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[Purpose] Physical development, foot morphology, and toe contact of children aged 3 to 5 years were assessed in order to investigate the relationships between body and foot morphology and the incidence of the condition known as “floating toe”. [Subjects] A total of 198 children, aged 3 to 5 years old, participated in this study. [Methods] Height an...
Context in source publication
Citations
... Many causes of floating toes have been reported. Physical factors [5,7], lifestyle effects [8], and even surgical procedures such as Weil osteotomy [9,10] have been associated with the condition. One key factor is excessive dorsiflexion at the metatarsophalangeal (MTP) joint, often resulting from inadequate plantarflexion force. ...
This study explored the relationship between floating toes and athletic performance among collegiate track and field athletes. A total of 422 athletes (sprinters, jumpers, and distance runners) and 136 controls participated in this study. Plantar surface images were captured using a specially designed foot scanner during standing to calculate the floating toe score. The score, which sums the floating toe points of all toes, categorizes them into ‘floating toe’, ‘incomplete contact’, or ‘normal toe’. The World Athletics score served as a measure of athletic performance. Overall, collegiate track and field athletes had a significantly higher mean floating toe score (14.22 ± 4.87 points) than controls (11.06 ± 6.05 points) (p < 0.05), suggesting that fewer floating toes may confer a performance advantage. Within the track and field events, sprinters and jumpers showed significantly higher floating toe scores than distance runners (p < 0.05), emphasizing the variations in floating toes across different events. Although no significant correlation between floating toe score and World Athletics score was observed overall, a significantly negative correlation was found among distance runners (r = -0.25, p = 0.006), indicating that distance runners with higher athletic performance tend to have more pronounced floating toes. These findings suggest a nuanced relationship between floating toes and various aspects of track and field performance, particularly in distance running.
... 40 In recent years, the Faculty of Medicine, University of Yamanashi, Chuo-shi, Yamanashi, Japan; The Faculty of Rehabilitation, Kobe International University, Japan; the Graduate School of Medicine, Kyoto University, Japan; Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan Medical and Dental University, Japan, conducted a study on factors associated with floating toes in preschool children up to the age of 8 years. [40][41][42][43] Wako and her team 40,41,44 concluded that physiological floating toes in children are often caused by: 1. Underdeveloped nervous system: the immature development of the nervous system in children leads to insufficient coordination between nerves and muscles, resulting in physiological floating toes. 2. Laxity of the ligaments: in children, the ligaments are relatively lax and do not pull sufficiently on the bones of the toes. ...
The floating toe deformity is classified as a forefoot deformity wherein the distal portion of the toe does not establish touch with the ground, resulting in a suspended or elevated position while the finger is in a relaxed state. At first, it garnered considerable interest as a complication It is worth noting that this condition is particularly common in children under the age of 8, which usually disappears as the individual reaches maturity. Studies have shown that with the aggravation of floating toe deformity, its adverse effects on patients' gait and overall quality of life also increase. Despite the prevalence of floating toe deformity in clinical settings, there is a lack of comprehensive literature investigating its underlying causes and potential preventive strategies. This scope review follows the preferred reporting items for systematic reviews and meta‐analyses extension for scoping reviews (PRISMA‐ScR) statement guidelines for scope reviews. The literature was obtained from various full‐text databases, including China National Knowledge Infrastructure Database (CNKI), Wanfang Database, PubMed, and Web of Science Database. Our search focused on published literature related to floating toes, Weil osteotomy, and distal metatarsal osteotomy, up until March 1, 2023. The literature search and data analysis are conducted by two independent reviewers. If there are any disagreements, a third researcher will participate in the discussion and negotiate a decision. Furthermore, two experienced foot and ankle surgeons conducted a thorough literature analysis for this review. Sixty‐two articles were included. Through the clinical analysis of the structural changes of the forefoot before and after operation, the classification of floating toe was described, the causes of pathological floating toe were summarized, and the possible intervention measures for the disease were put forward under the advice of foot and ankle surgery experts. We comprehensively summarize the current knowledge system about the etiology of floating toe and put forward the corresponding intervention strategy. We recommend that future studies will focus on the improvement of surgical procedures, such as the combination of Weil osteotomy, proximal interphalangeal (PIP) arthrodesis and flexor tendon arthrodesis.
... Floating toes are a condition and deformity of the toes in which all the toes do not contact the ground while standing [1][2][3][4][5][6][7]. Many functional impairments in floating toes have been previously reported. ...
... A possible relationship between floating toes and throwing injuries in baseball players has recently been reported [7]. Studies regarding floating toes have gained attention in recent years, as the prevalence of floating toes has been reported to increase among children in Japan [2,8,9]. ...
