Effect of plantar intrinsic muscle training on medial longitudinal arch morphology and dynamic funct

NewsBot · May 4, 2013

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Effect of plantar intrinsic muscle training on medial longitudinal arch morphology and dynamic function
Edward P. Mulligan, Patrick G. Cook
Manual Therapy; In Press

A specific training program emphasizing the neuromuscular recruitment of the plantar intrinsic foot muscles, colloquially referred to as “short foot” exercise (SFE) training, has been suggested as a means to dynamically support the medial longitudinal arch (MLA) during functional tasks. A single-group repeated measures pre- and post-intervention study design was utilized to determine if a 4-week intrinsic foot muscle training program would impact the amount of navicular drop (ND), increase the arch height index (AHI), improve performance during a unilateral functional reaching maneuver, or the qualitative assessment of the ability to hold the arch position in single limb stance position in an asymptomatic cohort. 21 asymptomatic subjects (42 feet) completed the 4-week SFE training program. Subject ND decreased by a mean of 1.8 mm at 4 weeks and 2.2 mm at 8 weeks (p < 0.05). AHI increased from 28 to 29% (p < 0.05). Intrinsic foot muscle performance during a static unilateral balancing activity improved from a grade of fair to good (p < 0.001) and subjects experienced a significant improvement during a functional balance and reach task in all directions with the exception of an anterior reach (p < 0.05). This study offers preliminary evidence to suggest that SFE training may have value in statically and dynamically supporting the MLA. Further research regarding the value of this exercise intervention in foot posture type or pathology specific patient populations is warranted.
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NewsBot · Feb 20, 2018

The effect of additional activation of the plantar intrinsic foot muscles on foot dynamics during gait
KazunoriOkamuraaShusakuKanaibMasakiHasegawabAkiraOtsukacSadaakiOkib
The Foot Volume 34, March 2018, Pages 1-5

What is already known
•The plantar intrinsic foot muscles contribute to the support of the medial longitudinal arch.
•The activities of the plantar intrinsic foot muscles increase with increasing gait velocity and ground reaction force.
•The relationship between the hypofunction of the plantar intrinsic foot muscles and plantar fasciitis has been suggested.
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What this study adds
•The additional activation of the plantar intrinsic foot muscles during gait caused a delay in the timing for the navicular height to reach the minimum value, and a reduction of the vertical ground reaction force (2nd peak).
•The plantar intrinsic foot muscles most likely contribute to shock absorption and facilitate efficient foot ground force transmission during gait.
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Background
The plantar intrinsic foot muscles (PIFMs) contribute to support the medial longitudinal arch. But the functional role of the PIFMs during dynamic activities is not clear. The purpose of this study was to examine the change in the foot dynamics during gait accompanied with the change in the PIFMs activity to determine the functional role of the PIFMs during gait.

Methods
Twenty healthy male subjects were randomly assigned to the electrical stimulation group (ESG) or control group (CG). In the ESG, the electrical stimulation to the PIFMs was provided from mid-stance to pre-swing using surface electrodes to simulate reinforcement of the PIFMs. The foot dynamics during the stance phase of gait was measured using a 3D motion analysis, and the amount of change from baseline (electrical stimulation was not provided) was compared between groups using an independent sample t-test.

Results
In the ESG, the timing for the navicular height to reach the minimum value was significantly later, and the vertical ground reaction force (2nd peak) significantly decreased more. There were no group differences in the amount of change from baseline on gait velocity, stance phase duration, minimum navicular height and ground reaction force in other directions.

Conclusion
Results from this study showed that the functions of the PIFMs most likely include shock absorption and facilitation of efficient foot ground force transmission during the stance phase of gait.
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NewsBot · Aug 10, 2023

EXERCISES AND NEUROMUSCULAR ELECTRIC STIMULATION FOR MEDIAL LONGITUDINAL ARCH: CLINICAL TRIAL
André Setti Persiane et al
Acta Ortop Bras. 2023 Jun 9;31(spe2)

Objective: The extrinsic muscles, such as the posterior tibialis and long flexor of the hallux and the intrinsic of the foot, are part of the active subsystem of the central system of the foot and play an essential role in the control of the medial longitudinal arch resulting from difficulty in contracting the muscle, neuromuscular electrostimulation (NMES) becomes a resource combined with strengthening and recommended for rehabilitation. T this work aims to evaluate the effectiveness of NMES associated with exercise in deforming the medial longitudinal arch.

Methods: This is a randomized blind clinical trial. 60 asymptomatic participants were divided into three groups: NMES, exercise and control. The NMES and exercise group performed seven exercises for the intrinsic and extrinsic muscles twice a week for 6 weeks, and the NMES group used an NMES associated with five exercises. Navicular height and medial longitudinal arch angle were taken before and after the intervention period.

Results: No statistically significant differences existed between groups for navicular height and medial longitudinal arch angle.

Conclusion: NMES associated with exercise does not change the characteristics of the medial longitudinal arch in association with asymptomatic
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NewsBot · Nov 9, 2023

Morphological and mechanical characteristics of the intrinsic and extrinsic foot muscles under loading in individuals with flat feet
Takumi Kobayashi et al
Gait & Posture; 4 November 2023

Background
The intrinsic and extrinsic soft-tissue structures that apply force and support the medial longitudinal arch (MLA) have been implicated in the development of flat feet. However, the relationship between the changes in MLA height under increasing load and the morphological and mechanical properties of individual intrinsic and extrinsic foot soft tissue structures is not fully understood.

Research question
To examine the morphological and mechanical characteristics of the soft tissue structures in flat feet when subjected to loading.

