A novel tool for measuring ankle dorsiflexion

P Larsen; H B Nielsen; C Lund; D S Sorenson; B T  Larson; Mark Matthews; B Vicenzino; R Elsoe

doi:10.1016/j.fas.2016.01.008

A novel tool for measuring ankle dorsiflexion

P Larsen, H B Nielsen, C Lund, D S Sorenson, B T Larson, Mark Matthews, B Vicenzino, R Elsoe

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

BACKGROUND:
Assessment of ankle joint movement in a weight bearing position has important clinical implications. The lunge ankle dorsiflexion measurement device (LAD) has been developed with the aim of facilitating ease of and standardisation of the measurement of ankle joint movement. The literature lacks studies evaluating the reliability of weight bearing measurements of the ankle joint in study groups with ankle disabilities. The objective of this study was to examine the intra- and inter-tester reliability of ankle dorsiflexion measured with the novel LAD in patients following a fracture of the ankle.

METHOD:
This study was a randomized intra- and inter-tester reliability study with blinding of testers and participants. All participants were tested twice by each tester, with the order of testers randomized. The intra- and inter-tester reliability was assessed by the calculation of interclass correlation coefficients (ICC).

RESULTS:
The study sample consisted of 24 patients: 15 females and nine males post-immobilisation following surgery for ankle fractures. The mean age was 51.0 years, ranging from 22 to 92 years. All patients had sustained an AO classification 44- fracture of the ankle. The mean follow-up time was 9.3 months (16.2 SD) after the time of fracture. The inter-tester reliability was high, with an ICC of 0.984 (95%CI: 0.963-0.993) and SEmeas of 0.14cm. The ICC for Tester A was 0.989 (95%CI: 0.974-0.995) and SEmeas 0.10cm. The ICC for Tester B was 0.990 (95%CI: 0.977-0.996) and SEmeas 0.09cm.

CONCLUSION:
This study shows a high inter- and intra-tester reliability for measuring ankle dorsiflexion with the LAD following a fracture of the ankle.

Original language	English
Pages (from-to)	274
Number of pages	277
Journal	Foot and Ankle Surgery
Volume	4
DOIs	https://doi.org/10.1016/j.fas.2016.01.008
Publication status	Published - 6 Feb 2016

Keywords

Ankle fracture
Ankle movement
Measuring device

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@article{bac27f0b759447cebb3c51d07fc169ec,

title = "A novel tool for measuring ankle dorsiflexion",

abstract = "BACKGROUND:Assessment of ankle joint movement in a weight bearing position has important clinical implications. The lunge ankle dorsiflexion measurement device (LAD) has been developed with the aim of facilitating ease of and standardisation of the measurement of ankle joint movement. The literature lacks studies evaluating the reliability of weight bearing measurements of the ankle joint in study groups with ankle disabilities. The objective of this study was to examine the intra- and inter-tester reliability of ankle dorsiflexion measured with the novel LAD in patients following a fracture of the ankle.METHOD:This study was a randomized intra- and inter-tester reliability study with blinding of testers and participants. All participants were tested twice by each tester, with the order of testers randomized. The intra- and inter-tester reliability was assessed by the calculation of interclass correlation coefficients (ICC).RESULTS:The study sample consisted of 24 patients: 15 females and nine males post-immobilisation following surgery for ankle fractures. The mean age was 51.0 years, ranging from 22 to 92 years. All patients had sustained an AO classification 44- fracture of the ankle. The mean follow-up time was 9.3 months (16.2 SD) after the time of fracture. The inter-tester reliability was high, with an ICC of 0.984 (95%CI: 0.963-0.993) and SEmeas of 0.14cm. The ICC for Tester A was 0.989 (95%CI: 0.974-0.995) and SEmeas 0.10cm. The ICC for Tester B was 0.990 (95%CI: 0.977-0.996) and SEmeas 0.09cm.CONCLUSION:This study shows a high inter- and intra-tester reliability for measuring ankle dorsiflexion with the LAD following a fracture of the ankle.",

keywords = "Ankle fracture, Ankle movement, Measuring device",

author = "P Larsen and Nielsen, {H B} and C Lund and Sorenson, {D S} and Larson, {B T} and Mark Matthews and B Vicenzino and R Elsoe",

