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Daisuke Uritani, Takahiko Fukumoto, Daisuke Matsumoto and Masayuki Shima

Evaluating toe flexor strength may be an important method for predicting and preventing walking dysfunction and falls, particularly among older adults. In this study, toe grip strength (TGS), the functional reach (FR, a measure of dynamic balance) test, the timed up and go (TUG) test (a measure of functional ability), isometric knee extension strength (IKES), sex, age, weight, and height were analyzed among 665 healthy Japanese older adults. Statistical analyses were used to assess the relationships between TGS and FR or TUG and to investigate whether TGS was independently associated with FR or TUG. Our results indicate that, among both men and women, TGS was associated with TUG, independent of age, height, weight, and IKES, but TGS was not associated with FR. These results may facilitate the development of strategies for improving functional mobility through physical therapy.

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Mieko Yokozuka, Chie Miki, Makoto Suzuki and Rieko Katsura

The foot is the primary body part in contact with the ground and supports the body during walking and standing. As observed on measuring the electromyographic activity of the foot flexor muscles that are in contact with the ground, the intrinsic muscles are active from midstance to toe-off ( Mann

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Adam Kelly and Justin Stanek

rehabilitation. Previous research has indicated that dysfunction within the foot and ankle complex may negatively affect balance. 4 – 7 Various pathologies of the foot and toes can negatively influence dynamic balance 8 , 9 and, therefore, could potentially increase the risk of injury and reduce the overall

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Aiko Sakurai, Kengo Harato, Yutaro Morishige, Shu Kobayashi, Yasuo Niki and Takeo Nagura

concluded that risk factor was laterally flexed the trunk in the frontal plane toward the side of the injured knee without altering the alignment of the feet. On the other hand, toe direction is known as a critical factor affecting knee biomechanics during various movements. 18 – 21 Tran et al 21

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Piaolin Peng, Shaolan Ding, Zhikang Wang, Yifan Zhang and Jiahao Pan

superior cushioning properties of running shoes to decrease running-related injuries, especially in high-speed running. The purpose of this study was to investigate the influence of running speed and midsole types on foot loading for heel–toe running. Our primary hypothesis was that faster speeds would not

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Daniel Hamacher, Dennis Hamacher, Roy Müller, Lutz Schega and Astrid Zech

variability of minimum foot clearances (local minimum foot-ground distance during swing phases) or minimum toe clearance (MTC) may be an even more promising gait parameter for gauging gait control and perhaps eventually the risk of falling. In a recent review ( Barrett, Mills, & Begg, 2010 ), it was suggested

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Shinya Ogaya, Hisashi Naito, Akira Iwata, Yumi Higuchi, Satoshi Fuchioka and Masao Tanaka

Toe-out angle alternation is a potential tactic for decreasing the knee adduction moment during walking. Published reports have not examined the medial knee contact force during the toe-out gait, although it is a factor affecting knee articular cartilage damage. This study investigated the effects of increased toe-out angle on the medial knee contact force, using musculoskeletal simulation analysis. For normal and toe-out gaits in 18 healthy subjects, the muscle tension forces were simulated based on the joint moments and ground reaction forces with optimization process. The medial knee contact force during stance phase was determined using the sum of the muscle force and joint reaction force components. The first and second peaks of the medial knee contact force were compared between the gaits. The toe-out gait showed a significant decrease in the medial knee contact force at the second peak, compared with the normal gait. In contrast, the medial knee contact forces at the first peak were not significantly different between the gaits. These results suggest that the toe-out gait is beneficial for decreasing the second peak of the medial knee contact force.

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Christopher A. Miller, Alan H. Feiveson and Jacob J. Bloomberg

Gait kinematics have been shown to vary with speed and visual-target fixation distance, but their combined effects on toe trajectory during treadmill walking are not known. The purpose of this investigation was to determine the role of walking speed and target distance on vertical toe trajectory during treadmill walking. Subjects walked on a treadmill at five speeds while performing a dynamic visual-acuity task at both “far” and “near” target distances (ten trials total). The analysis concentrated on three specific toe trajectory events during swing: the first peak toe height just after toe-off; the minimum toe height (toe clearance), and the second peak toe height just before heel strike. With increasing speed, toe clearance decreased and the peak toe height just before heel strike increased. Only the peak toe height just after toe-off was significantly changed between the near-target and far-target tasks, though the difference was small. Therefore, walking speed and visual-fixation distance cannot be neglected in the analysis of toe trajectory. Otherwise, differences observed between populations may be attributed to age- or clinically related factors, instead of disparities of speed or target-fixation distance.

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Jacky J. Forsyth, Chris Mann and James Felix


In rowing ergometry, blood for determining lactate concentration can be removed from the toe tip without the rower having to stop. The purpose of the study was to examine whether sampling blood from the toe versus the earlobe would affect lactate threshold (Tlac) determination.


Ten physically active males (mean ± age 21.2 ± 2.3 y; stature 179.2 ± 7.5 cm; body mass 81.7 ± 12.7 kg) completed a multistage, 3 min incremental protocol on the Concept II rowing ergometer. Blood was sampled simultaneously from the toe tip and earlobe between stages. Three different methods were used to determine Tlac.


There were wider variations due to the method of Tlac determination than due to the sample site; for example, ANOVA results for power output were F(1.25, 11.25) = 11.385, P = .004 for method and F(1, 9) = 0.633, P = .45 for site. The greatest differences in Tlac due to sample site in rowing occurred when Tlac was determined using an increase in blood lactate concentration by >1 mmol/L from baseline (TlacΔ1).


The toe tip can be used as a suitable sample site for blood collection during rowing ergometry, but caution is needed when using the earlobe and toe tip interchangeably to prescribe training intensities based on Tlac, especially when using TlacΔ1 or at lower concentrations of lactate.