Reliability of Goniometric Techniques for Measuring Hip Flexor Length Using the Modified Thomas Test.

IF 1.6 Q3 SPORT SCIENCES International Journal of Sports Physical Therapy Pub Date : 2024-08-01 eCollection Date: 2024-01-01 DOI:10.26603/001c.120899
Kira Eimiller, Emma Stoddard, Briana Janes, Mason Smith, Andrew Vincek
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Abstract

Background: The modified Thomas test (MTT) is commonly used to assess the flexibility of hip musculature, including the iliopsoas, rectus femoris, and tensor fascia latae. This measurement is important to include in a comprehensive musculoskeletal examination. However, existing research shows conflicting results regarding its reliability, particularly due to variations in controlling pelvic tilt during testing, which may lead to inaccurate measurements of hip extension when quantifying the test outcomes.

Purpose/hypothesis: This study aimed to evaluate the intra- and inter-rater reliability of the Modified Thomas Test (MTT) in assessing hip flexor length using a goniometer. It was hypothesized that controlling for pelvic tilt would enhance the reliability of these measurements.

Study design: Intra- and inter-rater reliability study.

Methods: Sixty-four healthy individuals were recruited to participate in this study. The MTT was performed twice on each leg by both an experienced and a student physical therapist. Blinded goniometric measurements for hip extension range of motion (ROM) in the MTT position were taken with neutral pelvic tilt being enforced via palpation. A double-blind protocol was used where both examiners were unaware of each other's measurements and the goniometer was covered to blind the measuring therapist to the values as well. ROM values were entered into a Microsoft Excel spreadsheet and quantified using SPSS software. Statistical analysis included calculating Intraclass Correlation Coefficients (ICCs) and Standard Errors of Measurement (SEMs) using SPSS software.

Results: The study included 64 participants (mean age = 23.7 ± 4.34 years). The MTT demonstrated high intra-rater reliability (ICC = 0.911) and inter-rater reliability (ICC = 0.851). The SEMs indicated minimal variability around the mean scores. The average hip extension ROM measured was 5.43± 9.73 degrees.

Conclusion: These results suggest that the MTT is a reliable tool for assessing hip flexor length in clinical practice, particularly when pelvic tilt is controlled. These results have important implications for accurately testing orthopedic limitations that can contribute to low back, hip, and knee pain.

Level of evidence: 3.

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使用改良托马斯测试法测量髋关节屈肌长度的动态关节角度测量技术的可靠性
背景:改良托马斯试验(MTT)通常用于评估髋关节肌肉组织的柔韧性,包括髂腰肌、股直肌和张力筋膜。这种测量方法在全面的肌肉骨骼检查中非常重要。然而,现有研究显示,其可靠性方面的结果相互矛盾,特别是由于在测试过程中控制骨盆倾斜的变化,这可能导致在量化测试结果时对髋关节伸展的测量不准确:本研究旨在评估改良托马斯测试(MTT)在使用动态关节角度计评估髋关节屈肌长度时的评分者内部和评分者之间的可靠性。研究假设,控制骨盆倾斜将提高这些测量的可靠性:研究设计:内部和评分者之间的可靠性研究:本研究招募了 64 名健康人。由一名经验丰富的理疗师和一名学生分别对每条腿进行两次 MTT 测量。在 MTT 体位下对髋关节伸展运动范围(ROM)进行盲测角测量,并通过触诊来强制骨盆中性倾斜。测量采用双盲方案,两位检查者都不知道对方的测量结果,而且动态关节角度计被盖住,使测量治疗师也看不到测量值。ROM 值被输入 Microsoft Excel 电子表格,并使用 SPSS 软件进行量化。统计分析包括使用 SPSS 软件计算类内相关系数(ICC)和测量标准误差(SEM):研究包括 64 名参与者(平均年龄 = 23.7 ± 4.34 岁)。MTT 显示了较高的评分者内部可靠性(ICC = 0.911)和评分者之间可靠性(ICC = 0.851)。SEM显示平均分的变化极小。所测得的平均髋关节伸展 ROM 为 5.43±9.73 度:这些结果表明,MTT 是临床实践中评估髋关节屈肌长度的可靠工具,尤其是在骨盆倾斜得到控制的情况下。这些结果对于准确测试可能导致腰背、髋关节和膝关节疼痛的矫形限制具有重要意义:3.
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来源期刊
CiteScore
2.50
自引率
5.90%
发文量
124
审稿时长
16 weeks
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