Methods
This study consisted of two studies focusing on the extrinsic foot muscles (10 normal feet/11 flat feet) and intrinsic foot muscles (14 normal feet/13 flat feet). Images of the extrinsic and intrinsic foot muscles and plantar fascia (PF) under 10, 50, and 90% body weight conditions were obtained using ultrasound-based shear-wave elastography.

Results
The cross-sectional area (CSA) of the peroneus brevis was larger in the flat-foot group than in the normal-foot group under all loading conditions. The CSAs of the intrinsic foot muscles (abductor hallucis, flexor digitorum brevis, and quadratus plantae) and thickness of the PF in the flat-foot group decreased significantly with increasing load. As for mechanical characteristics, the stiffness of the flexor digitorum longus and abductor hallucis was higher in the flat-foot group than in the normal group under high loading conditions. In addition, flat feet with greater flexibility tended to exhibit a greater decrease in PF thickness and smaller increase in stiffness.

Significance
Excessive stretching of the intrinsic foot muscles and PF occurs in flat feet, and excessive contraction of the flexor digitorum longus may counteract the excessive lowering of the foot arch. Therefore, it is necessary to promote the contraction of the intrinsic foot musculature in feet with greater flexibility of the MLA during loading.
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NewsBot · Dec 17, 2023

CHARACTERISTICS OF INTRINSIC FOOT MUSCULATURE IN INDIVIDUALS WITH ASYMPTOMATIC FLEXIBLE FLATFOOT AND THE EFFECT OF EXERCISE THERAPY A RANDOMIZED CONTROLLED TRIAL
Raf Dejonghe, Yani Van Den Bossche and Miquel Van Den Driessche
Source

Background: Flatfoot is a foot deformity that is common in the adult population. Flatfoot deformity encompasses a variety of pathologic etiologies in various lower extremity overuse injuries. The foot core, including the intrinsic foot muscles (IFM), plays an important role in normal foot function and lower extremity function. Therefore, training the IFM to avoid excessive pronation may help prevent some of these injuries and pathologies. However, the effects of IFM training are not clear. Study objectives: This study aims to investigate two study objectives. 1: Evaluate IFM function and strength in subjects with asymptomatic flatfoot and controls (neutral foot). 2: Evaluate the effect of IFM strengthening in subjects with asymptomatic flatfoot. Study design: Randomized controlled trial Methods: Participants were asked to come to the laboratory for initial testing. On the basis of the results of the first two tests: Foot Posture Index (FPI) and navicular drop test (NDT), they were assigned to the study group (asymptomatic flatfoot group) or the control group. After this allocation, the following tests were performed: 1. The Lower Quarter Y-Balance Test (YBT-LQ) to evaluate dynamic balance; 2. Handheld dynamometry (HHD) to measure the toe flexor strength; 3. Thickness and cross-sectional area (CSA) measurements of IFM by the use of ultrasound. Participants randomized to the intervention-study group performed two exercises, the short foot exercise (SFE) and extend toes, daily over a period of six weeks. After the intervention period of six weeks, all participants of the intervention-study group and the control-study group were asked to return for subsequent testing. Results: At baseline, the control group had a significantly higher toe flexor strength (HHD) and M. Quadratus plantae (QP) thickness compared to the study group. For toe flexor strength (HHD) between baseline and week six in the intervention-study group, a significant difference was found. In the control-study group there was a significant difference for the thickness of the M. Flexor halluces brevis (FHB) between baseline and week six. No significant differences were found for YBT-LQ, HHD, thickness and CSA of the IFM between intervention-study group and control-study group at week six. Conclusion: This study provides some evidence for both study objectives. There is still a low level of evidence, so more research with larger study populations and longer time of intervention is needed in the future.
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NewsBot · Apr 16, 2024

The impact of intrinsic foot muscle strengthening exercises in asymptomatic athletes with normal foot structure: A systematic review
Maha Ahmed et al
Clinical Epidemiology and Global Health; Volume 27, May–June 2024, 101597

Highlights
•Intrinsic Foot Muscle (IFM) exercises improve foot strength and morphology in athletes, supporting injury prevention.
•All the studies showed an improvement in IFM strength.
•The clinician assessed motor performance and morphological assessments showed considerable improvements.
•Improved vertical running propulsive forces were reported, though the running economy showed no changes.
•Findings suggest that IFM exercises may be incorporated in sports rehabilitation.
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Purpose
The intrinsic foot muscles (IFM) are crucial to the passive, active, and neurological subsystems that compose the foot core, and their weakness may predispose to various foot pathologies, systemic diseases and musculoskeletal conditions. Strengthening of IFM is an effective intervention in clinical conditions, but its role in sports and clinical rehabilitation is still inconclusive. Thus, this review aims to evaluate the effects of IFM strengthening exercises in athletes with normal feet.

Methods
An electronic database search was conducted using Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science (WoS), Scopus, MEDLINE, PubMed, and the Physiotherapy Evidence Database (PEDro). The Cochrane risk of bias tool was used for assessing bias in the included studies.

Results
Four studies were included for qualitative review. The meta-analysis was not possible due to the heterogeneity of measuring units of outcome measures in the included studies. All the studies showed an improvement in intrinsic foot muscle strength, though the training protocols used by them were only roughly equivalent. One study reported no significant differences in MLA stiffness after 8 weeks of intervention. The clinician assessed motor performance and morphological assessments showed considerable improvements. Improved vertical running propulsive forces were reported, though the running economy showed no changes.

Conclusion
Findings suggest that IFM exercises effectively improve outcomes such as foot morphology and function, strength, running mechanics and subjective function in athletes and may be incorporated in sports rehabilitation. These conclusions should be considered with caution due to bias in included studies.
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