Hallux valgus and the intrinsic muscles

NewsBot · Nov 10, 2016

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Ultrasound evaluation of intrinsic plantar muscles and fascia in hallux valgus: A case-control study.
Lobo CC et al
Medicine (Baltimore). 2016 Nov;95(45):e5243.

A cross-sectional area (CSA) and thickness reduction of the abductor hallucis (AbH) is shown in subjects with hallux valgus (HV). To date, other soft-tissue structures have not been researched in relation with HV. The aim of this study was to compare the CSA and thickness of the intrinsic plantar muscles and fascia (PF) between feet with and without HV. Therefore, a cross-sectional and case-control study was performed using B-mode with an iU22 Philips ultrasound system and a 5 to 17-MHz transducer. The CSA and thickness were measured for the AbH, flexor digitorum brevis (FDB) and flexor hallucis brevis (FHB), and also the thickness for the anterior, middle, and posterior PF portions. A convenience sample of 40 feet, 20 with HV and 20 without HV, was recruited from a clinical and research center. A multivariate regression analysis using linear regression was performed to evaluate the ultrasound imaging measurements (α = 0.05). Consequently, statistically significant differences were observed between the groups (P < 0.05) for the AbH and FHB thickness, and CSA reduction, and also the plantar fascia thickness increase in favor of the HV group. On the contrary, the FDB thickness and CSA did not show statistically significant differences (P ≥ 0.05). In conclusion, the CSA and thickness of the AbH and FHB intrinsic plantar muscles are reduced, whereas the thickness of the anterior, middle, and posterior PF portions are increased, in subjects with HV compared with those without HV.
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Admin2 · Nov 10, 2016

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Other threads tagged with intrinsic muscles

NewsBot · Apr 9, 2019

Mechanical properties and morphologic features of intrinsic foot muscles and plantar fascia in individuals with hallux valgus
SerkanTaşaAlpÇetinb
Acta Orthopaedica et Traumatologica Turcica; 5 April 2019

Background
The aim of the present study was to investigate the morphologic features and mechanical properties of plantar fascia (PF), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), and abductor hallucis (AbH) muscles in individuals with halluks valgus (HV) and to compare the results with individuals without HV.

Methods
A total of 30 participants (27 female, 3 male) between the ages of 19–58 years with HV deformity and 30 individuals without HV (27 female, 3 male) between the ages of 20–58 years were included in the study. AbH, PF, FHB, and FDB thickness, cross-sectional area and stiffness were measured with an ultrasonography device. For stiffness measurements, Shear Wave Velocity (SWV) of the assessed soft tissues was calculated using a customized software program.

Results
Mean and standard deviation of SWV of PF, AbH, FHB, FDB, and thickness of PF, AbH, FHB, FDB, and cross-sectional area of AbH, FHB, FDB in individuals with HV were 7.6 ± 1.0 m/sec, 2.8 ± 0.3 m/sec, 2.6 ± 0.4 m/sec, and 3.4 ± 0.2 m/sec, 3.3 ± 0.5 mm, 11.4 ± 2.2 mm, 16.5 ± 1.9 mm, 8.9 ± 1.8 mm, 2.4 ± 0.5 cm2, 2.7 ± 0.5 cm2, 1.9 ± 0.6 cm2, respectively. Mean and standard deviation of SWV of PF, AbH, FHB, FDB and thickness of PF, AbH, FHB, FDB, and cross-sectional area of AbH, FHB, FDB in controls groups were 7.6 ± 1.2 m/sec, 2.3 ± 0.3 m/sec, 2.3 ± 0.4 m/sec, and 3.4 ± 0.4 m/sec, 3.3 ± 0.5 mm, 9.7 ± 2.1 mm, 14.5 ± 1.4 mm, 9.7 ± 1.2 mm, 2.1 ± 0.3 cm2, 2.3 ± 0.4 cm2, 2.1 ± 0.4 cm2, respectively. Individuals with HV had lower AbH and FHB thickness, cross-sectional area and SWV, however FDB thickness and cross-sectional area were higher in individuals with HV compared to that of individuals without HV (p < 0.05). PF thickness (p = 0.273), SWV of PF (p = 0.979) and FDB (p = 0.295) were similar in both groups.

