The Ankle Lunge Test for measurement of dorsiflexion in individuals following stroke; reliability, validity and evaluation of change following intervention for spasticity of the lower limb.

[INTRODUCTION] The Ankle Lunge Test (ALT) is a reliable method of measuring weight bearing ankle dorsiflexion range, a key component of gait, in healthy ankles and a range of musculoskeletal conditions. The aim of this study is to evaluate the reliability and concurrent validity of the ALT in people with stroke and investigate whether change in ALT is observed following treatment of spasticity with Botulinum Toxin.

[METHODOLOGY] Repeated Measure Design: Forty stroke survivors were recruited for reliability testing. Twenty three stroke survivors were evaluated with the ALT before and after treatment of the lower limb with Botulinum Toxin. Measurement with the ALT was performed for all participants. For the reliability group, two physiotherapists evaluated the ALT on Day 1 and one therapist re-evaluated the ALT one to 5 days later. For the change evaluation group, the ALT was tested prior to and six to eight weeks after intervention. Other measures evaluated were velocity, the Functional Ambulation Category, Timed Up and Go and the Modified Tardieu Scale.

[RESULTS] Intra-rater, inter-rater and test-retest reliability yielded intra-class correlation coefficients at or above 0.92. Moderate correlations were found between the ALT and velocity r = 0.605 (p < 0.01), the Timed Up and Go r = -0.598 (p < 0.01) and the Functional Ambulation Category r = 0.380 (p < 0.05). Following intervention with Botulinum Toxin, there was significant (p < 0.02) improvement in the ALT; pre-median 20 mm (IQR -25 to 35) to post-median 21 mm (IQR 0 to 40) and the Timed Up and Go; pre-median 21.40 s (IQR 13.43 to 28.82) to post-median 20.08 s (IQR 14.06 to 28.47).

[CONCLUSION/SIGNIFICANCE] The ALT is a reliable and valid measure which may be applied in clinical practice to evaluate change in weight bearing ankle dorsiflexion in people with stroke.