The Ankle 1st Toe Flexion Strength Test measures isometric force output during flexion of the big toe, also called the hallux. The client pushes the 1st toe downward into a Muscle Meter, handheld dynamometer or fixed setup while the professional controls foot position and records force. When used on its own, the Muscle Meter primarily measures peak force. When used with Measurz, additional force-time metrics may be recorded or analysed depending on the setup, protocol and data quality. The result should be interpreted alongside symptoms, toe range of motion, foot posture, gait, balance, footwear, sport or work demands, baseline comparison and repeated testing.
The 1st toe, or hallux, plays an important role in foot loading, balance, walking, running, propulsion, change of direction and push-off.
1st toe flexion strength may involve:
flexor hallucis longus
flexor hallucis brevis
intrinsic foot muscles
plantar fascia and foot-stabilising structures
coordinated ankle and foot control
A Muscle Meter or handheld dynamometer can help quantify 1st toe flexion force rather than relying only on observation or manual resistance. This makes baseline testing, side-to-side comparison and progress tracking more objective.
The test does not diagnose plantar plate injury, sesamoid pathology, flexor hallucis longus injury, hallux valgus, turf toe, nerve involvement or return-to-sport readiness on its own. It is a strength measurement that should be interpreted with the broader assessment.
The Ankle 1st Toe Flexion Strength Test measures how much force the client can produce when pushing the big toe downward against a fixed or resisted device.
In a Muscle Meter or handheld dynamometer setup, the client usually performs a make test:
the device stays still
the client gradually builds force
the client pushes into the device as hard as safely possible
the peak or average force is recorded
For this article, the default version is a push test. The client pushes the plantar surface of the 1st toe into the Muscle Meter or handheld dynamometer.
A strap-stabilised or fixed setup may also be used. This can reduce the influence of assessor strength and improve consistency, especially when testing stronger clients or when several staff members need to repeat the same protocol.
Toe flexor strength can be measured in several ways, including dynamometry, pressure platforms and custom devices. Research comparing seated toe flexion dynamometry with standing pressure-mat tasks found that different methods may assess related but not identical aspects of foot strength, which is why test setup should be recorded clearly.
The Muscle Meter is a handheld dynamometry tool used to measure force output during push, pull and isometric strength assessments. When used on its own, the Muscle Meter primarily measures peak force, which is the highest force value produced during the test.
When the Muscle Meter is used with Measurz, the assessment can be recorded, analysed and interpreted with a broader set of strength and force-time metrics. Depending on the test setup, protocol and available data, Measurz and the Muscle Meter can be used to assess and record:
Peak force
Impulse
Torque
Rate of torque development
Rate of force development
Time to peak
Fatigue index
These metrics help professionals move beyond a single strength number and better understand how force is produced, how quickly it is produced, how long it is sustained, and how performance changes across repeated efforts.
For the Ankle 1st Toe Flexion Strength Test, the most useful routine metric is usually peak force. Other metrics may be useful in specific situations:
Impulse may be useful if sustained toe flexion force over a selected time window is relevant.
Rate of force development may be useful when early force production matters, such as rapid foot gripping or sport-specific push-off.
Time to peak may provide context when a client produces force slowly.
Torque may be used only if a meaningful lever arm around the 1st metatarsophalangeal joint is measured.
Fatigue index may be useful only if repeated or sustained toe flexion efforts are part of the protocol.
Not every test needs every metric. The most appropriate metric depends on the test goal, body region, setup, client population, device placement, protocol quality and the professional question being asked.
The Muscle Meter and Measurz should be used for measurement, assessment reasoning, comparison, education and progress tracking. They should not be positioned as diagnosing a condition, confirming readiness, clearing participation or explaining symptoms on their own.
1st toe flexion strength testing may be useful because the hallux contributes to foot stability, balance and push-off.
