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Lunge Test Update

Discussion in 'Biomechanics, Sports and Foot orthoses' started by nevparker, Jul 13, 2010.

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  1. nevparker

    nevparker Member


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    Hi

    I have been wanting to learn more about the Lunge teat so that it can be incorporated into my depaertment's protocols.

    I have read the threads from 2006 http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=1605

    But there doesn#'t seem to be any more recent information.

    Craig, did you continue to validate the test after 2006 and what were your results? Has anyone else furthered the work on it?

    Thanks

    Neville
     
  2. Griff

    Griff Moderator

    Hi Neville,

    Following on from Bennell et al and Pope et al in 1998, and then Gabbe et al in 2004, the lunge test had some further reliability studies performed by the team of Physiotherapists at Headley Court in 2005 which may interest you (they built a little jig from memory):

    http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7CVK-4GMGWFX-1&_user=10&_coverDate=12%2F31%2F2005&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1398781106&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=03e452721b9a2f9c63d1cd728c0d7f55

    Also this by the La Trobe team in 2009:

    http://www.jsams.org/article/S1440-2440(07)00188-0/abstract
     
  3. nevparker

    nevparker Member

    Thanks for that, i'll get hold of them later today.
     
  4. Griff

    Griff Moderator

    Cool. PM me if you struggle to get them - pretty sure I have both of them on my laptop at home which I could email to you if need be
     
  5. Mart

    Mart Well-Known Member

    Hi Neville

    I have used a modified approach to this idea for clinically for several years. Instead of measuring wall to foot distance I simply take video of a precisely parallel saggital to foot view and use a contact switched LED as a cue for measuring the anterior edge of the tibia at frame before heel pad unloads using software measurement of pertinant frame.

    Jones et al state

    “Since completion of the study, a number of
    modifications have been made to the measurement tool. The
    most significant improvement is the inclusion of a pressure
    pad incorporated into the base plate at the heel section. This
    makes an audible noise when heel contact with the base plate
    ceases. This excludes the need for the observer to hold the
    heel in contact with the base plate, and thus may reduce the
    error of measurement.

    There is an acceptance that using a weight-bearing dorsiflexion
    lunge measure does not assess the effect and range of
    each joint or soft tissue structure involved. Thus, this measure
    cannot be considered to be a valid measure of isolated
    weight-bearing talocrural dorsiflexion range. Future studies
    may wish to separate this movement into component parts
    and measure each individually. However, identification of
    restrictions in movement and the subsequent success with
    improving weight-bearing range suggests that there will be
    benefits to weight-bearing functional performance.”


    I concur with both points. Because my podiatry assistant does the data collection, using the LED cue allows me to quickly review the data for errors in interpretation and examine outliers which appear to occur mostly with those with stability issues who perform inappropriate movements. Similarly having a video record to audit data seems preferable to using handheld goniometer which doesnt allow for any scrutiny of events

    As you know their second point is an important one. When reviewing the videos the behavior of the foot distal to the TCJ becomes qualitatively apparent and may be factored into interpretation.

    An issue not raised in this paper is value of measuring TCJ with knee flexed vs extended.

    Since during stance phase of walking gait knee should be extended during peak of eccentric triceps activity I would view this as most useful attribute to measure. Theoretically I would anticipate with knee flexed the TNC stiffness might be lower with gastrocnemius largely removed from the equation.

    I did a quick and dirty study of several subjects to investigate this and found around 3 degree difference measuring with knee extended and flexed, there were plenty of possible problems with interpreting this which I won’t elaborate now.

    Likewise I was also interested to see if there was any eccentric activity of triceps during this test, again quick and dirty study was consistent for no measurable surface EMG signal which I found interesting if considering comparison with walking.

    I am considering doing a proper study to look at the effect of various stretching protocols on functional TCJ behavior, possibly using diagnostic ultrasound to measure excursion of musculotendinous junction as comparative index. Please let me know if you (anyone else) have any interest in collaboration in such a project.



