PTOTOtherArchives of physiotherapy2025

Biomechanical of bilateral heel rise, and its association with balance, functional mobility, and walking speed in older adults.

Cristian Caparrós-Manosalva, Rodrigo Guzmán-Venegas, Francisca Gajardo-Garrido and 5 others

PMID 40741288

WHAT IT FOUND

How fast and high older adults rise on their toes predicts how quickly they walk and stand up, but does not predict how long they can balance on one leg.

Assessing heel rise speed is useful for mobility screening, not for static balance.

Key findings

01Peak force during the heel rise strongly correlated with walking speed and Timed Up & Go performance, but only moderately with single-leg stance time.

02The ability to control the downward phase of the heel rise (eccentric) correlated with functional mobility and balance, whereas the upward phase did not.

03Vertical stiffness and center of mass velocity during both the rise and drop phases of the heel rise were associated with better performance on functional tests.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

Ankle plantarflexor strength and ankle range of motion were not directly measured, so the biomechanical findings cannot be definitively attributed to muscle strength or joint mobility. The sample was 88% female, which limits generalizability to older men. Participants were allowed to lightly touch a wall for balance support during the heel rise, and the use of this support was not controlled or recorded, which may have influenced the biomechanical data. This was a cross-sectional study, so it shows association but cannot prove that improving heel rise mechanics will improve balance or walking speed.

Declared interests

The authors declared no potential conflicts of interest and received no specific grant for this research.

The easy way to misread this

Do not interpret the correlation between heel rise force and single-leg stance time as evidence that heel rise strength causes better balance. The study is cross-sectional and shows association, not causation. Additionally, heel rise force is a much stronger predictor of walking speed and dynamic mobility than it is of static balance.

Read it on PubMed →