The test can help professionals:
establish a baseline strength score
compare left and right 1st toe flexion force
monitor progress after training or rehabilitation
track changes after foot, ankle or toe symptoms
identify whether effort is limited by pain, fatigue or confidence
support client education with objective data
compare strength with gait, balance, calf raise or running tasks
record consistent strength information in Measurz
The test should support assessment reasoning. It should not be used as a stand-alone diagnostic or clearance measure.
When used independently, the Muscle Meter measures peak force.
When used with Measurz, Muscle Meter testing can support deeper analysis of force and strength performance, including:
Peak force: The highest force produced during the test.
Impulse: The total force applied across a selected time period.
Torque: The rotational force produced around the 1st metatarsophalangeal joint when force and lever arm are considered.
Rate of torque development: How quickly torque is produced.
Rate of force development: How quickly force is produced.
Time to peak: How long it takes to reach the highest force or torque value.
Fatigue index: How much performance declines across repeated or sustained efforts.
For 1st toe flexion, peak force is usually the primary score. Impulse may be useful for sustained gripping or push-off-related questions. Rate of force development and time to peak may be relevant in sport or rapid-control contexts, but they should not be treated as automatically meaningful for every client.
The test may provide insight into:
hallux flexion force capacity
side-to-side force differences
confidence producing toe flexion force
pain response during resisted 1st toe flexion
change in force over time
relationship between toe force and function
It does not directly measure:
1st toe flexion range of motion
1st toe extension range of motion
plantar plate integrity
sesamoid pathology
flexor hallucis longus tendon integrity
foot posture
gait quality
balance
endurance
power
readiness to return to running, sport or work
Explain the test clearly.
Example wording:
“We are going to measure how much force you can produce when pushing your big toe downward into the Muscle Meter. This is a strength test, not a diagnosis. Tell me if you feel pain, cramping, numbness or anything unusual.”
Use:
Muscle Meter, handheld dynamometer or fixed dynamometry device
small flat pad, toe plate, strap pad or suitable attachment for the 1st toe
optional strap or fixed frame for stabilisation
chair, plinth or bench
pain rating scale
Measurz recording workflow
Default method:
Push test / make test
The client pushes the 1st toe downward into the stationary device.
The professional holds or fixes the device in place.
Alternative method:
Strap-stabilised fixed test
The device or plate resists the 1st toe flexion force.
This can reduce the influence of assessor strength.
Push and pull values should be recorded separately. Do not compare them unless the protocol supports that comparison.
Common seated position:
seated on a chair or plinth
hip flexed around 90 degrees
knee flexed around 90 degrees
foot flat or supported depending on setup
ankle near neutral
1st toe positioned on or against the device
trunk upright
hands resting comfortably
Alternative long-sitting position:
client long-sitting
knee extended or slightly flexed
ankle near neutral
foot stabilised
1st toe placed against the device
Record the exact position used.
The professional should position themselves to:
stabilise the foot
keep the device aligned with the 1st toe force direction
prevent device slipping
avoid allowing ankle or foot compensation
observe compensations
read the device safely
Record:
ankle position
1st metatarsophalangeal joint position
interphalangeal joint position if relevant
whether the toe starts neutral, slightly extended or flexed
whether the foot is weight-bearing or non-weight-bearing
For routine testing, a consistent neutral or slightly extended starting position may be practical. The chosen position should be repeated at retest.
Place the device against the plantar surface of the 1st toe, often under the distal phalanx or proximal phalanx depending on the protocol.
Record the placement clearly, such as:
under distal phalanx of hallux
under proximal phalanx of hallux
under 1st toe pad
toe plate under hallux
distance from 1st MTP joint if measured
Avoid allowing the device to contact multiple toes if the goal is isolated 1st toe flexion.
