Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2005

01-01-2005 | Sports Medicine

The reliability of isokinetic testing of the ankle joint and a heel-raise test for endurance

Authors: Michael Möller, Karin Lind, Jorma Styf, Jon Karlsson

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2005

Login to get access

Abstract

The aim of the present study was to investigate the reliability of different methods used for isokinetic testing of calf muscle strength and endurance. The detailed evaluation of test-retest reliability serves the purpose of establishing reliable research tools when evaluating patients who have sustained an Achilles tendon rupture. The test-retest reliability of isokinetic measurements at the ankle for eccentric and concentric muscle action was calculated in ten healthy male volunteers using intra-class correlation (ICC) and coefficient of variation (CV). Three different positions were compared at the angular velocities of 30°/s and 180°/s for right and left ankles. The ICC for plantar flexion was 0.37–0.95, whilst it was 0.00–0.96 for dorsiflexion. The corresponding CVs were 4.0–19.9 and 2.4–19.8 respectively. The test-retest reliability of standardised heel-raises, Achilles tendon width, calf circumference and ankle range of motion revealed ICC values of 0.71–0.98 and CVs of 0.67–19.1. The test-retest interval was 5 to 7 days. We conclude that all three positions studied for the isokinetic evaluation of calf muscle function are equally reliable concerning plantar flexion at the ankle joint. The same level of reliability was also found in the evaluation of the standing heel-raise test and the isokinetic dorsiflexion test, except for dorsiflexion in the supine position. The reliability of the investigated methods was only fair despite the use of a detailed and standardised test protocol.
Literature
1.
go back to reference Alexander MJ (1990) Peak torque values for antagonist muscle groups and concentric and eccentric contraction types for elite sprinters. Arch Phys Med Rehabil 71:334–339PubMed Alexander MJ (1990) Peak torque values for antagonist muscle groups and concentric and eccentric contraction types for elite sprinters. Arch Phys Med Rehabil 71:334–339PubMed
2.
go back to reference Andersen H (1996) Reliability of isokinetic measurements of ankle dorsal and plantar flexors in normal subjects and in patients with peripheral neuropathy. Arch Phys Med Rehabil 77:265–268PubMed Andersen H (1996) Reliability of isokinetic measurements of ankle dorsal and plantar flexors in normal subjects and in patients with peripheral neuropathy. Arch Phys Med Rehabil 77:265–268PubMed
3.
go back to reference Balogun J, Onigbinde A (1992) Hand and leg dominance: do they really affect limb muscle strength? Physiother Theory Pract 8:89–96 Balogun J, Onigbinde A (1992) Hand and leg dominance: do they really affect limb muscle strength? Physiother Theory Pract 8:89–96
4.
go back to reference Bland J, Altman D (1986) Statistical methods for assessing agreement between two methods of clinical measurements. Lancet 1:307–310PubMed Bland J, Altman D (1986) Statistical methods for assessing agreement between two methods of clinical measurements. Lancet 1:307–310PubMed
6.
go back to reference Bobbert MF, van Ingen Schenau GJ (1990) Mechanical output about the ankle joint in isokinetic plantar flexion and jumping. Med Sci Sports Exerc 22:660–668PubMed Bobbert MF, van Ingen Schenau GJ (1990) Mechanical output about the ankle joint in isokinetic plantar flexion and jumping. Med Sci Sports Exerc 22:660–668PubMed
7.
go back to reference Calmels PM, Nellen M, van der Borne I, Jourdin P, Minaire P (1997) Concentric and eccentric isokinetic assessment of flexor-extensor torque ratios at the hip, knee, and ankle in a sample population of healthy subjects. Arch Phys Med Rehabil 78:1224–1230PubMed Calmels PM, Nellen M, van der Borne I, Jourdin P, Minaire P (1997) Concentric and eccentric isokinetic assessment of flexor-extensor torque ratios at the hip, knee, and ankle in a sample population of healthy subjects. Arch Phys Med Rehabil 78:1224–1230PubMed