... Several factors related to floating toes have been reported, including physique, physical fitness, balance, shoes, heel load, exercise quantity, and frequency of toe use [2,8,9]. Also, genetic factors, inflammatory conditions, neuromuscular or metabolic disease, and post-surgical complications of Weil osteotomy, which causes the toes to afloat by an imbalance between the intrinsic and extrinsic muscles [10][11][12]. ...
Background
Floating toes are a condition and deformity in which some of the toes are afloat. Many functional impairments in floating toes have been previously studied lately and several factors related to floating toes have also been reported. However, no reports have considered the relationship between lifestyle and floating toes among children. The purpose of this study was to reveal the prevalence of floating toes among school children and reveal its relationship with lifestyle.
Methods
In total, 138 young male baseball players were recruited. Lifestyle was evaluated by using a questionnaire and chosen whether the main lifestyle was Japanese or Western, if the bedding was futons or beds, and if the toilet was Japanese style (a squat toilet) or Western style. Floating toes were defined as toes that were not in contact with the mat. Ankle dorsiflexion in the knee-flexed and knee-extended positions was measured in a weight-bearing position. The relationship between the floating toes and lifestyles, and the comparison of ankle dorsiflexion range of motion between the lifestyles were statistically analyzed.
Results
Players living in a Western style showed a significantly higher prevalence of floating toes on both feet compared with the players living in a Japanese style (throwing side; 39% vs. 19%, p = 0.04, and non-throwing side; 43% vs. 19%, p = 0.01). Players living in a Western style with beds showed a significantly smaller range of motion on both sides of ankle dorsiflexion in the knee-flexed position compared with those who were not (throwing side; 37.2 ± 5.7° vs. 39.0 ± 6.6°, p = 0.04, and non-throwing side; 36.8 ± 5.8° vs. 38.6 ± 6.1°, p = 0.04).
Conclusion
Children mainly living in a Western lifestyle showed a significantly higher prevalence of floating toes on both feet compared to those mainly living in a Japanese lifestyle. The prevalence of floating toes may be related to lifestyles among children.
Trial registration
The study was approved by the institutional review board of the Waseda University Graduate School of Sport Sciences (IRB number 2021–185).
... Floating toe (FT) is defined as a condition, in which the toes are in insufficient contact with the ground in the standing position, and the weight does not shift to the toe while walking 1) . FT has recently been considered one of the causes of toe dysfunction 1,2) . Originally, FT was reported as a complication of surgery and is one of the most common complications of Weil osteotomy 3,4) . ...
... While FT is reportedly very common among children, with an estimated incidence rate of approximately 40. .7% in Japanese children 2,7,9) , its frequency decreases in adults. Increased muscle strength has been speculated as a reason for the decline in FT with aging. ...
... Furthermore, the current study indicated no significant correlation between lower limb muscle weight and the degree of FT. FT is an originally reported condition that occurs as a complication of Weil osteotomy 3,4) , and FT has been highlighted as a possible cause of toe dysfunction in recent studies 1,2) . Some previous reports have shown a high frequency of FT in children, ranging from 40.3-98.7%, ...
[Purpose] Floating toe is a condition in which the toes make insufficient contact with the ground. Weak muscle strength is reportedly one cause of floating toe. However, little evidence exists regarding the relationship between foot muscle strength and floating toe. Here we examined the relationship between foot muscle strength and floating toe by investigating the children’ lower extremity muscle mass and floating toe conditions. [Participants and Methods] This cohort study enrolled 118 8-year-old children (62 females, 56 males) with recorded footprints and muscle mass evaluations using dual-energy X-ray absorptiometry. We calculated the floating toe score using the footprint. We measured the muscle weights and the muscle weights divided by the lengths of the lower limbs separately on the left and right sides using dual-energy X-ray absorptiometry. [Results] No significant correlations were observed between the floating toe score and muscle weights or muscle weights divided by lower-limb lengths for either gender or side. [Conclusion] In this study, no significant correlation was found between floating toe degree and lower limb muscle mass, suggesting that lower limb muscle strength is not the primary cause of floating toe, at least in children.
... Therefore, toe function is important for preserving healthy daily activities such as standing, moving, and walking. Recently, "floating toe" (FT) has received attention as a possible cause of toe dysfunction [4,5]. Originally, the condition reportedly occurred as a result of surgery, and is one of the most common complications of Weil osteotomy [6,7]. ...
... In recent years, some reports have shown that the frequency of FT in children ranges from 40% to 98%. Araki et al. assessed 198 children aged 3 to 5 years using footprint images and reported that FT was found in 87.7% to 98.7% of them [5]. Tasaka et al. studied 635 children aged 9 to 11 years and reported that 40.3% of all feet had no toe contact with the floor at all, and they were concerned about the trend of declining foot function in children [10]. ...
