Raising the standards of the calf-raise test: A systematic review

Abstract

The calf-raise test is used by clinicians and researchers in sports medicine to assess properties of the calf muscle-tendon unit. The test generally involves repetitive concentric-eccentric muscle action of the plantar-flexors in unipedal stance and is quantified by the number of raises performed. Although the calf-raise test appears to have acceptable reliability and face validity, and is commonly used for medical assessment and rehabilitation of injuries, no universally acceptable test parameters have been published to date. A systematic review of the existing literature was conducted to investigate the consistency as well as universal acceptance of the evaluation purposes, test parameters, outcome measurements and psychometric properties of the calf-raise test. Nine electronic databases were searched during the period May 30th to September 21st 2008. Forty-nine articles met the inclusion criteria and were quality assessed. Information on study characteristics and calf-raise test parameters, as well as quantitative data, were extracted; tabulated; and statistically analysed. The average quality score of the reviewed articles was 70.4+/-12.2% (range 44-90%). Articles provided various test parameters; however, a consensus was not ascertained. Key testing parameters varied, were often unstated, and few studies reported reliability or validity values, including sensitivity and specificity. No definitive normative values could be established and the utility of the test in subjects with pathologies remained unclear. Although adapted for use in several disciplines and traditionally recommended for clinical assessment, there is no uniform description of the calf-raise test in the literature. Further investigation is recommended to ensure consistent use and interpretation of the test by researchers and clinicians.

Analysis of Knee Flexion Angles During 2 Clinical Versions of the Heel Raise Test to Assess Soleus and Gastrocnemius Function

“…6,16,28 Many studies have used the reduction in heel raise height as an indicator of triceps surae muscle fatigue and a termination criterion for the heel raise test, and, recently, as a measure of decreased triceps surae muscle-tendon unit function. 20,45 The confirmatory GEE analysis supports these practices, estimating a 13.3-mm drop in heel raise height from the early to the late phase (P<.001), which demonstrates a decline in heel raise test performance. 35 This is the first study to provide an estimate of the amount of variation in heel raise height during 2 heel raise test versions when individuals are instructed to attempt maximum heel raise height during each raise and the test is not terminated if a certain height is not reached.…”

“…doi:10.2519/jospt.2011 [ research report ] tendon unit, the heel raise test most commonly involves performing unilateral heel raises until fatigue. 20 Fatigue during the heel raise test has been defined as the inability to continue performing a "proper" heel raise, 35 where a decrease in performance can be observed by a reduction in heel raise height or pace, loss of balance or forward lean, or inability to maintain a defined knee position. 21 The total number of heel raise repetitions completed to this point is counted and used as the main clinical outcome measure.…”

“…The heel raise test instructions and parameters relating to heel raise height, pace, foot position, and balance support were based on those most frequently cited and utilized in the literature. 20 Stance foot placement and head position were standardized by positioning the first metatarsal on a predetermined floor marking and by focusing straight ahead on a visual target set at eye level. The nontested lower limb was free in space, in a position comfortable to participants, and allowed lower limb clearance during the heel raise test.…”

Influence of Knee Flexion Angle and Age on Triceps Surae Muscle Fatigue During Heel Raises

“…One complete heel raise was defined by 2 consecutive heel-to-floor contacts and included a data point when the heel was at maximal height during that raise as identified in Figure 1. The chosen heel-raise parameters for balance support, body position, and pace were based on those most frequently cited in the literature (15) and used in a previous study (17). An overview of subjects' position and apparatus used for heelraise testing is provided in Figure 2.…”

Decade Wise Analysis of Ankle Plantar Flexors Strength in Adults Using One Leg Heel Raise Test (OLHR)

“…[4,5] In a systematic review done by Kim Hébert-Losiera et al on parameters of Calf raise test, it was found that most studies gave an average value of 27 repetitions in healthy adults and 19 repetitions in pathological subjects. [12] However, this normative grading method does not take into consideration the age of the subject. There is a possibility that the normative values may not be same for all the ages owing to degenerative changes in the muscle tissue and reduced function in normal subjects as well.…”