
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• 2019

Purpose: This study examined the influence of longitudinal arch on the strength and muscle activity of the abductor hallucis in the standing position in subjects with and without navicular drop signs. Methods: A sample of 34 subjects with and without navicular drop signs between 22 and 28 years of age were enrolled in this study. The strength and muscle activity of the abductor hallucis was measured using a tensiometer. The Smart KEMA System and electromyography device was used on the subjects with and without navicular drop signs. Two groups were classified using the navicular drop test to identify the longitudinal arch of the foot. The strength of the abductor hallucis was evaluated in standing, both with and without an external arch support condition. The two-way mixed ANOVA was used. The level of statistical significance was set to ${\alpha}=0.05$. Results: The strength and muscle activity of the abductor hallucis in standing was significantly higher with external arch support than that without the external arch support in the group with navicular drop signs. There was no significant difference in the abductor hallucis strength and muscle activity with and without external arch support in the subjects without navicular drop signs. Conclusions: The strength and muscle activity of the abductor hallucis in standing can be influenced by the external arch support in the group with navicular drop signs. The strength measurement of the abductor hallucis in standing should be separately performed in conditions with and without longitudinal arch of foot.

• The Journal of Korean Physical Therapy
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• v.26 no.2
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• pp.56-61
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• 2014

Purpose: The aim of this study was to investigate relationship between the angle of the first metatarsophalangeal joint (1st MPJ) and the dimensions of the abductor hallucis; dorso-plantar (DP) thickness, medio-lateral (ML) width, and cross-sectional area (CSA), in subjects with and without hallux valgus. Methods: Sixty feet, mean (SD) age of 22.5 (2.1) years old, were included in this study (hallux valgus = 30; control = 30). An X-ray device was used for measurement of the angle of the 1st MPJ, and an ultrasound system was used for determination of mean (SD) DP thickness, ML width, and CSA of the abductor hallucis muscle in each foot from three trials. Results: The results showed the DP thickness, ML width, and CSA of the abductor hallucis did not differ significantly between subjects with and without hallux valgus. In addition, the correlations between the angle of the 1st MPJ and DP thickness, ML width, and CSA of the abductor hallucis showed poor correlation (Pearson r=-0.09, -0.20, and -0.18, respectively). Conclusion: Based on these findings, we speculate that morphological changes to the abductor hallucis muscle cannot be representative of the angle of the 1st MPJ, and also cannot be used in differentiation between subjects with and without hallux valgus.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.2
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• pp.121-128
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• 2020

PURPOSE: This study examined the changes in the cross-sectional area (CSA) of the abductor hallucis muscle during various ankle positions while performing toespread-out (TSO) exercise. METHODS: Thirty subjects with an average age of 22.1 years were recruited for this study. All subjects were firstly measured for the angle of their first metatarsophalangeal joint using a goniometer. Those with angles greater than 15° were allocated to the HV group. The remaining subjects were placed in the normal group. The CSA of the abductor hallucis was measured by ultrasound in the resting position with no movement and three ankle positions: neutral (0°), plantarflexion (30°), and dorsiflexion (30°). All data were analyzed using a two-way mixed analysis of variance between the groups (normal and HV group) and within the groups (resting, neutral, plantarflexion, and dorsiflexion) to determine the group x position interaction effects. RESULTS: During TSO exercise in the normal group, the CSA of the abductor hallucis was significantly greater in both the plantarflexion and neutral positions compared to the resting position (p_adj < .01), and plantarflexion was significantly greater than the dorsiflexion position (p_adj < .01). During the TSO exercise in the HV group, the CSA of the abductor hallucis for plantarflexion was significantly greater than it was for the resting, neutral, and dorsiflexion positions (p_adj < .01). CONCLUSION: Based on the above results, the TSO exercise in plantarflexion is an effective rehabilitation exercise for subjects with HV.

