Test: Foot Eversion with plantar flexion or dorsiflexion

Video Link

Background/Purpose

Foot eversion is accompanied by either dorsiflexion or plantar flexion. The toe extensors are the primary dorsiflexors accompanying eversion because of the Peroneus tertius in an inconstant muscle. The primary motion of eversion with plantar flexion is accompanied by the Peroneus brevis because the Peroneus longus is primarily a depressor of the 1st metatarsal head rather than an evertor. The Peroneus brevis cannot be isolated if both the peronei are innervated and active. If there is a difference in strength between the Peroneus longus and the Peroneus brevis, the stronger of the two can be ascertained by the relative amount of resistance taken in eversion versus the resistance taken at the 1st metatarsal head. If greater resistance is taken at the 1st metatarsal head, the Peroneus longus is the stronger muscle.

Procedure

Grade 5 (Normal)
Position of patient: Short sitting with the ankle in the neutral position (midway between dorsiflexion and plantar flexion). Test also may be performed with patient supine.
Position of clinician: Sitting on a low stool in front of the patient or standing at the end of the table if patient is supine. One hand grips the ankle just above the malleoli for stabilization. The hand giving resistance is directed toward inversion and slight dorsiflexion.
Instructions to patient: "Turn your foot down and out. Hold it! Don't let me move it in."
Grade 1 (Trace) and Grade 0 (Zero)
Position of patient: Short sitting or supine.
Position of clinician: Sitting on a low stool or standing at the end of the table. To palpate the Peroneus longus, place fingers on the lateral leg over the upper one-third just below the head of the fibula. The tendon of the muscle can be felt posterior to the lateral malleolus but behind the tendon of the Peroneus brevis.
To palpate the tendon of the Peroneus brevis, place index finger over the tendon as it omes forward from behind the lateral malleolus, proximal to the base of the 5th metatarsal. The belly of the Peroneus brevis can be palpated on the lateral surface of the distal leg over the fibula.
Performed: Unilaterally

Dialog

Patient everts foot with depression of first metatarsal head and some plantar flexion.

Criteria

• Grade 5 Normal: Patient completes full range and holds end position against maximal resistance.
• Grade 4 Good: Patient completes available range of motion against strong to moderate resistance.
• Grade 3 Fair: Patient completes available range of eversion but tolerates no resistance.
• Grade 2 Poor: Patient will be able to complete only a partial range of eversion motion.

Measurement

LOINC Code

0

Scale/Grading

Pass/Fail