The effect of toe-tap exercise on abductor hallucis activity and medial longitudinal arch angle in individuals with pes planus

Abstract

BACKGROUND: Active interventions for pes planus, including short-foot exercises (SF) and toe-spread-out exercises (TSO), aim to continuously support the medial longitudinal arch (MLA) by activating the abductor hallucis (AbdH) muscle. However, compensatory movements, such as ankle supination and/or plantar flexion, often occur during these exercises. OBJECTIVE: To examine the effects of a novel exercise, i.e., the toe-tap (TT) exercise on AbdH activity and MLA angle. METHODS: A total of 16 participants with pes planus participated in this study. Participants performed SF, TSO, and TT exercises. Electromyographic activity of the AbdH and MLA angle during three AbdH contraction exercises were recorded using surface EMG system and digital image analysis program, respectively. The differences in outcome measures among the three exercises were analyzed using one-way repeated-measures analysis of variance. RESULTS: The EMG activity of the AbdH was significantly greater during the TT exercise compared to the SF and TSO exercises. The MLA angle was significantly smaller during the TT exercise compared with the SF and TSO exercises. CONCLUSIONS: These findings suggest that the TT exercise could be effective in activating the AbdH and increasing height of the MLA, as part of a sports rehabilitation program for individuals with pes planus.

Effect of Peroneus Longus Muscle Release on Abductor Hallucis Muscle Activity and Medial Longitudinal Arch before Toe-Tap Exercise in Participants with Flexible Pes Planus

“…To ensure optimum electrical conductivity prior to data collection, the skin resistance was reduced by attaching the skin area to the electrode, which was cleaned with alcohol. The surface EMG sensor on the abductor hallucis muscle was attached 1–2 cm below the rough surface of the navicular bone [ 23 ]. The peroneus longus muscle was attached to the top 75% point along the line connecting the fibular head and the lateral talus.…”

“…For the MVIC of the abductor hallucis muscle, the rater clasped the participants’ first toes on the medial and plantar sides, while the participants maintained a neutral heel position. The participant then performed maximum abduction of the first toe and plantar flexion against resistance [ 23 ]. To determine the MVIC of the peroneus longus muscle, the participants were asked to perch on a chair with a neutral ankle position.…”

“…The mean of the triplicate measurements was used in the analysis. The mean muscle activity for each intervention was quantified as %MVIC [ 23 ].…”

“…It plays a key role in elevating the medial longitudinal arch upon its contraction [ 17 , 18 , 19 , 20 , 21 ]. Hence, in numerous studies and clinical practice, exercises that strengthen the abductor hallucis muscle are performed to control the depression of the medial longitudinal arch [ 19 , 22 , 23 ]. The most widely used strengthening exercises in clinical practice are the short-foot, toe-curl, toe-spread, and toe-tap exercises.…”

“…The most widely used strengthening exercises in clinical practice are the short-foot, toe-curl, toe-spread, and toe-tap exercises. In a previous study comparing the abductor hallucis activity and the medial longitudinal arch angle during a strengthening exercise, significant improvements in the abductor hallucis activity and the medial longitudinal arch angle were obtained after the toe-tap exercise compared with those after the short-foot or toe-curl exercises [ 23 , 24 ]. The toe-tap exercise induces abduction and flexion of the first metatarsophalangeal joint, while the sole of the foot is resting on an inclined wooden board.…”