Normative Value of Single Heel-rise Test in School-going Children Along With Its Inter-session Agreement
Condition: Healthy
Study type: Observational

Summary: 
      Background:

      Single heel-rise test (SHRT) is a method of assessing the strength and endurance of
      plantar-flexors manually. Single heel-rise test also known as calf rise test, is a method of
      assessing the strength of plantar-flexor. The test was first done to determine the integrity
      of calf muscle. There are few studies which has established the reliability and normative
      value of heel-rise test in adults. But till date, there is no documented evidence of
      normative value of heel-rise test in children.

      Aim:

      The study is focused to derive reliability and normative value of single heel-rise test in
      children of age group 8-12 years.

      Methods:

      The study will recruit healthy school-going children of 8-12 years age. Any pathology which
      can limit or interfere with the test outcome will be excluded. The samples will be collected
      by stratified sampling technique. Procedure of test will be demonstrated prior to the test.
      Heel raising and lowering will be performed until child feels fatigue. Test will be performed
      on both the lower extremities individually.

      Data analysis:

      Test will be assessed on both the heel individually. Three sessions will be conducted by the
      same rater on same child for intra-rater and test-retest reliability, and another rater will
      assess the test on same individual for establishing inter-rater reliability. Normative value
      of the test will be determined by deriving the mean of test-values for each age group.
    

Detailed description: 
      1. Introduction:

           Plantar flexors play a crucial role in gait cycle, during foot clearance. It assists in
           forward propulsion, and is also responsible for maintaining the static and dynamic
           balances. Single heel-rise test is a physical examination which evaluates the strength
           of plantar-flexors. This study aims to assess the intra-rater and inter-rater
           reliability and normative value of single heel-rise test in healthy school-going
           children of age group 8-12 years.

           1.1.Problem Statement: The documented evidences does not have normative value for single
           heel-rise test in children. The normative value is provided only for adults. Therefore,
           there is an absolute need of deriving normative value for this test in children.

           1.2.Purpose of the study: The purpose of this study is to derive the normative value of
           single-heel rise test along with reliability.

           1.3.Objectives of the study: 1.3.1.To establish inter-rater and intra-rater and
           test-retest reliability of single heel-rise test 1.3.2.To derive normative value of
           single heel-rise test

        2. Procedure:

      The study will be a cross-sectional study. The study protocol has been approved from the
      Institutional Ethics Committee of Maharishi Markandeshwar (Deemed to be University).

      All the anthropometrics of the children will be taken prior to the test which includes
      height, weight, calf muscle girth and length. The maximum number of heel-rises will be
      performed by the child in single limb stance until maximal exertion will be recorded. The
      test will be repeated in standing position on both the sides. For balancing, 2-finger support
      on wall will be allowed.

      Reliability testing: For inter-rater, 2 raters will assess on two different sessions on same
      day. For intra-rater, same rater will assess the test twice on same day, and after 24 hours
      for test-retest reliability.

      Normative value: The mean of all the test-values for each age group will be normative value
      for that particular age group.
    

Intervention name(s): Single-heel rise test
Intervention type(s): Diagnostic Test
Intervention description(s): Single heel-rise test is used to assess the strength of plantar-flexors clinically
Observational model: Other
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        The study will be conducted on healthy children of 8-12 years age group. Any condition that
        can limit the test measure will be excluded as the test is aimed to achieve normative
        value.
      
Keywords: Children; Heel; Reliability