Unilateral Heel-Raise Test: Estimating Normative Value and Reliability in Healthy Teenagers

Abstract

Abstract Background: The unilateral heel-raise test (UHRT) is a manual muscle testing procedure used to evaluate the power and endurance of the plantar flexors, which are important muscles for human locomotion. UHRT is commonly used in clinical practice, and normative reference values for UHRT in both adults and the pediatric population can be found in the literature. However, there is a lack of normative values for UHRT specifically for teenagers. The objective of this research study was to determine the normative value of UHRT and establish intra-and inter-tester reliability in teenagers in age group 13–17 years old. Materials and Methods: A total of 315 healthy adolescents were recruited as a part of this research. The participants were instructed to stand on the dominant foot by keeping the opposite foot off the ground (by flexing the knee to 90°). UHRT was performed actively up to maximum repetitions until the development of fatigue. Observations were recorded and further analyzed. Results: The inter- and intra-reliability of UHRT were ICC(2,k) = 0.83 (0.77–0.88) and ICC(3,1) = 0.83 (0.76–0.88), respectively. The median value (25th and 75th interquartile range) obtained for UHRT was 21 (18, 24). The Bland-Altman limits of agreement were also satisfied. The standard error of measurement (SEM) was 0.41, and the minimal detectable change (MDC) for the test was estimated to be 2. Conclusions: This study determined the normative values for UHRT in healthy teenagers of the age group 13–17 years old. It provides a valuable benchmark for interpreting the results of UHRT in teenagers. The analyses revealed good inter- and intra-reliability and minimal error, suggesting that it can be used objectively in research and clinical evaluations.