Stabilise:
foot or midfoot
1st metatarsal if appropriate
ankle position
device position
chair or plinth position
Avoid:
ankle plantarflexion compensation
curling all toes if testing only the 1st toe
lifting the heel
pressing through the whole foot
hip or knee pushing
device sliding
toe pain provocation beyond safe limits
Toe flexion testing can be challenging because clients may compensate with the ankle, lesser toes or whole foot. A fixed or well-supported setup improves repeatability.
The client attempts to flex the 1st toe:
“push your big toe downward into the device”
force is directed downward or plantarward into the device
the device resists the movement
the toe should remain close to isometric, with minimal visible movement
Use consistent instructions:
“Build up gradually.”
“Push your big toe down into the device.”
“Keep the rest of the foot still.”
“Push as hard as you safely can.”
“Hold the effort.”
“Keep breathing.”
“Tell me if you feel pain or symptoms.”
Use:
1–2 submaximal practice trials
1 familiarisation maximal effort if needed
consistent cueing
enough rest before recorded trials
Familiarisation is especially important because many clients find isolated 1st toe flexion difficult.
A practical protocol:
2–3 recorded trials per side
3–5 second contraction
30–60 seconds rest between trials
test the same side first each time
record best trial or average of trials
Use the same method at retest.
Use enough rest to reduce fatigue:
30 seconds minimum for low-irritability testing
60 seconds or more for symptomatic clients or repeated efforts
longer rest if pain, cramping or fatigue affects effort
Repeat or mark a trial invalid if:
device slips
the whole foot pushes down
the heel lifts
ankle plantarflexion dominates
lesser toes dominate the effort
the client curls the toes around the device
pain limits effort unexpectedly
the client does not understand the task
compensations make the result unreliable
Stop testing if the client reports:
sharp toe, sesamoid or plantar pain
worsening neurological symptoms
cramping that does not settle
dizziness or distress
numbness or unusual symptoms
inability to produce safe effort
For clients with acute 1st MTP joint pain, suspected turf toe, sesamoid pain, plantar plate symptoms or recent surgery, use a lower-intensity test or defer maximal testing.
Retest using the same:
device
attachment
position
toe placement
1st toe joint angle
ankle angle
stabilisation
side order
number of trials
contraction duration
rest period
scoring method
unit of measurement
A push test usually means the client pushes into the Muscle Meter or handheld dynamometer.
For 1st toe flexion:
the device is placed under or against the plantar surface of the hallux
the client pushes the big toe downward
the device stays still
the score usually reflects peak force
Benefits:
practical and simple
useful for baseline testing
easy to repeat when setup is documented
can isolate the 1st toe if stabilisation is good
Limitations:
device placement affects results
compensations are common
small toe surfaces can make placement harder
assessor strength and hand stability may influence handheld tests
A pull test may use a strap, toe loop, plate or fixed attachment where the client pulls or presses the toe into resistance.
Benefits:
may improve repeatability when fixed well
may reduce assessor strength influence
useful for repeated monitoring
Limitations:
requires more setup
strap or loop placement must be consistent
values may differ from handheld push testing
should be recorded separately
A fixed setup can improve consistency because the device or toe plate is anchored rather than held by the assessor.
This is often helpful when:
the client is strong
repeated testing matters
toe placement needs to be very precise
multiple staff need to test consistently
small changes over time are being tracked
Push, pull and strap-stabilised scores should not be mixed unless the protocol and evidence support comparison.
Record the exact unit displayed by the device:
kilograms, kg
pounds, lb
Newtons, N
kilograms-force, kgf
pounds-force, lbf
percentage of body weight, %BW
In strict physics terms, force is measured in Newtons, while kilograms are a unit of mass. In applied dynamometry, some devices display force-equivalent values in kilograms. For practical Measurz recording, use the unit displayed by the device and keep the same unit across retesting.
If using the Muscle Meter alone, the primary score is usually peak force.
