Heel Rise Test Accuracy in the Assessment of the Functional Capacity of Individuals With Peripheral Arterial Disease

Objective: The purpose of this study was to evaluate the accuracy of heel rise test (HRT) for assessing the functional capacity (FC) of individuals with peripheral arterial disease (PAD) and determine the best sensitivity cutoff point to stratify individuals with worse FC.

Methods: This retrospective methodological study included adults of both sexes diagnosed with PAD and intermittent claudication. Individuals performed the HRT (number of plantar flexions, execution time, and execution rate were recorded) and the incremental shuttle walking test (distance walked was recorded). The accuracy analysis and the determination of the sensitivity of the HRT in assessing FC were performed by the receiver operating characteristic curve based on the following incremental shuttle walking test cutoff point: 380 meters. Alpha was set at 5%.

Results: In this study, 120 individuals were included (64 ± 9.65 years). The number of plantar flexions showed better accuracy for FC assessment (area under the curve, 0.78; 95% CI, 0.65-0.90). The best sensitivity cutoff to stratify the individuals with the worst FC was 63 plantar flexions (sensitivity, 0.952; specificity, 0.562).

Conclusion: The HRT showed good accuracy, adequate sensitivity, and acceptable specificity in assessing the FC of individuals with PAD. The best sensitivity cutoff point to stratify individuals with worse FC was 63 plantar flexions.