Reference values for the bilateral heel-rise test

BACKGROUND: The bilateral heel-rise test is an instrument that evaluates the performance of the triceps surae. Normative parameters need to be established for the use of the heel-rise test in clinical practice. OBJECTIVE: To determine the reference values for the bilateral heel-rise test. METHODS: This cross-sectional study assessed healthy subjects using the bilateral heel-rise test. We analyzed the number of repetitions, time (in seconds), and repetition rate (repetitions/second) during execution of the heel-rise test, until the point of voluntary fatigue. The estimates were stratified by age and gender. Multiple linear regression was performed to define the reference equation for the bilateral heel-rise test. RESULTS: A total of 147 individuals were included. The median age was 37 years (IQR 28–46). It was observed that the number of repetitions decreases with age, with a higher number of repetitions in male participants compared to female participants. Gender, body mass index, and maximum activity scores predict 14% of the number of plantar flexions performed in the bilateral heel-rise test. Age and adjusted activity scores predict 18% of the repetition rate in the bilateral heel-rise test. CONCLUSION: The bilateral heel-rise test reference values for an adult population were defined as scores above the 25th percentile for number of repetitions, time, and repetition rate. The number of heel-rise test repetitions that corresponds to the 25th percentile, according to age and gender, is as follows: age 20–29, 65 repetitions for men and 45.5 for women; age 30–39, 62.75 men and 41.5 women; age 40–49, 67.25 men and 45 women; and age 50–59, 54 men and 39.25 women.