Floating toe (FT) is a frequently seen condition in which a toe is inadequately in contact with the ground. Although toes play an important role in stabilizing standing posture and walking, many aspects of the effects of FT on the body remain unclear. To our knowledge, there have been no reports about the relationship between FT and postural stability, especially in children. This study aimed to clarify the prevalence of FT and its relationship with static postural stability in children. Of the 400 children aged 8 years who participated in our cohort study, 396, who were examined for static postural stability, were included in this study. Postural stability and FT were assessed using a foot pressure plate. The sway path length of the center of pressure and the area of the ellipse defined as the size of the area marked by the center of pressure, were measured as an evaluation of static postural stability. We calculated the “floating toe score (FT score: small FT score indicates insufficient ground contact of the toes)” using the image of the plantar footprint obtained at the postural stability measurement. The rate of FT was elevated at more than 90%, and the FT score in the eyes-closed condition was significantly higher than that in the eyes-open condition in both sexes. The FT score significantly correlated with the center of pressure path and area. Our results suggest that ground contact of the toes is not directly related to static postural stability in children, but it may function to stabilize the body when the condition becomes unstable, such as when the eyes are closed.
... Some researchers had reported the dysfunctions concerning floating toes 10,11) . For example, lowered toe grip strength in floating toes children compared with normal toes children are reported 6) . ...
... Participants in most of the previous reports concerning floating toes were Japanese 6,11,13,14,[23][24][25]28) , so the speculation by Matsuda et al. 23) that barefoot life style prevents the incidence of floating toes may not be applicable because Japanese people have habits of spending most of the time barefoot inside of the house. In the present study, many incidences of floating toes were observed in KND, despite them practicing and training with bare feet. ...
[Purpose] We aimed to determine the cause of floating toe syndrome, along with methods for correction and prevention. [Participants and Methods] We recruited 93 Japanese male students. Participants were grouped, according to primary sport, as Sprinters (SPR), Swimmers (SWM), Gymnasts (GYM), Kendoists (KND) and Controls (CON). Degree of floating toe syndrome was measured according to whether any toe was not in full contact with the ground in a static standing posture—the Floating Toe Point (FTP). Two points were given for each toe that was not at the FTP. The sum of the FTP was defined as the Floating Toes Score (FTS), and was classified as follows: Normalcy (over 18 points), Incomplete Contact (between 10 and 17 points), and Floating Toes (Under 9 points). [Results] The mean FTS for all participants (10.40 ± 5.803) met the criteria for Floating Toes. Scores were highest for SWMs (13.46 ± 5.710), followed by GYMs (13.26 ± 4.505), and SPRs (12.00 ± 4.870), who all met the criteria for Incomplete Contact. Both KNDs (6.55 ± 5.409) and CONs (9.45 ± 4.824) met the criteria for Floating Toes. [Conclusion] SWMs had the highest FTSs, followed by GYMs, and SPRs. KNDs had the lowest FTS. However, no group was classified as Normal. We suggest that athletes who practice or train with bare feet do not necessarily have higher FTSs, if evaluated in the standing posture.
... Previously, most reports on floating toes were the sequelae after toe surgery 5) . However, the occurrence of floating toe in normal adults and children has recently been reported 4,[6][7][8] . Moreover, the prevalence of floating toe has been reported to increase in infants in Japan 9) . ...
[Purpose] This study aimed to investigate the plantar contact condition in females and to clarify the relationship between the foot alignment and floating toes classified in static and dynamic conditions. [Participants and Methods] The participants were 122 females. We evaluated the plantar contact condition, calculated the floating toe score, and classified the floating toes of the participants. The floating toes were classified into improvable and unimprovable floating toe groups based on the floating toe score measured in dynamic conditions. Furthermore, foot alignment was evaluated in 35 participants randomized and extracted from the contact toe and the improvable and unimprovable floating toe groups. [Results] The Arch Height Index in the unimprovable floating toe group was significantly smaller than that in the improvable floating toe group. The digitus minimus varus angle in the unimprovable floating toe group was significantly larger than that in the improvable floating toe group. No significant differences were observed in other items. [Conclusion] This study revealed that the foot alignment between the improvable and unimprovable floating toe groups has different features. However, no significant difference was found in the foot alignment between the contact and floating toe groups. Henceforth, it is necessary to evaluate and classify floating toes considering the functional aspects.
... In Japan, floating toe has recently been focused on as a malalignment of the foot both in adults 6,7) and children 8,9) . Because these studies are epidemiological studies, the association between floating toe and physical function has remained unclear. ...