    Cheers

    Martin




    The St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    Phone [204] 837 FOOT (3668)
    Fax [204] 774 9918
    www.winnipegfootclinic.com
     
  6. Why don't we just measure ankle dorsiflexion stiffness?
     
  7. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Neville, sorry there is not much more tosay on it that what we covered at the Boot Camps and what is discussed in these threads. We continue to use it and have done a few projects, but nothing to report at this stage.

    Like SImon mentioned, ankle joint stiffness is the key...
     
  8. Mart

    Mart Well-Known Member

    Are you thinking of stiffness at specific point (heel off?) or through a range of time/movement?

    I think this would technologicaly a little more demanding.

    I am assuming that you would use a torque gauge coupled the front of the tibia or do you have a simpler solution? Also how would you control for angular velocity, I guess you could measure passive motion with a servo driving the motion?

    The results would be more meaningful though, especially to investigate if the VE properties changed throught the subjects normal activity range by varying the rate of applied force (inferred walking/running velocity).

    cheers

    Martin

    The St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  9. Jonatan García

    Jonatan García Active Member

    Hello everyone,

    As a comment to reply to Simon Spooner and Craig Payne, I would comment that the test does not isolate the measurement of ankle dorsiflexión stiffness, as due to the way it is done, apply a torque not only in the joint ankle, but also in other joints of the foot, so it accumulates the amount of available torquesat the tibiofibular joint, talus joint, subtalar and tarsal joints. So, in my opinion, the test would measure the dorsiflexión stiffness of the joints involved in goblal dorsiflexion of the foot.

    As is normal for me, not I explained it very well, and I've used the google translator, so I do not know what the outcome.

    Greetings to all

    Jonatan
     
  10. Mart

    Mart Well-Known Member

    Buenos días Jonatan

    This is well understood and is quite explicit in Jones et al discussion.

    Perhaps Simon was hinting at way of measuring torque which isolates talocural joint but think this would be difficult

    As aside is anyone else noticing this virus alert when openinng this thread since Simon posted?

    virus.jpg

    cheers


    Martin


    The St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  11. I think you are making it more difficult than it needs to be . Lunge test is a static test, so you can measure ankle joint dorsiflexion stiffness statically too. Get a force gauge and measure load/ deformation. Mathematically, rotational stiffness, k, is given by
    k = M / θ
    Where:
    M is the applied moment (moment = force x distance from axis)
    θ is the rotation


    You can do it dynamically using a force plate and kinematic analysis.

    I have not seen any virus alert Martin and as I use an Apple, viruses are extremely rare. However, even Apple users can act as carriers to you PC's so I do have anti-virus software. This has not detected anything. I'll update and re-scan.
     
  12. Mart

    Mart Well-Known Member

    Agreed on that approach but then need 3D kinematics to measure linear distances and errors associated with markers + lot of setup tome for clinical use. My thoughts were that torque gauge would take care of data collection in one shot and by measuring angular velocity also eliminate need for 3D, much faster and probably cheaper instrumentation without pre-exisitng 3D system. Also issue of joints distal to TCJ adding to measured motion but this occrus with lunge too of course.

    I think that lunge still remains best potential for clincial use, possibly fo monitoring exercise effect (which may be lacking). As we know good studies needed. Would be good to discuss further what that migh involve if you are agrreable?

    What do you think about torque measurement idea cf linear measurement calculations?

    Virus thing may be over sensitivity of my virus software or some other wierdness if no one else is noticing this.

    cheers

    Martin
     
  13. Martin,

    You don't need 3D kinematics to measure static stiffness of the ankle joint, just a force gauge and a goniometer. So why should the lunge test be better than this? How does the lunge test measure dynamic ankle joint stiffness- it doesn't right? Although it may be predictive of it. So why couldn't the static measure of ankle joint dorsiflexion stiffness using a force gauge be used to model ankle joint motion during gait? Answer: no reason at all. I've asked this question before, what is the model which links the lunge test with ankle joint motion during gait? Y= mx +c ?

