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Are repeated single-limb heel raises and manual muscle testing associated with peak plantar-flexor force in people with inclusion body myositis?
[inclusion body myositis]
Repeated
heel
raises
have
been
proposed
as
a
method
of
ankle
plantar
-flexor
strength
testing
that
circumvents
the
limitations
of
manual
muscle
testing
(
MMT
)
.
The
study
objective
was
to
examine
the
relationships
among
ankle
plantar
-
flexion
isometric
maximum
voluntary
contraction
(
MVC
)
,
repeated
single
-
limb
heel
raises
(
SLHRs
)
,
and
MMT
in
people
with
myositis
.
This
was
a
cross-sectional
study
with
a
between-group
design
.
The
ability
to
complete
1
SLHR
determined
group
assignment
(
SLHR
group
,
n
=
24
;
no
-
SLHR
group
,
n
=
19
)
.
Forty
-
three
participants
with
myositis
(
13
women
;
median
age
=
64
.
9
years
)
participated
.
Outcome
measures
included
MVC
,
predicted
MVC
,
Kendall
MMT
,
and
Daniels-
Worthingham
MMT
.
T
he
Kendall
MMT
was
unable
to
detect
significant
ankle
plantar
-flexor
weakness
established
by
quantitative
methods
and
was
unable
to
discriminate
between
participants
who
could
and
those
who
could
not
perform
the
SLHR
task
.
Ankle
plantar
-
flexion
MVC
was
not
associated
with
the
number
of
heel-raise
repetitions
in
the
SLHR
group
(
pseudo
R
(
2
)
=
.
13
)
.
No
significant
relationship
was
observed
between
MVC
values
and
MMT
grades
in
the
SLHR
and
no
-
SLHR
groups
.
However
,
a
moderate
relationship
between
MVC
values
and
MMT
grades
was
evident
in
a
combined-group
analysis
(
ρ
=
.
50
-
.
67
)
.
The
lower
half
of
both
MMT
grading
scales
was
not
represented
in
the
study
despite
the
profound
weakness
of
the
participants
.
Both
Kendall
MMT
and
Daniels-
Worthingham
MMT
had
limited
utility
in
the
assessment
of
ankle
plantar
-flexor
strength
.
Repeated
SLHRs
should
not
be
used
as
a
proxy
measure
of
ankle
plantar
-
flexion
MVC
in
people
with
myositis
.