note = "[1] Moseley A, Adams R. Measurement of passive ankle dorsiflexion: procedure and reliability. Aust J Physiother 1991;37:175–81. [2] Segal G, Elbaz A, Parsi A, Heller Z, Palmanovich E, Nyska M, et al. Clinical outcomes following ankle fracture: a cross-sectional observational study. J Foot Ankle Res 2014;7. 50-014-0050-9 eCollection 2014. [3] Bennell KL, Talbot RC, Wajswelner H, Techovanich W, Kelly DH, Hall AJ. Intrarater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother 1998;44:175–80. [4] Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury 2006;37:691–7. [5] Daly PJ, Fitzgerald Jr RH, Melton LJ, Ilstrup DM. Epidemiology of ankle fractures in Rochester, Minnesota. Acta Orthop Scand 1987;58:539–44. [6] Jensen SL, Andresen BK, Mencke S, Nielsen PT. Epidemiology of ankle fractures. A prospective population-based study of 212 cases in Aalborg, Denmark. Acta Orthop Scand 1998;69:48–50. [7] Court-Brown CM, McBirnie J, Wilson G. Adult ankle fractures – an increasing problem. Acta Orthop Scand 1998;69:43–7. [8] Stufkens SA, van den Bekerom MP, Kerkhoffs GM, Hintermann B, van Dijk CN. Long-term outcome after 1822 operatively treated ankle fractures: a systematic review of the literature. Injury 2011;42:119–27. [9] van Dijk CN, Verhagen RA, Tol JL. Arthroscopy for problems after ankle fracture. J Bone Joint Surg Br 1997;79:280–4. [10] Sigward SM, Ota S, Powers CM. Predictors of frontal plane knee excursion during a drop land in young female soccer players. J Orthop Sports Phys Ther 2008;38:661–7. [11] Fong CM, Blackburn JT, Norcross MF, McGrath M, Padua DA. Ankle-dorsiflexion range of motion and landing biomechanics. J Athl Train 2011;46:5–10. [12] Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med 2001;33:337–43. [13] Malliaras P, Cook JL, Kent P. Reduced ankle dorsiflexion range may increase the risk of patellar tendon injury among volleyball players. J Sci Med Sport 2006;9:304–9. [14] Backman LJ, Danielson P. Low range of ankle dorsiflexion predisposes for patellar tendinopathy in junior elite basketball players: a 1-year prospective study. Am J Sports Med 2011;39:2626–33. [15] Pope R, Herbert R, Kirwan J. Effects of ankle dorsiflexion range and pre-exercise calf muscle stretching on injury risk in Army recruits. Aust J Physiother 1998;44:165–72. [16] Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, et al. Fracture and dislocation classification compendium – 2007: orthopadic trauma assocoation classification, database and outcome committee. J Orthop Trauma 2007;21(10 suppl):1–133. [17] Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159–74. [18] O{\textquoteright}Shea S, Grafton K. The intra and inter-rater reliability of a modified weightbearing lunge measure of ankle dorsiflexion. Man Ther 2013;18:264–8. [19] Konor MM, Morton S, Eckerson JM, Grindstaff TL. Reliability of three measures of ankle dorsiflexion range of motion. Int J Sports Phys Ther 2012;7: 279–87.",

year = "2016",

month = feb,

day = "6",

doi = "10.1016/j.fas.2016.01.008",

language = "English",

volume = "4",

pages = "274",

journal = "Foot and Ankle Surgery",

issn = "1268-7731",

publisher = "Elsevier",

}

TY - JOUR

T1 - A novel tool for measuring ankle dorsiflexion

AU - Larsen, P

AU - Nielsen, H B

AU - Lund, C

AU - Sorenson, D S

AU - Larson, B T

AU - Matthews, Mark

AU - Vicenzino, B

AU - Elsoe, R

N1 - [1] Moseley A, Adams R. Measurement of passive ankle dorsiflexion: procedure and reliability. Aust J Physiother 1991;37:175–81. [2] Segal G, Elbaz A, Parsi A, Heller Z, Palmanovich E, Nyska M, et al. Clinical outcomes following ankle fracture: a cross-sectional observational study. J Foot Ankle Res 2014;7. 50-014-0050-9 eCollection 2014. [3] Bennell KL, Talbot RC, Wajswelner H, Techovanich W, Kelly DH, Hall AJ. Intrarater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother 1998;44:175–80. [4] Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury 2006;37:691–7. [5] Daly PJ, Fitzgerald Jr RH, Melton LJ, Ilstrup DM. Epidemiology of ankle fractures in Rochester, Minnesota. Acta Orthop Scand 1987;58:539–44. [6] Jensen SL, Andresen BK, Mencke S, Nielsen PT. Epidemiology of ankle fractures. A prospective population-based study of 212 cases in Aalborg, Denmark. Acta Orthop Scand 1998;69:48–50. [7] Court-Brown CM, McBirnie J, Wilson G. Adult ankle fractures – an increasing problem. Acta Orthop Scand 1998;69:43–7. [8] Stufkens SA, van den Bekerom MP, Kerkhoffs GM, Hintermann B, van Dijk CN. Long-term outcome after 1822 operatively treated ankle fractures: a systematic review of the literature. Injury 2011;42:119–27. [9] van Dijk CN, Verhagen RA, Tol JL. Arthroscopy for problems after ankle fracture. J Bone Joint Surg Br 1997;79:280–4. [10] Sigward SM, Ota S, Powers CM. Predictors of frontal plane knee excursion during a drop land in young female soccer players. J Orthop Sports Phys Ther 2008;38:661–7. [11] Fong CM, Blackburn JT, Norcross MF, McGrath M, Padua DA. Ankle-dorsiflexion range of motion and landing biomechanics. J Athl Train 2011;46:5–10. [12] Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med 2001;33:337–43. [13] Malliaras P, Cook JL, Kent P. Reduced ankle dorsiflexion range may increase the risk of patellar tendon injury among volleyball players. J Sci Med Sport 2006;9:304–9. [14] Backman LJ, Danielson P. Low range of ankle dorsiflexion predisposes for patellar tendinopathy in junior elite basketball players: a 1-year prospective study. Am J Sports Med 2011;39:2626–33. [15] Pope R, Herbert R, Kirwan J. Effects of ankle dorsiflexion range and pre-exercise calf muscle stretching on injury risk in Army recruits. Aust J Physiother 1998;44:165–72. [16] Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, et al. Fracture and dislocation classification compendium – 2007: orthopadic trauma assocoation classification, database and outcome committee. J Orthop Trauma 2007;21(10 suppl):1–133. [17] Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159–74. [18] O’Shea S, Grafton K. The intra and inter-rater reliability of a modified weightbearing lunge measure of ankle dorsiflexion. Man Ther 2013;18:264–8. [19] Konor MM, Morton S, Eckerson JM, Grindstaff TL. Reliability of three measures of ankle dorsiflexion range of motion. Int J Sports Phys Ther 2012;7: 279–87.