• Physical Therapy Korea
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• v.23 no.3
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• pp.21-28
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• 2016

Background: The toe-spread-out (TSO) exercise has been introduced as a strengthening exercise for the abductor hallucis muscle in subjects with hallux valgus. Visual biofeedback using ultrasound imaging during exercise, may increase the ability to selectively contract the abductor hallucis muscle, compared with exercise alone. Objects: The aim of this study was to investigate the effects of ultrasound imaging visual feedback during the TSO exercise with respect to its influence on the angle of the first metatarsophalangeal joint (1st MPJ) and the cross-sectional area (CSA) of the abductor hallucis muscle in subjects with hallux valgus. Methods: Twenty-five healthy young subjects with a mean average age of 22.5 years, and a standard deviation of 2.3 years, were recruited for this study. Hallux valgus was defined as an angles greater than $15^{\circ}$ angle of 1st MPJ. Goniometric measurement was used to determine the angle of 1st MPJ. In addition, an ultrasound system was used to collect the CSA of the abductor hallucis muscle in each foot. The angle of the 1st MPJ and CSA of the abductor hallucis were measured in three positions; the resting position, during TSO exercise, and during TSO exercise in conjunction with real-time ultrasound imaging feedback. All data analyzed using a repeated analysis of variance with Bonferroni correction in order to compare the dependent variables in all three positions. Statistical level of significance was set up as p<.05. Results: The angle of the 1st MPJ was noted to be significantly reduced and the CSA of the abductor hallucis to be significantly greater during TSO exercise used in conjunction with ultrasound imaging visual feedback, compared to when the values were recorded during TSO exercise alone (p<.05). Conclusion: Based on these findings, it can be concluded that the application of ultrasound imaging visual feedback during TSO exercise is more effective in contracting selectively the abductor hallucis than the use of exercise alone.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.1
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• pp.25-31
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• 2023

Background: In this study, the abductor hallucis activity and medial longitudinal arch angle were compared by performing four exercises, namely the short foot exercise, the short foot exercise with 2^nd~5^th toe extension, the short foot exercise with 2^nd~5^th toe extension with a load of 1kt on the sole, and the short foot exercise with 2^nd~5^th toe extension with a load of 2kg on the sole. Methods: Four short foot exercises as described above were performed by 20 healthy adult males and females. The abductor hallucis activity and medial longitudinal arch angle were measured and analyzed by surface electromyography and the Kinovea software program. Results: The short foot exercise with 2^nd~5^th toe extension, short foot exercise with 2^nd~5^th toe extension with a load of 1kg on the sole, and the short foot exercise with 2^nd~5^th toe extension with a load of 2kg on the sole showed significantly higher abductor hallucis activity than the short foot exercise alone. Among these, the short foot exercise with the 2^nd~5^th toe extension was the most effective. All exercises showed a significantly decreased medial longitudinal arch angle post-exercise than pre-exercise, and the short foot exercise with the 2^nd~5^th toe extension showed a significantly decreased medial longitudinal arch angle compared to the other three exercises. Conclusion: It is believed that the short foot exercise with the 2^nd~5^th toe extension can be proposed as an effective exercise that can replace the short foot exercise alone.

• PNF and Movement
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• v.18 no.1
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• pp.97-106
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• 2020

Purpose: This study aimed to determine the most effective way to facilitate the abductor hallucis muscle during PNF leg pattern-emphasized hallux abduction. Methods: The study recruited 18 healthy adults. All participants agreed voluntarily to take part in the study following an explanations of its purpose and procedures. They randomly performed the PNF leg pattern-emphasized hallux abduction variations in a hook-lying or sitting position. Activation of the abductor hallucis (AbH), adductor hallucis (AdH), extensor hallucis longus (EHL), and tibialis anterior (TA) muscles, and the ratio of AbH/AdH, were measured during PNF exercises using electromyography. One-way repeated ANOVA was used to compare the activation of foot intrinsic and extrinsic muscles during the four PNF exercises. Results: PNF leg pattern-emphasized hallux abduction using normal timing was significantly higher in TA compared to PNF leg pattern-emphasized hallux abduction using timing for emphasis, regardless of the starting position. The PNF leg pattern-emphasized hallux abduction using timing for emphasis in the hook-lying position was significantly higher in AbH than in other exercises. Although there was no statistically significant difference in the ratio of AbH/AdH, it was higher in the hook-lying position. Conclusion: PNF leg pattern-emphasized hallux abduction using timing for emphasis in the hook-lying position can be recommended as a method to optimize the activation of AbH and the ratio of AbH/AdH.

