Bone variables at different sites are well correlated with muscle mass and strength, which have been evaluated through various protocols measuring voluntary peak knee extensor strength (1), or through performance in exercises such as the leg press (2), leg extension, leg curl (3), and half-squat (4). However, the relationship between foot strength, as evaluated by toe grip, and bone variables remains unexplored. Toe grip strength has been shown to correlate with overall lower extremity strength and balance, which contribute to fall prevention and reduce the risk of fractures in the elderly (5). The toes play a crucial role in maintaining stability during standing and walking, making toe grip strength an essential component of functional mobility (6).

In the elderly, muscle strength is a determinant of bone mineral density (BMD), potentially through mechanical loading, muscle-bone interactions, and the preservation of postural stability. Yet, the specific relationship between TGS and bone mass (BM) in elderly men has not been studied.

In the current study, we aim to explore the association between TGS and BM in elderly men. We hypothesized that TGS (like handgrip strength (HGS) (7, 8)) would be positively correlated with bone health variables.