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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
.
Diseases
Validation
Diseases presenting
"weakness"
symptom
achondroplasia
adrenomyeloneuropathy
alexander disease
aniridia
aromatase deficiency
coats disease
congenital toxoplasmosis
epidermolysis bullosa simplex
esophageal adenocarcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
focal myositis
gm1 gangliosidosis
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
pendred syndrome
pleomorphic liposarcoma
pyomyositis
pyruvate dehydrogenase deficiency
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
triple a syndrome
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
werner syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated