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Published on: September 13, 2015
Evaluation of clinical methods for peroneal muscle testing
Hilla Sarig-Bahat1, Andrei Krasovsky, Elliot Sprecher
1Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Mount Carmel, Haifa, Israel. hbahat@research.haifa.ac.il
Summary
Manual muscle testing for peroneal muscles often misinterprets their function, with many physiotherapists incorrectly resisting dorsiflexion instead of plantarflexion. This study highlights inconsistencies between clinical practice and functional anatomy, urging a re-evaluation of peroneal muscle testing methods.
Area of Science:
- Musculoskeletal physiotherapy
- Ankle biomechanics
- Clinical assessment techniques
Background:
- Manual muscle testing of peroneal muscles is standard in musculoskeletal physiotherapy for foot and ankle assessment.
- Peroneus longus and brevis are primary ankle evertors and secondary plantar flexors.
- Discrepancies exist in international textbooks regarding peroneal muscle testing, describing them as dorsiflexors.
Purpose of the Study:
- Investigate common clinical methods for peroneal muscle testing.
- Evaluate the compatibility of these clinical methods with functional anatomy.
- Identify potential inaccuracies in current peroneal muscle testing protocols.
Main Methods:
- Cross-sectional study design.
- Electronic questionnaire distributed to 143 Israeli musculoskeletal physiotherapists.
- Survey focused on anatomical resistance location and resisted motion combinations during peroneal testing.
Main Results:
- 69% of respondents correctly identified peronei as evertors but incorrectly localized resistance over the fifth metatarsus.
- 38% described peroneal muscles as dorsiflexors instead of plantar flexors.
- Only 2% used the anatomically correct technique of resisting plantarflexion and eversion at the first metatarsus base.
- Correspondence analysis revealed a common error of resisting dorsiflexion, aligning with reported frequencies.
Conclusions:
- Significant inconsistencies exist between textbook instructions and functional anatomy for peroneal muscle testing.
- Clinical application of functional anatomy in peroneal testing shows a lack of accuracy.
- Re-evaluation of teaching materials and clinical methods for peroneal muscle testing is recommended.
- Further research is needed to determine the clinical value of peroneal muscle testing in ankle evaluation.
