Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
권호 표지
DOI QR코드

DOI QR Code

The Effects of Ultrasound Imaging Visual Feedback During Toe-Spread-Out Exercise in Subjects With Hallux Valgus

엄지발가락가쪽휨증의 발가락벌리기 운동 시 초음파 영상을 이용한 시각적 피드백의 효과

  • Kang, Sun-young (Company-affiliated Research Institute, Korea Industry Development Institute) ;
  • Choung, Sung-dae (Dept. of Physical Therapy, Division of Health Science, Baekseok University) ;
  • Shim, Jae-hoon (Dept. of Physical Therapy, Division of Health Science, Baekseok University)
  • 강선영 (한국산업진흥원 기업부설연구소) ;
  • 정성대 (백석대학교 보건학부 물리치료학과) ;
  • 심재훈 (백석대학교 보건학부 물리치료학과)
  • Received : 2016.07.17
  • Accepted : 2016.08.18
  • Published : 2016.09.17
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The toe-spread-out (TSO) exercise has been introduced as a strengthening exercise for the abductor hallucis muscle in subjects with hallux valgus. Visual biofeedback using ultrasound imaging during exercise, may increase the ability to selectively contract the abductor hallucis muscle, compared with exercise alone. Objects: The aim of this study was to investigate the effects of ultrasound imaging visual feedback during the TSO exercise with respect to its influence on the angle of the first metatarsophalangeal joint (1st MPJ) and the cross-sectional area (CSA) of the abductor hallucis muscle in subjects with hallux valgus. Methods: Twenty-five healthy young subjects with a mean average age of 22.5 years, and a standard deviation of 2.3 years, were recruited for this study. Hallux valgus was defined as an angles greater than $15^{\circ}$ angle of 1st MPJ. Goniometric measurement was used to determine the angle of 1st MPJ. In addition, an ultrasound system was used to collect the CSA of the abductor hallucis muscle in each foot. The angle of the 1st MPJ and CSA of the abductor hallucis were measured in three positions; the resting position, during TSO exercise, and during TSO exercise in conjunction with real-time ultrasound imaging feedback. All data analyzed using a repeated analysis of variance with Bonferroni correction in order to compare the dependent variables in all three positions. Statistical level of significance was set up as p<.05. Results: The angle of the 1st MPJ was noted to be significantly reduced and the CSA of the abductor hallucis to be significantly greater during TSO exercise used in conjunction with ultrasound imaging visual feedback, compared to when the values were recorded during TSO exercise alone (p<.05). Conclusion: Based on these findings, it can be concluded that the application of ultrasound imaging visual feedback during TSO exercise is more effective in contracting selectively the abductor hallucis than the use of exercise alone.

