Intraobserver and Interobserver Reliability of a Method to Measure Ankle Plantar-Flexion Range of Motion in the Hook-Lying Position

2012 ◽  
Vol 21 (4) ◽  
Author(s):  
Guilherme S. Nunes ◽  
Gabriela S. Bayer ◽  
Leticia M.R. da Costa ◽  
Marcos de Noronha
Keyword(s):  
Range Of Motion ◽  
Physical Therapists ◽  
Interobserver Reliability ◽  
Plantar Flexion ◽  
Method Of Measurement ◽  
Experienced Therapist ◽  
Healthy Participants ◽  
Ankle Plantar Flexion ◽  
Very High ◽  
Treatment Table

Context: Physical therapists often have to measure ankle range of motion (ROM) to decide on intervention and investigate improvements. The most common method of measurement is goniometry, but it has been questioned due to its unsatisfactory levels of reliability. Objective: To investigate the intraobserver and interobserver reliability of a new method of measuring plantar-flexion ROM. Design: Prospective and descriptive. Setting: Laboratory. Participants: 20 healthy participants (12 women and 8 men). Main Outcome Measurements: Ankle plantar flexion was measured by 3 observers (A, B, and C) with 3 methods (goniometry, measurement in hook-lying position [MHP], and static-image analysis [SIA]). Observer A was the most experienced therapist, and C, the least. MHP was performed with the participant in the supine position, knees flexed, and first and fifth metatarsals in contact with the treatment table. SIA was recorded and analyzed in the same position. Goniometry was performed with participant seated, lower legs unsupported, and axis positioned on the lateral malleolus. Results: For the interobserver analysis, the ICC2,1 was high for the MHP (.88), high for SIA (.87), and moderate for goniometry (.57). For the intraobserver analysis, the ICC2,1 was high or very high for MHP (.91-.92), high for SIA (.79-.83), and low to moderate for goniometry (.18-.60). Conclusion: MHP is inexpensive, fast, and more reliable than goniometry for measuring plantar-flexion ROM.

scholarly journals Effect of mobilization on ankle mobility and balance performance in diabetic patients

Biomedicine ◽  
2020 ◽  
Vol 39 (2) ◽  
pp. 305-309
Author(s):  
Albin Jerome ◽  
Karthikeyan Jeyabalan ◽  
Hoe Kean Keong ◽  
Gaurai Gharote
Keyword(s):  
Range Of Motion ◽  
Conventional Treatment ◽  
Plantar Flexion ◽  
Joint Mobility ◽  
Functional Reach ◽  
Significant Difference ◽  
Functional Reach Test ◽  
Diabetic Population ◽  
Experimental Group ◽  
Ankle Plantar Flexion

Introduction and Aim: Diabetic Cheiroarthropathy is defined as the condition of restriction joint mobility due to pseudo-sclerodermatous hand, the fibrosis of the elastin connective tissues over the skin. It limits joint mobility especially around Tibia fibular mobility that are interrelated with the flexibility of ankle motion that results in the balance disorder in diabetic population. The aim of the study was to determine the effects of the tibia fibular mobilization technique on ankle joint in diabetes mellitus patients. Materials and Methods: 60 diabetic subjects were randomly assigned into experimental group and control, in which experimental group received Tibia fibular mobilization technique and conventional treatment whereas control group received only conventional treatment 1 time a week for 3 weeks. Results: There is no significant difference in Ankle dorsi flexion range of motion in both extremities but there is significant difference in ankle plantar flexion range of motion in both extremities and functional reach test in both extremities. Conclusion: There is a significant difference in the ankle plantar flexion range of motion and functional reach test, Hence, mobilization of Tibiofibular joint will be beneficial in improving the ankle range of motion and balance factor in the diabetic population.  

scholarly journals Validity of a Smartphone Application for Measuring Ankle Plantar Flexion

2018 ◽  
Vol 27 (3) ◽  
Author(s):  
Robert W. Cox ◽  
Rodrigo E. Martinez ◽  
Russell T. Baker ◽  
Lindsay Warren
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
Plantar Flexion ◽  
Smartphone Application ◽  
Convenience Sample ◽  
Correlational Design ◽  
Valid Instrument ◽  
Highly Correlated ◽  
Motion Assessment ◽  
Ankle Plantar Flexion