8.
go back to reference Capranica L, Battenti M, Demarie S, Figura F (1998) Reliability of isokinetic knee extension and flexion strength testing in elderly women. J Sports Med Phys Fitness 38:169–176PubMed Capranica L, Battenti M, Demarie S, Figura F (1998) Reliability of isokinetic knee extension and flexion strength testing in elderly women. J Sports Med Phys Fitness 38:169–176PubMed
9.
go back to reference Cox PD (1995) Isokinetic strength testing of the ankle: a review. Physiother Can 47:97–106 Cox PD (1995) Isokinetic strength testing of the ankle: a review. Physiother Can 47:97–106
10.
go back to reference Daube JR, Sandok RA, Reagan TJ, Westmorland BF (1978) In: Brown L (ed) Medical Neuroscience, Boston, pp 379–382 Daube JR, Sandok RA, Reagan TJ, Westmorland BF (1978) In: Brown L (ed) Medical Neuroscience, Boston, pp 379–382
11.
go back to reference Dvir Z (1995) Isokinetics of the ankle muscles. In: Dvir Z, Isokinetics; muscle testing, interpretation and clinical applications. Churchill-Livingstone, Edinburgh, pp 129–143 Dvir Z (1995) Isokinetics of the ankle muscles. In: Dvir Z, Isokinetics; muscle testing, interpretation and clinical applications. Churchill-Livingstone, Edinburgh, pp 129–143
12.
go back to reference Fugl-Meyer AR, Sjöström M, Wahlby L (1979) Human plantar flexion strength and structure. Acta Physiol Scand 107:47–56PubMed Fugl-Meyer AR, Sjöström M, Wahlby L (1979) Human plantar flexion strength and structure. Acta Physiol Scand 107:47–56PubMed
13.
go back to reference Fugl-Meyer AR, Gustafsson L, Burstedt Y (1980) Isokinetic and static plantar flexion characteristics. Eur J Appl Physiol 45:221–234 Fugl-Meyer AR, Gustafsson L, Burstedt Y (1980) Isokinetic and static plantar flexion characteristics. Eur J Appl Physiol 45:221–234
14.
go back to reference Good P (2000) Permutation tests. A practical guide to resampling methods for testing hypotheses. Springer, Berlin Heidelberg New York Good P (2000) Permutation tests. A practical guide to resampling methods for testing hypotheses. Springer, Berlin Heidelberg New York
15.
go back to reference Häggmark T, Liedberg H, Eriksson E, Wredmark T (1986) Calf muscle atrophy and muscle function after non-operative vs operative treatment of Achilles-tendon ruptures. Orthopedics 9:160–164PubMed Häggmark T, Liedberg H, Eriksson E, Wredmark T (1986) Calf muscle atrophy and muscle function after non-operative vs operative treatment of Achilles-tendon ruptures. Orthopedics 9:160–164PubMed
16.
go back to reference Holmbäck AM, Porter MM, Downham D, Lexell J (1999) Reliability of isokinetic ankle dorsiflexor strength measurements in healthy young men and women. Scand J Rehabil Med 31:229–239PubMed Holmbäck AM, Porter MM, Downham D, Lexell J (1999) Reliability of isokinetic ankle dorsiflexor strength measurements in healthy young men and women. Scand J Rehabil Med 31:229–239PubMed
17.
go back to reference Karnofel H, Wilkinson K, Lentell G (1989) Reliability of isokinetic muscle testing at the ankle. J Orthop Sports Phys Ther 11:150–154 Karnofel H, Wilkinson K, Lentell G (1989) Reliability of isokinetic muscle testing at the ankle. J Orthop Sports Phys Ther 11:150–154
18.
go back to reference Kawakami Y, Sale DG, MacDougall JD, Moroz JS (1998) Bilateral deficit in plantar flexion: relation to knee joint position, muscle activation, and reflex excitability. Eur J Appl Physiol 77:212–216 Kawakami Y, Sale DG, MacDougall JD, Moroz JS (1998) Bilateral deficit in plantar flexion: relation to knee joint position, muscle activation, and reflex excitability. Eur J Appl Physiol 77:212–216
19.
go back to reference Keating JL, Matyas TA (1996) The influence of subject and test design on dynamometric measurements of extremity muscles. Phys Ther 76:866–889PubMed Keating JL, Matyas TA (1996) The influence of subject and test design on dynamometric measurements of extremity muscles. Phys Ther 76:866–889PubMed
20.
go back to reference Komi P (1979) Neuromuscular performance: factors influencing force and speed production. Scand J Sports Sci 1:2–15 Komi P (1979) Neuromuscular performance: factors influencing force and speed production. Scand J Sports Sci 1:2–15