PY - 2016/2/6

Y1 - 2016/2/6

N2 - BACKGROUND:Assessment of ankle joint movement in a weight bearing position has important clinical implications. The lunge ankle dorsiflexion measurement device (LAD) has been developed with the aim of facilitating ease of and standardisation of the measurement of ankle joint movement. The literature lacks studies evaluating the reliability of weight bearing measurements of the ankle joint in study groups with ankle disabilities. The objective of this study was to examine the intra- and inter-tester reliability of ankle dorsiflexion measured with the novel LAD in patients following a fracture of the ankle.METHOD:This study was a randomized intra- and inter-tester reliability study with blinding of testers and participants. All participants were tested twice by each tester, with the order of testers randomized. The intra- and inter-tester reliability was assessed by the calculation of interclass correlation coefficients (ICC).RESULTS:The study sample consisted of 24 patients: 15 females and nine males post-immobilisation following surgery for ankle fractures. The mean age was 51.0 years, ranging from 22 to 92 years. All patients had sustained an AO classification 44- fracture of the ankle. The mean follow-up time was 9.3 months (16.2 SD) after the time of fracture. The inter-tester reliability was high, with an ICC of 0.984 (95%CI: 0.963-0.993) and SEmeas of 0.14cm. The ICC for Tester A was 0.989 (95%CI: 0.974-0.995) and SEmeas 0.10cm. The ICC for Tester B was 0.990 (95%CI: 0.977-0.996) and SEmeas 0.09cm.CONCLUSION:This study shows a high inter- and intra-tester reliability for measuring ankle dorsiflexion with the LAD following a fracture of the ankle.

AB - BACKGROUND:Assessment of ankle joint movement in a weight bearing position has important clinical implications. The lunge ankle dorsiflexion measurement device (LAD) has been developed with the aim of facilitating ease of and standardisation of the measurement of ankle joint movement. The literature lacks studies evaluating the reliability of weight bearing measurements of the ankle joint in study groups with ankle disabilities. The objective of this study was to examine the intra- and inter-tester reliability of ankle dorsiflexion measured with the novel LAD in patients following a fracture of the ankle.METHOD:This study was a randomized intra- and inter-tester reliability study with blinding of testers and participants. All participants were tested twice by each tester, with the order of testers randomized. The intra- and inter-tester reliability was assessed by the calculation of interclass correlation coefficients (ICC).RESULTS:The study sample consisted of 24 patients: 15 females and nine males post-immobilisation following surgery for ankle fractures. The mean age was 51.0 years, ranging from 22 to 92 years. All patients had sustained an AO classification 44- fracture of the ankle. The mean follow-up time was 9.3 months (16.2 SD) after the time of fracture. The inter-tester reliability was high, with an ICC of 0.984 (95%CI: 0.963-0.993) and SEmeas of 0.14cm. The ICC for Tester A was 0.989 (95%CI: 0.974-0.995) and SEmeas 0.10cm. The ICC for Tester B was 0.990 (95%CI: 0.977-0.996) and SEmeas 0.09cm.CONCLUSION:This study shows a high inter- and intra-tester reliability for measuring ankle dorsiflexion with the LAD following a fracture of the ankle.

KW - Ankle fracture

KW - Ankle movement

KW - Measuring device

U2 - 10.1016/j.fas.2016.01.008

DO - 10.1016/j.fas.2016.01.008

M3 - Article

VL - 4

SP - 274

JO - Foot and Ankle Surgery

JF - Foot and Ankle Surgery

SN - 1268-7731

ER -