    And although there will be some error with 2D kinematics, And 1D kinetics, I think for a clinical estimation you could probably use a pressure mat and video based system to assess dynamic ankle stiffness- but i need some more time to think about this one, you'd need to measure angular position / velocity, CoP position / magnitude- I'm thinking about this one.

    I'm pretty busy at the moment preparing to lecture at biomechanics summer school. In the meantime, there have been two methods employed to measure ankle joint stiffness dynamically:

    Stefanyshyn D, Nigg B. Dynamic angular stiffness of the ankle joint during running and sprinting. J Appl Biomech 1998: 14: 292–299.

    And the more questionable method employed by:
    Arampatzis A, Bruggemann G, Metzler V. The effect of speed on leg stiffness and joint kinetics in human running. J Biomech 1999: 32: 1349–1353.
     
  14. Mart

    Mart Well-Known Member


    Yes I agree with your reasoning and will check out your references thanks for that.

    As far as the lunge test; if the correlation between stiffness and tibial position at heel off is sound (which we assume) and the purpose of the lunge test is to measure exercise induced change and possibly a predictive value for injury (which evidence points to) then the actual stiffness calculation clinically seems mute to me. If the correlation is poor and/or lacks predicitve value compared to stiffness then I agree stiffness value would be worth the extra effort to measure.

    From a functional point of view, the moment of heel off intuitively seems an appropriate measurement point because it marks the start of a large change in forefoot behaviour (sagital motion and ground reaction force). However I wonder if the main reason it has been used is that it is also a conveniently (statically the only?) reliable identifiable event.

    Behind my thoughts on static vs dynamic measurement were that a dynamic approach is the only way I could see to give an insight into importance of the static measurement point we choose.

    Based on my observations on how many of my patients seem to perform exercises poorly on review (despite clear demonstration and printed takaway), plus difficulty evaluating compliance I suspect that much of the stretching exercise regimen for soleus and gastocnemius that I prescribe may be ineffectual. Alos the actual length of stretch needed to alter fascia tension seems somewhat unclear and may vary from person to person.

    To have a validated quick and reliable tool to evaluate exercise effect would be worthwhile because it might allow reasoned modification to exercise parameters

    cheers

    Martin


    The St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  15. We can measure exercise induced change in any variable. Enlighten me, which "injuries" does the lunge test predict and what are the predictive models in statistical terms, i.e. give me the y = mx + c or whatever model was fitted, with the r square value, where y is the pathology and x = lunge test measurement. Or just point me to the publications, please.

    You see, here's my problem: I've heard that this test is "predictive" but when I've previously asked for the predictive model it has not been forthcoming. If it's predictive (what of?), there's a predictive model(s) what are they? I've heard that Charlie's auntie can predict my future if I cross her palm with silver..... But gypsy Rose Wanklespacken is not the way I go about things.
     
  16. Mart

    Mart Well-Known Member

    Geeze Simon
    You academics must be getting overworked or something :empathy:.

    Forget about "gypsy Rose", even from over here in cloud cuckoo land I have heard that she is not that reliable . . . you need some proven superstition. Go get yourself an octopus and a bag of mussels . . . . . never mind this Wankenspanken (was that a freudian mispellin?).

    Anyhow . . . . .

