Does the Duncan-Ely test predict abnormal activity of the rectus femoris in stroke survivors with a stiff knee gait?
Martin J B Tenniglo, Marc J Nederhand, Judith F Fleuren and 3 others
PMID 34723344WHAT IT FOUND
The Duncan-Ely test does not predict abnormal rectus femoris activity in stroke survivors with stiff knee gait.
Resistance and hip flexion scores showed no correlation with EMG findings, performing no better than random guessing. Clinicians should stop using this test to guide treatment decisions.
Key findings
01The Duncan-Ely test has no diagnostic value for predicting abnormal rectus femoris activity during the swing phase in stroke survivors with stiff knee gait.
02The area under the curve for perceived resistance was 0.488, indicating the test performs no better than random guessing.
03The authors recommend stopping the use of the Duncan-Ely test for this purpose and using sEMG instead.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
18 participants were excluded from the main analysis because their EMG signals were categorized as cross-talk or undefined, though sensitivity analyses showed this did not change the conclusion. The Duncan-Ely test relies on subjective examiner perception of resistance and visual inspection of hip flexion, which can vary between clinicians. The speed of the knee flexion during the test was not strictly controlled, which may affect the velocity-dependent response. The study used surface EMG, which can be susceptible to cross-talk from nearby muscles, although the authors attempted to filter this.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not assume that a positive Duncan-Ely test confirms rectus femoris spasticity. The study found no diagnostic value in the test for predicting abnormal activity during walking, so a positive result may reflect tightness or activity in other muscles, or simply examiner subjectivity.