Abstract
BackgroundAnkle strength is often impaired in some of the most common neuromuscular disorders. Consequently, strength generated around this joint is important to assess, because it has a great impact on balance and gait. The objectives of this study were to establish normative data and predictive equations for both ankle dorsi- and plantar-flexion strength from a population of healthy subjects (children and adults), to assess the reliability of the measurements and to study the feasibility of using a novel dynamometer on a group of patients with a neuromuscular disorder.MethodsMeasurements of maximal isometric torque for dorsi- and plantar-flexion were performed on 345 healthy subjects from 5 to 80 years of age. The feasibility of the method was tested on nine patients diagnosed with type 2A limb girdle muscular dystrophy.ResultsThe results documented normal strength values depending on gender and age on ankle dorsi- and plantar-flexion. The reliability of the technique was good with no evaluator effect and a small learning effect. The dynamometer was found suitable in the group of patients, even very weak.ConclusionsThe device developed was both reliable and accurate in assessing both ankle dorsi-flexion and plantar-flexion torque measurements from weak patients and children to strong healthy adults. Norms and predictive equations are provided for these two muscle functions.
Highlights
Ankle strength is often impaired in some of the most common neuromuscular disorders
Hand held dynamometry has the advantage over manual muscle testing (MMT) of being more sensitive but the reproducibility and accuracy of measurements is dependent upon standardization of joint position which can be problematic for neuromuscular disorders such as Duchenne muscular dystrophy (DMD) or spinal muscular atrophy (SMA) where patients present contractures [7,10]
Subjects Three hundred and forty five subjects were included for the measurement of ankle strength: 57 children under 18 years (28 boys, 29 girls), 288 adults (119 men, 169 women)
Summary
Ankle strength is often impaired in some of the most common neuromuscular disorders. strength generated around this joint is important to assess, because it has a great impact on balance and gait. Hand held dynamometry has the advantage over MMT of being more sensitive but the reproducibility and accuracy of measurements is dependent upon standardization of joint position which can be problematic for neuromuscular disorders such as DMD or spinal muscular atrophy (SMA) where patients present contractures [7,10]. Another limitation of hand held dynamometry is that the tester has to be stronger than the patient to hold the dynamometer stationary [11]. All of these methods have advantages and disadvantages and none have been currently unanimously recognized as a reference measurement method for ankle strength
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