    Not to overstate my comment which was that the evidence “points towards” as opposed to “provides clear unequivocal evidence for”

    there was only

    Gabbe, B. J., C. F. Finch, et al. (2004). "Predictors of Lower Extremity Injuries at the Community Level of Australian Football." Clinical Journal of Sport Medicine 14(2): 56-63.
    Objective: To identify risk factors for general lower extremity injury at the community level of Australian football. Design: Prospective cohort study. Setting: Community-level Australian football. Participants: One hundred twenty-six adult players from 4 community-level Australian football clubs. Methods: During the 2000 preseason period, all participants underwent a baseline assessment involving a self-report questionnaire and a battery of musculoskeletal screening tests to collect information about potential risk factors for lower extremity injury. Over the course of the season, injury surveillance and exposure data collection were undertaken at each club. Main outcome measure: A lower extremity injury, resulting in missed participation and/or treatment from a health professional, as the first injury during the season. Results: For 59 players, a lower extremity injury was the first injury sustained during the season. Only ankle dorsiflexion range of movement, measured using the weightbearing lunge test, was significantly associated with sustaining a lower extremity injury through univariate analyses. Using survival analyses, and after adjusting for exposure, age, frequency of weight training participation, and the past injury status of players were identified as independent, but not significant, predictors of time to sustaining a lower extremity injury. Conclusions: Despite the large number of potential risk factors studied and the high incidence of lower extremity injuries in the cohort, a definitive individual injury risk profile for all lower extremity injuries was not identified, potentially due to the heterogeneity of the outcome of interest. Further research should focus on the identification of risk factors for the most common and costly individual injuries in Australian football.



    Who reported and summarized the following which I cut and paste from the paper below.

    Outcome Measures; Any injury resulting in missed participation time and/or treatment from a health professional was included in this study.

    Cohort Description and Injury Pattern One hundred forty-eight male Australian football players commenced preseason training with the 4 clubs at the time of recruitment. One hundred twenty-six (85.1%) consented to participate. Of the remaining 22 players, 15 were ineligible to participate due to a current injury, while 7 refused to participate.

    Risk Factors for Sustaining a Lower Extremity Injury Of all of the bivariate analyses performed, only the range of ankle dorsiflexion measured through the weight-bearing lunge test was found to be significantly associated with sustaining a lower extremity injury. The most flexible players (_13 cm) were significantly less likely to sustain a lower extremity injury (RR, 0.63; 95% CI, 0.40–0.98) than players in the least flexible group (_9 cm). Players in the middle tertile (10–12 cm) demonstrated an equivocal risk of lower extremity injury (RR, 0.99; 95% CI, 0.70–1.40) to that of the least flexible group (_9 cm). There were a number of strengths to this study. The prospective study design was appropriate for identifying risk factors and, therefore, potential causal relationships. The number of potential risk factors studied was comprehensive and included both objective musculoskeletal measures and self reported information contained in a questionnaire. Injury information was collected by qualified health professionals, and all exposure data were recorded prospectively, without reliance on player recall of participation. A 100% capture rate for injuries resulting in missed participation time was achieved. Lower extremity injury was not a rare event, with over half of the cohort sustaining a lower extremity injury, increasing the likelihood of identifying existing relationships between baseline factors and the injury outcome of interest. Nevertheless, a number of limitations must be acknowledged. Although participants were blinded to their baseline results, whether they undertook specific interventions to improve their performance on these tests was not determined. However, a comparison of baseline and postseason performance on the musculoskeletal screening tests in a subsample of the cohort found no difference; therefore, this is unlikely. The potential for selection bias exists due to the inability to recruit all players at baseline. A relatively small proportion refused to participate or were injured at baseline and therefore were ineligible for testing. Whether the inclusion of these players would have significantly altered the study findings cannot be determined. Similarly, baseline assessment was undertaken during preseason training sessions. Players who do not participate in preseason training could not be recruited and contribute to the possibility of selection bias. Information about these nonresponders would have been useful for determining the degree of selection bias. Therefore, the inability to collect information for nonresponse analysis is a limitation of this study.