Conclusion
Our results suggest that individuals with HV had lower AbH and FHB stiffness, however PF and FDB stiffness were similar in HV and control group. In addition, AbH and FHB thickness and cross-sectional area were lower in individuals with HV; however, FDB thickness and cross-sectional area were higher in individuals with HV compared to that of individuals without HV.
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NewsBot · Jun 22, 2020

The functional capacity and morphological characteristics of the intrinsic foot muscles in subjects with Hallux Valgus deformity: A systematic review
NasrinMoulodiaFatemehAzadiniaacIsmailEbrahimi TakamjanibcRashaAtlasidMaryamJalaliaMohammadKamalie
The Foot; 15 June 2020, 101706

Highlights
•The evidence is available on the functional capacity and morphological characteristics of the intrinsic foot muscles in subjects with HV deformity.
•There is association between intrinsic foot muscle weakness and HV deformity.
•Subjects with HV deformity have different intrinsic foot muscle performances compared to subjects without deformity.
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Background
The intrinsic foot muscles are vital for maintaining normal foot function. This study was conducted to systematically review the literature on the functional capacity and morphological characteristics of the intrinsic foot muscles in subjects with Hallux Valgus (HV) deformity.

Methods
A search was carried out in electronic databases, including Pub Med, Scopus, Embase and Web of Science, for identifying any relevant studies published from 1990 to October 2018.

Results
Three studies had investigated intrinsic foot muscle size using ultrasound imaging; two had reported electromyography parameters and four had measured the muscle force capacity. The results of the present review suggested that the functional capacity and morphological characteristics of intrinsic foot muscles are different in subjects with HV compared to those without this deformity.

Conclusion
This review found scientific evidence on muscle performance impairment in the abductor hallucis and flexor hallucis brevis in subjects with HV deformity.
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NewsBot · Jun 22, 2020

Related Thread:
Abductor hallucis muscle in hallux valgus

NewsBot · Aug 3, 2022

Positional and Dimensional Relation of Tendons
Around the First Metatarsal Bone with Hallux Valgus
Zeliha Kurtoğlu Olgunus et al
Research Square

It was aimed to reveal whether the positions and dimensions of the extrinsic and intrinsic muscle tendons
related to the hallux around the first metatarsal bone are affected by the severity of hallux valgus (HV)
and whether tendon positional changes and tendon sizes affect each other.
In formalin-fixed 46 feet, three HV angle subgroups (normal, mild and moderate/severe ) were defined.
Width, thickness and cross sectional area (CSA) of tendons of the extensor hallucis longus (EHL) and
brevis (EHB), abductor hallucis (AH) and flexor hallucis longus (FHL) were measured. On the clock model
created in coronal plane, positional variations of each tendon were indicated. In the moderate-severe HV
group, thickness and CSA of the EHB, width and CSA of the AH were smaller, compared to mild HV. Width
and CSA of the FHL were smaller in moderate/severe HV than in the normal. Regardless of HV, the width
and CSA of the FHL was greater in cases where the FHL located more lateral, and the width of both FHL
and AT were greater in cases where AH located more plantar.
The smaller tendon size of two intrinsic (one plantar and one dorsal) and one extrinsic muscle in the
moderate/severe HV group indicates that the changes reflected in the tendons are more pronounced in
the case of high HV severity, and the changes are not limited to the tendons on just one side of the foot.
The possible biomechanical effects of AH, FHL and EHB tendon dimensional weakness may be
important when planning surgery for moderate/severe HV cases.
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NewsBot · Jan 17, 2023

Positional and dimensional relation of tendons around the first metatarsal bone with hallux valgus
Zeliha Kurtoğlu Olgunus et al
Surg Radiol Anat. 2022 Dec 29

Purpose: It was aimed to reveal whether the positions and dimensions of the extrinsic and intrinsic muscle tendons related to the hallux around the first metatarsal bone are affected by the severity of hallux valgus (HV) and whether tendon positional changes and tendon sizes affect each other.

Methods: In formalin-fixed 46 feet, three HV angle subgroups (normal, mild, and moderate/severe) were defined. Width, thickness, and cross-sectional area (CSA) of tendons of the extensor hallucis longus (EHL) and brevis (EHB), abductor hallucis (AH), and flexor hallucis longus (FHL) were measured. On the clock model created in coronal plane, positional variations of each tendon were determined.

