First metatarsophalangeal joint range of motion: influence of ankle joint position and gastrocsoleus muscle stretching

Ian Graham North

    Research output: ThesisMaster's Thesis

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    [Truncated abstract] First metatarsophalangeal joint (MTPJ1) motion is an important factor in normal weight transference during walking. Disruptions to normal range can influence joints both proximal and distal to the MTPJ1, potentially leading to pain and dysfunction. Whilst the MTPJ1 has been investigated significantly, the numerous methodologies described to quantify range of motion can be questioned and makes comparisons difficult. Range of MTPJ1 motion is commonly assessed in a clinical setting to determine pathology as well as to make decisions on appropriate intervention. The anatomical and biomechanical influence of tendo Achilles load and MTPJ1 motion has been well described; however few studies measuring MTPJ1 range control for Achilles load or describe ankle joint positioning. Further to this the effects of reducing tendo Achilles stiffness on MTPJ1 extensions has yet to be investigated. The purpose of this study was to describe a technique to quantify passive MTPJ1 extension and to determine the influence of ankle joint position on joint range. Secondly the effect of calf muscle stretching on MTPJ1 range was also investigated. The information gathered will assist both research and clinical protocols for quantifying MTPJ1 range, and provide a greater understanding of the anatomic and biomechanical relationship between tendo Achilles load and MTPJ1 extension. In order to fulfil the purposes of the study it was necessary to establish a reliable methodology to quantify non weight bearing MTPJ1 extension. Reliability testing was undertaken in three parts. '...' The results demonstrated a statistically significant increase in joint range immediately following a one minute stretch for variables ankle joint range of motion as well as MTPJ1 extension for ankle joint plantar flexed at 10 Newton's and ankle joint neutral and plantar flexed at 30 Newtons. No significant differences were noted in ankle or MTPJ1 range of motion in either the control group on immediate re-testing, or in both groups after a one week stretch program. The findings of this study support those documented in the literature pertaining to the ankle joint position, tendo Achilles load and plantar fascial stiffness to MTPJ1 range of motion. Increased stiffness at the MTPJ1 was noted dependant on ankle joint position from ankle joint plantar flexion through to ankle joint dorsiflexion. This appears most likely due to increases in tendo Achilles load and subsequent forces transmitted to the plantar aponeurosis. The present study also demonstrated a trend towards increased joint extensibility and limb dominance. The study also supports previous literature into gender differences and joint extensibility, with a positive trend towards increased MTPJ1 range evident in the female subjects tested. The study also demonstrated the immediate effect of calf muscle stretching on ankle and MTPJ1 range of motion. It remains however unclear as to the exact mechanisms involved in producing increased joint range be it reflex inhibition or actual changes to the viscoelastic properties of the soft tissues. Despite this, no changes were evident following a one week stretching program, which supports previous literature describing a short lag time before soft tissues revert to baseline length properties following a single stretch session.
    Original languageEnglish
    Publication statusUnpublished - 2008


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