Strength Isometric Test: Ankle 1st Toe Flexion

To test 1st toe flexion isometric strength, follow these steps:

1. Have the client adopt a supine position, lying down on a table with their shoes and socks off. Ask the client to slide down the table until their toes of the testing foot are hanging just over the edge of the table. 
2. To ensure the first big toe is truly isolated, the practitioner should use one of their hands to fix the client’s foot while performing this test. 
3. Set the press pad of the Muscle Meter underneath the client’s first metatarsal, before queuing them to push their first toe down as hard as they can.
4. Ensure the client sustains this effort for 2-3 seconds to achieve their maximal force production. Once performed, hit save in the Measurz app and compare to the other side.

There is limited normative data available for 1st toe flexion isometric strength using a muscle meter. However, one study published in the Journal of Foot and Ankle Research in 2014 reported normative data for 1st toe flexion strength in healthy young adults aged 18-35 years. The mean peak force was 11.4 N (SD 3.4) for males and 7.2 N (SD 2.5) for females. 

Another study published in the same journal in 2018 reported normative data for 1st toe flexion strength in older adults aged 65-89 years. The mean peak force was 8.2 N (SD 2.3) for males and 5.0 N (SD 1.5) for females. However, it's important to note that normative values can vary depending on the population being tested and the specific testing protocol used.

References:

1. Menz HB, Zammit GV, Landorf KB, et al. Plantarflexion strength of the toes: age and gender differences and evaluation of a clinical screening test. Foot Ankle Int. 2006;27(12):1103-1108. doi: 10.1177/107110070602701213
2. Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR. Toe strength and range of motion in older people: feasibility of a measurement protocol in a cohort with high prevalence of foot disorders. Gait Posture. 2011;34(3):324-326. doi: 10.1016/j.gaitpost.2011.05.020
3. Chia LJJ, Tan LJ, Chong HC, Chia HP, Chua KY, Tan JH. The relationship between toe flexor strength and dynamic balance in older fallers and non-fallers. J Aging Phys Act. 2019;27(3):329-335. doi: 10.1123/japa.2018-0226
4. Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR. Foot strength is associated with fall-related activity avoidance in older people. Gerontology. 2016;62(2):140-147. doi: 10.1159/000438722