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Comparison of Great Toe Extension, Ankle Dorsiflexion, and Eversion Strength in Individuals With and Without L4–5, L5–S1 Disc Herniation

Year: 2026

Type: article

Abstract: Ankle eversion strength Dorsiflexion strength Great toe extension strength Intervertebral disc height Lumbar disc herniationBackground: Lumbar disc herniation (LDH) can cause distal lower-extremity weakness through nerve root compression.Specifically, compression of the L5 nerve root may cause weakness in great toe extension (GTE), ankle dorsiflexion (DF), and eversion (EV).Although magnetic resonance imaging (MRI)-derived disc height reflects structural degeneration, few studies have quantitatively examined the association between disc height and L5-innervated muscle strength in individuals with LDH.Objects: This study compared GTE, DF, and EV strength between individuals with LDH and healthy controls and examined the association between MRI-derived disc height and muscle strength within the LDH group.Methods: Thirty participants were divided into two groups: individuals with LDH (n = 15) and healthy controls (n = 15).GTE, DF, and EV strengths were measured using a digital dynamometer.In the LDH group, lumbar MRI was analyzed to measure anterior, middle, and posterior disc heights at both L4-5 and L5-S1.Results: GTE, DF, and EV strength were significantly lower in individuals with LDH than in healthy controls (all p < 0.001).After adjustment for visual analogue scale, the betweengroup differences in normalized GTE, DF, and EV strength remained significant.Within the LDH group, posterior disc height at L4-5 was positively correlated with GTE and DF strength, while posterior disc height at L5-S1 was positively correlated with EV strength (r = 0.532, 0.613, and 0.631, respectively; p < 0.001, respectively).Conclusion: Individuals with LDH showed significantly lower GTE, DF, and EV strength than healthy controls.Within the LDH group, posterior disc height was positively correlated with GTE and DF strength at L4-5 and with EV strength at L5-S1.

Source: Physical Therapy Korea

DOI: 10.12674/ptk.2026.33.2.215

Authors: Hyeok-jun Lee, Il-kyu Ahn, Oh-yun Kwon

Institutions: Yonsei University, Yonsei University Mirae Campus

Language: English

Topic: Spine and Intervertebral Disc Pathology

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $230