title: Association between toe flexor strength and spatiotemporal gait parameters in community-dwelling older people.
abstract: BACKGROUND
  The toe flexor muscles perform a crucial function to control foot movement and assist with propulsive force when walking. However, the association between toe flexor strength and spatio-temporal gait parameters is largely unknown. Spatiotemporal gait parameters represent gait characteristics, and are good measures of the functional status and degree of safe ambulation among community-dwelling older adults. Herein, we examined the association between the toe flexor strength and spatiotemporal gait parameters in community-dwelling older adults.
  
  
  METHODS
  Ninety-three community-dwelling older people (mean age: 73.2 ± 4.2 years, 53 women) participated in this study. The strength of the toe flexor muscles was assessed using a toe strength measuring instrument and a strain gauge. The measurements were performed once on each foot, and the average of the right and left was used in the analysis. Gait analysis was performed on a 15-m walkway under usual- and fast-pace conditions. The medial 10-m walking time was measured and walking speed was calculated. Acceleration and angular velocity of the right heel were measured using a wireless miniature sensor unit and used to compute cadence, percent of swing time in gait cycle (%swing time), and stride length.
  
  
  RESULTS
  In multiple regression analyses adjusted for age, sex, body height, body weight, and hand grip strength, no associations between toe flexor strength and spatiotemporal gait parameters at usual pace were found. Conversely, under the fast-pace condition, decreased toe flexor strength was significantly associated with slower walking speed (β = 0.22, p = 0.049), lower%swing time (β = 0.34, p = 0.009), and shorter stride length (β = 0.22, p = 0.011) after adjustment.
  
  
  CONCLUSIONS
  In community-dwelling older people, decreased strength of toe flexor was correlated with slower walking speed, shorter periods of single-limb support phase, and shorter stride length during fast-pace walking. These data provide further support for an important role of toe flexor muscles in walking.
authors.affiliation: Kobe City Hospital Organization, Kobe City Medical Center, West Hospital, 2-4 Ichibancho, Nagata-ku, Kobe, Hyogo 653-0013, Japan. s-misu@kobe-nishishimin-hospi.jp.
authors.forename: Shogo
authors.initials: S
authors.lastname: Misu
authors.forename: Takehiko
authors.initials: T
authors.lastname: Doi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Asai
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Sawa
authors.forename: Kota
authors.initials: K
authors.lastname: Tsutsumimoto
authors.forename: Sho
authors.initials: S
authors.lastname: Nakakubo
authors.forename: Minoru
authors.initials: M
authors.lastname: Yamada
authors.forename: Rei
authors.initials: R
authors.lastname: Ono
mesh_terms: D000368:Aged; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D014034:Toes / Q000502:physiology*; D016138:Walking / Q000502:physiology*