Execution
- 1Position the patient standing facing a wall with the test foot flat on the floor and pointing forward.
- 2Ask the patient to lunge the knee toward the wall while keeping the heel down.
- 3Move the foot farther from the wall until the knee can just touch the wall without the heel lifting.
- 4Measure the toe-to-wall distance or tibial inclination angle.
- 5Repeat on the opposite side and record symptoms, heel lift, and compensatory pronation or foot rotation.
Positive outcome
Restricted weight-bearing dorsiflexion is present when the patient cannot reach an expected distance or angle, commonly about 9 to 10 cm toe-to-wall distance or more than 35 degrees tibial inclination. A side-to-side difference is often more useful than a single cutoff. Pain during the lunge should be recorded separately from true dorsiflexion restriction.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Bennell et al. (1998) | Inter-rater ICC 0.97 (angle), 0.99 (distance); intra-rater ICC 0.97-0.98; SEm ~1 cm or 1-3°; 4 raters, n=13 healthy subjects | NA | NA | NA | NA |
| Chisholm et al. (2012) | Test-retest ICC 0.93-0.99, MDC90 1.0 cm (affected limb) / 1.5 cm (between-limb difference), patient population n=53 with ankle dysfunction | NA | NA | NA | NA |
CommentThe WBLT is a standardized measurement of functional dorsiflexion and has strong reliability (Bennell 1998 ICC ≥0.97 both within and between raters of varying experience, SEm ~1 cm or 1-3°). A change of >1 cm or >3° likely reflects genuine change rather than measurement error. It is not diagnostic of one ankle pathology. Foot rotation, arch collapse, heel lift, and tibial progression strategy can all change the result. It is best used for baseline, side-to-side comparison, and rehabilitation progress.
Low Clinical Value