If using the Muscle Meter with Measurz, additional metrics may be available, including:
impulse
torque
rate of torque development
rate of force development
time to peak
fatigue index
For 1st toe flexion, peak force is usually the most practical primary metric. Impulse may be useful when sustained toe flexion is relevant. Torque is useful only when a lever arm from the 1st MTP joint is recorded. Rate of force development and time to peak may be useful in sport or rapid push-off contexts. Fatigue index is only relevant when repeated or sustained efforts are part of the protocol.
Do not present force-time metrics as diagnostic or clearance tools.
There is no fixed universal score range. Scores depend on:
device
units
body size
test position
toe joint angle
ankle angle
stabilisation
population
effort quality
pain or symptoms
scoring method
Record whether the final score is:
best trial
average of trials
peak force
left-right difference
percentage of body weight
Either best trial or average trial may be used if it is applied consistently.
A higher score may suggest:
greater 1st toe flexion force output in the tested position
improved ability to generate force against resistance
better side-to-side symmetry if the opposite side is similar
progress from baseline if the protocol is unchanged
A lower score may suggest:
reduced 1st toe flexion force output in that position
pain-limited effort
fatigue
cramping
guarding
reduced confidence
poor familiarisation
poor stabilisation
altered motor control
symptoms affecting effort
A lower score does not explain the reason for the difference on its own.
Side-to-side comparison can be useful when one side is affected.
Record:
left score
right score
difference in kg, lb or N
percentage difference
affected side
dominant side if relevant
Symmetry is useful, but symmetry alone does not confirm readiness or explain symptoms.
Percentage of body weight expresses force relative to body mass.
If the device displays kilograms:
Force in kg ÷ body mass in kg × 100 = percentage of body weight
If the device displays pounds:
Force in lb ÷ body weight in lb × 100 = percentage of body weight
If the device displays Newtons:
Force in N ÷ body weight in N × 100 = percentage of body weight
Example:
body mass = 80 kg
1st toe flexion score = 10 kg
10 ÷ 80 × 100 = 12.5% body weight
A value of 100% body weight means the client produced force equal to their body weight. A value of 50% body weight means the client produced force equal to half their body weight.
Body weight percentage may help with:
comparing clients of different body sizes
interpreting force relative to the body the client needs to move
tracking changes if body mass changes
comparing to matched reference data
Limitations:
body weight percentage values are test-specific
they should not be compared across different muscle groups
they should not be compared across different devices or protocols unless closely matched
they are not universal pass/fail thresholds
they should be interpreted with symptoms, function, goals and related findings
The score does not prove:
diagnosis
cause of weakness
tendon injury
plantar plate injury
sesamoid pathology
turf toe severity
hallux valgus severity
nerve injury
readiness to run
readiness for sport
readiness for work duties
effectiveness of one intervention by itself
Published toe flexion and hallux flexion strength values exist, but they are highly protocol-specific.
A study on functional assessments of foot strength compared seated toe flexion dynamometry with standing pressure-mat tests and found that different methods may assess different aspects of foot strength. This means reference values from one method should not be directly applied to another setup without caution.
A reliability study of doming and toe flexion testing reported novel methods for measuring doming, hallux flexion and lesser toe flexion strength, and noted that toe flexion values vary across methods and previous studies.
A study of toe strength measurements in children aged 10–12 reported excellent reliability for a fixed handheld dynamometer protocol testing hallux and lesser toe flexor strength, but those values are specific to children and the study protocol.
For older adults, toe grip strength and toe flexor strength have been associated with functional measures in some studies, but these are not interchangeable with isolated 1st toe flexion Muscle Meter scores. Toe grip strength has also been shown to decline with age in older men.
For this exact Measurz Muscle Meter 1st toe flexion setup, broad universal norms or body-weight percentage thresholds are not appropriate unless the protocol and population match the reference source.
