Objective method to determine the contribution of the great toe to standing balance and preliminary observations of age-related effects

The purpose of this study was to examine the relationship between toe pressure and tactile sensitivity in the great toe and to describe two newly developed measurements of postural stability. The subjects of the study were 21 healthy volunteers. The subjects were divided into two age groups, the young group (mean 21.0±1.6 years, 7 males and 6 females), and the elderly group (mean 71.4±2.8 years, 4 males and 4 females). The methods and materials used for the first experiment (balance test): The instrument for measuring standing balance was a force plate. Data were analyzed to provide two main variables: (1) body sway index (SI: mm) and (2) toe pressure (%BW/cm²). The subjects were asked to stand in a relaxed posture for 20 s. The variables of body sway were measured in four conditions: normal surface with eyes open or closed, and soft surface with eyes open or closed. Second experiment (tactile sense test): This experiment utilized a new system which was developed for measuring the tactile sensation. The tactile threshold value was measured with the subject seated in a chair, the back supported, and the hips and knees flexed at 90 degrees. The contactor pulled and pushed the toe longitudinally along its axis at a constant velocity of 1 mm/s. There were significant differences between the young and elderly groups in the tactile sense of the great toe (p<.001). No significant difference between age groups was found for postural sway while the subjects stood on the normal surface with eyes open; however, when they stood on the soft surface with their eyes open and closed, the elderly showed significantly more sway (p<0.01) than the young. Moreover, the maximal great toe pressure in the elderly group was significantly greater than that in the young group. The results suggest that the reduced tactile sense, deprivation of visual information, and toe pressure weakness are all important factors associated with postural instability