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Phys. Ther. Korea 2024; 31(1): 63-71

Published online April 20, 2024

https://doi.org/10.12674/ptk.2024.31.1.63

© Korean Research Society of Physical Therapy

Comparison of Foot Muscle Activity During Short Foot and Toe Spread-out Exercises in Different Weight Bearing Conditions in Individuals With Pes Planus

Hyun-ji Lee1,2 , PT, BPT, Sae-hwa Kim1,3 , PT, BPT, Seung-min Baik1 , PT, PhD, Heon-seock Cynn1 , PT, PhD

1Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, 2Samsung Medical Center, 3The Catholic University of Korea Eunpyeong St. Mary's Hospital, Seoul, Korea

Correspondence to: Heon-seock Cynn
E-mail: cynn@yonsei.ac.kr
https://orcid.org/0000-0002-5810-2371

Received: March 24, 2024; Accepted: April 3, 2024

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Background: Individuals with pes planus tend to overuse the extrinsic foot muscles, such as the tibialis anterior (TA) and peroneus longus (PL), to compensate for the weakened intrinsic foot muscles, such as the abductor hallucis (AbdH). Furthermore, differences in weight-bearing can affect the activity of muscles in both the intrinsic and extrinsic foot muscles. To date, no study has compared the effects of the short foot exercise (SFE) and toe spread-out exercise (TSO) on intrinsic and extrinsic foot muscle activity and the corresponding ratios in different weight-bearing positions.
Objects: To compare the effects of the SFE and TSO on AbdH, TA, and PL activity and the AbdH/TA and AbdH/PL activity ratios in the sitting and standing positions in individuals with pes planus.
Methods: Twenty participants with pes planus were recruited. Surface electromyography was used to assess the amplitudes of AbdH, TA, and PL activity. Participants performed both exercises while adopting both the sitting and standing positions.
Results: No significant interaction between exercise and position was found regarding the activity of any muscle or ratio of the activity, except for PL activity. We observed a significant increase in AbdH activity during the TSO compared to the SFE, and no significant difference in TA and PL activity between the two exercises. AbdH, TA, and PL activity were significantly higher in the standing position than in the sitting position. Furthermore, the AbdH/PL activity ratio significantly increased in the sitting position, although there was a significant increase in AbdH activity in the standing position.
Conclusion: In individuals with pes planus, we recommend performing the TSO in the sitting position, which may increase the activity of the AbdH while concurrently decreasing the activity of the TA and PL, thus strengthening the AbdH.

Keywords: Abductor hallucis, Pes planus, Surface electromyography, Weight bearing

Article

Original Article

Phys. Ther. Korea 2024; 31(1): 63-71

Published online April 20, 2024 https://doi.org/10.12674/ptk.2024.31.1.63

Copyright © Korean Research Society of Physical Therapy.

Comparison of Foot Muscle Activity During Short Foot and Toe Spread-out Exercises in Different Weight Bearing Conditions in Individuals With Pes Planus

Hyun-ji Lee1,2 , PT, BPT, Sae-hwa Kim1,3 , PT, BPT, Seung-min Baik1 , PT, PhD, Heon-seock Cynn1 , PT, PhD

1Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, 2Samsung Medical Center, 3The Catholic University of Korea Eunpyeong St. Mary's Hospital, Seoul, Korea

Correspondence to:Heon-seock Cynn
E-mail: cynn@yonsei.ac.kr
https://orcid.org/0000-0002-5810-2371

Received: March 24, 2024; Accepted: April 3, 2024

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Individuals with pes planus tend to overuse the extrinsic foot muscles, such as the tibialis anterior (TA) and peroneus longus (PL), to compensate for the weakened intrinsic foot muscles, such as the abductor hallucis (AbdH). Furthermore, differences in weight-bearing can affect the activity of muscles in both the intrinsic and extrinsic foot muscles. To date, no study has compared the effects of the short foot exercise (SFE) and toe spread-out exercise (TSO) on intrinsic and extrinsic foot muscle activity and the corresponding ratios in different weight-bearing positions.
Objects: To compare the effects of the SFE and TSO on AbdH, TA, and PL activity and the AbdH/TA and AbdH/PL activity ratios in the sitting and standing positions in individuals with pes planus.
Methods: Twenty participants with pes planus were recruited. Surface electromyography was used to assess the amplitudes of AbdH, TA, and PL activity. Participants performed both exercises while adopting both the sitting and standing positions.
Results: No significant interaction between exercise and position was found regarding the activity of any muscle or ratio of the activity, except for PL activity. We observed a significant increase in AbdH activity during the TSO compared to the SFE, and no significant difference in TA and PL activity between the two exercises. AbdH, TA, and PL activity were significantly higher in the standing position than in the sitting position. Furthermore, the AbdH/PL activity ratio significantly increased in the sitting position, although there was a significant increase in AbdH activity in the standing position.
Conclusion: In individuals with pes planus, we recommend performing the TSO in the sitting position, which may increase the activity of the AbdH while concurrently decreasing the activity of the TA and PL, thus strengthening the AbdH.

Keywords: Abductor hallucis, Pes planus, Surface electromyography, Weight bearing

Fig 1.

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Figure 1.(A) SFE-SIT and (B) SFE-STA. SFE, short foot exercise; SIT, in the sitting position; STA, in the standing position.
Physical Therapy Korea 2024; 31: 63-71https://doi.org/10.12674/ptk.2024.31.1.63

Fig 2.

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Figure 2.(A) TSO-SIT and (B) TSO-STA. TSO, toe spread-out exercise; SIT, in the sitting position; STA, in the standing position.
Physical Therapy Korea 2024; 31: 63-71https://doi.org/10.12674/ptk.2024.31.1.63

Fig 3.

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Figure 3.Comparison of AbdH activity during (A) the SFE and TSO and (B) in the sitting and standing positions. %MVIC, percentage of the mean maximal voluntary isometric contraction; AbdH, abductor hallucis; SFE, short foot exercise; TSO, toe spread-out exercise. *p < 0.05, significant difference in main effect.
Physical Therapy Korea 2024; 31: 63-71https://doi.org/10.12674/ptk.2024.31.1.63

Fig 4.

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Figure 4.(A) Comparison of TA activity in the sitting and standing positions. (B) Comparison of PL activity during the four conditions (SFE-SIT, SFE-STA, TSO-SIT, and TSO-STA). %MVIC, percentage of the mean maximal voluntary isometric contraction; TA, tibialis anterior; PL, peroneus longus; SFE, short foot exercise; TSO, toe spread-out exercise; SIT, in the sitting position; STA, in the standing position. *p < 0.05, significant difference in main effect. **p < 0.01, significant difference in simple effect.
Physical Therapy Korea 2024; 31: 63-71https://doi.org/10.12674/ptk.2024.31.1.63

Fig 5.

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Figure 5.Comparison of the AbdH/PL activity ratio in the sitting and standing positions. AbdH, abductor hallucis; PL, peroneus longus. *p < 0.05, significant difference in main effect.
Physical Therapy Korea 2024; 31: 63-71https://doi.org/10.12674/ptk.2024.31.1.63