Use practical comparison guidance:
compare left and right sides
compare with the client’s own baseline
use the same device and unit
calculate % body weight if useful
compare only with matched protocols where available
interpret with pain, toe ROM, gait, balance and activity demands
avoid universal pass/fail thresholds
At the time of writing, high-quality peer-reviewed normative or body-weight percentage reference values for this exact Muscle Meter 1st toe flexion test, device, position and population appear limited. Interpretation should rely more heavily on baseline comparison, side-to-side comparison, repeated testing, internal benchmarks, client goals, symptoms, confidence, movement quality and related assessment findings.
In youth clients, 1st toe flexion testing may be useful for:
baseline strength profiling
monitoring growth-related changes
comparing sides after injury
tracking progress over time
A higher score may suggest greater force output in the tested position. A lower score may suggest reduced force output, but it may also reflect coordination, attention, test unfamiliarity or confidence.
In youth clients, changes in force output may reflect:
growth
maturation
improved coordination
familiarisation
strength adaptation
confidence
body size changes
A fixed handheld dynamometer protocol for toe strength in children aged 10–12 has shown excellent reliability, but adult values should not be applied automatically to youth.
For general fitness clients, Muscle Meter testing is often most useful for:
baseline comparison
progress tracking
side-to-side comparison
education
monitoring response to training
A higher score may suggest greater force output. A lower score may suggest reduced force capacity, but it should be interpreted with activity level, symptoms, toe range of motion, footwear and test familiarity.
Repeated testing is usually more useful than one isolated value.
In older adults, 1st toe flexion strength may be relevant to:
balance
walking
push-off
foot stability
uneven-ground confidence
daily movement
Foot and ankle characteristics, including hallux plantar flexor strength, have been associated with balance and functional ability in older people. However, one hallux flexion score should not be treated as a single predictor of function.
Older adults may need:
slower ramp-up
more familiarisation
longer rest
cautious effort cues
careful symptom monitoring
For athletes, 1st toe flexion strength may be relevant to:
push-off
sprinting
jumping
cutting
landing
balance
foot stiffness and control
return-to-training monitoring
A higher force score may suggest greater capacity in the tested position, but performance also depends on:
rate of force development
impulse
power
coordination
reactive strength
calf strength
ankle mobility
footwear
surface
sport skill
workload tolerance
For athletes, Measurz force-time metrics may be useful when the protocol is designed well. For example, rate of force development and time to peak may provide more context than peak force alone when rapid push-off is relevant. These metrics still should not be treated as diagnostic or clearance tools.
In workplace or occupational settings, 1st toe flexion testing may provide context for:
walking
stairs
ladders
prolonged standing
uneven surfaces
footwear tolerance
carrying tasks over variable surfaces
The score should be interpreted alongside:
job demands
symptoms
footwear
fatigue
balance
gait
task exposure
professional judgement
Do not use one force score to clear a worker for full duties.
For clients returning after foot, ankle or lower-limb injury, 1st toe flexion testing may help monitor:
side-to-side force recovery
confidence producing force
pain during resisted toe flexion
baseline-to-retest change
relationship with gait, balance and calf raise tasks
A side-to-side difference may provide useful monitoring information, but symmetry alone does not confirm readiness or explain symptoms.
Pain may reduce force output through:
guarding
apprehension
reduced confidence
fatigue
cramping
symptom flare
unfamiliarity with loading
A lower force score may reflect reduced force capacity, pain, guarding, apprehension, fatigue or test unfamiliarity. It should not be used to explain the cause of pain on its own.
Always record pain during the test.
A client may produce a high absolute force score but a lower value relative to body weight.
This may be relevant for bodyweight tasks such as:
walking
running
stair climbing
stepping
jumping
changing direction
Body-weight percentage can help contextualise force relative to the body being moved, but it should be interpreted with function, symptoms and goals.
Reliability describes how consistent the test is when repeated.
Validity describes whether the test measures what it is intended to measure.
SEM estimates measurement error around a score.
MDC estimates how much change may be needed to exceed measurement error.
Typical error and coefficient of variation help explain normal variation across repeated testing.