Results: In the moderate/severe HV group, thickness and CSA of the EHB, width and CSA of the AH were smaller, compared to mild HV. Width and CSA of the FHL were smaller in moderate/severe HV than in the normal. Regardless of HV, the width and CSA of the FHL were greater in cases where the FHL was located more lateral, and the width of both FHL and AT were greater in cases where AH located was more plantar.

Conclusion: The smaller tendon size of two intrinsic (one plantar and one dorsal) and one extrinsic muscle in the moderate/severe HV group indicates that changes in the tendons are evident in cases of high severity of HV but not in cases of mild HV. Accordingly, the changes do not appear to be due to a factor limited to only one aspect of the foot. It is recommended to consider the possible biomechanical effects of AH, FHL, and EHB tendon dimensional weakness in surgical planning in moderate/severe HV cases.
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NewsBot · Sep 15, 2023

Comparison of abductor hallucis muscle activity in subjects with mild hallux valgus during three different foot exercises
Byeong-Hun Hwang , In-Cheol Jeon
J Back Musculoskelet Rehabil. 2023 Aug 14

Background: Normal alignment of the foot is important because the feet support the body's weight. The intrinsic muscles of the foot mainly maintain the alignment and movement of the foot, whereas the abductor hallucis (AbdH) aligns the first metatarsophalangeal joint and maintains the medial longitudinal arch.

Objective: This study was conducted to investigate the muscle activity of the AbdH and hallux valgus (HV) angle during three different foot exercises.

Methods: Participants included 15 subjects aged 20-24 years with mild HV. All subjects performed three different foot exercises in random order: short foot exercise (SF), toe spread out exercise (TSO), and TSO with a pressure bio-feedback unit (TSOP). The muscle activity of the AbdH and the HV angle were measured during each foot exercise using surface electromyography and X-ray and then compared using one-way repeated-measures analysis of variance, followed by Bonferroni adjustment.

Results: AbdH muscle activity differed significantly among SF, TSO, and TSOP. AbdH muscle activity was greater in TSOP (89.60%) than in SF (19.99%) and TSO (60.96%) (p= 0.006). The HV angle was significantly smaller in TSOP (15.72∘) than in SF (18.85∘) and TSO (16.81∘) (p= 0.001).

Conclusions: TSOP can be recommended as an effective AbdH strengthening exercise in subjects with mild HV
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NewsBot · Feb 28, 2024

Additional effect of neuromuscular electrical stimulation in a conservative intervention on morphology and strength of abductor hallucis muscle and correction of hallux valgus deformity: a randomized controlled trial
Nasrin Moulodi , PhD,Javad Sarrafzadeh , PhD,Fatemeh Azadinia , PhD,Ali Shakourirad , MD &Maryam Jalali , PhD
Physiotherapy Theory and Practice

Background
In hallux valgus, morphological changes and functional weakness of intrinsic foot muscles occur, especially in the abductor hallucis muscle.

Objectives
This study aimed to investigate how a conservative treatment with the addition of neuromuscular electrical stimulation affects the volume and strength of the muscle, the correction of deformity, passive range of motion, pain, and disability.

Methods
Twenty-eight female participants (48 feet) were randomly assigned to two groups. The interventions included orthoses and exercise (Ortho) in both groups. One group received additional neuromuscular electrical stimulation of abductor hallucis muscle to activate it. Each group received the treatments for one month and was assessed two times, at baseline before starting and after one month of treatment. Mixed within-between ANOVA, analysis of covariance, and nonparametric tests were used for data analysis.

Results
The muscle volume, abduction strength, goniometric angle, and passive hallux dorsi/plantar flexion showed significant changes in both groups (p < .001). Subscales of the foot and ankle ability questionnaire, significantly changed (p ≤ .05). Pain decreased significantly in the two groups (p < .001 and p = .02). Intermetatarsal angle did not significantly differ between the two groups (p = .86, partial eta effect size = 0.001). But, the hallux valgus angle mean (on MRI) in the Ortho group was less than that of the orthoNMES group (p = .007, partial eta effect size = 0.15).

Conclusion
Both groups showed nearly identical treatment effects in the primary volume and hallux valgus correction outcome measures. In this study, adding neuromuscular electrical stimulation did not have an additional effect compared to conservative in the treatment of hallux valgus.
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