THE RELATIONSHIP BETWEEN PES PLANUS, TRIGGER POINTS AND MUSCLE STRENGTH

Yıl 2023, Cilt: 4 Sayı: Ek Sayı, 227 - 231, 16.10.2023

Fulya Bakılan , Burcu Ortanca , Ayşe Aydemir Ekim , Onur Armağan

Öz

Introduction: The objective was to compare the rate and localization of trigger points and muscle strength in patients with and without pes planus.
Methods: A total of 88 female patients were divided into two groups according to the presence (with the mean age of 32.50 ± 7.95) (n=52) or absence of pes planus (with the mean age of 33.5 ± 7.80) (n=36). Muscle strength was evaluated with handgrip-strength, leg-back strength. The presence of trigger points (present/absent), the pain region of trigger points (masseter muscle, cervical/thoracic/lumber regions, upper/lower extremity) and the Visual Analog-Scale for pain severity were detected.
Results: The rate of trigger points was significantly higher in the pes planus group in all regions: in the masseter muscle (p=0.042), upper extremities (p=0.006), cervicotorasic region (p=0.020), lumbar region (p=0.014), and lower extremities (p=0.020). 98.1% of the patients with pes planus were found to have at least one trigger point. The pain severity of trigger points was significantly higher in pes planus group (p=0.037). However muscle strength were found to be significantly similar between the groups.
Conclusion: A significant relationship was found between pes planus and the rate of having trigger points not only in lower extremities and lumbar region, but also in masseter, upper extremities and the servicotorasic region in females. However, any relationship were not found between pes planus and muscle strength.

Anahtar Kelimeler

Fascia, Hand grip strength, Pes planus, Trigger point

PES PLANUS, TETİK NOKTA VE KAS GÜCÜ ARASINDAKİ İLİŞKİ

Öz

Giriş: Bu çalışmanın amacı, pes planusu olan ve olmayan hastalarda tetik nokta görülme oranını, lokalizasyonunu ve kas güçlerini kıyaslamaktır.
Yöntemler: Toplam 88 kadın hasta çalışmaya alındı ve pes planus varlığı (yaş ortalaması: 32.50±7.95) (n=52) ve yokluğuna (yaş ortalaması 33.5±7.80) (n=36) göre iki gruba ayrıldı. Kas gücü el kavrama gücü ve bacak-bel gücü ile değerlendirildi. Tetik noktaların varlığı (var/yok), tetik noktaların bölgesi (masseter kası, servikal/torasik/lumbar bölge, üst/alt ekstremite), ağrı yoğunluğu için Vizüel Analog Skala değerlendirildi.
Bulgular: Tetik nokta görülme oranı pes planus grubunda istatistiksel olarak anlamlı şekilde yüksek idi: masseter kası (p=0.042), üst ekstremite (p=0.006), servikotorasik bölge (p=0.020), lumbar bölge (p=0.014) ve alt ekstremiteler (p=0.020). Pes planuslu hastaların %98.1’inde en az bir tetik nokta saptandı. Tetik noktaların ağrı yoğunluğu da, pes planus grubunda anlamlı düzeyde yüksek saptandı (p=0.037). Ancak kas güçleri istatistiksel olarak gruplar arasında benzer bulundu.
Sonuç: Pes planus ile tetik nokta görülme oranı arasında sadece alt ekstremite ve lumbar bölgede değil, maaseter, üst ekstremiteler ve servikotorasik bölgede de istatistiksel olarak anlamlı bir ilişki bulundu. Ancak pes planus ve kas gücü arasında herhangi bir ilişki bulunmadı.

