Abstract
BackgroundThe ankle joint is a common site of musculoskeletal pathology. Measurement of its functional range of motion is a primary indicator for rehabilitation outcomes in therapy settings. The present study was designed to assess reliability and validity of a new standardised method using a D-Flex device to assess ankle range of motion.MethodsA cohort of 20 healthy volunteers were recruited to measure the weight-bearing ankle range of motion using three assessment tools, namely, a goniometer, inclinometer and the D-Flex measurement devices. Repeated measures were performed both between and within observers for each device over a 48 h period. Performance evaluation of each device and their reliability was assessed using intra-class correlation coefficients and Bland and Altman plots.ResultsAlthough significant correlations (p < 0.05) were observed between devices, there were large mean differences in ankle range of motion values ranging from 4.3°-15.7°. The D-flex produced the highest inter- and intra-rater reliability (ICCs 0.76–0.95), compared to values of 0.55–0.85 and 0.32–0.71 for the goniometer and inclinometer, respectively. The Bland and Altman plots revealed a low mean observer difference for the D-Flex (mean difference = 0.7°), with the vast majority of data coincident within the 95% confidence intervals. For both the goniometer and inclinometer mean differences were higher, with values of 3.1° and 5.7° respectively.ConclusionThe results of the present study provide evidence to support the use of the D-Flex system as a valid, portable, and easy to use alternative to the weight-bearing lunge test when assessing ankle dorsiflexion ROM in healthy participants.
Highlights
The ankle joint is a common site of musculoskeletal pathology
Participants A total of 20 participants were recruited from the local university population using poster advertisement
The range of motion (ROM) in the ankle reduced with the knee fully extended, with values ranging between 10 and 35% depending on the measurement device
Summary
The ankle joint is a common site of musculoskeletal pathology. The ankle is a common site for musculoskeletal injury for both the general public and specific sporting populations. Foot and ankle injuries are reported to represent over a quarter of musculoskeletal injuries in elite athletics [1]. Despite the high prevalence and potential severity of painful symptoms that follow the acute episode [4, 5], ankle sprains are commonly regarded as benign injuries that will resolve quickly with limited treatment [6, 7]. Outcomes of conservative treatment range widely, with as many as 74% of patients with ankle sprains experiencing symptoms up to 4 years post injury [8]. Improving range of motion in the joint is one of the primary goals of therapy
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