Display options
Cite
Simondson J, Simondson D, Formby C, et al. The Ankle Lunge Test for measurement of dorsiflexion in individuals following stroke; reliability, validity and evaluation of change following intervention for spasticity of the lower limb. Physiother Res Int. 2021;27(1):e1925doi: 10.1002/pri.1925.
Simondson, J., Simondson, D., Formby, C., & Brock, K. (2022). The Ankle Lunge Test for measurement of dorsiflexion in individuals following stroke; reliability, validity and evaluation of change following intervention for spasticity of the lower limb. Physiotherapy research international : the journal for researchers and clinicians in physical therapy, 27(1), e1925. https://doi.org/10.1002/pri.1925
Simondson, Janine, et al. "The Ankle Lunge Test for measurement of dorsiflexion in individuals following stroke; reliability, validity and evaluation of change following intervention for spasticity of the lower limb." Physiotherapy research international : the journal for researchers and clinicians in physical therapy vol. 27,1 (2022): e1925. doi: https://doi.org/10.1002/pri.1925
Simondson J, Simondson D, Formby C, Brock K. The Ankle Lunge Test for measurement of dorsiflexion in individuals following stroke; reliability, validity and evaluation of change following intervention for spasticity of the lower limb. Physiother Res Int. 2022 Jan;27(1):e1925. doi: 10.1002/pri.1925. Epub 2021 Oct 13. PMID: 34644454.
Copy Download .nbib Format: NLM
Share it on

Physiother Res Int. 2022 Jan;27(1):e1925. doi: 10.1002/pri.1925. Epub 2021 Oct 13.

The Ankle Lunge Test for measurement of dorsiflexion in individuals following stroke; reliability, validity and evaluation of change following intervention for spasticity of the lower limb.

Physiotherapy research international : the journal for researchers and clinicians in physical therapy

Janine Simondson, David Simondson, Claire Formby, Kim Brock

Affiliations

  1. Physiotherapy Department, Health Independence Program & Rehabilitation Unit, St Vincent's Hospital Melbourne, St George's Health Service, Kew, Victoria, Australia.
  2. Physiotherapy Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
  3. Health Independence Program, St Vincent's Hospital Melbourne, St George's Health Service, Kew, Victoria, Australia.

PMID: 34644454 DOI: 10.1002/pri.1925

Abstract

INTRODUCTION: The Ankle Lunge Test (ALT) is a reliable method of measuring weight bearing ankle dorsiflexion range, a key component of gait, in healthy ankles and a range of musculoskeletal conditions. The aim of this study is to evaluate the reliability and concurrent validity of the ALT in people with stroke and investigate whether change in ALT is observed following treatment of spasticity with Botulinum Toxin.

METHODOLOGY: Repeated Measure Design: Forty stroke survivors were recruited for reliability testing. Twenty three stroke survivors were evaluated with the ALT before and after treatment of the lower limb with Botulinum Toxin. Measurement with the ALT was performed for all participants. For the reliability group, two physiotherapists evaluated the ALT on Day 1 and one therapist re-evaluated the ALT one to 5 days later. For the change evaluation group, the ALT was tested prior to and six to eight weeks after intervention. Other measures evaluated were velocity, the Functional Ambulation Category, Timed Up and Go and the Modified Tardieu Scale.

RESULTS: Intra-rater, inter-rater and test-retest reliability yielded intra-class correlation coefficients at or above 0.92. Moderate correlations were found between the ALT and velocity r = 0.605 (p < 0.01), the Timed Up and Go r = -0.598 (p < 0.01) and the Functional Ambulation Category r = 0.380 (p < 0.05). Following intervention with Botulinum Toxin, there was significant (p < 0.02) improvement in the ALT; pre-median 20 mm (IQR -25 to 35) to post-median 21 mm (IQR 0 to 40) and the Timed Up and Go; pre-median 21.40 s (IQR 13.43 to 28.82) to post-median 20.08 s (IQR 14.06 to 28.47).

CONCLUSION/SIGNIFICANCE: The ALT is a reliable and valid measure which may be applied in clinical practice to evaluate change in weight bearing ankle dorsiflexion in people with stroke.

© 2021 John Wiley & Sons Ltd.