Toe flexion testing can be reliable when the protocol is well controlled, but method matters. A fixed handheld dynamometer protocol has shown excellent reliability for hallux and lesser toe strength testing in children, while adult foot strength studies have reported that test method and position influence results.
A study of doming, hallux flexion and lesser toe flexion testing reported novel ways to quantify foot muscle strength and highlighted that toe flexion values vary across methods.
A 2023 study of an intrinsic foot muscle dynamometer reported moderate-to-excellent reliability and validity, supporting the broader idea that foot strength measurement can be quantified when the setup is controlled. However, this does not mean its values are interchangeable with every Muscle Meter 1st toe flexion setup.
For the exact Measurz Muscle Meter 1st toe flexion protocol, high-quality peer-reviewed evidence reporting SEM, MDC, typical error or coefficient of variation appears limited unless the device, position and stabilisation match a published protocol.
Reliability is stronger when you standardise:
device
attachment
1st toe joint angle
ankle angle
client position
device placement
stabilisation
force direction
contraction duration
rest period
trial selection method
symptom recording
A change is more meaningful when:
it exceeds known measurement error for a matching protocol
it is repeated across sessions
it aligns with improved function
symptoms are stable or improved
effort quality is consistent
the same device and setup were used
Common errors include:
not recording the test position
changing the 1st toe joint angle at retest
placing the device inconsistently
allowing whole-foot pushing
allowing heel lift
allowing ankle plantarflexion to dominate
allowing lesser toes to dominate if testing the 1st toe
not stabilising the foot
using different devices across sessions
mixing kg, lb and N without conversion
not recording pain during the test
treating the score as a diagnosis
using symmetry as the only readiness marker
assuming every Measurz force-time metric is relevant to every test
Limitations include:
device placement affects results
toe angle affects force output
pain and apprehension can reduce effort
cramping can affect later trials
normative values are protocol-specific
body-weight percentage values are not universal
torque requires an accurate lever arm
rate of force development requires high-quality time-series data
fatigue index requires repeated or sustained effort testing
the test measures force in one position, not full movement performance
The Ankle 1st Toe Flexion Strength Test may help with:
baseline hallux strength testing
monitoring 1st toe flexion strength over time
left-right comparison
foot and ankle injury progress tracking
balance and foot-control context
running and push-off context
sport performance support
workplace task assessment
client education
It is most useful when combined with:
1st toe extension range of motion
1st toe flexion range of motion
ankle dorsiflexion strength
calf raise testing
balance testing
gait observation
hop or jump testing where appropriate
pain and symptom notes
footwear and workload history
Record:
test name: Ankle 1st Toe Flexion Strength Test
muscle group or movement: 1st toe flexion / hallux flexion
test type: push test, pull test, make test, strap-stabilised or handheld
device used: Muscle Meter, handheld dynamometer or other
attachment used: flat pad, toe plate, strap or other
side tested: left or right
dominance if relevant
score/result
primary metric: usually peak force
additional metrics if used:
impulse
torque
rate of torque development
rate of force development
time to peak
fatigue index
units: kg, lb, N, kgf, lbf or %BW
body mass if calculating body-weight percentage
lever arm if calculating torque
trial number
best score or average score
client position: seated, long-sitting or other
ankle angle
1st MTP joint position
1st IP joint position if relevant
device placement landmark
stabilisation method
force direction
contraction duration
client instructions
pain score
symptom location
symptoms during testing
compensations:
heel lift
ankle plantarflexion
whole-foot push
lesser-toe gripping
knee movement
hip movement
trunk movement
effort quality
confidence
invalid trials
comparison side
baseline comparison
retest date
related findings:
1st toe ROM
ankle ROM
gait
balance
calf raise
dorsiflexion strength
toe extension strength
notes on interpretation
referral or further assessment notes if appropriate
Recording these details improves:
repeatability
communication
client education
assessment reasoning
monitoring over time
team consistency
reporting quality
It measures isometric force output during big toe flexion, usually by having the client push the 1st toe downward into a Muscle Meter or handheld dynamometer.
