A randomised crossover trial on the effects of foot starting position on calf raise test outcomes: Position does matter

This randomised crossover study with repeated measures examined the influence of the three most common foot starting positions used in conducting the calf raise test (CRT) on test outcomes. This study also accounted for the potential influence of gender, age, body mass index (BMI), and level of physical activity on test outcomes. Forty-nine healthy individuals (59 % female, 21 ± 4 years) performed single-leg calf raise repetitions in a human movement laboratory in three randomised foot starting positions: flat, 10° incline, and step. The validated Calf Raise application was used to track the vertical displacement of a marker placed on the foot using computer vision. The application extracted the following CRT outcomes from the vertical displacement curve: number of repetitions, peak vertical height, total vertical displacement, and total positive work. Data were analysed using mixed-effects models and stepwise regression. There was a significant main effect (P females) and BMI (P = 0.002; lower BMI>higher BMI) significantly influenced the number of repetitions. Gender (P females) also influenced total positive work. Age and physical activity levels did not significantly influence CRT outcomes. CRT foot starting position mattered and significantly affected all CRT outcomes. CRT foot starting position needs consideration when contrasting data in research and practice. •Varying foot starting position significantly affected calf raise test outcomes.•Repetitions, peak height, total displacement, and total work were greater from flat than 10° incline and step.•Gender and body mass index were significant predictors of calf raise test outcomes.•This study provides information useful for clinicians in implementing evidence-based practice.