Assessment of Dorsiflexion Range of Motion Using Two Clinical Weight-Bearing Measurements

Abstract

Ankle dorsiflexion is needed for everyday activities, as well as sport-specific movements, such as walking, running, climbing stairs, squatting, and jumping. Various lower extremity musculoskeletal pathologies have been associated with a lack of dorsiflexion.1-6 Thus it is imperative that clinicians understand and are able to accurately assess ankle dorsiflexion. Typically, dorsiflexion range of motion (ROM) is measured with a long arm goniometer; however, the large intrapatient variation, improper alignment of the goniometer, and nonidentification of bony anatomic locations may all increase goniometric measurement error.7 The use of a fluid-filled bubble inclinometer has been reported to have higher reliability when compared with the long arm goniometer when assessing dorsiflexion ROM.7 Dorsiflexion ROM can be performed in nonweight bearing and weight bearing. Assessment of dorsiflexion in the nonweightbearing or weight-bearing position can be performed with the knee extended, as well as with the knee flexed. Assessment of dorsiflexion in these positions allows clinicians to assess all components of the triceps surae complex.8 Traditionally, nonweight-bearing measurement techniques have been used to assess dorsiflexion; however, measurement of dorsiflexion in a weightbearing position may provide clinicians with a better indicator of an athlete’s functional ROM. In this column, we discuss the use of a fluid-filled bubble inclinometer as a clinical tool to assess dorsiflexion ROM in a weightbearing position. We will present the benefits and indications of each position, a brief description of how to position the patient for each dorsiflexion ROM measurement, and the reported reliability of the measures.