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Review
. 2023 Jul 17;9(8):e18252.
doi: 10.1016/j.heliyon.2023.e18252. eCollection 2023 Aug.

Current evidence regarding 2D ultrasonography monitoring of intrinsic foot muscle properties: A systematic review

Nicolas Haelewijn  1 , Jean-Louis Peters Dickie  2 , Filip Staes  3 , Evie Vereecke  4 , Kevin Deschamps  1   5
Affiliations
Review

Current evidence regarding 2D ultrasonography monitoring of intrinsic foot muscle properties: A systematic review

Nicolas Haelewijn et al. Heliyon. .

Abstract

Background: Ultrasonography can discriminate between intrinsic and extrinsic foot muscle properties and has therefore gained considerable popularity as an indirect strength evaluation. However, an overview on the use of ultrasound for assessing intrinsic foot musculature (IFM) is currently lacking.

Research question: What is the current evidence regarding (1) 2D ultrasonography protocols and its reliability? (2) Reference values for cross-sectional area and dorso-plantar thickness evaluation in asymptomatic and symptomatic persons?

Methods: The PRISMA guidelines were used to conduct this systematic review. Eight databases (PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, SPORTDiscus and EuropePMC) were searched up to November 1, 2021. Studies reporting quantitative 2D ultrasound findings of the intrinsic foot muscles with no limitation to sex, BMI, ethnicity or physical activity were included. Studies were assessed for methodological quality using the Downs and Black checklist.

Results: Fifty-three studies were retained. Protocols showed an overall good to great reliability, suggesting limits of agreement between 8 and 30% of relative muscle size with minimal detectable changes varying from 0.10 to 0.29 cm2 for cross-sectional area and 0.03-0.23 cm for thickness. Reference values are proposed for both cross-sectional area and thickness measurements of the abductor hallucis, flexor digitorum brevis, flexor hallucis brevis and quadratus plantae in asymptomatic persons. This could not be performed in the symptomatic studies due to a limited number of relevant studies addressing the symptomatic population, therefore a clinical overview is outlined. Clinically, IFM properties have been studied in ten distinct pathological conditions, predominantly pointing towards decreased muscle properties of the abductor hallucis.

Significance: We provide a clear and comprehensive overview of the literature regarding 2D ultrasonography of the IFM, making the available evidence more accessible to decision makers and researchers.

Keywords: Intrinsic foot muscles; Reference values; Reliability; Systematic review; Ultrasound imaging.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
PRISMA flowchart illustrating the process for the selection of the included articles for the systematic review.
Fig. 2
Fig. 2
Reference values for cross-sectional area of the (a) abductor hallucis (c) flexor digitorum brevis (e) flexor hallucis brevis (g) quadratus plantae and dorsoplantar thickness of the (b) abductor hallucis (d) flexor digitorum brevis (f) flexor hallucis brevis and (h) quadratus plantae. Athletic populations are indicated with a square in front of the author’s name.
See this image and copyright information in PMC

References

    1. Kelly L.A., Cresswell A.G., Racinais S., Whiteley R., Lichtwark G. Intrinsic foot muscles have the capacity to control deformation of the longitudinal arch. J. R. Soc. Interface. Apr 6 2014;11(93) doi: 10.1098/rsif.2013.1188. in eng. - DOI - PMC - PubMed
    1. Kelly L.A., Lichtwark G., Cresswell A.G. Active regulation of longitudinal arch compression and recoil during walking and running. J. R. Soc. Interface. Jan 6 2015;12(102) doi: 10.1098/rsif.2014.1076. in eng. - DOI - PMC - PubMed
    1. Zelik K.E., La Scaleia V., Ivanenko Y.P., Lacquaniti F. Coordination of intrinsic and extrinsic foot muscles during walking. Eur. J. Appl. Physiol. Apr 2015;115(4):691–701. doi: 10.1007/s00421-014-3056-x. in eng. - DOI - PubMed
    1. Fiolkowski P., Brunt D., Bishop M., Woo R., Horodyski M. Intrinsic pedal musculature support of the medial longitudinal arch: an electromyography study. J. Foot Ankle Surg. Nov-Dec 2003;42(6):327–333. doi: 10.1053/j.jfas.2003.10.003. in eng. - DOI - PubMed
    1. McKeon P.O., Hertel J., Bramble D., Davis I. The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br. J. Sports Med. Mar 2015;49(5):290. doi: 10.1136/bjsports-2013-092690. - DOI - PubMed

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