Keywords

References

  1. Arinci Incel N, Genc H, Erdem HR, et al. Muscle imbalance in hallux valgus: An electromyographic study. Am J Phys Rehabil. 2003;82(5): 345-349.
  2. Bayar B, Erel S, SIMSEK IE, et al. The effects of taping and foot exercises on patients with hallux valgus: a preliminary study. Turk J Med Sci. 2011;41(3):403-409.
  3. Bemben MG. Use of diagnostic ultrasound for assessing muscle size. J Strength Cond Res. 2002;16(1):103-108.
  4. Brenner E. Insertion of the abductor hallucis muscle in feet with and without hallux valgus. Anat Rec. 1999;254(3):429-434. https://doi.org/10.1002/(SICI)1097-0185(19990301)254:3<429::AID-AR14>3.0.CO;2-5
  5. Cameron AF, Rome K, Hing WA. Ultrasound evaluation of the abductor hallucis muscle: Reliability study. J Foot Ankle Res. 2008;1(1):12. http://dx.doi.org/10.1186/1757-1146-1-12
  6. Choung SD, Kang SY, Kim MH, et al. Reliability and validity of the goniometer for hallux valgus angle measurement. Phys Ther Korea. 2013;20(2): 46-51. http://dx.doi.org/10.12674/ptk.2013.20.2.046
  7. Cong Y, Cheung JT, Leung AK, et al. Effect of heel height on in-shoe localized triaxial stresses. J Biomech. 2011;44(12):2267-2272. http://dx.doi.org/10.1016/j.jbiomech.2011.05.036
  8. Coughlin MJ. Hallux valgus. J Bone Joint Surg Am. 1996;78(6):932-966. https://doi.org/10.2106/00004623-199606000-00018
  9. Coughlin MJ, Jones CP. Hallux valgus: Demographics, etiology, and radiographic assessment. Foot Ankle Int. 2007;28(7):759-777. https://doi.org/10.3113/FAI.2007.0759
  10. Fiolkowski P, Brunt D, Bishop M, et al. Intrinsic pedal musculature support of the medial longitudinal arch: An electromyography study. J Foot Ankle Surg. 2003;42(6):327-333. https://doi.org/10.1053/j.jfas.2003.10.003
  11. Groiso JA. Juvenile hallux valgus. A conservative approach to treatment. J Bone Joint Surg Am. 1992;74(9):1367-1374. https://doi.org/10.2106/00004623-199274090-00010
  12. Henry SM, Westervelt KC. The use of real-time ultrasound feedback in teaching abdominal hollowing exercises to healthy subjects. J Orthop Sports Phys Ther. 2005;35(6):338-345. https://doi.org/10.2519/jospt.2005.35.6.338
  13. Heo HJ, Koo YM, Yoo WG. Comparison of selective activation of the abductor hallucis during various exercises. J Phys Ther Sci. 2011;23(6): 915-918. https://doi.org/10.1589/jpts.23.915
  14. Hodges PW. Ultrasound imaging in rehabilitation: Just a fad? J Orthop Sports Phys Ther. 2005;35(6):333-337. https://doi.org/10.2519/jospt.2005.0106
  15. Kang SY, Choung SD, Kim MH. Relationship between angle of metatarsophalangeal joint and abductor hallucis in hallux valgus. J Korean Soc Phys Ther. 2014;26:56-61.
  16. Kim MH, Koh EK, Jung DY. Analysis of kinematic motions of first metatarsophalangeal joint during electrical stimulation of abductor hallucis muscle in subjects with hallux valgus. J Korean Soc Phys Ther. 2012;24(4):276-281.
  17. Kim MH, Kwon OY, Kim SH, et al. Comparison of muscle activities of abductor hallucis and adductor hallucis between the short foot and toe-spread-out exercises in subjects with mild hallux valgus. J Back Musculoskelet Rehabil. 2013;26(2):163-168. https://doi.org/10.3233/BMR-2012-00363
  18. Kim MH, Yi CH, Weon JH, et al. Effect of toe-spread-out exercise on hallux valgus angle and cross-sectional area of abductor hallucis muscle in subjects with hallux valgus. J Phys Ther Sci. 2015;27(4):1019-1022. http://dx.doi.org/10.1589/jpts.27.1019
  19. Lieber RL. Skeletal Muscle Structure, Function, and Plasticity: The physiological basis of rehabilitation. 3rd ed. Baltimore, Lippincott Williams & Wilkins, 2010:203-206.
  20. McKiernan S, Chiarelli P, Warren-Forward H. A survey of diagnostic ultrasound within the physiotherapy profession for the design of future training tools. Radiography. 2011;17(2):121-125. https://doi.org/10.1016/j.radi.2010.08.003
  21. Mitsiopoulos N, Baumgartner RN, Heymsfield SB, et al. Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol (1985). 1998;85(1):115-122. https://doi.org/10.1152/jappl.1998.85.1.115
  22. Munuera PV, Dominguez G, Reina M, et al. Bipartite hallucal sesamoid bones: Relationship with hallux valgus and metatarsal index. Skeletal Radiol. 2007;36(11):1043-1050. https://doi.org/10.1007/s00256-007-0359-6
  23. Potter CL, Cairns MC, Stokes M. Use of ultrasound imaging by physiotherapists: A pilot study to survey use, skills and training. Man Ther. 2012;17(1):39-46. https://doi.org/10.1016/j.math.2011.08.005
  24. Sahrmann S. Diagnosis and Treatment of Movement Impairment Syndromes. 1st ed. St. Louis, Mosby, 2002:16.
  25. Severinsen K, Andersen H. Evaluation of atrophy of foot muscles in diabetic neuropathy-a comparative study of nerve conduction studies and ultrasonography. Clin Neurophysiol. 2007;118(10): 2172-2175. https://doi.org/10.1016/j.clinph.2007.06.019
  26. Shimazaki K, Takebe K. Investigations on the origin of hallux valgus by electromyographic analysis. Kobe J Med Sci. 1981;27(4):139-158.
  27. Smith BW, Coughlin MJ. The first metatarsocuneiform joint, hypermobility, and hallux valgus: What does it all mean? Foot Ankle Surg. 2008;14(3):138-141. http://dx.doi.org/10.1016/j.fas.2008.05.006
  28. Stewart S, Ellis R, Heath M, et al. Ultrasonic evaluation of the abductor hallucis muscle in hallux valgus: a cross-sectional observational study. BMC Musculoskelet Disord. 2013:14:45. http://dx.doi.org/10.1186/1471-2474-14-45
  29. Takai Y, Katsumata Y, Kawakami Y, et al. Ultrasound method for estimating the cross-sectional area of the psoas major muscle. Med Sci Sports Exerc. 2011;43(10):2000-2004. http://dx.doi.org/10.1249/MSS.0b013e31821994cb
  30. Teyhen DS, Miltenberger CE, Deiters HM, et al. The use of ultrasound imaging of the abdominal drawing-in maneuver in subjects with low back pain. J Orthop Sports Phys Ther. 2005;35(6): 346-355. https://doi.org/10.2519/jospt.2005.35.6.346
  31. Whittaker JL, Warner MB, Stokes MJ. Ultrasound imaging transducer motion during clinical maneuvers: Respiration, active straight leg raise test and abdominal drawing in. Ultrasound Med Biol. 2010;36(8):1288-1297. http://dx.doi.org/10.1016/j.ultrasmedbio.2010.04.020