THE TOE SPREAD OUT EXERCISE IN PATIENTS WITH HALLUX VALGUS – PRESENTATION OF TWO CASES
Journal Title: Issues of Rehabilitation, Orthopaedics, Neurophysiology and Sport Promotion-IRONS - Year 2016, Vol 16, Issue 16
Abstract
Introduction Hallux valgus (Hv) is a common foot disor) der which can be a cause of functional diseability, including foot pain, stiffness, walking difficulties and shoes wearing. The precise etiology of hallux valgus is unknown. The deformity is multifactorial in origin and includes some intrinsic and extrinsic factors. Some studies suggest that the hallux valgus deformity can be caused by muscle imbalance between abductor hallucis muscle (AbdH) and adductor hallucis muscle (AddH) and that the activity of AbdH muscle during abduction in first metatarsal joint is significantly reduced in patients with hallux valgus compared to healthy people. Therefore, it is recommended to strengthen the AbdH muscle, particularly in mild deformity. The toe spread out exercise is the one of the method to achieve this effect. Aim The aim of this study is to present the preliminary results of applying of toe-spread-out exercises in patients with hallux valgus based on neurophysiological study results. Patients and methods The preliminary study involved two cases of patients with diagnosed hallux valgus who underwent the therapy of toe-spread-out exercise. The patients were examined twice, before and after 14 days of rehabilitation. They did the exercise only unilaterally with 200 repetitions a day. Apart from examinaA-tion using goniometer, surface electromyog- raphy study (sEMG) recorded from abductor hallucis muscle and electroneurography study (ENG) of motor fibers of tibial nerve and sensory fibers of sural nerve function were performed. The sEMG recordings of maximal voluntary contraction of abductor hallucis muscle were performed three times, during the three consecutive phases of toe-spread-out exercises. Results Conduction of nerve impulses in the tibial and sural nerves in both patients was proper and comparable during the ENG study in two stages of observation. In sEMG study the slight increase of the value of amplitude and more significant increase of the motor units recruitment during maximal contraction of left (the exercised side) abductor hallucis muscle have been recorded in the first patient after the therapy. The result of sEMG study in the second patient drew attention to asymmetry in bioelectrical activity of muscles with reduced interference pattern in the right abductor hallucis muscle only in the first test and in the first two phases of TSO exercise. The marked improvement of the interference pattern and symmetry of muscle contraction in the three phases of TSO exercise have been presented in the second stage of observation. Conclusions The preliminary results can confirm necessi-ty of providing studies on the TSO exercise in activating the AbdH in patients with hallux valgus based on results of sEMG study. There were no differences in the function of the lower extremity nerves studied before and after 14-days interventions of TSO exercises. Conduction velocity as well as the value of the compound action potential amplitude were similar in two periods of observation in ENG study. The further researches including a greater number of subjects and research method such as pain assessment or range of motion are required.
Authors and Affiliations
Kamila Mortka, Agnieszka Wiertel-Krawczuk
Keywords
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- EP ID EP197532
- DOI 10.19271/IRONS-00019-2016-16
- Views 77
- Downloads 0
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