Weight bearing versus non-weight bearing ankle dorsiflexion measurement in people with diabetes: a cross sectional study

Abstract

BackgroundAccurate measurement of ankle dorsiflexion is important in both research and clinical practice as restricted motion has been associated with many foot pathologies and increased risk of ulcer in people with diabetes. This study aimed to determine the level of association between non-weight bearing versus weight bearing ankle dorsiflexion in adults with and without diabetes, and to evaluate the reliability of the measurement tools.MethodsOne hundred and thirty-six adults with diabetes and 30 adults without diabetes underwent ankle dorsiflexion measurement non-weight bearing, using a modified Lidcombe template, and weight bearing, using a Lunge test. Pearson product-moment correlation coefficients, intraclass correlation coefficients (ICCs) with 95% confidence intervals, standard error of measurement and minimal detectable change were determined.ResultsThere was a moderate correlation (r = 0.62–0.67) between weight and non-weight bearing tests in the non-diabetes group, and a negligible correlation in the diabetes group(r = 0.004–0.007). Intratester reliability was excellent in both groups for the modified Lidcombe template (ICC = 0.89–0.94) and a Lunge test (ICC = 0.83–0.89). Intertester reliability was also excellent in both groups for the Lidcombe template (ICC = 0.91) and a Lunge test (ICC = 0.88–0.93).ConclusionsWe found the modified Lidcombe template and a Lunge test to be reliable tests to measure non-weight bearing and weight bearing ankle dorsiflexion in adults with and without diabetes. While both methods are reliable, further definition of weight bearing ankle dorsiflexion normative ranges may be more relevant for clinical practice.

Validation of a weight bearing ankle equinus value in older adults with diabetes

“…The test was completed three times, with 10 s rest between tests, and the average score was documented as the test result. The authors have previously shown this method to have excellent intrarater (ICC = 0.83 to 0.89) and interrater reliability (ICC = 0.88 to 0.93), so a single assessor recorded all the measurements in this study [ 12 ]. In-shoe plantar pressures were measured with the Novel Pedar-X ® system (Novel GmbH, Munich, Germany) which utilises flexible insoles that contain 99 capacitive sensors sampling at a frequency of 100 Hz.…”

Peer Review #1 of "Effect of a HIIT protocol on the lower limb muscle power, ankle dorsiflexion and dynamic balance in a sedentary type 1 diabetes mellitus population: a pilot study (v0.2)"

“…The average of the 3 trials scores was documented as the test result. Both feet were measured (Hall & Docherty, 2017;Langarika-Rocafort et al, 2017;Powden et al, 2015;Searle et al, 2018).…”

Peer Review #1 of "Effect of a HIIT protocol on the lower limb muscle power, ankle dorsiflexion and dynamic balance in a sedentary type 1 diabetes mellitus population: a pilot study (v0.1)"

“…This condition has been demonstrated to compromise skeletal muscle function, even beginning early in life in many cases, what would indicate that muscle dysfunction is a primary diabetic complication (being more accelerated with the development of neuropathy) (Krause et al, 2011;Monaco et al, 2019). Hyperglycemia also promotes the increase in ankle stiffness even without the presence of neuropathy (Francia et al, 2018;Searle et al, 2017Searle et al, , 2018 and compromises dynamic balance, also in young patients with no complications diagnosed (Katsarou et al, 2017;Kukidome et al, 2017;Turcot et al, 2009), among other physiological complications. Because of that, T1DM causes the premature loss of lower limb strength (Celes et al, 2017;Monaco et al, 2019), PeerJ reviewing PDF | (2020:05:48640:2:1:NEW 6 Nov 2020)…”