Instruments and Methods for the Assessment of Ankle Evertor Strength A systematic review of measurement properties

Background : After lateral ankle sprain (LAS), patient could still present chronic ankle instability (CAI). It has been established that evertors strength is weaker for CAI patient than healthy one. Additionally, the lesioning LAS movement could be counteracted by an eccentric contraction of the evertors. A potential weakness of the evertors should be quantified for rehabilitation.
Objective : this systematic review aims at evaluating the reliability and measurement error of instruments and their methods to measure evertors strength
Design : A systematic review of measurement properties was conducted. The quality of the articles included was assessed with COSMIN risk of bias tool
Setting : no setting restriction was applied.
Patients (or participants) : no population restriction was applied.
Interventions (or assessment of risk factors) : Instruments and their methods used to measure quantitatively evertors strength were the inclusion criteria of this review.
Main Outcome Measurements : Outcomes of test-retest and inter-rater, reliability and measurement errors were extracted.
Results : the literature search identified 2829 articles. A total of 21 articles met the inclusion criteria. The population was mainly healthy and, the only pathologic population was patients with a history of LAS. The isokinetic dynamometer (57%) and hand-held dynamometer (38%) are the main methods used to assess evertors strength. The test-retest and inter-rater reliability are sufficient (ICC ≥ 0.70) in the majority of the retrieved values (81%-89%). However, the test-retest and inter-rater measurement errors are sufficient (MDC or LoA ≤ 20%) in a low number of the retrieved values (35%-60%).
Conclusions : Although the existing methods are mainly reliable to assess evertors strength for healthy populations as well as for patients with a history of LAS, caution needs to be taken in regard to the protocol. Clinicians have to be aware of the parameters that could impact the measurement.