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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Oct 18, 2025; 16(10): 108858
Published online Oct 18, 2025. doi: 10.5312/wjo.v16.i10.108858
Published online Oct 18, 2025. doi: 10.5312/wjo.v16.i10.108858
Normative values of ankle strength and its importance for rehabilitation and return to activity: A cross-sectional study
Lucas Furtado da Fonseca, Eduardo Souza Maciel, Diego Costa Astur, Department of Ortho
Madhan Jeyaraman, Naveen Jeyaraman, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India
Madhan Jeyaraman, Naveen Jeyaraman, Department of Regenerative Medicine, Agathisha Institute of Stemcell and Regenerative Medicine (AISRM), Chennai 600030, Tamil Nadu, India
Thiago Resende Inojossa, Rehabilitation Sector, Hcor Heart Hospital, São Paulo 04003-905, Brazil
Cesar de Cesar Netto, Nacime Salomão Mansur, Department of Orthopedic Surgery, Duke University, Durham, NC 27710, United States
Co-corresponding authors: Lucas Furtado da Fonseca and Madhan Jeyaraman.
Author contributions: Da Fonseca LF contributed to conceptualization; da Fonseca LF, Maciel ES, Netto CC, Mansur NS, and Astur DC contributed to acquiring clinical data and performing the data analysis; da Fonseca LF, Jeyaraman M, and Jeyaraman N contributed to manuscript writing; Inojossa TR helped in manuscript revision; da Fonseca LF contributed for image acquisition; Jeyaraman M contributed to proofreading; da Fonseca LF and Jeyaraman M contributed to administration. da Fonseca LF and Jeyaraman M have played an important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors. All authors have agreed to the final version to be published and agree to be accountable for all aspects of the work.
Institutional review board statement: The study protocol was approved by the Ethics Committee of the Federal University of São Paulo (No. 3.696.560).
Informed consent statement: Obtained from all participants of the study.
Conflict-of-interest statement: All authors declare no conflicts of interest in publishing the manuscript.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: Data is contained within the manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lucas Furtado da Fonseca, MD, Associate Professor, Researcher, Department of Orthopaedics and Traumatology, Paulista School of Medicine, Federal University of Sao Paulo, R. Sena Madureira, 1500 - Vila Clementino, Sao Paulo 04024-900, Brazil. contato@drlucasfonseca.med.br
Received: April 25, 2025
Revised: May 28, 2025
Accepted: August 28, 2025
Published online: October 18, 2025
Processing time: 175 Days and 4.7 Hours
Revised: May 28, 2025
Accepted: August 28, 2025
Published online: October 18, 2025
Processing time: 175 Days and 4.7 Hours
Core Tip
Core Tip: Normative isokinetic strength values for non-athletic ankles serve as essential benchmarks for guiding rehabilitation and return-to-sport criteria. The findings reveal notable gender-based differences in maximum torque values, while showing no significant correlation with age or body mass index. Balanced Limb Symmetry Index and Muscular Deficiency Index across movements highlight the importance of standardization. These outcomes offer a robust framework for refining non-surgical treatments, developing targeted strength restoration programs, and reducing the risk of recurring injuries.