[Purpose] This study investigated the effect of floating toes on knee and trunk acceleration during walking in experimental setting. [Subjects and Methods] Twelve healthy volunteers walked barefoot at a preferred speed along a linear pathway under 2 conditions: normal gait (control) condition and floating toes (FT) condition. In the latter, weight bearing by the toes was avoided using kinesiology tape applied along the toe extensors. Accelerations of the knee (Kn) and lumbar spine (Lx) were assessed using triaxial accelerometers mounted on the right fibular head and the spinous process of L3. Acceleration vectors were oriented such that the anterior, right, and cranial deviations were positive along the anteroposterior, lateral, and vertical axes, respectively. The root mean squares (RMSs; anteroposterior, RMSap; lateral, RMSl; vertical, RMSv) were calculated, and the mean values of 3 trials in each condition were determined. Differences between the conditions were assessed using the Wilcoxon signed-rank test. [Results] LxRMSap and LxRMSv were larger in the FT condition than in the control condition. KnRMSv tended to be higher in the FT condition than in the control condition. [Conclusion] Floating toes increase acceleration and might create mechanical stress on the lower back and knee during walking.
... Recently, "floating toe" received attention as a possible cause of toe dysfunction 3,4) . Floating toe reportedly influences dynamic balance, stride length, and walking speed in studies from Japan. ...
... Floating toe is one of the most common complications of Weil osteotomy, an effective treatment for metatarsal overload 7,8) . In Japan, there is a high incidence of floating toe among infants and adults who have not undergone Weil osteotomy 3,4) . Despite the high incidence of floating toe in Japan, a precise etiology has not been identified. ...
... Previous studies reported the association between floating toe and differences in arch height percentage (sitting vs. standing) in adult females 3) and birth weight in infants 4) . However, no study has investigated school age children. ...
[Purpose] This study investigated the association between floating toe and toe grip strength. [Subjects and Methods] A total of 635 Japanese children aged 9–11 years participated in this study. Floating toe was evaluated using footprint images, while toe grip strength was measured using a toe grip dynamometer. All 1,270 feet were classified into a floating toe group and a normal toe group according to visual evaluation of the footprint images. Intergroup differences in toe grip strength were analyzed using the unpaired t-test and logistic regression analysis adjusted for age, gender, and Rohrer Index. [Results] There were 512 feet (40.3%) in the floating toe group. Mean toe grip strength of the feet with floating toe was significantly lower than that of normal feet (floating toe group, 12.9 ± 3.7 kg; normal toe group, 13.6 ± 4.1 kg). In addition, lower toe grip strength was associated with floating toe on logistic regression analysis after adjustment for age, gender, and Rohrer Index (odds ratio, 0.954; 95% confidence interval, 0.925–0.984). [Conclusion] This study revealed that lower toe grip strength was significantly associated with floating toe. Therefore, increasing toe grip strength may play a role in preventing floating toe in school age children.
... Untouched-toes are also called "floating-toes" [4]. In Japan, the number of children with untouched-toes is on the rise [2,5,6]. Some factors related to this condition have been pointed out, such as shoes, heel load, the amount of activity, posture, etc. [7]. ...
... Moreover, the height for boys and the body mass for girls in the second measurement also exhibited significant differences. However, as physique has not been reported to affect the occurrence ratio of untouched-toes [2,5], the difference in physique of the subjects was not considered in the following analysis. The purpose and procedure of this study were explained to the children's parents and kindergarten teachers in detail and informed consents were obtained before the study began or any measurements were taken. ...
Background
This study compared the effects of barefoot policy, a policy instructing preschool children to go without shoes, on untouched-toes, which do not touch the ground while standing normally, of preschool children attending kindergartens that follow this rule, to preschooler in kindergartens where they must wear shoes, i.e., no-barefoot policy.
Methods
The study used longitudinal data from measurements taken 2 years apart of the amount of times. The subjects were 59 children (34 boys and 25 girls) who went to a kindergarten that followed barefoot policy and 179 children (103 boys and 76 girls) who went to a kindergarten that did not follow barefoot policy. Images were taken of the contact surface area of the soles of the children’s feet by having them stand on the measurement device with their bare feet.
Results
The number of untouched-toes in children participating in the study was determined from the pictures. In boys who attended kindergartens following barefoot policy, the ratio of the children without untouched-toes significantly increased for 2 years of childhood (35.3–64.7 %). The number of untouched-toes were significantly fewer in boys from kindergartens following barefoot policy than in boys from kindergartens not following the policy, and the magnitude of the difference grew for the two study years (ES: 0.41–0.63). In girls, there were no significant differences between the two groups in the ratio of girls without untouched-toes and the number of untouched-toes.
Conclusions
In conclusion, the ground contact of the toes becomes better for boys in kindergarten with a barefoot policy. The results were inconclusive with regard to girls, and other factors may need to be examined. In the future, it will be necessary to increase the number of the subjects and perform detailed examinations.
