School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria 3086, Australia.
School of Health Sciences, Faculty of Medicine and Health, University of Newcastle, Ourimbah, New South Wales 2258, Australia.
Foot (Edinb). 2021 Mar;46:101751. doi: 10.1016/j.foot.2020.101751. Epub 2020 Nov 23.
To examine differences in lower limb muscle strength between older people with varying degrees of hallux valgus deformity.
Muscle strength was measured at the knee, ankle and foot using hand-held dynamometry and a clinical test of toe strength (the paper grip test) in 157 older people (99 women and 58 men) aged 65 to 91 (mean 74.1, SD 5.9) years. Hallux valgus severity was documented as none, mild, moderate or severe using validated photographs. Differences in muscle strength according to hallux valgus severity were evaluated using analysis of variance, adjusting for age. Paper grip test performance was compared across the hallux valgus severity groups using the chi-square (χ) statistic.
Knee extension, ankle joint dorsiflexion, ankle joint plantar flexion, ankle joint inversion, ankle joint eversion and lesser toe plantarflexion strength were not significantly different across the four hallux valgus severity groups. However, there was a significant, dose-response reduction in hallux plantarflexion strength with increasing severity of hallux valgus. This persisted after adjustment for age (F = 5.5, p = 0.001) with a medium effect size (partial η = 0.10). The number of participants who could successfully complete the paper grip test of the hallux significantly reduced across the four hallux valgus categories (χ = 18.5, p < 0.001).
There is a specific and progressive reduction in hallux plantarflexion strength with increasing severity of hallux valgus in older people. This finding has potential implications for both the aetiology and treatment of this common and disabling condition.
研究不同程度拇外翻畸形老年人下肢肌肉力量的差异。
本研究共纳入 157 名 65 至 91 岁（平均 74.1 岁，标准差 5.9 岁）老年人，使用手持测力计和临床足趾力量测试（纸夹测试）测量其膝关节、踝关节和足部的肌肉力量。使用经过验证的照片记录拇外翻严重程度，分为无、轻度、中度和重度。使用方差分析评估拇外翻严重程度与肌肉力量的差异，并对年龄进行调整。使用卡方（χ）检验比较拇外翻严重程度组之间的纸夹测试表现。
膝关节伸展、踝关节背屈、踝关节跖屈、踝关节内翻、踝关节外翻和小趾跖屈力量在四个拇外翻严重程度组之间无显著差异。然而，随着拇外翻严重程度的增加，拇趾跖屈力量呈显著、剂量反应性下降。这种趋势在调整年龄后仍然存在（F = 5.5，p = 0.001），具有中等的效应大小（部分η=0.10）。能够成功完成拇趾纸夹测试的参与者人数随着拇外翻的四个分类显著减少（χ=18.5，p < 0.001）。
在老年人中，随着拇外翻严重程度的增加，拇趾跖屈力量会出现特定且进行性的下降。这一发现可能对该常见且致残疾病的病因和治疗具有潜在影响。
