Zuil-Escobar JC1, Martínez-Cepa CB1, Rivas-Calvo P1, Martín-Urrialde JA1
1CEU-San Pablo University, Physiotherapy, Madrid, Spain
Background: The high medial longitudinal arch (MLA) of the foot is a lesser flexible structure, showing lesser foot mobility, higher leg stiffness, increased peak plantar pressure and reduced shock attenuation. In addition, it is associated with a great prevalence of injuries in the lower limb and changes in muscle functions.
Purpose: To evaluate the prevalence of latent trigger points (LTrPs) in several muscles of the lower limb muscles in subjects with a higher MLA compared with controls.
Methods: Forty pain-free volunteers (19 men, 21 women) were included in a cross sectional study. The navicular drop test (NDT) was used to evaluate the height of the MLA. The inclusion criteria include a NDT≤4 mm in the higher MLA group, and a NDT ranging from 5 to 9 mm in the control group. The exclusion criteria were undergone lower extremity surgery, acute injuries, deformities and reduced normal range of movement in the lower limbs and/or neurological or systemic diseases which could affect pain perception.
The LTrPs was considered positive if 2 or more of the following criteria were identified: a palpable taut band in skeletal muscle; a hypersensitive tender spot; reproduction of referred pain of the LTrP in response to compression; jump sign; located twitch response provoked by the snapping palpation of the taut band.
The muscles evaluated were gastrocnemius (LTrP1 and LTrP2), soleus (LTrP1), peroneus longus, peroneus brevis, tibialis anterior (TA), extensor digitorum longus (EDL), flexor digitorum longus, rectus femoris, vastus mediales (LTrP1 and LTrP2) and vastus lateralis (VL) of the quadriceps (LTrP1 and LTrP2).
The project observed the principles outlined in the Declaration of Helsinki of 1975. All the participants were informed of the aims and about the procedure of the study, completing a consent form before being included in the research.
Results: Eleven women and 9 men were included in the control group (22.7±3.02 years; 1.69±11.15 meters; 66.81±12.28 kilograms) and 10 women and 10 men in the higher MLA group (23,05±2.65; 1.70±10.44 meters; 65.55±10.87 kilograms). No statistically differences were shown in demographic variables between groups.
Thirteen subject of the control group (65%) presented at least 1 LTrP in the muscles evaluated. In the higher MLA group, 16 subjects (80%) presented at least 1 LTrP. The higher MLA group showed more LTrPs (4.6±3.84) than the control group (3.05±3.72), but no statistically significant difference was found.
Regarding the prevalence of each LTrPs, there were significantly (p˂0.05) more subjects with LTrPs in the higher MLA group than in the control group in the TA [8 (20%) vs 10 (50%)], EDL [8 (20%) vs 10 (50%)], LTrP1 VL [15 (45%) vs 15 (45%)] and LTrP2 VL [15 (45%) vs 15 (45%)].
Conclusion(s): LTrPs were common in several muscles of the lower limb in both controls and subjects with higher MLA. A higher MLA of the foot is associated with a higher prevalence of LTrPs in the TA, EDL and VL.
Implications: It may be considered the evaluation and control of the height on the MLA in the management of the myofascial pain syndrome.
Keywords: Myofascial trigger poing, foot, prevalence
Funding acknowledgements: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Purpose: To evaluate the prevalence of latent trigger points (LTrPs) in several muscles of the lower limb muscles in subjects with a higher MLA compared with controls.
Methods: Forty pain-free volunteers (19 men, 21 women) were included in a cross sectional study. The navicular drop test (NDT) was used to evaluate the height of the MLA. The inclusion criteria include a NDT≤4 mm in the higher MLA group, and a NDT ranging from 5 to 9 mm in the control group. The exclusion criteria were undergone lower extremity surgery, acute injuries, deformities and reduced normal range of movement in the lower limbs and/or neurological or systemic diseases which could affect pain perception.
The LTrPs was considered positive if 2 or more of the following criteria were identified: a palpable taut band in skeletal muscle; a hypersensitive tender spot; reproduction of referred pain of the LTrP in response to compression; jump sign; located twitch response provoked by the snapping palpation of the taut band.
The muscles evaluated were gastrocnemius (LTrP1 and LTrP2), soleus (LTrP1), peroneus longus, peroneus brevis, tibialis anterior (TA), extensor digitorum longus (EDL), flexor digitorum longus, rectus femoris, vastus mediales (LTrP1 and LTrP2) and vastus lateralis (VL) of the quadriceps (LTrP1 and LTrP2).
The project observed the principles outlined in the Declaration of Helsinki of 1975. All the participants were informed of the aims and about the procedure of the study, completing a consent form before being included in the research.
Results: Eleven women and 9 men were included in the control group (22.7±3.02 years; 1.69±11.15 meters; 66.81±12.28 kilograms) and 10 women and 10 men in the higher MLA group (23,05±2.65; 1.70±10.44 meters; 65.55±10.87 kilograms). No statistically differences were shown in demographic variables between groups.
Thirteen subject of the control group (65%) presented at least 1 LTrP in the muscles evaluated. In the higher MLA group, 16 subjects (80%) presented at least 1 LTrP. The higher MLA group showed more LTrPs (4.6±3.84) than the control group (3.05±3.72), but no statistically significant difference was found.
Regarding the prevalence of each LTrPs, there were significantly (p˂0.05) more subjects with LTrPs in the higher MLA group than in the control group in the TA [8 (20%) vs 10 (50%)], EDL [8 (20%) vs 10 (50%)], LTrP1 VL [15 (45%) vs 15 (45%)] and LTrP2 VL [15 (45%) vs 15 (45%)].
Conclusion(s): LTrPs were common in several muscles of the lower limb in both controls and subjects with higher MLA. A higher MLA of the foot is associated with a higher prevalence of LTrPs in the TA, EDL and VL.
Implications: It may be considered the evaluation and control of the height on the MLA in the management of the myofascial pain syndrome.
Keywords: Myofascial trigger poing, foot, prevalence
Funding acknowledgements: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Topic: Musculoskeletal: lower limb; Pain & pain management
Ethics approval required: Yes
Institution: CEU-San Pablo University
Ethics committee: CEU-San Pablo University
Ethics number: 093-14
All authors, affiliations and abstracts have been published as submitted.
