@article{25701,
  author = {Soysa A and Hiller C and Refshauge K and Burns J},
  title = {Importance and challenges of measuring intrinsic foot muscle strength},
  abstract = {<p>Background: Intrinsic foot muscle weakness has been implicated in a range of foot deformities and disorders.</p>

<p>However, to establish a relationship between intrinsic muscle weakness and foot pathology, an objective measure</p>

<p>of intrinsic muscle strength is needed. The aim of this review was to provide an overview of the anatomy and role</p>

<p>of intrinsic foot muscles, implications of intrinsic weakness and evaluate the different methods used to measure</p>

<p>intrinsic foot muscle strength.</p>

<p>Method: Literature was sourced from database searches of MEDLINE, PubMed, SCOPUS, Cochrane Library, PEDro</p>

<p>and CINAHL up to June 2012.</p>

<p>Results: There is no widely accepted method of measuring intrinsic foot muscle strength. Methods to estimate toe</p>

<p>flexor muscle strength include the paper grip test, plantar pressure, toe dynamometry, and the intrinsic positive</p>

<p>test. Hand-held dynamometry has excellent interrater and intrarater reliability and limits toe curling, which is an</p>

<p>action hypothesised to activate extrinsic toe flexor muscles. However, it is unclear whether any method can actually</p>

<p>isolate intrinsic muscle strength. Also most methods measure only toe flexor strength and other actions such as toe</p>

<p>extension and abduction have not been adequately assessed. Indirect methods to investigate intrinsic muscle</p>

<p>structure and performance include CT, ultrasonography, MRI, EMG, and muscle biopsy. Indirect methods often</p>

<p>discriminate between intrinsic and extrinsic muscles, but lack the ability to measure muscle force.</p>

<p>Conclusions: There are many challenges to accurately measure intrinsic muscle strength in isolation. Most studies</p>

<p>have measured toe flexor strength as a surrogate measure of intrinsic muscle strength. Hand-held dynamometry</p>

<p>appears to be a promising method of estimating intrinsic muscle strength. However, the contribution of extrinsic</p>

<p>muscles cannot be excluded from toe flexor strength measurement. Future research should clarify the relative</p>

<p>contribution of intrinsic and extrinsic muscles during intrinsic foot muscle strength testing.</p>
},
  year = {2012},
  journal = {Journal of Foot and Ankle Research},
  volume = {5},
  pages = {29},
  issn = {1757-1146},
  url = {http://www.jfootankleres.com/content/pdf/1757-1146-5-29.pdf},
  doi = {10.1186/1757-1146-5-29},
}