![]() 18,19 Closed-chain ankle DF ROM was measured using an electronic inclinometer (Clinometer Android App version 2.4 by Plaincode TM on Samsung Galaxy s9) in a standing modified lunge position with the subjects in a tandem heel to toe stance ( Figure 1). The modified lunge position ( Figure 1) was used for the discriminant measurement. The University of Evansville’s Institutional Review Board approved study procedures. Informed consent was obtained from each subject prior to data collection. Exclusion criteria consisted of participants with a previous lower extremity orthopedic surgery, current pain or injury, or diagnosed neurological disease. To be included in the study, subjects needed to be over 18 years of age and ambulatory without an assistive device. Subjects were recruited using fliers on a university campus. Methods SubjectsĪ convenience sample of university students was utilized. It was hypothesized that the SADS would have high reliability and discriminant validity. The purpose of this study was to determine the reliability and discriminant validity of a novel closed-chain DF ROM test, the standing ankle dorsiflexion screen (SADS). 21 Since the ankle dorsiflexion screen is in the standing lunge position, additional analysis comparing measure in that position is warranted. Researchers have examined the reliability and validity of a novel ankle DF screen, but used half kneeling dorsiflexion as the referent standard. As a result, there is a need for an ankle DF screen that requires minimal equipment and can be implemented quickly and efficiently. A screen is used to quickly identify if there is a potential problem whereas a measure requires equipment and gives a numerical result. 20 This decreases the utility of those tests, as well as the ability of sports medicine providers to effectively and efficiently screen ankle DF. 18,19 However, these tests require other devices, such as an inclinometer, which are not always readily available. 10,16 Previous closed-chain ankle DF testing has been performed in the half kneeling position 17 and in a modified lunge position both with high reliability and validity. 11,15 Thus, performing closed-chain ankle measurements allows for more functional clinical testing. 13,14 Normal ankle DF allows for lower extremity advancement, running, and proper jump landing. 13 Furthermore, athletic movement and competition are performed in the closed-chain position. 9,12Īnkle DF ROM has conventionally been assessed in the open-chain position however, open-chain ankle testing has poor reliability. Therefore, sports medicine providers have a need for easy to use on-field ankle screens. 8–11 In addition, limited ankle DF is a common injury sequela. 6,7 Research has suggested that limited ankle dorsiflexion (DF) range of motion (ROM) increases ankle and overall lower extremity injury risk. 3,4 Nearly 75% of athletic ankle sprains are recurrent, 5 burdening the sports medicine provider and health care system. ![]() Level of EvidenceĪthletic lower extremity injuries are common, 1–3 with ankle sprains being the most prevalent. The SADS can be used as a quick and efficient closed chain ankle DF ROM screen. Furthermore, there was a distinct closed chain ankle DF ROM difference between the “behind” and “beyond” SADS nominal scores. The SADS was observed to have excellent interrater reliability and high discriminant validity. There was a significant difference in ankle DF ROM between the nominally scored “behind” and “beyond” categories, regardless of rater or trial analyzed (behind: 41.3° ± 4.7° beyond: 51.8°± SD 6.1°, p <0.001). ResultsĮxcellent ICC values (0.95 ) and high kappa values were observed (0.61-0.81), with high percent agreement (86-94%). An independent t-test compared the SADS categories of “behind” and “beyond” to the modified lunge test ROM ( p<0.05). Reliability was calculated using intraclass correlation coefficients (ICC) and kappa coefficients for the raters using an electronic inclinometer and the SADS scale, respectively. Four raters measured ankle DF using the SADS. Two raters measured closed-chain ankle DF range of motion (ROM) using a modified lunge position with an electronic inclinometer. Thirty-seven healthy subjects participated in the study. The purpose of this study was to determine the reliability and discriminant validity of a novel closed-chain ankle DF ROM test, the standing ankle dorsiflexion screen (SADS). ![]() Current ankle measurements can be laborious to perform in an athletic environment. Limited ankle dorsiflexion (DF) is associated with ankle sprains and other lower extremity injuries. ![]()
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