Context: Range of motion is a component of a physical examination used in the diagnostic and rehabilitative processes. Following ankle injury and/or during research, it is common to measure plantar flexion with a universal goniometer. The ease and availability of digital inclinometers created as applications for smartphones have led to an increase in using this method of range of motion assessment. Smartphone applications have been validated as alternatives to inclinometer measurements in the knee; however, this application has not been validated for plantar flexion in the ankle. Objectives: The purpose of this study was (1) to assess the validity of the Clinometer Smartphone Application™ produced by Plaincode App Development for use in the ankle (ie, plantar flexion) and (2) to assess the validity of the inclinometer procedures used to measure ankle dorsiflexion for measuring ankle plantar flexion. Design: Blinded repeated measures correlational design. Setting: University-based outpatient rehabilitative clinic. Participants: A convenience sample (N = 50) of participants (27 females and 23 males) who reported to the clinic (mean age = 30.48 y). Intervention: Patients were long seated on a plinth, with the knee in terminal extension. Three plantar flexion measurements were taken with a goniometer on each foot by the primary researcher. The primary researcher then conducted 3 blinded measurements with The Clinometer Smartphone Application™ following the same procedure. A second researcher, who was blinded to the goniometer measurements, recorded the inclinometer measurements. After data were collected, a Pearson’s correlation was calculated to determine the validity of the clinometer app compared with goniometry. Main Outcome Measure: Degrees of motion for ankle plantar flexion. Results: Measurements produced using the Clinometer Smartphone Application™ were highly correlated for right foot (r = .92, P < .001), left foot (r = .92, P < .001), and combined (r = .92, P < .001) with goniometer measurements using a plastic universal goniometer. Conclusion: The Clinometer Smartphone Application™ is a valid instrument for measuring plantar flexion of the ankle.

scholarly journals Repeated Measurements of Arm Joint Passive Range of Motion After Stroke: Interobserver Reliability and Sources of Variation

2012 ◽  
Vol 92 (8) ◽  
pp. 1027-1035 ◽  
Author(s):  
Lex D. de Jong ◽  
Pieter U. Dijkstra ◽  
Roy E. Stewart ◽  
Klaas Postema
Keyword(s):  
Range Of Motion ◽  
Physical Therapists ◽  
Longitudinal Design ◽  
Interobserver Reliability ◽  
Arm Movements ◽  
Error Variance ◽  
Large Contribution ◽  
Standardized Protocol ◽  
Measurement Results ◽  
Sources Of Variation

Background Goniometric measurements of hemiplegic arm joints must be reliable to draw proper clinical and scientific conclusions. Previous reliability studies were cross-sectional and based on small samples. Knowledge about the contributions of sources of variation to these measurement results is lacking. Objective The aims of this study were to determine the interobserver reliability of measurements of passive range of motion (PROM) over time, explore sources of variation associated with these measurement results, and generate smallest detectable differences for clinical decision making. Design This investigation was a measurement-focused study with a longitudinal design, nested within a 2-arm randomized controlled trial. Methods Two trained physical therapists assessed 7 arm movements at baseline and after 4, 8, and 20 weeks in 48 people with subacute stroke using a standardized protocol. One physical therapist performed the passive movement, and the other read the hydrogoniometer. The therapists then switched roles. The relative contributions of several sources of variation to error variance were explored with analysis of variance. Results Interobserver reliability coefficients ranged from .89 to .97. The PROM measurements were influenced by error variance ranging from 31% to 50%. The participant × time interaction made the largest contribution to error variance, ranging from 59% to 81%. Smallest detectable differences were 6 to 22 degrees and were largest for shoulder movements. Limitations Verification of shoulder pain and hypertonia as sources of error variance led to a substantial number of unstable variance components, necessitating a simpler analysis. Conclusions The assessment of PROM with a standardized protocol, a hydrogoniometer, and 2 trained physical therapists yielded high interobserver reliability indexes for all arm movements. Error variance made a large contribution to the variation in measurement results. The resulting smallest detectable differences can be used to interpret future hemiplegic arm PROM measurements with more confidence.

scholarly journals Intrinsic factors associated with medial tibial stress syndrome in athletes: A large case-control study