21.
go back to reference Li RC, Maffulli N, Hsu YC, Chan KM (1996) Isokinetic strength of the quadriceps and hamstrings and functional ability of anterior cruciate deficient knees in recreational athletes. Br J Sports Med 30:161–164PubMed Li RC, Maffulli N, Hsu YC, Chan KM (1996) Isokinetic strength of the quadriceps and hamstrings and functional ability of anterior cruciate deficient knees in recreational athletes. Br J Sports Med 30:161–164PubMed
22.
go back to reference Lunsford BR, Perry J (1995) The standing heel-rise test for ankle plantar flexion: criterion for normal. Phys Ther 75:694–698PubMed Lunsford BR, Perry J (1995) The standing heel-rise test for ankle plantar flexion: criterion for normal. Phys Ther 75:694–698PubMed
23.
go back to reference Maupas E, Paysant J, Martinet N, Andre J (1999) Asymmetric leg activity in healthy subjects during walking, detected by electro goniometry. Clin Biomech 14:403–411 Maupas E, Paysant J, Martinet N, Andre J (1999) Asymmetric leg activity in healthy subjects during walking, detected by electro goniometry. Clin Biomech 14:403–411
24.
go back to reference Mayhew TP, Rothstein JM, Finucane SDG, Lamb RL (1994) Performance characteristics of the Kin-Com dynamometer. Phys Ther 74:1047–1054PubMed Mayhew TP, Rothstein JM, Finucane SDG, Lamb RL (1994) Performance characteristics of the Kin-Com dynamometer. Phys Ther 74:1047–1054PubMed
25.
go back to reference Miaki H, Someya F, Tachino K (1999) A comparison of electrical activity in the triceps surae at maximum isometric contraction with the knee and ankle at various angles. Eur J Appl Physiol 80:185–191 Miaki H, Someya F, Tachino K (1999) A comparison of electrical activity in the triceps surae at maximum isometric contraction with the knee and ankle at various angles. Eur J Appl Physiol 80:185–191
26.
go back to reference Morris-Chatta R, Buchner DM, de Lateur BJ, Cress ME, Wagner EH (1994) Isokinetic testing of ankle strength in older adults: assessment of inter-rater reliability and stability of strength over six months. Arch Phys Med Rehabil 75:1213–1216PubMed Morris-Chatta R, Buchner DM, de Lateur BJ, Cress ME, Wagner EH (1994) Isokinetic testing of ankle strength in older adults: assessment of inter-rater reliability and stability of strength over six months. Arch Phys Med Rehabil 75:1213–1216PubMed
27.
go back to reference Möller M, Lind K, Styf J, Karlsson J (2000) The test-retest reliability of concentric and eccentric muscle action during plantar flexion of the ankle joint in a closed kinetic chain. Isokinet Exerc Sci 8:223–228 Möller M, Lind K, Styf J, Karlsson J (2000) The test-retest reliability of concentric and eccentric muscle action during plantar flexion of the ankle joint in a closed kinetic chain. Isokinet Exerc Sci 8:223–228
28.
go back to reference Möller M, Movin T, Granhed H, Lind K, Faxén E, Karlsson J (2001) Acute rupture of tendon Achilles. A prospective randomised study of comparison between surgical and non-surgical treatment. J Bone Joint Surg Br 83:843–848PubMed Möller M, Movin T, Granhed H, Lind K, Faxén E, Karlsson J (2001) Acute rupture of tendon Achilles. A prospective randomised study of comparison between surgical and non-surgical treatment. J Bone Joint Surg Br 83:843–848PubMed
29.
go back to reference Möller M, Lind K, Movin T, Karlsson J (2002) Calf muscle function after Achilles tendon rupture. A prospective, randomised study comparing surgical and non-surgical treatment. Scand J Med Sci Sports 12:9–16PubMed Möller M, Lind K, Movin T, Karlsson J (2002) Calf muscle function after Achilles tendon rupture. A prospective, randomised study comparing surgical and non-surgical treatment. Scand J Med Sci Sports 12:9–16PubMed
30.
go back to reference Öberg B, Bergman T, Tropp H (1987) Testing of isokinetic muscle strength in the ankle. Med Sci Sports Exerc 19:318–322PubMed Öberg B, Bergman T, Tropp H (1987) Testing of isokinetic muscle strength in the ankle. Med Sci Sports Exerc 19:318–322PubMed
