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Comparing Quantification Methodologies for the Single-Leg Heel-Rise in Patients Following Operative and Non-Operative
Rebecca Franklin1,2, Josh Garofalo3,4, Sophie Zhu4
1Faculty of Kinesiology and Recreation Management University of Manitoba.
International Journal of Sports Physical Therapy
|January 5, 2026
Summary
The Single-Leg Heel-Rise test (SLHR) can be quantified using linear position transducers (LPT), motion capture, or a smartphone app after Achilles tendon rupture (ATR). However, results vary significantly between devices, meaning they cannot be used interchangeably for patient assessment.
Area of Science:
- Biomechanical analysis
- Rehabilitation medicine
- Orthopedic surgery
Background:
- The Single-Leg Heel-Rise test (SLHR) is a standard functional assessment for patients recovering from Achilles tendon rupture (ATR).
- Various methods, including linear position transducers (LPT), motion capture, and smartphone applications, exist to quantify SLHR performance.
- Direct comparisons of these quantification methods following operative or non-operative ATR management are lacking.
Purpose of the Study:
- To compare the accuracy of three distinct methods—LPT, motion capture, and a smartphone app—in quantifying SLHR performance.
- To evaluate these methods for measuring repetition count, heel-rise height, and total work in patients with ATR.
- To assess the comparability of these measurements between operative and non-operative ATR treatment groups.
Main Methods:
- A cross-sectional study involving 24 patients (12 operative, 12 non-operative) with complete ATR.
- Participants performed SLHR to failure on a 10° angle board, with data recorded by LPT, 2D motion capture, and the Calf Raise app.
- Statistical analyses included intraclass correlation coefficients, Bland-Altman plots, and two-way analyses of variance to compare devices and quantify work.
Main Results:
- All devices demonstrated strong positive correlations (r²=0.997 for motion capture and app), indicating good agreement in repetition and height measurements.
- However, Bland-Altman plots revealed wide limits of agreement across all methods, suggesting significant between-device variability.
- Reduced peak and accumulated heel-rise height on the affected limb translated to lower total work, with substantial mean differences observed between devices (e.g., -403.5 J for motion capture).
Conclusions:
- Linear position transducers (LPT), motion capture, and the Calf Raise app are viable tools for quantifying SLHR repetitions, height, and work in ATR patients.
- Despite strong correlations, the wide limits of agreement necessitate caution, as measurements from different devices should not be used interchangeably.
- These findings highlight the importance of consistent methodology selection for reliable functional status assessment post-ATR.