2013 ◽  
Vol 25 (3) ◽  
pp. 63 ◽  
Author(s):  
M Winters ◽  
H Veldt ◽  
EW Bakker ◽  
MH Moen
Keyword(s):  
Risk Factors ◽  
Range Of Motion ◽  
Plantar Flexion ◽  
Large Population ◽  
Multivariate Logistic Regression Analysis ◽  
Medial Tibial Stress Syndrome ◽  
Stress Syndrome ◽  
Hip Abduction ◽  
Ankle Plantar Flexion ◽  
Dorsal Flexion

Background. Medial tibial stress syndrome (MTSS) is the most common lower-leg injury in athletes, and is thought to be caused by bony overload. To prevent MTSS, both pathophysiological and aetiological factors specific to MTSS need to be identified. The intrinsic risk factors that contribute to the development of MTSS are still uncertain.Objective. To determine the intrinsic risk factors of MTSS by sampling a large population of athletic MTSS patients and controls.Methods. Athletes with MTSS and control subjects were medically examined in terms of range of motion of the leg joints (hip abduction, adduction, internal and external range of motion; ankle plantar and dorsal flexion; hallux extension and flexion; subtalar inversion and eversion), measures of over-pronation and maximal calf girth.Results. Ninety-seven subjects agreed to participate in the study: 48 MTSS patients and 49 active controls. The following variables were considered: gender, age, body mass index (BMI), hip abduction, hip adduction, internal and external hip range of rotation, ankle plantar and dorsal flexion, hallux flexion and extension, subtalar inversion and eversion, maximal calf girth, standing foot angle and navicular drop test. In multivariate logistic regression analysis, hip abduction (odds ratio (OR) 0.82; 95% confidence interval (CI) 0.72 - 0.94), ankle plantar flexion (OR 0.73; 95% CI 0.61 - 0.87) and subtalar inversion (OR 1.24; 95% CI 1.10 - 1.41) were significantly associated with MTSS. The Nagelkerke R2 for this model was 0.76, indicating that 76% of the variance in the presence of MTSS could be explained by these variables.Conclusion. Decreased hip abduction, decreased ankle plantar flexion and an increased subtalar inversion could be considered risk factors for MTSS.

scholarly journals Intrinsic factors associated with medial tibial stress syndrome in athletes: A large case-control study

2013 ◽  
Vol 25 (3) ◽  
pp. 63
Author(s):  
M Winters ◽  
H Veldt ◽  
EW Bakker ◽  
MH Moen
Keyword(s):  
Risk Factors ◽  
Range Of Motion ◽  
Plantar Flexion ◽  
Large Population ◽  
Multivariate Logistic Regression Analysis ◽  
Medial Tibial Stress Syndrome ◽  
Stress Syndrome ◽  
Hip Abduction ◽  
Ankle Plantar Flexion ◽  
Dorsal Flexion

Background. Medial tibial stress syndrome (MTSS) is the most common lower-leg injury in athletes, and is thought to be caused by bony overload. To prevent MTSS, both pathophysiological and aetiological factors specific to MTSS need to be identified. The intrinsic risk factors that contribute to the development of MTSS are still uncertain.Objective. To determine the intrinsic risk factors of MTSS by sampling a large population of athletic MTSS patients and controls.Methods. Athletes with MTSS and control subjects were medically examined in terms of range of motion of the leg joints (hip abduction, adduction, internal and external range of motion; ankle plantar and dorsal flexion; hallux extension and flexion; subtalar inversion and eversion), measures of over-pronation and maximal calf girth.Results. Ninety-seven subjects agreed to participate in the study: 48 MTSS patients and 49 active controls. The following variables were considered: gender, age, body mass index (BMI), hip abduction, hip adduction, internal and external hip range of rotation, ankle plantar and dorsal flexion, hallux flexion and extension, subtalar inversion and eversion, maximal calf girth, standing foot angle and navicular drop test. In multivariate logistic regression analysis, hip abduction (odds ratio (OR) 0.82; 95% confidence interval (CI) 0.72 - 0.94), ankle plantar flexion (OR 0.73; 95% CI 0.61 - 0.87) and subtalar inversion (OR 1.24; 95% CI 1.10 - 1.41) were significantly associated with MTSS. The Nagelkerke R2 for this model was 0.76, indicating that 76% of the variance in the presence of MTSS could be explained by these variables.Conclusion. Decreased hip abduction, decreased ankle plantar flexion and an increased subtalar inversion could be considered risk factors for MTSS.