Keywords: health care; outcome assessment; stroke

References

  1. Banky, M., Ryan, H., Clark, R., Olver, J., & Williams, G. (2017). Do clinical tests of spasticity accurately reflect muscle function during walking: A systematic review. Brain Injury, 31(4), 440-455. - PubMed
  2. Bennell, K., Talbot, R., Wajswelner, H., Techovanich, W., & Kelly, D. (1998). Intra-rater and inter-rater reliability of a weight bearing lunge measure of ankle dorsiflexion. Australian Journal of Physiotherapy, 44, 175-180. - PubMed
  3. Ben-Shabat, E., Palit, M., Fini, N., Brooks, C., Winter, A.,  & Holland, A. (2013). Intra and interrater reliability of the Modified Tardieu Scale for the assessment of lower limb spasticity in adults with neurologic injuries. Archives of Physical Medicine and Rehabilitation, 94, 2494-2501. - PubMed
  4. Chisholm, A., Perry, S., & McIlroy, W. (2013). Correlations between ankle-foot impairments and dropped foot gait deviations among stroke survivors. Clinical Biomechanics, 28, 1049-1054. - PubMed
  5. Dressler, D., Bhidayasiri, R., Bohlega, S., Chana, P., Chien, H., Chung, T., Colosimo, C., Ebke, M., Fedoroff, K., Frank, B., Kaji, R., & Saberi, F. (2018). Defining spasticity: A new approach considering current movement disorders terminology and botulinum toxin therapy. Journal of Neurology, 265, 856-862. - PubMed
  6. Gastaldi, L., Lisco, G., Pastorelli, S., & Dimanico, U. (2015). Effects of botulinum neurotoxin on spatio-temporal gait parameters of patients with chronic stroke: A prospective open-label study. European Journal of Physical and Rehabilitation Medicine, 51, 609-618. - PubMed
  7. Gupta, A., Chu, W., Howell, S., Chakraborty, S., Koblar, S., Visvanathan, R., Cameron, I., & Wilson, D. (2018). A systematic review: Efficacy of botulinum toxin in walking and quality of life in post-stroke lower limb spasticity. Systematic Reviews, 7(1), 1. - PubMed
  8. Hall, E., & Docherty, C. (2017). Validity of outcome measures to evaluate ankle range of motion during the weight-bearing lunge test. Journal of Science and Medicine in Sport(20), 618-621. - PubMed
  9. Kim, S. L., & Lee, B. H. (2018). The effects of posterior talar glide and dorsiflexion of the ankle plus mobilisation with movement on balance and gait function in patient with chronic stroke: A randomised controlled trial. Journal of Neurosciences in Rural Practice, 9(1), 61-67. - PubMed
  10. Kollen, B., Kwakkel, G., & Lindeman, E. (2006). Time dependency of walking classification in stroke. Physical Therapy, 86, 618-625. - PubMed
  11. Konor, M., Morton, S., Eckerson, J., & Grindstaff, T. (2012). Reliability of three measures of ankle dorsiflexion range of motion. The International Journal of Sports Physical Therapy, (7), 279-287. - PubMed
  12. Kuys, S. S., Brauer, S. G., & Ada, L. (2011). Test-retest reliability of the GAITRite system in people with stroke undergoing rehabilitation. Disability & Rehabilitation, 33(19-20), 1848-1853. - PubMed
  13. Leung, J., King, C., & Fereday, S. (2019). Effectiveness of a programme comprising serial casting, botulinum toxin, splinting and motor training for contracture management: A randomised controlled trial. Clinical Rehabilitation, 33(6), 1035-1044. - PubMed
  14. Malhotra, S., Pandyan, A., Day, C., Jones, P., & Hermens, H. (2009). Spasticity, an impairment that is poorly defined and poorly measured. Clinical Rehabilitation, 23, 651-658. - PubMed
  15. Mehrholz, J., Wagner, K., Rutte, K., Meibner, D., & Pohl, M. (2007). Predictive validity and responsiveness of the Functional Ambulation Category in hemiparetic patients after stroke. Archives Physical Medicine & Rehabilitation, 88, 1314-1319. - PubMed
  16. Ng, S. S., & Hui-Chan, C. W. (2005). The Timed up & go test: Its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke. Archives Physical Medicine and Rehabilitation, 86, 1641-1647. - PubMed
  17. Olney, S., & McBride, I. (1994). Temporal, kinematic and kinetic variables related to gait speed in subjects with hemiplegia: A regression approach. Physical Therapy, 74(9), 872-885. - PubMed
  18. Podsiadlo, D., & Richardson, S. (1991). The timed up and Go: A test of basic functional mobility for frail elderly persons. Journal of American Geriatric Society, 39, 142-148. - PubMed
  19. Portney, L., & Watkins, M. (2000). Foundations of clinical research (2nd ed.). Prentice Hall Health. - PubMed
  20. Powden, C. J., Hoch, J. M., & Hoch, M. C. (2015). Reliability and minimal detectable change of the weight-bearing lunge test: A systematic review. Manual Therapy, 20(4), 524-532. - PubMed
  21. Pradon, D., Hutin, E., Khadir, S., Taiar, R., Genet, F., & Roche, N. (2011). A pilot study to investigate the combined use of Botulinum toxin type-a and ankle foot orthosis for the treatment of spastic foot in chronic hemiplegic patients. Clinical Biomechanics, 26, 867-872. - PubMed
  22. Rabin, A., & Kozol, Z. (2012). Weightbearing and nonweightbearing ankle dorsiflexion range of motion: Are we measuring the same thing? Journal of the American Podiatric Medical Association, 102(5), 406-411. - PubMed
  23. Stanhope, V. A., Knarr, B. A., Reisman, D., & Higginson, J. (2014). Frontal plane compensatory strategies associated with self-selected walking speed in individuals post-stroke. Clinical Biomechanics, 29(5), 518-522. - PubMed
  24. Vohralik, S. L., Bowen, A. R., Hiller, J., & Nightingale, E. J. (2015). Reliability and validity of a smartphone App to measure joint range. American Journal of Physical Medicine & Rehabilitation, (94), 325-330. - PubMed
  25. Wissel, J., Verrier, M., Simpson, D., Charles, D., Guinto, P., Papapetropoulos, S., & Sunnerhagen, K. (2015). Post-stroke spasticity: Predictors of early development and considerations for therapeutic intervention. American Academy of Physical Medicine and Rehabilitation, 7(1), 60-67. - PubMed
  26. Yelnik, A., Simon, O., Parratte, B., & Gracies, J. M. (2010). How to clinically assess and treat muscle overactivity in spastic paresis. Journal of Rehabilitation Medicine, 42, 801-807. - PubMed

Publication Types

Grant support