Weight Bearing Lunge Test | Ankle Passive Range of Motion
This test can be used as a continuous assessment of ankle dorsiflexion. Several techniques have been described in the literature where during the lunge, either the front limb or back limb is assessed and the clinicians either used an inclinometer or tape measure to assess the degree of dorsiflexion. A review by Powden et al. (2015) reported no significant differences in reliability between the different measurement techniques.
There is widespread consensus that limited ankle dorsiflexion is a contributing factor in several conditions such as patellofemoral pain syndrome, and overpronation of the foot possibly causing plantar fasciitis.
I am going to demonstrate the wall distance technique using a tape measure.
To conduct the test, ask your patient to face the wall and then perform a lunge toward it. The patient should try and touch the wall with his knee while keeping the foot flat on the ground. You will then measure the distance between the wall and the big toe. The distance can be increased as long as the patient is able to touch the wall with the knee whilst keeping the foot planted on the ground.
A wall distance of at least 5 inches or 12,5 cm is considered normal ROM. Use one-hand width as a rule of thumb.
If you feel an anterior pinching sensation the restriction probably lies within the joint and mobilizations will help. Secondly, soft tissue may limit your ROM. Targeting the calf through stretching or foam rolling could improve mobility.
To assess progress a change of 1.9 cm is needed for a change in dorsiflexion ROM to be considered outside of the measurement error.
21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE
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