title: Scientific Investigation of the Calf Raise Test Using the Calf Raise Mobile Application to Inform Test Administration and Interpretation

authors: Fernandez, Ma. Roxanne

subjects: heel raises

abstract: The Calf Raise Test (CRT) is a widely used functional assessment of triceps surae muscle-tendon unit function. While it exhibits acceptable reliability, administration inconsistencies and test parameter variations likely contribute to observed normative value discrepancies in the literature. Additionally, devices employed in research for standardisation and quantification of outcomes beyond the number of repetitions are often inaccessible in clinics. This Thesis addresses these gaps by conducting an evidence-based assessment of the CRT and examining how changes in test parameters affect outcomes. The overarching aims of this Thesis were to: (1) develop a valid and reliable method to assess the CRT in clinical practice that provides research-grade outcomes, and (2) examine the influence of changing CRT parameters on outcomes and triceps surae muscle function. To achieve these overarching aims, two literature reviews and three experimental studies were conducted.

The first literature review, aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, provides an overview of CRT devices used in research. Thirty-five studies were included, identifying seven CRT devices. The linear encoder emerged as the most used, quantifying all three main CRT outcomes (repetitions, peak height, and total work). However, its limited clinical use is attributed to hardware costs and need for programming skills.

Chapter 3 introduces the Calf Raise application (CRapp), a smartphone application designed to aid standardise CRT procedures and automate outcomes. Thirteen individuals underwent single-leg CRT on both legs across three occasions. CRapp outcomes (i.e., repetitions, total work, total height, peak height, fatigue index, and peak power) were validated against 3D motion capture and force plate data, demonstrating excellent concurrent validity and agreement levels. The CRapp proved valid, reliable, and suitable for both research and clinical practice.

Chapter 4 explores the impact of varying ankle starting positions on CRT outcomes in 49 healthy individuals, accounting for gender, age, body mass index (BMI), and physical activity levels. Participants performed single-leg CRT in three randomised conditions on three occasions: flat (0°), incline (10° dorsiflexion), and step (full dorsiflexion). Analysis of CRapp data indicate significant effects of ankle starting position on all CRT outcomes, emphasising the importance of ankle start position for CRT administration and interpreting test outcomes. 

Chapter 5 investigates the effects of varying cadence on CRT outcomes in 36 healthy individuals, considering gender, age, BMI, and physical activity levels. Participants performed single-leg CRT in three randomised conditions on three occasions: 30, 60, and 120 beats per minute. Significant cadence effects were observed on CRapp outcomes, hence this study confirmed that cadence does matter when administering the CRT and interpreting its outcomes.

Chapter 6, a systematic review following PRISMA guidelines, examines changes in standing CRT parameters on triceps surae surface electromyography (EMG) activity and fatigue measures. Seven studies were included, indicating increased activity in medial gastrocnemius increased with feet externally rotated, knees straight, and added load; lateral gastrocnemius with feet internally rotated, knees straight, and added load; and soleus with knees bent, whole-body vibration, and added load. These findings can inform evidence-based practices, though further training studies are recommended.

Overall, this Thesis introduces the CRapp, an innovative, valid, and reliable method of quantifying key CRT outcomes. Also, this Thesis provides a better understanding of the influence of varying CRT parameters on outcomes. The evidence-base generated from this Thesis may be used to inform best practice use and interpretation of the CRT and guide future research.

text: Scientific Investigation of the Calf Raise Test Using the Calf Raise Mobile Application to Inform Test Administration and Interpretation The Calf Raise Test (CRT) is a widely used functional assessment of triceps surae muscle-tendon unit function. While it exhibits acceptable reliability, administration inconsistencies and test parameter variations likely contribute to observed normative value discrepancies in the literature. Additionally, devices employed in research for standardisation and quantification of outcomes beyond the number of repetitions are often inaccessible in clinics. This Thesis addresses these gaps by conducting an evidence-based assessment of the CRT and examining how changes in test parameters affect outcomes. The overarching aims of this Thesis were to: (1) develop a valid and reliable method to assess the CRT in clinical practice that provides research-grade outcomes, and (2) examine the influence of changing CRT parameters on outcomes and triceps surae muscle function. To achieve these overarching aims, two literature reviews and three experimental studies were conducted.

The first literature review, aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, provides an overview of CRT devices used in research. Thirty-five studies were included, identifying seven CRT devices. The linear encoder emerged as the most used, quantifying all three main CRT outcomes (repetitions, peak height, and total work). However, its limited clinical use is attributed to hardware costs and need for programming skills.

Chapter 3 introduces the Calf Raise application (CRapp), a smartphone application designed to aid standardise CRT procedures and automate outcomes. Thirteen individuals underwent single-leg CRT on both legs across three occasions. CRapp outcomes (i.e., repetitions, total work, total height, peak height, fatigue index, and peak power) were validated against 3D motion capture and force plate data, demonstrating excellent concurrent validity and agreement levels. The CRapp proved valid, reliable, and suitable for both research and clinical practice.

