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Inter-Examiner & Intra-Examiner Reliability Study of the Achilles Heel Tension Test: A Neurological Indicator for Adverse Mechanical Cord Tension


Karen Feeley D.C.

Annals of Vertebral Subluxation Research ~ March 30, 2017 ~ Pages 55-60



Background: Spinal and neural integrity can be considered through an evaluation of tension at the ankle while performing the leg check protocols involved with several chiropractic techniques and lower extremity orthopedic testing. This test is performed on each visit to evaluate progress that is presumably occurring in the spinal cord and to add to the data used for clinical applications for each individual.

Can chiropractors assess levels of tension at the Achilles tendon in people in a prone position and demonstrate intra and inter reliability. This study measured inter and intra reliability of the measurement of Achilles tendon tension (heel tension), in the plane of plantar flexion and dorsi flexion.

Three experienced Network Spinal Analysis practitioners examined 21 individuals, right and left ankles; at two different times. The examinees were lying prone on a table with the ankles over the edge of the table. All of the practitioners have advanced certification in Network Spinal Analysis, and are instructors for this program of care. The practitioners tested levels of tension while passively putting the ankle thru full flexion and extension. The amount of tension was graded from 1-mild, to 5-severe.  Statistical analysis consisting of inter-class correlation co-efficient (ICC) was applied to the heel tension data.

We observed strong agreement with intra reliability and moderate correlation for inter reliability done for this data on measuring heel tension.

This study revealed moderate to strong inter and intra reliability of the heel tension aspect of this test in the directions of plantar flexion and dorsi flexion of the ankle. The test for overall heel tension appears to be a reliable, objective finding.

Chiropractic, vertebral subluxation, adjustment, neurological assessments, Achilles Heel Tension, Adverse Mechanical Cord Tension