Evaluating ankle dorsiflexion in people with multiple sclerosis: Weight bearing vs. non-weight bearing methods

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-06-06 DOI:10.1016/j.clinbiomech.2025.106585

Michael Psarakis , Alexandra Badman , Louis Dennison , Phu Hoang

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引用次数: 0

Abstract

Background

Ankle joint contractures are common in Multiple Sclerosis (MS), significantly reducing dorsiflexion range of motion, hindering gait and increasing falls. Accurate, standardised ankle dorsiflexion measures for neurologically impaired populations are lacking. This study compared validity and reliability of the non-torque-controlled Weight-Bearing Lunge Test with the torque-controlled Modified Lidcombe Template in assessing ankle dorsiflexion among people with and without MS.

Methods

Sixty participants were included: 20 with MS, 20 healthy matched controls, and 20 young adults. Ankle dorsiflexion was assessed bilaterally in knee-flexed and knee-extended positions using both methods. Concurrent validity was analyzed using correlation coefficients. Discriminative validity was evaluated by comparing dorsiflexion between affected and less-affected sides in the MS group and contralaterally in controls. Intra-rater reliability was assessed with Intraclass Correlation Coefficients from measurements taken seven days apart.

Findings

High correlations were found between both tests in knee-flexed positions (r = 0.76) but moderate correlations in knee-extension (r = 0.58). The Weight-Bearing Lunge Test demonstrated greater sensitivity in detecting differences between affected and less-affected sides in MS, particularly in knee-flexion (effect size d = −1.04). However, knee-extension measures were less consistent, proving unsuitable for 20 % of MS participants due to balance limitations. The Modified Lidcombe Template exhibited excellent reliability across all conditions (> 0.90), with higher torques differentiating between affected and less-affected sides in MS.

Interpretation

The Modified Lidcombe Template offers greater consistency and appropriateness for neurological conditions. Measuring resistance to passive movement at higher torques provides a comprehensive understanding of contractures, potentially improving diagnostic accuracy.

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评估多发性硬化症患者的踝关节背屈：负重与非负重方法

背景：踝关节挛缩在多发性硬化症（MS）中很常见，显著减少背屈活动范围，阻碍步态和增加跌倒。目前缺乏针对神经功能受损人群的准确、标准化的踝关节背屈测量方法。本研究比较了非扭矩控制负重弓步试验与扭矩控制改良Lidcombe模板在评估多发性硬化症患者和非多发性硬化症患者踝关节背屈时的效度和信度。方法共纳入60名受试者：20名多发性硬化症患者，20名健康对照者和20名年轻人。使用两种方法评估双侧膝关节屈曲和膝关节伸直位置的踝关节背屈。采用相关系数分析并发效度。通过比较MS组受影响侧和不受影响侧的背屈以及对照组的对侧背屈来评估判别效度。用间隔7天测量的类内相关系数评估组内信度。两项测试在膝关节屈曲位置（r = 0.76）有高度相关性，而在膝关节伸直位置（r = 0.58）有中度相关性。负重弓步试验在检测多发性硬化症受累侧和不受累侧之间的差异方面表现出更高的灵敏度，特别是在膝关节屈曲方面（效应值d = - 1.04）。然而，膝关节伸展测量不太一致，由于平衡限制，证明不适合20%的MS参与者。改进的Lidcombe模板在所有条件下都表现出优异的可靠性(>；0.90)，在ms中具有更高的扭矩区分受影响和不受影响的侧。解释：改进的Lidcombe模板为神经系统疾病提供了更大的一致性和适当性。测量在高扭矩下被动运动的阻力提供了对挛缩的全面了解，有可能提高诊断的准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.