How is ankle dorsiflexion MMT performed?

• A. Seated with the foot free; patient dorsiflexes the foot against resistance applied to the dorsum of the foot, with the leg supported
• B. Prone with the foot plantarflexed
• C. Standing on the heel
• D. Supine with leg unsupported

Answer: (A)

Testing ankle dorsiflexion is best done with the patient seated, the leg supported, and the foot free to move. The examiner applies resistance to the dorsum of the foot as the patient attempts to pull the foot upward into dorsiflexion. This position isolates the dorsiflexors (mainly the tibialis anterior) and minimizes substitutions from the gastrocnemius since the knee is supported and can be positioned to reduce its involvement. The resistance applied on the top of the foot directs the effort specifically toward dorsiflexion.

Other positions don’t isolate this movement as well: testing with the foot plantarflexed targets the opposing muscles, standing on the heel asks the patient to function against gravity in a less controlled way, and lying supine with the leg unsupported provides poor stabilization and can introduce compensatory movements.