When used on its own, the Muscle Meter primarily measures peak force, which is the highest force value produced during the test.
When the Muscle Meter is used with Measurz, the assessment may support additional metrics such as impulse, torque, rate of force development, rate of torque development, time to peak and fatigue index. These metrics are only meaningful when the test setup and data quality support them.
The common Muscle Meter version is a push or make test. The client pushes the 1st toe downward into a stationary device. Strap-stabilised or pull-style setups may also be used, but they should be recorded separately.
The test mainly assesses the hallux flexors, including flexor hallucis longus, flexor hallucis brevis and related intrinsic foot muscles.
A lower score may suggest reduced force output in that position, but it does not explain why. Pain, fatigue, cramping, guarding, poor familiarisation, symptoms or poor setup may all influence the result.
If the device displays kilograms, divide force in kg by body mass in kg and multiply by 100. For example, 10 kg ÷ 80 kg × 100 = 12.5% body weight.
No. It may show reduced 1st toe flexion force or pain during testing, but it does not diagnose the cause. It should be interpreted with symptoms, history, toe range of motion, gait, footwear, loading history and related findings.
No. It can support strength monitoring, but return-to-sport reasoning should also consider symptoms, range of motion, balance, hopping, running, cutting, workload, footwear, fatigue, confidence and professional judgement.
The Ankle 1st Toe Flexion Strength Test measures isometric hallux flexion force.
The common Muscle Meter version is a push or make test.
The Muscle Meter alone primarily measures peak force.
When used with Measurz, additional metrics such as impulse, torque, rate of force development, time to peak and fatigue index may be recorded or analysed when relevant.
Peak force is usually the most useful primary metric for this test.
Record the exact device, attachment, toe position, ankle angle and units.
Body-weight percentage can help compare force relative to body size but is not a universal pass/fail value.
Reliability depends on consistent setup, stabilisation, device placement and instructions.
Measurz should record score, units, side, trials, pain, symptoms, body mass, comparison side and retest conditions.
Fraser, J. J., Koldenhoven, R. M., Saliba, S. A., & Hertel, J. (2017). Reliability of doming and toe flexion testing to quantify foot muscle strength. Journal of Foot and Ankle Research, 10, 55. https://doi.org/10.1186/s13047-017-0237-y
Goldmann, J.-P., & Brüggemann, G.-P. (2012). The potential of human toe flexor muscles to produce force. Journal of Anatomy, 221(2), 187–194. https://doi.org/10.1111/j.1469-7580.2012.01524.x
Mickle, K. J., Angin, S., Crofts, G., Nester, C. J., & Steele, J. R. (2016). Effects of age on strength and morphology of toe flexor muscles. Journal of Orthopaedic & Sports Physical Therapy, 46(12), 1065–1070. https://doi.org/10.2519/jospt.2016.6597
Menz, H. B., Morris, M. E., & Lord, S. R. (2010). Foot and ankle strength, range of motion, posture, and deformity are associated with balance and functional ability in older people. Archives of Physical Medicine and Rehabilitation, 91(1), 68–75. https://doi.org/10.1016/j.apmr.2009.09.024
Miura, S., Seko, T., Himuro, N., Koyama, M., Saitoh, S., & Ohnishi, H. (2022). Toe grip strength declines earlier than hand grip strength and knee extension strength in community-dwelling older men: A cross-sectional study. Journal of Foot and Ankle Research, 15, 79. https://doi.org/10.1186/s13047-022-00584-x
Xu, J., Goss, D. D., & Saliba, S. A. (2023). A novel intrinsic foot muscle strength dynamometer demonstrates moderate-to-excellent reliability and validity. International Journal of Sports Physical Therapy, 18(4), 864–874. https://doi.org/10.26603/001c.84310