    CONCLUSIONS Studies investigating sports injury risk factors are crucial for informing the development of injury prevention strategies. This study investigated risk factors for lower extremity injuries at the community level of Australian football to address the paucity of this information and to provide a basis for the development of injury prevention strategies in this sport. Despite the large number of potential risk factors studied and the relatively high number of lower extremity injuries, only 1 significant univariate association was identified. Multivariate analysis, through modeling time to injury, identified 3 independent but not significant predictors of a lower extremity injury: age, past injury history, and participation in regular weight training. Two of these, age and past injury history, cannot be modified in an individual to reduce the risk of injury, but can identify these groups as target populations for intervention. Insufficient information regarding the content of weight training programs participated in by the cohort precludes the direct development of prevention strategies based on these findings. The relative lack of significant findings likely reflects the heterogeneity of the injury outcome studied. As homogeneity of the study population limits the ability to identify risk factors through reduced variability in the baseline variables, heterogeneity of the outcome of interest also creates issues for risk factor identification. The types of lower extremity injuries sustained by the cohort were diverse in diagnosis, nature, and causes of injury, increasing the difficulty of identifying an individual injury risk profile for all lower extremity injuries. In light of the findings of this study, further research should focus on identifying risk factors for the most common and costly individual injuries in Australian football (e.g., hamstring muscle strains, lateral ligament sprains of the ankle, knee cartilage injuries). This approach is likely to be more clinically meaningful. However, the loss in study power must be considered due to the reduction in the number of outcomes of interest.


    So evidence is weak but supports the idea that the lunge MAY be useful predictive tool and as I think as Craig Payne pointed out, is the only piece of work which so far has attempted this.

    Theoretically the idea seems plausible, (please show me that is not) and I am unaware of any evidence to weaken the idea.

    Which I think is why the thread got started . . . see if it is worthwhile to pursue and if there is any way to get closer to the truth (not withstanding faith in the “Pauls” resonance with soccer outcomes; which for some might have been a nice little earner over the world cup).

    Look forward to the ongoing feast of your intellect as time permits.


    :drinks

    Martin


    The St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    Phone [204] 837 FOOT (3668)
    Fax [204] 774 9918
    www.winnipegfootclinic.com
     
  17. Mart

    Mart Well-Known Member

    Hi Simon and others

    I have been mulling over your suggestion regarding measuring ankle stiffness and trying to understand why I felt an intuitive resistance but a logical agreement with this idea, at least in terms of current clinical usefulness.

    It seems that clinically, when examining for clues relating to ankle dysfunction we are fixated on looking at the maximum available dorsiflexion angle; why is that?

    Because;

    When outside of certain limits it is associated with adverse perturbations on gait and potentially injurious gait compensations

    It gives an easy qualitative assessment of abnormality when sufficiently outside of these limits

    It is the only kinematic measurement we can usefully make with simple and fast instrumentation.

    To add to this information stiffness as a measurement has appeal because;

    It gives us insight into the end results of the mechanical properties of the plantar flexors without having to worry about measuring cross sectional areas and computing from Youngs modulus.

    We can infer possible positive effects of conditioning which are purported to alter dorsiflexion stiffness.

    We might attempt to normalise population data and see if it correlates to risk for injury (perhaps in a more rigorous manner than has been attempted!).

    What I have not seen discussed anywhere is that whilst dorsiflexion stiffness will influence final angular position and ankle angular acceleration during gait, it may be important to consider slackness ie at what angle the stiffness exceeds a certain (small) threshold.

    If as it seems, one of the most important bits of information about ankle behaviour is its maximum excursion within the range of forces normally experienced by the body, then slackness may be more correlated to dysfunction than stiffness per se. In this event it is not the material properties of the plantar flexors that is as important so much as their dimensions.

    There seems to be weak but consistent evidence for this in the literature.

    As you have already cited, good studies show increased ankle dorsiflexion stiffness with increased body velocity in healthy subjects running. Other studies show a seeming equilibrium with summation of knee and ankle stiffness varying with conditions and individuals to create an overall leg stiffness. So it is normal for stiffness to vary, indeed increase according to gait conditions.

    Most studies seem to indicate little or no long term effect of dorsiflexion stretching regimen in angular excursion but remarkable short term changes. This may be the result of short term increased compliance but no long term change in slackness. Compare this to surgical intervention where slackness is influenced with no intended effect on stiffness.