31.
go back to reference Porter MM, Vandervoort AA, Kramer JF (1996) A method of measuring standing isokinetic plantar and dorsiflexion peak torques. Med Sci Sports Exerc 28:516–522PubMed Porter MM, Vandervoort AA, Kramer JF (1996) A method of measuring standing isokinetic plantar and dorsiflexion peak torques. Med Sci Sports Exerc 28:516–522PubMed
32.
go back to reference Scranton PE Jr, Whitesel JP, Farewell V (1985) Cybex evaluation of the relationship between anterior and posterior compartment lower leg muscles. Foot Ankle 6:85–89PubMed Scranton PE Jr, Whitesel JP, Farewell V (1985) Cybex evaluation of the relationship between anterior and posterior compartment lower leg muscles. Foot Ankle 6:85–89PubMed
33.
go back to reference Sepic S, Murray P, Mollinger L, Spurr G, Gardner G (1986) Strength and range of motion in the ankle in two age groups of men and women. Am J Phys Med 65:75–84PubMed Sepic S, Murray P, Mollinger L, Spurr G, Gardner G (1986) Strength and range of motion in the ankle in two age groups of men and women. Am J Phys Med 65:75–84PubMed
34.
go back to reference Seymor R, Bacharach D (1990) The effect of position and speed on ankle plantar flexion in females. J Orthop Sports Phys Ther 12:153–156 Seymor R, Bacharach D (1990) The effect of position and speed on ankle plantar flexion in females. J Orthop Sports Phys Ther 12:153–156
35.
go back to reference Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428CrossRef Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428CrossRef
36.
go back to reference Steiner LA, Harris BA, Krebs DE (1993) Reliability of eccentric isokinetic knee flexion and extension measurements. Arch Phys Med Rehabil 7:1327–1335 Steiner LA, Harris BA, Krebs DE (1993) Reliability of eccentric isokinetic knee flexion and extension measurements. Arch Phys Med Rehabil 7:1327–1335
37.
go back to reference Svantesson U, Ernstoff B, Bergh P, Grimby G (1991) Use of a Kin-Com dynamometer to study the stretch-shortening cycle under plantar flexion. Eur J Appl Physiol 62:415–419 Svantesson U, Ernstoff B, Bergh P, Grimby G (1991) Use of a Kin-Com dynamometer to study the stretch-shortening cycle under plantar flexion. Eur J Appl Physiol 62:415–419
38.
go back to reference Svantesson U, Grimby G, Thomeé R (1994) Potentiation of concentric plantar flexion torque following eccentric and isometric muscle actions. Acta Physiol Scand 152:287–293PubMed Svantesson U, Grimby G, Thomeé R (1994) Potentiation of concentric plantar flexion torque following eccentric and isometric muscle actions. Acta Physiol Scand 152:287–293PubMed
39.
go back to reference Svantesson U, Österberg U, Grimby G, Sunnerhagen KS (1998) The standing heel-rise test in patients with upper motor neuron lesion due to stroke. Scand J Rehabil Med 30:73–80PubMed Svantesson U, Österberg U, Grimby G, Sunnerhagen KS (1998) The standing heel-rise test in patients with upper motor neuron lesion due to stroke. Scand J Rehabil Med 30:73–80PubMed
40.
go back to reference Wennerberg D (1991) Reliability of an isokinetic dorsiflexion and plantar flexion apparatus. Am J Sports Med 19:519–522PubMed Wennerberg D (1991) Reliability of an isokinetic dorsiflexion and plantar flexion apparatus. Am J Sports Med 19:519–522PubMed
41.
go back to reference Woodson C, Bandy WD, Curis D, Baldwin D (1995) Relationship of isokinetic peak torque with work and power for ankle plantar flexion and dorsiflexion. J Orthop Sports Phys Ther 22:113–115PubMed Woodson C, Bandy WD, Curis D, Baldwin D (1995) Relationship of isokinetic peak torque with work and power for ankle plantar flexion and dorsiflexion. J Orthop Sports Phys Ther 22:113–115PubMed
Metadata
Title
The reliability of isokinetic testing of the ankle joint and a heel-raise test for endurance
Authors
Michael Möller
Karin Lind
Jorma Styf
Jon Karlsson
Publication date
01-01-2005
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2005
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-003-0441-0

Other articles of this Issue 1/2005

Knee Surgery, Sports Traumatology, Arthroscopy 1/2005 Go to the issue