• The Journal of Korean Physical Therapy
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• v.28 no.2
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• pp.119-123
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• 2016

Purpose: The purpose of this study was to determine the intra- and inter-rater reliability of muscle thickness (MT) measurements of the abductor hallucis (AbdH) in subjects with hallux valgus (HV), using ultrasonography performed at different inward pressures of approximately 0.5 kg, 1.0 kg, 1.5 kg, and 2.0 kg, with no pressure control. Methods: Thirty-two subjects with HV were recruited. The thicknesses of both sides of the AbdH were measured randomly by two different examiners for assessment of the intra- and inter-rater reliability. The measurement values were analyzed using the intra-class correlation coefficient (ICC) with a 95% confidence interval (CI). ICC (2,1) was used to determine the inter-rater reliability of MT measurements of the AbdH, while ICC (3,1) was used to assess the intra-rater reliability. Results: The results showed higher ICC values for intra-rater reliability compared to inter-rater reliability, and the value for inter-rater reliability with no pressure control (ICC=0.74 [95%CI=0.53-0.87]) was smaller compared to pressures of 0.5 kg, 1.0 kg, 1.5 kg, and 2.0 kg. Other inward pressures for intra- and inter-rater reliability also showed excellent values (ICC=0.86-0.96). Conclusion: The findings showed that maintaining consistent inward pressure is essential for reliable results in measurement of the MT of the AbdH by different examiners in a clinical setting.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.2
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• pp.43-50
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• 2017

Purpose : There is no validated method for measuring the toe flexor strength that can isolate the intrinsic muscles of the foot from the extrinsic muscles. This study compared the hallux flexion force (HFF) and muscle activity in the foot and ankle according to ankle position [plantarflexion (PF), neutral, and dorsiflexion (DF)]. Method : The study enrolled 17 subjects. In the sitting position, the HFF and activities of the abductor hallucis (AbdH), tibialis anterior (TA), and gastrocnemius (GCM) muscles were measured using a digital dynamometer and a wireless electromyography system, respectively. Subjects were instructed to flex the great toe maximally in three different ankle positions. Three 5-second trials were performed to measure the HFF and muscle activities in each condition. Repeated-measures ANOVA was used to compare the variables and paired t-tests with the Bonferroni correction were used for post-hoc pair-wise comparisons. The significance level was set at .016. Result : The HFF in DF was significantly greater than in any other ankle position (p<.01). The TA activity was greatest in ankle DF and that of the GCM was greatest in PF (both p<.01). However, there was no significant difference in AbdH activity according to ankle position. Conclusion : These results suggest that selective strength measurement of the foot intrinsic muscles in HFF should be performed with the ankle in the neutral position.

• Physical Therapy Korea
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• v.16 no.2
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• pp.9-15
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• 2009

The purposes of this study were to compare abductor hallucis (AbdH) muscle activity during toe curl exercise according to position of interphalangeal joint (IPJ). Fifteen healthy subjects with neutral foot were recruit for this study. All subjects performed toe curl exercise with towel while maintaining the IPJ in flexion (condition 1) and extension (condition 2). Toe curl exercise with towel was perform three trials for five second periods in each condition. Surface electromyography (EMG) activities were recorded from three muscles (AbdH, tibialis anterior, peroneous longus) in each condition. EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). The EMG activities acoording to position of IPJ were compared using a paired t-test. This study showed that the EMG activity of AbdH during toe curl exercise with IPJ extension significantly increased compared to those during toe curl exercise with IPJ flexion (p<.05). However, the EMG activity of tibialis anterior and peroneus longus were not significantly different between the conditions (p>.05). These results suggest that toe curl exercise with towel must be performed with extension of IPJ in order to strengthen intrinsic muscle in subjects with overuse injuries related to excessive pronation.

• PNF and Movement
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• v.20 no.3
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• pp.409-416
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• 2022

Purpose: This study compared and analyzed the contractility of the abductor hallucis (AbdH), an intrinsic foot muscle, between flat feet and normal feet during a movement control test (single-leg small knee band test) using ultrasonography. Methods: A total of 23 subjects with (n = 11) and without (n = 12) flatfoot were included in the study. Each subject performed the short foot exercises (SFE) with a single-leg small knee bend (SLSKB) test, which is a functional movement. An ultrasound device was used to collect data regarding the changes in the contractility of the AbdH. Results: Intergroup comparison showed that dorsoplantar thickness was significantly reduced at baseline and during the SFE with SLSKB in the flatfoot group (p < 0.05). Intragroup comparison showed that the cross-sectional area significantly improved when the SFE was performed with SLSKB in the control group (p < 0.05). Conclusion: In this study, it was observed that the AbdH had inadequate contractility during the SLSKB test in subjects with flatfoot; therefore, it is important to train the contraction of the AbdH via functional movements during clinical interventions for subjects with flatfoot.