Anahtar Kelimeler

Fasya, Pes planus, Tetik nokta, El kavrama gücü

Kaynakça

• 1. Shibuya N, Jupiter DC, Ciliberti LJ, VanBuren V, La Fontaine J. Characteristics of adult flatfoot in the United States. Foot Ankle Surg 2010; 49 : 363-8.
• 2. Kerr CM, Zavatsky AB, Theologis T, Stebbins J. Kinematic differences between neutral and flat feet with and without symptoms as measured by the Oxford foot model. Gait posture 2019; 67:213-8.
• 3. Wiewiorski M, Valderrabano V. Painful flatfoot deformity. Acta Chir Orthop Traumatol Cech 2011; 78: 20-6.
• 4. Leung AKL, Mak AFT, Evans JH. Biomechanical gait evaluation of the immediate effect of orthotic treatment for flexible flat foot. Prosthet Orthot Int 1998; 22 :25-34.
• 5. Khamis A, Yizhar Z. Effect of feet hyperpronation on pelvic alignment in a standing position. Gait Posture 2007; 25:127-34.
• 6. Borges CS, Fernandes LFR, Bertoncello D. Relationship between lumbar changes and modifications in the plantar arch in women with low back pain. Acta Orthop Bras 2013;21:135-8.
• 7. Abdel-Raoof N, Kamel D, Tantawy S. Influence of second-degree flatfoot on spinal and pelvic mechanics in young females. Int J Ther Rehabil 2013; 20:428-34.
• 8. Yılmaz N, Erdal A, Demir O. A comparison of dry needling and kinesiotaping therapies in myofascial pain syndrome: A randomized clinical study. Turk J Phys Med Rehab 2020; 66:351-9.
• 9. Aksu Ö, Doğan YP, Çağlar NS, Şener BM. Comparison of the efficacy of dry needling and trigger point injections with exercise in temporomandibular myofascial pain treatment. Turk J Phys Med Rehab 2019;65:228-35.
• 10. Zuil-Escobar JC, Martínez-Cepa CB, Martín-Urrialde JA, Gómez-Conesa A. Prevalence of myofascial trigger points and diagnostic criteria of different muscles in function of the medial longitudinal arch. Arch Phys Med Rehabil 2015;96:1123-30.
• 11. Bird AR, Payne CB. Foot function and low back pain. Foot 1999; 9:175-80.
• 12. Kang JH, Chen MD, Chen SC, Hsi WL. Correlations between subjective treatment responses and plantar pressure parameters of metatarsal pad treatment in metatarsalgia patients: a prospective study. BMC Musculoskelet Disord 2006;7:1-8.
• 13. Kosashvili Y, Fridman T, Backstein D, Safir O, Ziv YB. The correlation between pes planus and anterior knee or intermittent low back pain. Foot Ankle Int 2008; 29: 910-3.
• 14. Ceyhan Ç, Sanalan GB, Akkaya N, Şahin F. Evaluation of relationship between pes planus and axial pain in medical school students. Pam Med J 2017; 10:158-64.
• 15. Stecco C. Functional Atlas of the Human Fascial System, Churchill Livingstone, Edinburgh, 2015.
• 16. Antonio S, Wolfgang G, Robert H, Fullerton B, Carla S. The anatomical and functional relation between gluteus maximus and fascia lata J Body Mov Ther 2013;17: 512-7.
• 17. Benjamin M. The fascia of the limbs and back a review. J Anat 2009;214:1-18.
• 18. Stecco C, Porzionato A, Macchi V et al. The Expansions of the Pectoral Girdle Muscles onto the Brachial Fascia: Morphological Aspects and Spatial Disposition, Cells Tissues Organs. 2007; 188:320-9.
• 19. Nilsson MK, Friis R, Michaelsen MS, Jakobsen PA, Nielsen RO. Classification of the height and flexibility of the medial longitudinal arch of the foot. J Foot Ankle Res 2012; 5:1-9.
• 20. Simons DG, Travell JG, Simons LS. Travell and Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol 1. 2nd ed. Baltimore. MD: Williams & Wilkins 1999.
• 21. Gallagher EJ, Liebman M, Bijur PE. Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med 2001; 38:633–8.
• 22. Ten Hoor GA, Musch K, Meijer K, Plasqui G. Test-retest reproducibility and validity of the back-leg-chest strength measurements. IES 2016; 24:209-16.
• 23. Angin S, Crofts G, Mickle KJ, Nester CJ. Ultrasound evaluation of foot muscles and plantar fascia in pes planus. Gait posture 2014; 40: 48-52.
• 24. Casato G, Stecco C, Busin R. Role of fasciae in nonspecific low back pain, Eur J Transl Myol 2019;29:8330.
• 25. Aydog ST, Özçakar L, Tetik O, Demirel HA, Hascelik Z, Doral MN. Relation between foot arch index and ankle strength in elite gymnasts: a preliminary study. Br J Sports Med 2005;39:e13.
• 26. Nakao H, Imaoka M, Hida M, et al. Correlation of medial longitudinal arch morphology with body characteristics and locomotive function in community-dwelling older women: A cross-sectional study. Journal of Orthopaedic Surgery 2021;29: 23094990211015504.
• 27. Tuna H. Pedobarographic evaluation in foot disorders. Turk J Phys Med Rehab 2005;51(suppl B):51-4.