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Phys. Ther. Korea 2024; 31(2): 114-122
Published online August 20, 2024
https://doi.org/10.12674/ptk.2024.31.2.114
© Korean Research Society of Physical Therapy
Joint Position Effects on Biceps Femoris and Peroneal Muscle Activation and Ankle Evertor Strength
Do-eun Lee1,2 
, PT, BPT, Jun-hee Kim2 , PT, PhD, Seung-yoon Han1,2 , PT, BPT, Oh-yun Kwon2,3 , PT, PhD
1Department of Physical Therapy, The Graduate School, Yonsei University, 2Kinetic Ergocise Based on Movement Analysis Laboratory, 3Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea
Correspondence to: Oh-yun Kwon
E-mail: kwonoy@yonsei.ac.kr
https://orcid.org/0000-0002-9699-768X
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.
Background: The peroneus longus (PL) and peroneus brevis (PB) function as the primary muscles of eversion, a movement closely associated with tibial external rotation for ankle mortise stability. Ankle motion and tibial rotation vary based on different ankle and knee positions. Objects: This study aimed to investigate the PL, PB, and biceps femoris (BF) muscle activation and eversion strength during side-lying isometric eversion exercise based on different ankle positions (neutral [N] and plantarflexion [PF]) and knee positions (90° flexion [KF] and extension [KE]).
Methods: Thirty healthy adults with an Ankle Joint Functional Assessment Tool score of ≥ 22 were recruited (mean age = 24.8 ± 3.1 years). Maximal isometric eversion strength and submaximal muscle activation of the PL, PB and BF were measured during isometric eversion exercise in side-lying. A 2 × 2 repeated measures analysis of variance was performed to investigate differences in muscle activation and strength.
Results: The PL and PB muscle activation showed significant main effects with the knee and ankle positions (p < 0.05); activation was greater in the KE and PF positions than in the KF and N positions. The BF muscle activation showed a significant interaction effect with knee and ankle positions, which was greater in knee extension and ankle plantarflexed (KEPF) position than in knee flexion and ankle plantarflexed (KFPF) position (p < 0.05). Eversion strength showed a significant main effect only in ankle position (p < 0.05) and was greater in the N position than in the PF position.
Conclusion: The results of this study indicate that the KEPF position can be recommended to facilitate contraction of the PL and PB during side-lying eversion exercise. Furthermore, the effects of the knee-ankle positions should be considered for measuring ankle eversion strength and implementing the isometric submaximal side-lying eversion exercise.
Keywords: Ankle joint, Electromyography, Isometric contraction, Peroneus longus, Subtalar joint
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Original Article
Phys. Ther. Korea 2024; 31(2): 114-122
Published online August 20, 2024 https://doi.org/10.12674/ptk.2024.31.2.114
Copyright © Korean Research Society of Physical Therapy.
Joint Position Effects on Biceps Femoris and Peroneal Muscle Activation and Ankle Evertor Strength
Do-eun Lee1,2 , PT, BPT, Jun-hee Kim2 , PT, PhD, Seung-yoon Han1,2 , PT, BPT, Oh-yun Kwon2,3 , PT, PhD
1Department of Physical Therapy, The Graduate School, Yonsei University, 2Kinetic Ergocise Based on Movement Analysis Laboratory, 3Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea
Correspondence to:Oh-yun Kwon
E-mail: kwonoy@yonsei.ac.kr
https://orcid.org/0000-0002-9699-768X
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: The peroneus longus (PL) and peroneus brevis (PB) function as the primary muscles of eversion, a movement closely associated with tibial external rotation for ankle mortise stability. Ankle motion and tibial rotation vary based on different ankle and knee positions. Objects: This study aimed to investigate the PL, PB, and biceps femoris (BF) muscle activation and eversion strength during side-lying isometric eversion exercise based on different ankle positions (neutral [N] and plantarflexion [PF]) and knee positions (90° flexion [KF] and extension [KE]).
Methods: Thirty healthy adults with an Ankle Joint Functional Assessment Tool score of ≥ 22 were recruited (mean age = 24.8 ± 3.1 years). Maximal isometric eversion strength and submaximal muscle activation of the PL, PB and BF were measured during isometric eversion exercise in side-lying. A 2 × 2 repeated measures analysis of variance was performed to investigate differences in muscle activation and strength.
Results: The PL and PB muscle activation showed significant main effects with the knee and ankle positions (p < 0.05); activation was greater in the KE and PF positions than in the KF and N positions. The BF muscle activation showed a significant interaction effect with knee and ankle positions, which was greater in knee extension and ankle plantarflexed (KEPF) position than in knee flexion and ankle plantarflexed (KFPF) position (p < 0.05). Eversion strength showed a significant main effect only in ankle position (p < 0.05) and was greater in the N position than in the PF position.
Conclusion: The results of this study indicate that the KEPF position can be recommended to facilitate contraction of the PL and PB during side-lying eversion exercise. Furthermore, the effects of the knee-ankle positions should be considered for measuring ankle eversion strength and implementing the isometric submaximal side-lying eversion exercise.
Keywords: Ankle joint, Electromyography, Isometric contraction, Peroneus longus, Subtalar joint
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Table 1 . Main and interaction effects according to knee and ankle positions.
Variable Main effect: knee position Main effect: ankle position Interaction effect: knee × ankle F(1,29) p-value F(1,29) p-value F(1,29) p-value PL 5.627 0.025* 0.163 78.001 <0.05* 0.729 1.967 0.171 0.064 PB 7.501 0.010* 0.205 29.708 <0.05* 0.506 1.559 0.222 0.051 BF 5.304 0.029* 0.155 43.973 <0.05* 0.603 12.914 0.001* 0.308 Maximal evertor strength 0.946 0.339 0.032 66.886 <0.05* 0.698 0.235 0.632 0.008 PL, peroneus longus; PB, peroneus brevis; BF, biceps femoris. *p < 0.05..
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Table 2 . Muscle activation and maximal evertor strength during four types of ankle eversion exercise.
Variable KFN KFPF KEN KEPF PL 30.7 ± 14.8 49.4 ± 22.8 34.9 ± 20.6 59.1 ± 23.6 PB 41.0 ± 15.8 52.2 ± 16.1 46.0 ± 14.7 61.4 ± 17.1 BF 17.5 ± 10.2 23.0 ± 11.9 20.0 ± 16.4 33.0 ± 23.4 Maximal evertor strength 19.0 ± 7.32 12.6 ± 3.9 18.1 ± 7.0 12.2 ± 5.0 Values are presented as mean ± standard deviation. KFN, knee flexion and ankle neutral; KFPF, knee flexion and ankle plantarflexed; KEN, knee extension and ankle neutral; KEPF, knee extension and ankle plantarflexed; PL, peroneus longus; PB, peroneus brevis; BF, biceps femoris..