title: The effect of Stage II posterior tibial tendon dysfunction on deep compartment muscle strength: a new strength test.
abstract: BACKGROUND
  The purpose of this study was to compare isometric subtalar inversion and forefoot adduction strength in subjects with Stage II posterior tibial tendon dysfunction (PTTD) to controls.
  
  
  METHODS
  Twenty four subjects with Stage II PTTD and fifteen matched controls volunteered for this study. A force transducer (Model SML-200, Interface, Scottsdale, AZ) was connected with a resistance plate and oscilloscope (TDS 410A, Tektronix, Beaverton, OR) to the foot. Via the oscilloscope, subjects were given feedback on the amount of force produced and muscle activation of the anterior tibialis (AT) muscle. Subjects were instructed to maintain a plantar flexion force while performing a maximal voluntary subtalar inversion and forefoot adduction effort. A two-way ANOVA model with the factors including, side (involved/uninvolved) and group (control/PTTD) was used.
  
  
  RESULTS
  The PTTD group on the involved side showed significantly decreased subtalar inversion and foot adduction strength (0.70 +/- 0.24 N/Kg) compared to the uninvolved side (0.94 +/- 0.24 N/Kg) and controls (involved side = 0.99 +/- 0.24 N/Kg, uninvolved side = 0.97 +/- 0.21 N/Kg). The average AT activation was between 11% to 17% for both groups, however, considerable variability in subjects with PTTD.
  
  
  CONCLUSIONS
  These data confirm a subtalar inversion and forefoot adduction strength deficit by 20% to 30% in subjects with Stage II PTTD. Although isolating the PT muscle is difficult, a test specific to subtalar inversion and forefoot adduction demonstrated the weakness in this population.
authors.affiliation: Ithaca College - Rochester, Physical Therapy, 1100 South Goodman, Rochester, NY 14620, USA. jhouck@ithaca.edu
authors.forename: Jeff R
authors.initials: JR
authors.lastname: Houck
authors.forename: Candace
authors.initials: C
authors.lastname: Nomides
authors.forename: Christopher Glenn
authors.initials: CG
authors.lastname: Neville
authors.forename: Adolph
authors.initials: A
authors.lastname: Samuel Flemister
mesh_terms: D000704:Analysis of Variance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D037081:Posterior Tibial Tendon Dysfunction / Q000175:diagnosis* / Q000503:physiopathology*
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