Clinical Methods for Peroneal Muscle Testing

admin · Aug 23, 2012

Members do not see these Ads. Sign Up.
Evaluation of Clinical Methods for Peroneal Muscle Testing.
Sarig-Bahat H, Krasovsky A, Sprecher E.
Physiother Res Int. 2012 Aug 22.

BACKGROUND:
Manual muscle testing of the peroneal muscles is well accepted as a testing method in musculoskeletal physiotherapy for the assessment of the foot and ankle. The peroneus longus and brevis are primary evertors and secondary plantar flexors of the ankle joint. However, some international textbooks describe them as dorsi flexors, when instructing peroneal muscle testing. The identified variability raised a question whether these educational texts are reflected in the clinical field.

PURPOSE:
The purposes of this study were to investigate what are the methods commonly used in the clinical field for peroneal muscle testing and to evaluate their compatibility with functional anatomy.

METHODS:
A cross-sectional study was conducted, using an electronic questionnaire sent to 143 Israeli physiotherapists in the musculoskeletal field. The survey questioned on the anatomical location of manual resistance and the combination of motions resisted.

RESULTS:
Ninety-seven responses were received. The majority (69%) of respondents related correctly to the peronei as evertors, but asserted that resistance should be located over the dorsal aspect of the fifth metatarsus, thereby disregarding the peroneus longus. Moreover, 38% of the respondents described the peronei as dorsi flexors, rather than plantar flexors. Only 2% selected the correct method of resisting plantarflexion and eversion at the base of the first metatarsus. We consider this technique to be the most compatible with the anatomy of the peroneus longus and brevis. The Fisher-Freeman-Halton test indicated that there was a significant relationship between responses on the questions (P = 0.0253, 95% CI 0.0249-0.0257), thus justifying further correspondence analysis. The correspondence analysis found no clustering of the answers that were compatible with anatomical evidence and were applied in the correct technique, but did demonstrate a common error, resisting dorsiflexion rather than plantarflexion, which was in agreement with the described frequencies.

CONCLUSION:
Inconsistencies were identified between the instruction method commonly provided for peroneal muscle testing in textbook and the functional anatomy of these muscles. Results reflect the lack of accuracy in applying functional anatomy to peroneal testing. This may be due to limited use of peroneal muscle testing or to inadequate investigation of the existing evaluation methods and their validity. Accordingly, teaching materials and clinical methods used for this test should be re-evaluated. Further research should investigate the value of peroneal muscle testing in clinical ankle evaluation
Click to expand...

Admin2 · Aug 23, 2012

Related threads:
Other threads tagged with Peroneal tendon
Anatomic variants and peroneal tendon disorders

NewsBot · Aug 22, 2013

A Clinical and Radiological Study of Peroneal Tendon Pathology
Eric Giza et al
Foot Ankle Spec August 21, 2013 1938640013501544

Background. The proportion of patients with clinical findings referable to peroneal pathology and magnetic resonance imaging (MRI)–diagnosed peroneal tendon pathology is unknown. Previous studies have correlated surgical findings with clinical data and preoperative MRI, but there are no published studies that reference clinical examination findings to imaging findings. Purpose. To determine the relationship between peroneal tendon pathology as diagnosed by MRI and clinical findings of peroneal tendon pathology.

Methods. Fifty-six patients who had both MRI evidence of peroneal tendon pathology and an associated clinical examination of the ankle were evaluated over a 3-year period at a tertiary care institution. Clinical examination criteria included lateral ankle tenderness, dislocation/snapping, and lateral ankle pain. A board-certified, fellowship-trained musculoskeletal radiologist confirmed the presence of MRI findings consistent with peroneal tendon pathology.

Results. Of the 56 patients with positive findings on MRI, 27 patients had an associated positive clinical exam and 29 patients had a negative clinical exam. The positive predictive value of MRI for peroneal tendon tears with positive clinical findings was 48% (95% confidence interval = 35% to 61%).

Conclusion. Patients with MRI findings of peroneal tendon pathology should undergo careful clinical examination, as the positive predictive value of MRI for peroneal tendon pathology with actual clinical findings is low. This study demonstrates that peroneal tendon tears are often incidental findings on MRI.
Click to expand...

admin Administrator Staff Member

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

Clinical Methods for predicting the effectiveness of functional foot orthoses

Ultrasound clinical references of the healthy toenail unit

Design of the Insole to Treat the PreClinical Clubfoot Deformity

Buying caseload and rental of established clinical room

Clinical guidelines for hallux valgus

Rothbarts Foot and PreClinical Clubfoot Deformity

Clinical Biomechanical Evaluation of the foot

Share This Page