Heel-Rise Test for functional assessment in chronic venous insufficiency: a validity study

Abstract

Abstract Background Chronic venous insufficiency (CVI) affects the superficial and/or deep venous system and is often associated with valve abnormalities and calf pump dysfunction, including reduced lower limb strength. Assessment of calf muscle strength should be part of the clinical routine for these patients. The Heel-Rise Test (HRT) has been proposed for this purpose, but its correlation with other functional instruments remains unclear. Objectives To verify the validity of the HRT for assessment of calf muscle strength and endurance in patients with CVI by comparing it with other functional tests. Methods Fifty-two patients with CVI (mean age of 67.2±13.2 years, CEAP 1 to 6) were evaluated. All patients undertook the HRT and were instructed to perform maximal plantar flexions until exhaustion. The number of repetitions and the time taken to complete the test were recorded. All Sit-to-Stand test variants (STS5, STS10, STS30, STS60) were also administered. Handgrip dynamometry, the Human Activity Profile (HAP), and the CIVIQ-14 questionnaire were also administered. Correlations were analyzed using Pearson or Spearman tests. Results HRT repetitions correlated significantly with STS5 (r = -0.676), STS10 (r = -0.701), STS30 (r = 0.691), STS60 (r = 0.697), handgrip dynamometry (r = 0.275), HAP (r = 0.457), and CIVIQ-14 (r = -0.646). However, HRT execution time was not correlated with handgrip dynamometry or CIVIQ-14. Conclusions The HRT is related to calf muscle strength, endurance, and functionality in patients with CVI and should be used for functional assessment of these patients.