Background: Ankle dorsiflexion is essential for lower extremity function and limitations in this motion are associated with musculoskeletal injury and decreased performance during functional tasks. The distance-based weight-bearing lunge test (WBLT) is a reliable and valid clinical measure of ankle dorsiflexion, yet normative data across age and sex are lacking.
Objectives: To establish adult age- and sex-specific normative values for the distance-based WBLT.
Design: Cross-sectional, multi-country observational study.
Method: A total of 899 adults from Canada, Spain, and Iran completed demographic and clinical measures including height, Foot Posture Index (FPI-6), supination resistance, and bilateral WBLT performance using a standardized knee-to-wall protocol. Participants were stratified into seven age groups and by sex. Between-limb differences were examined with paired t-tests. Associations between WBLT and height, FPI-6, and supination resistance were assessed using Pearson correlations. Age and sex effects were evaluated using two-way ANOVA with Bonferroni-adjusted comparisons. Percentile-based clinical categories were generated for each age-sex subgroup.
Results/findings: No meaningful difference was observed between limbs (p = 0.172, d = 0.05). WBLT performance declined progressively with age (p < 0.001, η2 = 0.283), with greater reductions evident beginning in the 60-69 age group. Males demonstrated slightly greater dorsiflexion than females across age groups (p = 0.003, η2 = 0.010). Height, FPI-6, and supination resistance showed small, non-clinically meaningful associations with WBLT scores (R2 ≤ 0.09).
Conclusions: This study provides robust age- and sex-specific normative values for the distance-based WBLT, improving clinical interpretation of weight-bearing ankle dorsiflexion across the adult lifespan.
Keywords: Ankle; Biomechanical phenomena; Foot; Physical examination; Podiatry.
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