Jornal Vascular Brasileiro
http://www.jvb.periodikos.com.br/article/doi/10.1590/1677-5449.202501772
Jornal Vascular Brasileiro
Artigo Original

Heel-Rise Test for functional assessment in chronic venous insufficiency: a validity study

Teste de elevação do calcanhar para avaliação funcional na insuficiência venosa crônica: um estudo de validação

Marina Silva Reis; Keity Lamary Souza Silva; Antonielly Rocha de Souza Pereira; Vivian Camargo Chaves; Stefânia Guimarães Nery; Dalyla Lemos de Souza Silva; Pedro Henrique Scheidt Figueiredo; Henrique Silveira Costa

http://dx.doi.org/10.1590/1677-5449.202501772 J Vasc Bras, vol.25, e20250177, 2026
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Abstract

Background: Chronic venous insufficiency (CVI) affects the superficial and/or deep venous system and is often associated with valve abnormalities and calf pump dysfunction, including reduced lower limb strength. Assessment of calf muscle strength should be part of the clinical routine for these patients. The Heel-Rise Test (HRT) has been proposed for this purpose, but its correlation with other functional instruments remains unclear.

Objectives: To verify the validity of the HRT for assessment of calf muscle strength and endurance in patients with CVI by comparing it with other functional tests.

Methods: Fifty-two patients with CVI (mean age of 67.2±13.2 years, CEAP 1 to 6) were evaluated. All patients undertook the HRT and were instructed to perform maximal plantar flexions until exhaustion. The number of repetitions and the time taken to complete the test were recorded. All Sit-to-Stand test variants (STS5, STS10, STS30, STS60) were also administered. Handgrip dynamometry, the Human Activity Profile (HAP), and the CIVIQ-14 questionnaire were also administered. Correlations were analyzed using Pearson or Spearman tests.

Results: HRT repetitions correlated significantly with STS5 (r = -0.676), STS10 (r = -0.701), STS30 (r = 0.691), STS60 (r = 0.697), handgrip dynamometry (r = 0.275), HAP (r = 0.457), and CIVIQ-14 (r = -0.646). However, HRT execution time was not correlated with handgrip dynamometry or CIVIQ-14.

Conclusions: The HRT is related to calf muscle strength, endurance, and functionality in patients with CVI and should be used for functional assessment of these patients.

Keywords

venous insufficiency; muscle strength; muscle weakness; muscle fatigue

Resumo

Contexto: A insuficiência venosa crônica (IVC) acomete o sistema venoso superficial e/ou profundo e está frequentemente associada a alterações valvares e à disfunção da bomba muscular da panturrilha, incluindo redução da força dos membros inferiores. Avaliação da força da musculatura da panturrilha deve fazer parte da rotina clínica desses pacientes. O teste de elevação do calcanhar (HRT) foi proposto para essa finalidade, mas sua associação com outros instrumentos permanece incerta.

Objetivos: Verificar a validade do HRT na avaliação da força e resistência da musculatura da panturrilha em pacientes com IVC, comparado esse com outros testes funcionais.

Métodos: Foram avaliados 52 pacientes com IVC (idade média de 67,2±13,2 anos, classificação CEAP de 1 a 6). Todos realizaram o HRT e foram orientados a executar flexões plantares até a exaustão. O número de repetições e o tempo de execução foram registrados. Também foram aplicadas variações do teste de sentar e levantar (STS5, STS10, STS30, STS60), dinamometria de preensão palmar, Perfil de Atividade Humana (PAH) e questionário Chronic Venous Insufficiency Quality of Life Questionnaire-14 (CIVIQ-14). As correlações foram analisadas pelos testes de Pearson ou Spearman.

Resultados: O número de repetições no HRT apresentou correlação significativa com os testes STS5 (r = -0,676), STS10 (r = -0,701), STS30 (r = 0,691), STS60 (r = 0,697), dinamometria de preensão palmar (r = 0,275), PAH (r = 0,457) e CIVIQ-14 (r = -0,646). No entanto, o tempo de execução do HRT não apresentou correlação com dinamometria de preensão palmar, nem com CIVIQ-14.

Conclusões: O HRT está relacionado à força, à resistência e à funcionalidade da musculatura da panturrilha em pacientes com IVC, devendo ser utilizado para avaliação funcional desses pacientes.

Palavras-chave

insuficiência venosa; força muscular; fraqueza muscular; fadiga muscular

Referências

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Submetido em:
18/10/2025

Aceito em:
16/06/2026

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