Reference values for the bilateral heel-rise test.
Débora Pantuso Monteiro, Raquel Rodrigues Britto, Guilherme Augusto de Freitas Fregonezi and 3 others
PMID 28709587WHAT IT FOUND
Bilateral heel-rise reference values for healthy adults aged 20 to 60: men had a middle value of 82 repetitions versus 56.50 in women, and repetition rate did not differ.
Use sex and age ranges, not for older adults.
Key findings
01Men completed more bilateral heel-rise repetitions than women (middle value 82 versus 56.50), while repetition rate did not differ.
02Across the whole sample, the reported mean number of plantar flexions was 71 (middle half range 50 to 108), the reported total time was 57 seconds (middle half range 42 to 80), and the reported average repetition rate was 1.16 repetitions per second (middle half range 0.9 to 1.48).
03Reference values for total repetitions were stratified by sex and age group, and scores between the 25th and 75th percentiles were treated as normal.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The reference values came only from healthy adults aged 20 to 60 years, so they do not apply to older adults or people with active disease. The sample was mostly active: 144 of 147 people were considered active and 3 were moderately active, so less active or clinical patients may not fit these ranges. The regression models explained little variation, with R2 = 0.14 for repetitions and R2 = 0.18 for repetition rate, so age, sex, BMI, and activity scores did not make the values easy to predict. The test was self-paced and bilateral, with a hand on the wall, so values may not transfer to unilateral tests, fixed-speed tests, or unsupported standing. The study did not test patients with peripheral arterial disease, chronic venous insufficiency, stroke, or Achilles tendon injury, so it provides reference ranges, not diagnostic thresholds for those conditions.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not treat a low heel-rise score as abnormal for an older adult or a patient with disease. These values came from healthy adults aged 20 to 60 years, used a self-paced bilateral test, and did not show that the test predicts clinical outcomes.