Eimiller Kira, Stoddard Emma, Janes Briana, Smith Mason, Vincek Andrew
Physical Therapy Daemen University.
Int J Sports Phys Ther. 2024 Aug 1;19(8):997-1002. doi: 10.26603/001c.120899. eCollection 2024.
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.
Intra- and inter-rater reliability study.
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.
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.
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.
改良托马斯试验（MTT）常用于评估髋部肌肉组织的灵活性，包括髂腰肌、股直肌和阔筋膜张肌。在全面的肌肉骨骼检查中纳入该测量很重要。然而，现有研究表明其可靠性存在相互矛盾的结果，特别是由于测试过程中控制骨盆倾斜的方式存在差异，这可能导致在量化测试结果时髋部伸展测量不准确。
目的/假设：本研究旨在评估使用角度计进行改良托马斯试验（MTT）评估髋屈肌长度时的评分者内和评分者间信度。假设控制骨盆倾斜会提高这些测量的可靠性。
评分者内和评分者间信度研究。
招募了64名健康个体参与本研究。由一名经验丰富的物理治疗师和一名学生物理治疗师对每条腿进行两次MTT。在MTT位置，通过触诊强制保持骨盆中立位，对髋部伸展活动范围（ROM）进行盲法角度测量。采用双盲方案，两位检查者都不知道对方的测量结果，并且角度计被覆盖，以使测量治疗师也看不到测量值。ROM值输入到Microsoft Excel电子表格中，并使用SPSS软件进行量化。统计分析包括使用SPSS软件计算组内相关系数（ICC）和测量标准误差（SEM）。
该研究包括64名参与者（平均年龄 = 23.7 ± 4.34岁）。MTT显示出高评分者内信度（ICC = 0.911）和评分者间信度（ICC = 0.851）。SEM表明平均分数周围的变异性最小。测量的平均髋部伸展ROM为5.43± 9.73度。
这些结果表明，MTT是临床实践中评估髋屈肌长度的可靠工具，特别是在控制骨盆倾斜时。这些结果对于准确测试可能导致腰、髋和膝疼痛的骨科限制具有重要意义。
3级。
