Background

Poor postural balance in the upright position is strongly correlated to morbidities, such as falls in older adult populations and to lower limb injuries in the younger populations. Good postural balance depends on muscular strength and the integration of neurological and muscular feedback mechanisms throughout the body. Since the interface with the ground is the plantar surface of each foot, an improved understanding of the role of foot muscles in postural balance is warranted.

Research question

Does improved toe flexor strength result in better postural balance, across the lifespan?

Methods

A systematic review was conducted of papers from 1900 to 2019 inclusive, from five databases. Inclusion and exclusion criteria were established prior to selection. Inclusion criteria were: observational and longitudinal studies, healthy subjects, at least one balance and one toe flexor strength test conducted. Exclusion criteria were: subjects with a pathology/disability, case study, systematic or literature review. Two examiners assessed a study’s suitability for inclusion in this review, based on the above criteria. Study quality was assessed using the Critical Appraisal Skills Program Tools. The type of studies and methodological heterogeneity precluded the feasibility of conducting a meta-analysis.

Results

Nine studies were included. In each study, participants were over sixty years of age, and over 73 % of them were female. No study was found for a younger population group. There were seven cross-sectional studies, two randomized control trials and there was one case-control study. All studies provided evidence of directly proportional, clinically significant correlations between toe flexor strength and postural balance.

Significance

Toe flexor strength contributes to improved postural balance for people over the age of 60. Research is needed to establish the relationship between foot muscle strength and balance in younger adults and children.

中文翻译：

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通过加强脚趾屈肌来改善平衡的证据：系统综述。

背景

直立姿势不良的姿势平衡与发病率密切相关，例如成年人口跌倒和年轻人口下肢受伤。良好的姿势平衡取决于肌肉强度以及全身神经和肌肉反馈机制的整合。由于与地面的界面是每只脚的足底表面，因此需要更好地了解脚部肌肉在姿势平衡中的作用。

研究问题

脚趾屈肌强度的改善是否在整个生命周期中带来更好的姿势平衡？

方法

对来自五个数据库的1900年至2019年（含）的论文进行了系统的综述。选择之前先建立了纳入和排除标准。入选标准为：观察和纵向研究，健康受试者，至少一项平衡和一项脚趾屈肌力量测试。排除标准为：患有病理/残疾的受试者，案例研究，系统或文献综述。两名审查员根据上述标准评估了一项研究是否适合纳入本评价。使用“关键评估技能计划”工具评估研究质量。研究类型和方法的异质性排除了进行荟萃分析的可行性。

结果

包括九项研究。在每项研究中，参与者的年龄都在60岁以上，其中超过73％是女性。没有针对年轻人群的研究。有七项横断面研究，两项随机对照试验和一项病例对照研究。所有研究都提供了脚趾屈肌力量与姿势平衡之间成正比，临床上显着相关的证据。

意义

脚趾屈肌强度有助于改善60岁以上人群的姿势平衡。需要进行研究以建立年轻人和儿童的脚部肌肉力量与平衡之间的关系。