    Dannenbergs work on fibular manipulation, if the data is sound, might be explained be change in slackness by influencing the functional position of the joint mortise and hence joint axis.

    It is possible that the stiffness is moot.

    If I am correct in my assumptions then the lunge test has merit because it measures angular excursion which although dependent on stiffness also takes into consideration slackness.

    Anyone take issue with my statements? If not, then is stiffness really a major consideration clinically compared to slackness given the current knowledge?

    Cheers

    Martin

    The St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  18. Scott-stra

    Scott-stra Welcome New Poster

    Without reading all of the replies (hoping this has not already been addressed). On reading an article relating to the Lunge test, no where did it imply the foot be positioned in neutral?

    My concern is relating to the amount of pronation that may compensate/ increase the tibial angle achieved.... Since some people with have more pronation availble than others...

    Regards
     
  19. Griff

    Griff Moderator

    Thats correct, the foot does not have to be positioned in neutral.
     
  20. Ian - whats neutral ? How do you find Neutral ? :D:D:D:D:D
     
  21. Griff

    Griff Moderator

    Exactly Mike...
     
  22. celeste

    celeste Welcome New Poster

    Hi, Im a final year podiatry student, studying in South Africa. For my research topic Im attemping to do the repeatability of the Lunge test, does anyone have any ideas, advice or suggestions....

    Kind Regards, Celeste
     
  23. Mart

    Mart Well-Known Member

    I think the following questions are worth exploring;
    1 What parameters might influence the lunge test value other than soleus/gastrocnemius/ tendo-calcaneus stiffness or properties of anterior talocrural joint tissues?
    2 If there are any, (it seems likely that sub-talar joint position will be an issue in many feet) can they be usefully controlled to isolate the talocrural joint?
    3 How much variance might be attributed to change in stiffness according to activity level prior to testing. In other words is it important to control for this to avoid confounding results.
    4 If the test can be shown to be usefully reproducible does it have useful sensitivity and specificity for any specific problems?
    5 Could it be an accurate tool to explore the effects of stretching exercise regimen for soleus and gastrocnemius?
    Cheers

    Martin

    The St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  24. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Its been done:
    Aust J Physiother. 1998;44(3):175-180. Intra-rater and inter-rater reliability of a
    weight-bearing lunge measure of ankle dorsiflexion. Bennell KL, Talbot RC, Wajswelner H, Techovanich W, Kelly DH, Hall AJ

    A weightbearing technique for the measurement of ankle joint dorsiflexion with the knee extended is reliable
    Shannon E. Munteanu, Andrea B. Strawhorn, Karl B. Landorf, Adam R. Bird,George S. Murley Journal of Science and Medicine in Sport
    Volume 12, Issue 1 , Pages 54-59, January 2009
     
  25. Mart

    Mart Well-Known Member


    I agree with Craig that this paper is convincing in terms of intra-rater reliability though there is no harm in repeating the experiment and comparing results.
    The authors do address the limitation in interpreting a generalized meaning of the lunge value because it represents the summation of the behavior of several joints. Simon Spooner already pointed out the weakness of evidence for association between lunge value and predisposition to injury or significance of this value as an index of perpetuating factor for poor recovery from a MSK foot injury.
    The value for lunge as a measurement tool for individual response to intervention seems reasonable currently but beyond this there seems little evidence.
    I think there remains a problem in that we cannot reasonably assume that intra-subject lunge values usefully measure the same parameters. It may be that this is not important i.e. if the non talocrural joint components are relatively insignificant. For some individuals this seems unlikely. To be able to generalize the meaning of lunge values this would need further understanding. Perhaps exploring this idea is where time might be usefully spent.
    cheers

    Martin

    sjThe St. James Foot Clinic
    1749 Portage Ave.
    Winnipeg
    Manitoba
    R3J 0E6
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  26. One of our Portuguese colleagues who writes here (Romeo), recently suggested a nice study regarding the lunge test and it's relationship to STJ axial position.... p.S. I'd forgotten all about Gypsy Rose Wankelspacken... must consult her soon.
     
