title: Reference values for toe grip strength among Japanese adults aged 20 to 79 years: a cross-sectional study.
abstract: BACKGROUND
  No standardised method has been adopted for measuring toe-grip strength (TGS), and no reference values have been established for evaluating it. The present study investigated age-related changes in TGS and the association of TGS with various descriptive characteristics.
  
  
  METHODS
  TGS was measured in both feet of 1842 community-dwelling individuals aged 20-79 years using a toe-grip dynamometer. The participants were classified by decade into six age groups: 20-29, 30-39, 40-49, 50-59, 60-69, and 70-79 years. Correlations for TGS between the dominant and non-dominant sides were analysed according to decade and sex using Pearson's correlation coefficient. The mean TGS and TGS-to-weight ratio (TGS/Wt%) were compared between sexes by each decade and among all decades by sex using two-way analysis of variance with post-hoc tests. To assess relationships between mean TGS and various descriptive characteristics, we determined Pearson's correlation coefficient by sex and performed a stepwise multiple-regression analysis. Significance was set at 5%.
  
  
  RESULTS
  Correlations for TGS between the dominant and non-dominant sides were significant in all decades by sex, ranging from 0.73 for men in their 70s to 0.91 for women in their 50s. Mean TGS and TGS/Wt% significantly differed between the sexes in all decades and in all decades except the 40s, respectively. In men, the mean TGS and TGS/Wt% significantly decreased with aging after the 50s and 60s, respectively. In women, both the mean TGS and TGS/Wt% significantly decreased between the 40s and 50s and between the 60s and 70s. TGS significantly correlated with age, height, and weight in both sexes. The stepwise multiple-regression analysis revealed TGS was significantly associated with sex, age, height, and weight (adjusted R(2) = 0.31).
  
  
  CONCLUSIONS
  TGS was closely correlated between the dominant and non-dominant sides. TGS and TGS/Wt were significantly reduced with aging after the 50s in men and significantly reduced between the 40s and 50s and between the 60s and 70s in women. Age, sex, height, and weight accounted for only 30.8% of the variance in TGS. Therefore, other factors (e.g. toe flexibility, structural characteristics) should be considered for improving the accuracy of predicting TGS.
authors.affiliation: Department of Physical Therapy, Faculty of Health Science, Kio University, 4-2-2 Umaminaka, Koryocho, Kitakatsuragigun, Nara 6350832, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Uritani
authors.affiliation: Department of Physical Therapy, Faculty of Health Science, Kio University, 4-2-2 Umaminaka, Koryocho, Kitakatsuragigun, Nara 6350832, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Fukumoto
authors.affiliation: Department of Physical Therapy, Faculty of Health Science, Kio University, 4-2-2 Umaminaka, Koryocho, Kitakatsuragigun, Nara 6350832, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsumoto
authors.affiliation: Department of Public Health, Graduate School of Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya, Hyogo 6638501, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shima
keywords: Aging; Flexor strength; Foot; Movement; Muscle degeneration; Physical function; Sex