Acute Effects of Tissue Flossing on Ankle Range of Motion and Tensiomyography Parameters

2021 ◽  
Vol 30 (1) ◽  
pp. 129-135
Author(s):  
Matjaž Vogrin ◽  
Fiona Novak ◽  
Teja Licen ◽  
Nina Greiner ◽  
Samo Mikl ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Plantar Flexion ◽  
Contraction Time ◽  
Acute Effects ◽  
Single Session ◽  
Elastic Band ◽  
Gastrocnemius Medialis ◽  
University Laboratory ◽  
Muscle Contractile ◽  
Ankle Plantar Flexion

Context: Recently, a few papers have suggested that tissue flossing (TF) acutely improves range of motion (ROM) and neuromuscular performance. However, the effects of TF on muscle contractile properties are yet to be defined. Objective: To investigate the acute effects of TF on ankle ROM and associated muscle gastrocnemius medialis displacement and contraction time assessed with tensiomyography. Design: Crossover design in a single session. Setting: University laboratory. Participants: Thirty recreationally trained volunteers (age 23.00 [4.51] y). Intervention: Active ankle plantar flexion and dorsiflexion were performed for the duration of 2 minutes (3 sets, 2-min rest between sets), while a randomly selected ankle was wrapped using TF elastic band (BAND) and the other ankle served as a control condition (CON). Main Outcome Measures: Participants performed an active ankle plantar flexion and dorsiflexion ROM test and muscle gastrocnemius medialis tensiomyography displacement and contraction time measurement pre, 5, 15, 30, and 45 minutes after the floss band application. Results: There were no statistically significant differences between BAND and CON conditions (active ankle plantar flexion ROM: P = .09; active ankle dorsiflexion ROM: P = .85); however, all ROM measurements were associated with medium or large effect sizes in favor of BAND compared with CON. No significant changes were observed in the tensiomyography parameters. Conclusions: The results of this study suggest that TF applied to the ankle is a valid method to increase ROM and at the same time maintaining muscular stiffness.

scholarly journals Reliability of Bi-Axial Ankle Stiffness Measurement in Older Adults

Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1162
Author(s):  
Hogene Kim ◽  
Sangwoo Cho ◽  
Hwiyoung Lee
Keyword(s):  
Older Adults ◽  
Range Of Motion ◽  
Angular Displacement ◽  
Plantar Flexion ◽  
Significant Negative Correlation ◽  
Talocrural Joint ◽  
Ankle Foot Orthosis ◽  
Ankle Stiffness ◽  
Ankle Movement ◽  
Test Retest Reliability

This study involves measurements of bi-axial ankle stiffness in older adults, where the ankle joint is passively moved along the talocrural and subtalar joints using a custom ankle movement trainer. A total of 15 elderly individuals participated in test–retest reliability measurements of bi-axial ankle stiffness at exactly one-week intervals for validation of the angular displacement in the device. The ankle’s range of motion was also compared, along with its stiffness. The kinematic measurements significantly corresponded to results from a marker-based motion capture system (dorsi-/plantar flexion: r = 0.996; inversion/eversion: r = 0.985). Bi-axial ankle stiffness measurements showed significant intra-class correlations (ICCs) between the two visits for all ankle movements at slower (2.14°/s, ICC = 0.712) and faster (9.77°/s, ICC = 0.879) speeds. Stiffness measurements along the talocrural joint were thus shown to have significant negative correlation with active ankle range of motion (r = −0.631, p = 0.012). The ankle movement trainer, based on anatomical characteristics, was thus used to demonstrate valid and reliable bi-axial ankle stiffness measurements for movements along the talocrural and subtalar joint axes. Reliable measurements of ankle stiffness may help clinicians and researchers when designing and fabricating ankle-foot orthosis for people with upper-motor neuron disorders, such as stroke.

scholarly journals Evaluation of Ankle Mobility Loss in Patients Undergoing Subtalar Arthrodesis

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0011
Author(s):  
Tiago S. Baumfeld ◽  
Roberto Zambelli de A. Pinto ◽  
Fernando Araujo S. Lopes ◽  
Daniel Baumfeld ◽  
Camilo Tavares
Keyword(s):  
Range Of Motion ◽  
Plantar Flexion ◽  
Contralateral Side ◽  
Foot And Ankle ◽  
Lower Range ◽  
Open Chain ◽  
Subtalar Arthrodesis ◽  
Closed Chain ◽  
Ankle Mobility ◽  
Dorsal Flexion

