A study of the reproducibility and reliability of the musculo-articular stiffness of the ankle joint

Abstract

The objective of this work was to evaluate the reproducibility, reliability and usefulness of the musculo-articular stiffness (MAS) of the ankle joint, measuring it by the free vibration technique. Seventeen (nine males and eight females) healthy university students were included in the study. Force (f), MAS (k) and unitary MAS (ku) (defined as the ratio between the value of stiffness k obtained in the test (absolute terms) and the value of force (f)) were obtained. A test-retest protocol was designed and performed on the same day to determine the short-term reproducibility of f, k and ku. Short-term reproducibility of k and ku on 1 day in absolute terms (< 7% Coefficient of Variation (CV)) and relative reproducibility (Intraclass Correlation Coefficient (ICC) and Pearson ≥ 0.97) for both feet were obtained. The reliability of k and ku in absolute terms (< 9% CV) and in relative terms (ICC and Pearson ≥0.93) based on repeating the protocol for 1 week was analysed for both feet. To analyse the usefulness, the Effect Size (ES) ratio = “Trivial” for all variables (for 1 day and 1 week) and the Smallest Worthwhile Change (SWC) ratio (Typical Error (TE)< SWC) = “GOOD” for k and ku (1 day and 1 week) were considered. The Minimal Difference needed to be considered “real” (MD) for ku ≅ 3.5% (1 day); ku≅ 8.5% (1 week) (p < 0.05) was obtained. The statistical analysis carried out displayed the high reproducibility, reliability and usefulness of the MAS test, which was more consistent with ku than k. Therefore, the unitary stiffness (ku) proven to be representative of the mechanical response of the ankle joint obtained by free vibration techniques, which allows comparison between different subjects.