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Vol. 21. Num. 5.
Pages 305-388 (01 September 2017)
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Vol. 21. Num. 5.
Pages 305-388 (01 September 2017)
Original Research
DOI: 10.1016/j.bjpt.2017.06.002
Reference values for the bilateral heel-rise test
Débora Pantuso Monteiroa, Raquel Rodrigues Brittoa, Guilherme Augusto de Freitas Fregonezib, Fernando Augusto Lavezzo Diasc, Marconi Gomes da Silvaa, Danielle Aparecida Gomes Pereiraa,
Corresponding author

Corresponding author at: Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, CEP: 31270-901, Belo Horizonte, MG, Brazil.
a Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
b Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil
c Departamento de Fisiologia, Universidade Federal do Paraná (UFPR), Londrina, PR, Brazil

  • Bilateral HRT reference values were established, stratified by age and gender.

  • Bilateral HRT reference values may be used as a basis for research and clinical practice.

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Figures (1)
Tables (4)
Table 1. A comparison of characteristics and bilateral HRT performance outcomes between genders, expressed as median and interquartile range (25–75%). BMI is presented as mean±standard deviation.
Table 2. Linear regression analysis, examining the entire sample, for the dependent variables ‘number of plantar flexions’ and ‘repetition rate’ in the bilateral HRT.
Table 3. Descriptive analysis of performance outcomes on the bilateral HRT, with the sample stratified by age group and gender, expressed as median and interquartile range (25–75%).
Table 4. Data for the total number of plantar flexions in the bilateral HRT, stratified by gender and age group, expressed as 10th, 25th, 50th, 75th, and 90th percentiles.
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The bilateral heel-rise test is an instrument that evaluates the performance of the triceps surae. Normative parameters need to be established for the use of the heel-rise test in clinical practice.


To determine the reference values for the bilateral heel-rise test.


This cross-sectional study assessed healthy subjects using the bilateral heel-rise test. We analyzed the number of repetitions, time (in seconds), and repetition rate (repetitions/second) during execution of the heel-rise test, until the point of voluntary fatigue. The estimates were stratified by age and gender. Multiple linear regression was performed to define the reference equation for the bilateral heel-rise test.


A total of 147 individuals were included. The median age was 37 years (IQR 28–46). It was observed that the number of repetitions decreases with age, with a higher number of repetitions in male participants compared to female participants. Gender, body mass index, and maximum activity scores predict 14% of the number of plantar flexions performed in the bilateral heel-rise test. Age and adjusted activity scores predict 18% of the repetition rate in the bilateral heel-rise test.


The bilateral heel-rise test reference values for an adult population were defined as scores above the 25th percentile for number of repetitions, time, and repetition rate. The number of heel-rise test repetitions that corresponds to the 25th percentile, according to age and gender, is as follows: age 20–29, 65 repetitions for men and 45.5 for women; age 30–39, 62.75 men and 41.5 women; age 40–49, 67.25 men and 45 women; and age 50–59, 54 men and 39.25 women.

Physical endurance
Muscle strength
Physical therapy


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