Category: Hindfoot Introduction/Purpose: Objective: To evaluate and quantify the loss of ankle mobility in patients undergoing subtalar arthrodesis compared to the contralateral side, through physical examination. Methods: A total of 12 patients who had only the subtalar arthrodesis procedure from various causes in one foot were selected. The same foot and ankle surgeon performed all measurements of bilateral tibiotarsal range of motion, with loaded closed-chain and unloaded open-chain tests. Then, to assess whether there was a difference between the operated and the non-operated side, statistical analysis was performed with the Mann-Whitney test (Hollander and Wolfe 1999). Results: On the loaded closed-chain test, the operated side had a significantly lower range of motion than the contralateral side, with a mean difference of 5.4 degrees for dorsal flexion and 7.6 degrees for plantar flexion. The open-chain tests showed non- significant differences of 3 degrees for dorsal flexion and 5.3 degrees for plantar flexion. Conclusion: Subtalar joint arthrodesis was shown to cause a loss of mobility in the ipsilateral ankle, which is greater in plantar flexion movement.

scholarly journals Arthroscopically-Asissted Achilles Tendon Repair; Long-Term Results

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0022
Author(s):  
Akın Turgut ◽  
Mert Zeynel Asfuroğlu
Keyword(s):  
Achilles Tendon ◽  
Range Of Motion ◽  
Sural Nerve ◽  
Plantar Flexion ◽  
Tendon Repair ◽  
Long Term Results ◽  
Calf Circumference ◽  
Achilles Tendon Repair ◽  
Arthroscopically Assisted

Objectives: The ruptures of the Achilles tendon (AT) are relatively common. Since there is no consensus on the best method of the repair of the AT; the treatment is determined on the preference of the surgeon and the patient. The study evaluating the cadaveric and short term clinical results done by our clinic in 2002, has shown us that arthroscopically Achilles tendon repair can be good choise in achilles tendon ruptures. Methods: Fortyfour patients who underwent arthroscopically assisted achilles tendon repair during 1997-2011 in Osmangazi University Orthopaedics and Traumatology Department were retrospectively observed. The mean follow-up time was 69,7 months. One of patients had bilateral rupture. The diagnosis was based on loss of plantar flexion strength, palpation of the gap in the tendon, and a positive Thompson test. MRI and USG were used when needed. The ruptures were left-sided in nineteen patients and right-sided in twentysix. The cause of the rupture was recreational sports activity in thirtyeight, fall from height in four, missing a step in a staircase in two. Return the regular activity, ankle range of motion as compared with the opposite side, calf circumference, and ability to walk and stand tiptoe were recorded. All patients were operated on within 2-32 days after the rupture. Thirtysix operations were performed under spinal anesthesia and eight operations were performed under general anesthesia. Tourniquet was always used. Before starting the procedure, the rupture site and location of the gap are marked. Using the common videoarthroscopic instruments, a 70 degrees scope was inserted into the AT through the stab incision made previously, and the torn ends of the tendon were visualized with plantar flexion an extension of the ankle. After the visualization of the torn ends of the tendon and repair by the technique of Ma and Griffith care was focused to contact the ends of the tendon anatomically; then the sutures were knotted. A short leg circular cast with the ankle in slight plantar flexion was applied. American Orthopaedics Foot-Ankle Society (AOFAS) score was used to evaluate the long-term results.. Results: All patients had satisfactory results that no reruptures had occurred. No significant difference in range of motion of the ankle and calf circumference between the opposite sides was observed in any patient. All patients could walk and stand on tiptoe. AOFAS mean score was 94.5 (65-100). The interval from injury to return to regular work and activities was 8-10 weeks. All the patients were able to return back to their activity level before surgery. In three patients temporary sural hypoestesia, in one patient permanent sural hipoestesia and in one patient wound enfection appeared. No sensory deficit was detected in the temporary sural hypoestesia patients after postoperative second year controls. Medical care was supported to the patient with the wound enfection and the enfection was under control in the early stages. Conclusion: In summary; arthroscopically-assisted percutaneous repair of AT appears to overcome some certain problems of open, conservative and percutaneous techniques; but the neurovascular structure damage risk especially the sural nerve remains a potent problem. Accurate knowledge of the anatomy appears to be a solution. Novel percutaneous repairs have been promising to minimize the risk of sural nerve damage.

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