Arthritis & Musculoskeletal Research Group, Faculty of Health Science, University of Sydney, Sydney, Australia.
J Foot Ankle Res. 2012 Nov 26;5(1):29. doi: 10.1186/1757-1146-5-29.
Intrinsic foot muscle weakness has been implicated in a range of foot deformities and disorders. However, to establish a relationship between intrinsic muscle weakness and foot pathology, an objective measure of intrinsic muscle strength is needed. The aim of this review was to provide an overview of the anatomy and role of intrinsic foot muscles, implications of intrinsic weakness and evaluate the different methods used to measure intrinsic foot muscle strength.
Literature was sourced from database searches of MEDLINE, PubMed, SCOPUS, Cochrane Library, PEDro and CINAHL up to June 2012.
There is no widely accepted method of measuring intrinsic foot muscle strength. Methods to estimate toe flexor muscle strength include the paper grip test, plantar pressure, toe dynamometry, and the intrinsic positive test. Hand-held dynamometry has excellent interrater and intrarater reliability and limits toe curling, which is an action hypothesised to activate extrinsic toe flexor muscles. However, it is unclear whether any method can actually isolate intrinsic muscle strength. Also most methods measure only toe flexor strength and other actions such as toe extension and abduction have not been adequately assessed. Indirect methods to investigate intrinsic muscle structure and performance include CT, ultrasonography, MRI, EMG, and muscle biopsy. Indirect methods often discriminate between intrinsic and extrinsic muscles, but lack the ability to measure muscle force.
There are many challenges to accurately measure intrinsic muscle strength in isolation. Most studies have measured toe flexor strength as a surrogate measure of intrinsic muscle strength. Hand-held dynamometry appears to be a promising method of estimating intrinsic muscle strength. However, the contribution of extrinsic muscles cannot be excluded from toe flexor strength measurement. Future research should clarify the relative contribution of intrinsic and extrinsic muscles during intrinsic foot muscle strength testing.
内在足部肌肉无力与多种足部畸形和疾病有关。然而，要确定内在肌肉无力与足部病理之间的关系，就需要对内在肌肉力量进行客观的测量。本综述的目的是概述内在足部肌肉的解剖结构和功能、内在肌肉无力的影响，并评估用于测量内在足部肌肉力量的不同方法。
文献资料来源于 MEDLINE、PubMed、SCOPUS、Cochrane 图书馆、PEDro 和 CINAHL 数据库，检索时间截至 2012 年 6 月。
目前尚无广泛接受的测量内在足部肌肉力量的方法。估计趾屈肌力量的方法包括纸握力测试、足底压力、趾力计和内在正性测试。手握式测力计具有极好的组内和组间可靠性，可限制足趾卷曲，而足趾卷曲被假设可以激活外在的趾屈肌。然而，目前尚不清楚是否有任何方法可以真正分离出内在肌肉力量。此外，大多数方法仅测量趾屈肌力量，而其他动作，如趾伸肌和外展肌，尚未得到充分评估。间接方法可用于研究内在肌肉结构和功能，包括 CT、超声、MRI、肌电图和肌肉活检。间接方法通常可以区分内在和外在肌肉，但缺乏测量肌肉力量的能力。
要准确地孤立测量内在肌肉力量存在许多挑战。大多数研究已经测量了趾屈肌力量，作为内在肌肉力量的替代测量指标。手握式测力计似乎是一种很有前途的估计内在肌肉力量的方法。然而，在测量趾屈肌力量时，不能排除外在肌肉的贡献。未来的研究应该阐明在进行内在足部肌肉力量测试时，内在和外在肌肉的相对贡献。
