Relationship between knee and ankle muscle strength and performance tests in young female adults with flexible flat feet.
Decreased activation of the knee and ankle muscles is one of the main reasons for flat feet. Knee and ankle muscle strength in patients with flat feet can affect performance tests consisting of activities of daily living. The purpose of this study was to determine the relationship between knee and ankle muscle strength on performance tests in young female adults with flexible flat feet. We also aimed to observe if the severity of flatfoot affected ankle muscle strength and performance test scores. A cross-sectional single-center study was conducted. Muscle strength measurements for knee flexion-extension, dorsal-plantar ankle flexion, and ankle inversion-reversal movements were assessed with a manual muscle testing (MMT) device. Timed Up-and-Go Test (TUG), Five-Repeat Sit-and-Stand Test (5STS)
Bakırhan, S., Elibol, N., Özkeskin, M. etal. Relationship between knee ankle muscle strength and performance tests in young female adults with flexible flat feet. Bull FAC PHYS THER 26, 4 (2021). https://doi.org/10.1186/s43161-021-00021-3
Commentary
The purpose of this study was to demonstrate the relationship between knee and ankle muscle strength on a performance test in young female adults with flexible muscles and flat feet. The results stated that due to the disruption of the medial longitudinal arch in flat feet, associated biomechanical problems can cause impaired balance and posture. It was also determined that muscle strength values were not related to the parameters of the performance test, explaining that the severity of flatfoot did not affect the physical performance of the patients.
Prospective studies have reported that soft tissue and foot injuries are more common in people with high arch height than in those with low arch height. In addition, injuries from falls have been reported to be related to foot muscle strength. This study looked at differences in the arch height of knee and ankle muscle strength and found no significant difference between ankle muscle strength and flat foot grade in young female adults aged 18-24 years, thus stating the possibility that younger individuals with higher activity levels are associated with disability. This may be due to the fact that there is
In addition to the inequality of load distribution caused by the disruption of the medial arch support in individuals with flat feet, the weakness of muscle, tendon, and ligament structures with biomechanical impairments can cause rapid fatigue and impaired balance in individuals. As a result, balance parameters are adversely affected as individuals with flat feet have shorter periods of balance.
Also, in the performance tests conducted in this study, patients with second-degree flat feet completed the five sitting and standing tests in less time than the other degrees of flat feet, although there was a small but significant difference. The difference in time to complete the five sitting and standing tests between the groups was less than one second, suggesting that flat feet may not have affected their physical performance.
Conclusion
With these test methods and the association between foot muscle strength and flat feet, the only one that seems to be valid is the 5STS (the test of five repetitions of sitting and standing as described above), where a significant difference was confirmed, and the others showed no association, a result that may lack support for investigating muscle strength to confirm flat feet.
