Comparative analysis of the validity of goniometric, inclinometric, and radiographic methods to measure ankle joint dorsiflexion

Background. The search for an optimal method to assess the amplitude of ankle joint dorsiflexion remains topical for scientific discussions. The purpose of the research was to analyze the validity of goniometric and inclinometric methods for measuring the scope of ankle joint (AJ) dorsiflexion compared to radiological data. Materials and methods. The research included 25 healthy and physically active people (50 ankle joints), 18 men and 7 women with an average age of 25.8 ± 5.2 years; their mean body mass index was 25.01 ± 5.01 kg/m2. Ankle dorsiflexion measures were obtained in a weight-bearing lunge position using a double-plane goniometer and inclinometer, then compared with X-ray data. The measurement results were evaluated by descriptive statistics. Results. Mean values of AJ dorsiflexion obtained with a double-plane goniometer were 37.62 ± 5.56°; with an inclinometer — 40.61 ± 5.15°; radiological results — 23.69 ± 7.25°. Their difference was significant (p < 0.001). The mean variability index for the radiological method was 0.31 prevailing over goniometric (0.15) and inclinometric (0.13) methods (p < 0.001). X-ray ima-ging of a weight-bearing AJ at its maximum dorsiflexion raises the indicator of a talus-first metatarsal angle. Conclusions. The values of the dorsiflexion angle parameters of an AJ, measured using goniometric and inclinometric methods, significantly exceed those obtained by X-ray imaging. Higher variation index for radiological imaging demonstrates better reproducibility of inclinometry and goniometry when evaluating AJ dorsiflexion. A weight-bearing AJ radiogram at maximum extended position demonstrates an increase in a talus-first metatarsal angle compared to normal values that should be considered when interpreting the results of X-ray imaging of an AJ dorsiflexion.

Clinical measures of foot posture and ankle joint dorsiflexion do not differ in adults with and without plantar heel pain

Foot posture and ankle joint dorsiflexion have long been proposed to be risk factors for plantar heel pain, however body mass may be a confounder when investigating these factors. The aim of this study was to determine if clinical measures of foot posture and ankle joint dorsiflexion differ in adults with and without plantar heel pain after accounting for body mass. This was a cross-sectional observational study that compared 50 participants with plantar heel pain to 25 control participants without plantar heel pain who were matched for age, sex and body mass index. Foot posture was assessed using the Foot Posture Index and the Arch Index. Ankle joint dorsiflexion was assessed with a weightbearing lunge test with the knee extended and with the knee flexed. No significant differences (P < 0.05) were found between the groups for foot posture, whether measured with the Foot Posture Index or the Arch Index. Similarly, no significant differences were found in the weightbearing lunge test whether measured with the knee extended or with the knee flexed. Clinical measures of foot posture and ankle joint dorsiflexion do not differ in adults with and without plantar heel pain when body mass is accounted for. Therefore, clinicians should not focus exclusively on foot posture and ankle dorsiflexion and ignore the contribution of overweight or obesity.

The Design, Development, and Reliability Testing of a New Innovative Device to Measure Ankle Joint Dorsiflexion

Background: In clinical and research settings, ankle joint dorsiflexion needs to be reliably measured. Dorsiflexion is often measured by goniometry, but the intrarater and interrater reliability of this technique have been reported to be poor. Many devices to measure dorsiflexion have been developed for clinical and research use. An evaluation of 12 current tools showed that none met all of the desirable criteria. The purpose of this study was to design and develop a device that rates highly in all of the criteria and that can be proved to be highly reliable. Methods: While supine on a treatment table, 14 participants had a foot placed in the Charles device and ankle joint dorsiflexion measured and recorded three times with a digital inclinometer. The mean of the three readings was determined to be the ankle joint dorsiflexion. Results: The analysis used was intraclass correlation coefficient (ICC). There was very little difference in ICC single or average measures between left and right feet, so data were pooled (N = 28). The single-measure ICC was 0.998 (95% confidence interval, 0.996-0.998). The average-measure ICC was 0.998 (95% confidence interval, 0.995-0.999). Limits of agreement for the average measure were also very good: −1.30° to 1.65°. Conclusions: The Charles device meets all of the desirable criteria and has many innovative features, increasing its appropriateness for clinical and research applications. It has a suitable design for measuring dorsiflexion and high intrarater and interrater reliability.