Biomechanics Research Team, Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia.
Gait Posture. 2020 Sep;81:56-66. doi: 10.1016/j.gaitpost.2020.07.006. Epub 2020 Jul 11.
Poor postural balance in the upright position is strongly correlated to morbidities, such as falls in older adult populations and to lower limb injuries in the younger populations. Good postural balance depends on muscular strength and the integration of neurological and muscular feedback mechanisms throughout the body. Since the interface with the ground is the plantar surface of each foot, an improved understanding of the role of foot muscles in postural balance is warranted.
Does improved toe flexor strength result in better postural balance, across the lifespan?
A systematic review was conducted of papers from 1900 to 2019 inclusive, from five databases. Inclusion and exclusion criteria were established prior to selection. Inclusion criteria were: observational and longitudinal studies, healthy subjects, at least one balance and one toe flexor strength test conducted. Exclusion criteria were: subjects with a pathology/disability, case study, systematic or literature review. Two examiners assessed a study's suitability for inclusion in this review, based on the above criteria. Study quality was assessed using the Critical Appraisal Skills Program Tools. The type of studies and methodological heterogeneity precluded the feasibility of conducting a meta-analysis.
Nine studies were included. In each study, participants were over sixty years of age, and over 73 % of them were female. No study was found for a younger population group. There were seven cross-sectional studies, two randomized control trials and there was one case-control study. All studies provided evidence of directly proportional, clinically significant correlations between toe flexor strength and postural balance.
Toe flexor strength contributes to improved postural balance for people over the age of 60. Research is needed to establish the relationship between foot muscle strength and balance in younger adults and children.
直立位姿势平衡不佳与多种疾病密切相关，如老年人跌倒和年轻人下肢损伤。良好的姿势平衡依赖于肌肉力量以及全身神经系统和肌肉反馈机制的整合。由于与地面的接口是每个足的足底表面，因此有必要更好地了解足部肌肉在姿势平衡中的作用。
在整个生命周期中，改善脚趾屈肌力量是否会导致更好的姿势平衡？
对从 1900 年到 2019 年的五个数据库中的论文进行了系统回顾。在选择之前确定了纳入和排除标准。纳入标准为：观察性和纵向研究，健康受试者，至少进行一次平衡和一次脚趾屈肌力量测试。排除标准为：患有病理学/残疾、病例研究、系统综述或文献综述的受试者。两名审查员根据上述标准评估研究是否适合纳入本综述。使用批判性评估技能计划工具评估研究质量。由于研究类型和方法学的异质性，无法进行荟萃分析。
共纳入 9 项研究。在每项研究中，参与者年龄均在 60 岁以上，其中 73%以上为女性。未发现针对年轻人群组的研究。有 7 项横断面研究、2 项随机对照试验和 1 项病例对照研究。所有研究均提供了证据，证明脚趾屈肌力量与姿势平衡之间存在直接比例关系，且具有临床意义。
对于 60 岁以上的人，脚趾屈肌力量有助于改善姿势平衡。需要研究年轻人和儿童的足部肌肉力量与平衡之间的关系。
