Reliability of Ankle-Foot Morphology, Mobility, Strength, and Motor Performance Measures

Abstract

Background: Assessment of foot posture, morphology, intersegmental mobility, strength and motor control of the ankle-foot complex are commonly used clinically, but measurement properties of many assessments are unclear.Purpose: To determine test-retest and inter-rater reliability, standard error of measurement, and minimal detectable change of morphology, joint excursion and play, strength, and motor control of the ankle-foot complex.Design: Reliability study.Methods: 24 healthy, recreationally-active young adults without history of ankle-foot injury were assessed by two clinicians on two occasions, three to ten days apart. Measurement properties were assessed for foot morphology (foot posture index, total and truncated length, width, arch height), joint excursion (weight-bearing dorsiflexion, rearfoot and hallux goniometry, forefoot inclinometry, 1 st metatarsal displacement) and joint play, strength (handheld dynamometry), and motor control rating during intrinsic foot muscle (IFM) exercises. Clinician order was randomized using a Latin Square. The clinicians performed independent examinations and did not confer on the findings for the duration of the study. Test-retest and inter-tester reliability and agreement was assessed using intraclass correlation coefficients (ICC 2,k ) and weighted kappa (K w ).Results: Test-retest reliability ICC were as follows: morphology: .80-1.00, joint excursion: .58-.97, joint play: -.67-.84, strength: .67-.92, IFM motor rating: K W -.01-.71. Inter-rater reliability ICC were as follows: morphology: .81-1.00, joint excursion: .32-.97, joint play: -1.06-1.00, strength: .53-.90, and IFM motor rating: K w .02-.56. Conclusion:Measures of ankle-foot posture, morphology, joint excursion, and strength demonstrated fair to excellent test-retest and inter-rater reliability. Test-retest reliability for rating of perceived difficulty and motor performance was good to excellent for short-foot, toe-spread-out, and hallux exercises and poor to fair for lesser toe extension. Joint play measures had poor to fair reliability overall. The findings of this study should be considered when choosing methods of clinical assessment and outcome measures in practice and research. Level of evidence: 3

Increased Contact Time and Strength Deficits in Runners With Exercise-Related Lower Leg Pain

“…Lower extremity alignment measures of leg length, arch height index (seated and standing), arch rigidity index, arch drop, foot posture index, tibial torsion, Q-angle, and hip anteversion were collected using previously described methods. 17,18 Similarly, passive ROM and strength measures for the first metatarsophalangeal (flexion and extension), 17 ankle (plantar flexion, dorsiflexion, inversion, and eversion), 17 knee (flexion and extension), 19 and hip (abduction, flexion, and extension) 19 were obtained. The measurement order was not randomized and followed the methods of previous researchers 17 who performed clinical assessments of foot alignment, lower extremity ROM, and strength.…”

Gait biofeedback and impairment‐based rehabilitation for chronic ankle instability

“…Passive ankle ROM was assessed using a standard plastic goniometer to measure dorsiflexion, plantarflexion, rearfoot inversion, and eversion. 23 Weightbearing dorsiflexion was also measured. 23 Participants performed 3 10-second trials of single limb balancing on a force plate with their eyes open, and again with their eyes closed.…”

“…23 Weightbearing dorsiflexion was also measured. 23 Participants performed 3 10-second trials of single limb balancing on a force plate with their eyes open, and again with their eyes closed. The average center of pressure area (cm 2 ) and velocity (cm/s) of the 3 trials were calculated.…”

“…24 A composite SEBT score was calculated by combining the average score for 3 trials in each direction. 8 Isometric strength was assessed using established methods for ankle dorsiflexion, plantarflexion, inversion, eversion, 1st toe flexion, toes 2-5 flexion, 23 hip abduction, and hip extension. 25…”

Measurement of Dorsal First Ray Mobility: A Topical Historical Review and Commentary

“…Since radiographs are not always feasible or necessary, FRM is most often quantified in clinical studies with a mechanical device 2,3,7,31,39 or handheld rulers. 21,41,42,46,49,53 Both of these methods use a motion detector that rests in contact with the first ray. Unlike radiographs, a motion detector has freedom to follow the trajectory of the first ray when a displacement load is imposed.…”