# Characterization of Great Toe Extension Strength Using ToeScale—A Novel Portable Device

## TL;DR

A new portable device called ToeScale helps assess great toe strength, revealing differences based on age, sex, and other factors.

## Contribution

The study introduces ToeScale, a novel device for measuring great toe extension strength and explores its use with machine learning.

## Key findings

- Males showed significantly higher peak great toe extension strength than females across age groups.
- Associations between great toe extension strength and BMI or grip strength varied by age and sex.
- Machine learning models showed low–moderate accuracy but were consistent with traditional statistical methods.

## Abstract

Great toe strength (GTS) weakness is linked to declines in balance and mobility. Accurately assessing GTS, particularly great toe extension strength (GTES), is often neglected in clinical evaluations due to cumbersome and subjective methods. This study aims to characterize the force development curve output from the ToeScale and examine GTES variations with age, sex, BMI, and grip strength (GS) using traditional analyses and machine learning (ML). We conducted a pilot, cross-sectional feasibility study with convenience samples. We assessed GS using a hand-grip dynamometer and GTES using the ToeScale. The data analysis included descriptive statistics, correlations, independent samples t-tests, and accuracy and area under the curve (AUC) scores for three ML models. Thirty-one participants (males: 9; females: 22), 14 young (18–24 years) and 17 older (>65 years) adults, participated in the study. Males had significantly higher peak GTES than females in both age groups. The associations of GTES parameters with BMI and GS varied by age and sex. The ML model accuracies and AUC scores were low–moderate but aligned with traditional analyses. Future studies with larger samples and optimized ML models are needed.