  27. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Reliability and smallest real difference of the ankle lunge test post ankle fracture.
    Simondson D, Brock K, Cotton S.
    Man Ther. 2011 Sep 27. [Epub ahead of print]
     
  28. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The intra and inter-rater reliability of a modified weight-bearing lunge measure of ankle dorsiflexion
    Simon O'Shea, Kate Grafton
    Manual Therapy 8 October 2012
     
  29. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Reliability and validity of a weight-bearing measure of ankle dorsiflexion range of motion.
    Chisholm MD, Birmingham TB, Brown J, Macdermid J, Chesworth BM.
    Physiother Can. 2012 Fall;64(4):347-55.
     
  30. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    A simplified version of the weight-bearing ankle lunge test: description and test-retest reliability
    Antonio Cejudo, et al
    Manual Therapy; Available online 2 April 2014
     
  31. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Reliability and Minimal Detectable Change of the Weight-Bearing Lunge Test: A Systematic Review
    Cameron J. Powden, MSEd, ATC, Johanna M. Hoch, PhD, ATC, Matthew C. Hoch, PhD, ATC
    Manual Therapy; Article in Press
     
  32. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Intra-rater reliability and agreement of various methods of measurement to assess dorsiflexion in the Weight Bearing Dorsiflexion Lunge Test (WBLT) among female athletes
    Argia Langarika-Rocafort et al
    Physical Therapy in Sport; Article in Press
     
  33. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Intra-rater reliability and agreement of various methods of measurement to assess dorsiflexion in the Weight Bearing Dorsiflexion Lunge Test (WBLT) among female athletes.
    Langarika-Rocafort A
    Phys Ther Sport. 2016 Jun 29;23:37-44. doi: 10.1016/j.ptsp.2016.06.010
     
  34. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Validity of clinical outcome measures to evaluate ankle range of motion during the weight-bearing lunge test.
    Emily A. Hall, Carrie L. Docherty
    Phys Ther Sp; Article in Press
     
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    Assessing Lower Extremity Injury Risk in a Mid-Atlantic Drum Corps
    Using the Weight Bearing Lunge Test

    Nicolás C Merritt and Cameron J Powden
    Clin Pract Athl Train. 2018;1(2):37-41.
     
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    Validation of a weight bearing ankle equinus value in older adults with diabetes
    A. Searle , M. J. Spink and V. H. Chuter
    Journal of Foot and Ankle Research201811:62
     
  37. Petcu Daniel

    Petcu Daniel Active Member

    Ok, so which one and for which reasons you'll choose:
    - that from 'The Lunge Test; forget ankle range, think ankle stiffness', https://sportspodiatryinfo.wordpres...est-forget-ankle-range-think-ankle-stiffness/
    OR
    - the one described in the 'Validation of a weight bearing ankle equinus value in older adults with diabetes'

    Thanks,
     
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    Within-session reliability for inter-limb asymmetries in ankle 10 dorsiflexion range of motion during the weight-bearing lunge test
    Howe, Louis P and Waldron, Mark and North, Jamie and Bampouras, Theo (2019) Within-session reliability for inter-limb asymmetries in ankle 10 dorsiflexion range of motion during the weight-bearing lunge test. International Journal of Sports Physical Therapy. ISSN 2159-2896 (In Press)
     
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    How Much Does the Talocrural Joint Contribute to Ankle Dorsiflexion Range of Motion During the Weight-Bearing Lunge Test? A Cross-Sectional Radiographic Validity Study
    Michelle D. Smith et al
    Journal of Orthopaedic & Sports Physical Therapy, 2019 Volume:0 Issue:0 Pages:1–29 DOI: 10.2519/jospt.2019.8697
     
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