Assessment of an electronic goniometer designed to measure equinus contracture.

To achieve more objective and repeatable measurements of equinus contracture, we developed the equinometer, a device that allows the measurement of ankle range of motion under controlled torque conditions. This study assessed its accuracy across different subjects and examiners. Two examiners used the equinometer to measure the angle of ankle dorsiflexion at 15 N x m torque on five subjects. Accounting for variation in measurements because of subjects, examiners, and placement of device, we used linear mixed-effects models. Accounting for the variation because of subject, different placements of the equinometer within each subject and the adjustment for the effects of examiner and trial sequence, the standard deviation was 0.94 degrees, 95% confidence interval (0.79 degrees, 1.13 degrees). An upper standard deviation of 1.36 degrees is felt to be acceptable for clinical investigation.

[1]  W. Lehman,et al.  Equinus Deformity in Cerebral Palsy: A Retrospective Analysis of Treatment and Function in 39 Cases , 1985, Journal of pediatric orthopedics.

[2]  D. Bates,et al.  Mixed-Effects Models in S and S-PLUS , 2001 .

[3]  J. Czerniecki,et al.  Can the presence of equinus contracture be established by physical exam alone? , 2001, Journal of rehabilitation research and development.

[4]  A. Boulton,et al.  The role of diabetic neuropathy and high plantar pressures in the pathogenesis of foot ulceration. , 1996, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[5]  D. Armstrong,et al.  Lengthening of the Achilles tendon in diabetic patients who are at high risk for ulceration of the foot. , 1999, The Journal of bone and joint surgery. American volume.

[6]  K. Wapner,et al.  Plantar forefoot ulceration with equinus deformity of the ankle in diabetic patients: the effect of tendo-Achilles lengthening and total contact casting. , 1996, Orthopedics.

[7]  J. Craig,et al.  The importance of gastrocnemius recession in the correction of equinus deformity in cerebral palsy. , 1976, The Journal of bone and joint surgery. British volume.

[8]  V. Carey,et al.  Mixed-Effects Models in S and S-Plus , 2001 .

[9]  R Price,et al.  Design and validation of an instrument package designed to increase the reliability of ankle range of motion measurements. , 2001, Journal of rehabilitation research and development.

[10]  Christopher L. Lee,et al.  Surgical Correction of Equinus Deformity in Cerebral Palsy , 1980, Developmental medicine and child neurology.

[11]  F. Kummer,et al.  Equinus deformity in cerebral palsy: recurrence after tendo Achillis lengthening , 1997, Developmental medicine and child neurology.

[12]  W. Sharrard,et al.  Equinus deformity in cerebral palsy. A comparison between elongation of the tendo calcaneus and gastrocnemius recession. , 1972, The Journal of bone and joint surgery. British volume.

[13]  A. Veves,et al.  Role of Neuropathy and High Foot Pressures in Diabetic Foot Ulceration , 1998, Diabetes Care.