title: Three single leg standing tests for clinical assessment of chronic plantar heel pain syndrome: static stance, half-squat and heel rise.
abstract: OBJECTIVE
  To assess reliability and validity of three single leg standing clinical tests in patients with plantar heel pain syndrome (PHPS).
  
  
  METHODS
  Cross-sectional reliability study.
  
  
  METHODS
  Forty patients diagnosed with PHPS.
  
  
  METHODS
  Patients stood on their affected foot in a static stance for up to 30seconds, a half squat for up to 10 repetitions, and a heel rise for up to 10 repetitions. The first sensation of pain (p1) determined the termination of each test, and established a positive test result. The level of p1 was measured using a visual analogue scale (VAS); time or repetitions for each test were recorded. Prior to performing the tests, all patients completed the Foot & Ankle Computerized Adaptive Test to measure functional status (FS).
  
  
  RESULTS
  Detection of p1 in each test showed good reliability for inter- and intrarater assessment (Kappa=0.60 to 0.78 and 0.56 to 0.77, respectively). The intraclass correlation coefficient for the VAS measures was 0.85 to 0.95 for inter-rater assessment and 0.78 to 0.92 for intrarater assessment. However, the Bland and Altman limits of agreement were wide, indicating that these measures were less reliable than the correlation coefficients suggested. Thirty-five patients (88%) experienced a positive pain response to at least one test. Significant correlations were found between the VAS measures in each test and FS (r=0.63 to 0.72).
  
  
  CONCLUSIONS
  The static stance, half squat and heel rise tests were easily implemented, and found to be reliable and valid according to one analysis, yet less reliable with another, for pain provocation and VAS levels in patients with PHPS. All three VAS levels correlated well with FS.
authors.affiliation: Spinal Research Laboratory, Department of Physical Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Physical Therapy Service, Maccabi Healthcare Services, Petach Tikva, Israel. Electronic address: saban_b@mac.org.il.
authors.forename: B
authors.initials: B
authors.lastname: Saban
authors.affiliation: Spinal Research Laboratory, Department of Physical Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Masharawi
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005534:Foot Diseases / Q000175:diagnosis* / Q000503:physiopathology; D006365:Heel; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D026741:Physical Therapy Modalities / Q000592:standards*; D015203:Reproducibility of Results
keywords: Half squat; Heel pain; Heel rise; Plantar fasciitis; Static stance