Chapter 4 explores the impact of varying ankle starting positions on CRT outcomes in 49 healthy individuals, accounting for gender, age, body mass index (BMI), and physical activity levels. Participants performed single-leg CRT in three randomised conditions on three occasions: flat (0°), incline (10° dorsiflexion), and step (full dorsiflexion). Analysis of CRapp data indicate significant effects of ankle starting position on all CRT outcomes, emphasising the importance of ankle start position for CRT administration and interpreting test outcomes. 

Chapter 5 investigates the effects of varying cadence on CRT outcomes in 36 healthy individuals, considering gender, age, BMI, and physical activity levels. Participants performed single-leg CRT in three randomised conditions on three occasions: 30, 60, and 120 beats per minute. Significant cadence effects were observed on CRapp outcomes, hence this study confirmed that cadence does matter when administering the CRT and interpreting its outcomes.

Chapter 6, a systematic review following PRISMA guidelines, examines changes in standing CRT parameters on triceps surae surface electromyography (EMG) activity and fatigue measures. Seven studies were included, indicating increased activity in medial gastrocnemius increased with feet externally rotated, knees straight, and added load; lateral gastrocnemius with feet internally rotated, knees straight, and added load; and soleus with knees bent, whole-body vibration, and added load. These findings can inform evidence-based practices, though further training studies are recommended.

Overall, this Thesis introduces the CRapp, an innovative, valid, and reliable method of quantifying key CRT outcomes. Also, this Thesis provides a better understanding of the influence of varying CRT parameters on outcomes. The evidence-base generated from this Thesis may be used to inform best practice use and interpretation of the CRT and guide future research.

year: 2023

title: Doctorates in the dark: Threshold concepts and the improvement of doctoral supervision

authors: Johnson, E. Marcia

subjects: threshold concepts

abstract: The overall goal of this qualitative research case study into doctoral writing was to determine if there were knowable threshold concepts and, if so, to develop effective strategies for helping students overcome them. In addition, it was understood that such strategies could have change implications for supervisory practice. Interview and survey data were collected from students and supervisors. From the student data two threshold concepts had emerged: “Talking to think”—a strategy for developing clarity in writing; and self-efficacy—the belief in one's ability to overcome writing barriers and become an independent academic researcher. In this paper, those two threshold concepts provide an organising framework for the presentation of supervisor findings and for discussion of supervisor professional development needs. The paper concludes with insights into how supervisor professional development could be improved and extended beyond its current focus on regulations and compliance issues.

text: Doctorates in the dark: Threshold concepts and the improvement of doctoral supervision The overall goal of this qualitative research case study into doctoral writing was to determine if there were knowable threshold concepts and, if so, to develop effective strategies for helping students overcome them. In addition, it was understood that such strategies could have change implications for supervisory practice. Interview and survey data were collected from students and supervisors. From the student data two threshold concepts had emerged: “Talking to think”—a strategy for developing clarity in writing; and self-efficacy—the belief in one's ability to overcome writing barriers and become an independent academic researcher. In this paper, those two threshold concepts provide an organising framework for the presentation of supervisor findings and for discussion of supervisor professional development needs. The paper concludes with insights into how supervisor professional development could be improved and extended beyond its current focus on regulations and compliance issues.

year: 2014

title: Through the eyes of whānau: Destruction of cultural identity through education

authors: Ngaamo, Raewyn Brenda

subjects: Māori

abstract: This thesis examines how the schooling experiences of a dual cultural heritage whānau influenced the development of their identity, their language and culture across three generations. Koro, Tuakana, Teina and Moko share their experiences with us and through these stories reveal how they were forced through the colonising beliefs and practices of schooling to reshape themselves in a bid to belong. The compromise and abuse of cultural identity in wider society, replicated and validated in schooling, created a vicious and dehumanising experience for each of them. School was a major site of assimilation for this whānau. They experienced racism, rejection, low expectations and cultural disconnection across the three generations. They suffered particularly as dual heritage children who experienced rejection and racial micro aggressions from both Pākehā and Māori alike. Instead of education being a means to realise their potential and to achieve success it was actually the vehicle for the destruction of their cultural identity.

text: Through the eyes of whānau: Destruction of cultural identity through education This thesis examines how the schooling experiences of a dual cultural heritage whānau influenced the development of their identity, their language and culture across three generations. Koro, Tuakana, Teina and Moko share their experiences with us and through these stories reveal how they were forced through the colonising beliefs and practices of schooling to reshape themselves in a bid to belong. The compromise and abuse of cultural identity in wider society, replicated and validated in schooling, created a vicious and dehumanising experience for each of them. School was a major site of assimilation for this whānau. They experienced racism, rejection, low expectations and cultural disconnection across the three generations. They suffered particularly as dual heritage children who experienced rejection and racial micro aggressions from both Pākehā and Māori alike. Instead of education being a means to realise their potential and to achieve success it was actually the vehicle for the destruction of their cultural identity.

year: 2019