Valores normativos do teste ponta do pé

Abstract

Adults with peripheral arterial obstructive disease (PAOD) have a smaller cross sectional area of the triceps surae and lower strength of this muscle than individuals who do not have this health condition. Considering the muscle alterations observed in these patients and the possible functional repercussions, valid and reliable tests that asses more specifically the muscle performance of individuals with PAOD are necessary. The heel-rise test (HRT) is a clinically relevant tool for vascular rehabilitation for assessment of the endurance of triceps surae. A limitation of the use of HRT in clinical practice is that there are no normative values for the Brazilian population, complicating the interpretation of their results. The aim of this study was to to establish normative values for HRT for the Brazilian population and verify if the test is sensitive in differentiating individuals with PAOD with distinct functional capacities. In the first study 239 healthy subjects with ages varying between 20 and 89 years, were assessed by the HRT. We analyzed the number of plantar flexion, time (seconds) and speed (plantar flexion/second) for test execution up to the point of volunteer fatigue. The median and interquartile range age was 45.00 (32.00 to 57.00) years. The results of the HRT variables considering the overall sample was 64 (47.00 to 87.00) repetitions for number of plantar flexion, 58.00 (46.00 to 84.00) seconds for time of execution and 1.05 (0.79 to 1.37) plantar flexion/second for speed. Ranges of variation of results were defined for the HRT (interquartile range 25-75%) for each age group and gender. If an individual reaches a value above 25% interquartile range for the number of plantar flexions, according to sex and age, it presents performance within normal limits. In the second study, twenty-five individuals (14 males) with a mean age of 63.36 ± 9.83 years, with PAOD were assessed by the HRT, the Walking Impairment Questionnaire (WIQ) and the Shuttle Walk Test (SWT). The variables number of plantar flexions and time to perform the HRT were sensitive to differentiate individuals with PAOD with distinct functional capacities (p=0.003 and 0.009, respectively). However, this result was not found for the variable velocity in the HRT. The number of plantar flexions in the HRT was sensitive to differentiate individuals of extreme classes on the WIQ domain stairs (p=0.008). Thus, the results of first study allowed determining the possible range of variation of results for the HRT for each age group and gender. The results of the second study demonstrated that HRT can be applied in clinical practice for the assessment of patients with PAOD, with different functional capabilities. This study enhances the use of HRT, guaranteeing greater clinical applicability in the assessment of individuals with PAOD, and its results can be used as a basis for comparison in future studies involving the assessment of healthy individuals and patients with specific health conditions in different clinical situations.