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      Validation of a new Equinometer device for measuring ankle range of motion in patients with cerebral palsy : An observational study

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          Abstract

          The goniometer is the gold-standard measurement tool of ankle range of motion (ROM). However, several studies have questioned its inter- and intra-rater reliability. Therefore, we conducted this validation study to assess the reliability of a different tool, named Equinometer, as a measurement device of ankle ROM in addition to comparing the reproducibility of their results.

          Sixteen healthy individuals were included. They underwent both goniometer and Equinometer measurements in knee extension and 90° knee flexion (Silfverskjöld Test). Three raters reported the values of dorsiflexion (DF) and plantarflexion (PF) in each session using both measurement tools. Intra-rater reliability was assessed between 2 raters on another study group of 24 participants. Intraclass correlation coefficients were used to determine the reliability of the used device.

          The age of study subjects ranged from 22 to 85 years. Fifty percent were males, and the right ankle joint was the most examined side (68.75%). In terms of DF and PF during knee extension and flexion, our analysis revealed that the measurements recorded by the Equinometer were equivalent to the goniometer. Of note, the intra-rater reliability of the Equinometer was excellent for both DF and PF assessment during both knee flexion and extension (Intraclass correlation coefficient ranged from 0.90 to 0.98), with minimal mean differences from goniometer measurements. Subgroup analysis based on age did not reveal any significant differences ( P > .05).

          Given the high intra-rater correlations of the Equinometer, we suggest that it is reliable and precise in recording ankle ROM in outpatient clinics, particularly to obtain reproductive, comparable and unbiased data from different observers.

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          Most cited references25

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          Reliability of three measures of ankle dorsiflexion range of motion.

          A variety of methods exist to measure ankle dorsiflexion range of motion (ROM). Few studies have examined the reliability of a novice rater. The purpose of this study was to determine the reliability of ankle ROM measurements using three different techniques in a novice rater.
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            Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion.

            This study aimed to evaluate the inter-rater and intra-rater reliability of a weight-bearing dorsiflexion (DF) lunge in 13 healthy subjects. Our raters with varying clinical experience tested all subjects in random order. Two of the raters repeated the measurements one week later. Two methods were used to assess the DF lunge: (i) the distance from the great toe to the wall and (ii) the angle between the tibial shaft and the vertical using an inclinometer. The average of three trials was used in data analysis. Intra-rater intraclass correlation coefficients (iccs) ranged from 0.97 to 0.98. Inter-rater ICC values were 0.97 (angle) and 0.99 (distance). results indicate excellent reliability for both methods of assessing a DF lunge.
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              Impact of chronic plantar heel pain on health-related quality of life.

              Chronic plantar heel pain (CPHP) is common and is thought to have a detrimental impact on health-related quality of life. However, no study has used normative data or a control data set for comparison of scores. Therefore, we describe the impact of CPHP on foot-specific and general health-related quality of life by comparing CPHP subjects with controls. Foot Health Status Questionnaire scores were compared in 80 subjects with CPHP and 80 sex- and age-matched controls without CPHP. The CPHP group demonstrated significantly poorer foot-specific quality of life, as evidenced by lower scores on the foot pain, foot function, footwear, and general foot health domains of the Foot Health Status Questionnaire. The group also demonstrated significantly poorer general health-related quality of life, with lower scores on the physical activity, social capacity, and vigor domains. In multivariate analysis, CPHP remained significantly and independently associated with Foot Health Status Questionnaire scores after adjustment for differences in body mass index. Age, sex, body mass index, and whether symptoms were unilateral or bilateral had no association with the degree of impairment in people with CPHP. Chronic plantar heel pain has a significant negative impact on foot-specific and general health-related quality of life. The degree of negative impact does not seem to be associated with age, sex, or body mass index.

                Author and article information

                Contributors
                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Lippincott Williams & Wilkins (Hagerstown, MD )
                0025-7974
                1536-5964
                29 April 2022
                06 May 2022
                : 101
                : 17
                : e29230
                Affiliations
                [a ]Department of Orthopedics,Heidelberg University Hospital,Germany
                [b ]Marienkrankenhaus Soest, Orthopedics and Trauma Surgery, Soest, Germany.
                Author notes
                []Correspondence: Axel Horsch, UniversitatsKlinikum Heidelberg Department Orthopadie Unfallchirurgie und Paraplegiologie, Heidelberg, Baden Würtemberg Germany (e-mail: axel.horsch@ 123456med.uni-heidelberg.de ).
                Author information
                http://orcid.org/0000-0002-6487-030X
                Article
                MD-D-21-07556 29230
                10.1097/MD.0000000000029230
                9276144
                35512083
                9d948d36-348b-4977-a881-41fbba52a08e
                Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

                History
                : 16 November 2021
                : 15 March 2022
                : 15 March 2022
                Funding
                Funded by: Deutsche Arthrosestiftung e.V.
                Award ID: P477-A1123
                Award Recipient : M.D. Axel Horsch
                Categories
                5300
                Research Article
                Observational Study
                Custom metadata
                TRUE

                ankle,range of motion,cerebral palsy,equinometer,equinus foot,goniometer

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