Lunge test in achilles tendinopathy

NewsBot · May 13, 2016

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Forefoot and rearfoot contributions to the lunge position in individuals with and without insertional achilles tendinopathy
R.L. Chimentic, A. Forenza, E. Previte, J. Tome, D.A. Nawoczenski
Clinical Biomechanics; in press

Highlights
Tibial inclination in the lunge position can detect limited motion due to Achilles tendinopathy pain.
In participants with insertional Achilles tendinopathy, but not controls, greater forefoot dorsiflexion was correlated with greater tibial inclination in the lunge position with the knee bent and knee straight.
Increased forefoot dorsiflexion may stress structures supporting the medial longitudinal arch when using the lunge position for evaluation and treatment.
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Background
Clinicians use the lunge position to assess and treat restricted ankle dorsiflexion. However, the individual forefoot and rearfoot contributions to dorsiflexion and the potential for abnormal compensations are unclear. The purposes of this case-control study were to 1) compare single- (representing a clinical lunge position measure) versus multi-segment contributions to dorsiflexion, and 2) determine if differences are present in patients with tendinopathy.

Methods
32 individuals (16 with insertional Achilles tendinopathy and 16 age- and gender-matched controls) participated. Using three-dimensional motion analysis, the single-segment model was defined as tibial inclination relative to the whole foot. The multi-segment model consisted of rearfoot (tibia relative to calcaneus) and forefoot (1st metatarsal relative to calcaneus) motion. Two-way (kinematic model and group) analyses of variance were used to assess differences in knee bent and straight positions. Associations between models were tested with Pearson correlations.

Findings
Single-segment modeling resulted in ankle DF values 50greater than multi-segment modeling that isolated rearfoot dorsiflexion for knee bent and straight positions (P<0.01). Compared to controls, the tendinopathy group had 100 less dorsiflexion with the knee bent (P<0.01). For the tendinopathy group, greater dorsiflexion was strongly associated with greater rearfoot (r=0.95, P<0.01) and forefoot (r=0.81, P<0.01) dorsiflexion. For controls, dorsiflexion was strongly associated with rearfoot (r=0.87, P<0.01) but not forefoot dorsiflexion (r=0.23, P=0.39).

Interpretation
Clinically used single-segment models of ankle dorsiflexion overestimate rearfoot dorsiflexion. Participants with insertional Achilles tendinopathy may compensate for restricted and/or painful ankle dorsiflexion by increased lowering of the medial longitudinal arch (forefoot dorsiflexion) with the lunge position.
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Ian Drakard · May 16, 2016

Anyone got full text please?

NewsBot · Apr 17, 2019

The Prevalence of Lower Extremity Non-Contact Injuries in Athletic Populations in
Relation to Measured Ankle Dorsiflexion
Logan, Richard et al
Source

Context: Ankle dorsiflexion is the degree to which the dorsal aspect of the foot can
be brought closer in relation to the shin. Restricted ankle dorsiflexion can cause
altered biomechanics and loading patterns, which can lead to injury from overcompensation in movement patterns. Limited ankle dorsiflexion alters frontal and
sagittal plane biomechanics and has been hypothesized to contribute to common
lower extremity injuries. The weight-bearing lunge test is a simple clinical evaluation
test that can measure the range of ankle dorsiflexion. Objective: The purpose of this
study was to determine if there was a correlation between restricted range of
motion with ankle dorsiflexion and lower extremity injuries. We hypothesized
restricted range of motion at the ankle would lead to increased stress on other joints
resulting in chronic stress injuries. Design: Cross-sectional study Setting: Athletic
training clinic at a mid-west NAIA institution. Participants: One-hundred forty-eight
college athletes (104 males and 44 females; age = 19.32 ± 1.21 years, height = 69.64
± 4.89 inches, mass = 81.39 ± 18.57 kg) who were all fall sport athletes (football,
N=70; women’s volleyball, N=17; men’s soccer, N=34 and women’s soccer, N=27)
were the participants of this study. Some athletes were excluded from the study if
they had suffered a lower extremity injury in the previous year. Main Outcome
Measures: Ankle dorsiflexion range of motion measured using the weight-bearing
lunge test; lower extremity noncontact injuries recorded via The Athletic Trainer
System®. Results: Results were calculated using T-Tests via IBM SPSS® software.
There was a total of 25 injured and 123 uninjured athletes. There was no statistical
significance in ankle dorsiflexion between recorded injured and uninjured
participants (p = 0.817). The average dorsiflexion for injured participants = 41.01° ±
6.28°. The average for uninjured = 41.85° ± 6.76°. Asymmetry between left and right
ankle when compared to injured (2.1° ± 1.63°) vs. uninjured (2.49° ± 1.92°) was not
significance (p = 0.290). Conclusion: There was no significant data to assume
correlation or causation between restricted ankle dorsiflexion measured via the
weight-bearing lunge test and increased risk of lower extremity noncontact
injury. Lack of significance comparing asymmetry between left and right leg in both
injured and uninjured groups provided further support for this conclusion.
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