Abstract
BackgroundThe aims of this study were to evaluate the construct validity (known group), concurrent validity (criterion based) and test-retest (intra-rater) reliability of manual goniometers to measure passive hip range of motion (ROM) in femoroacetabular impingement patients and healthy controls.MethodsPassive hip flexion, abduction, adduction, internal and external rotation ROMs were simultaneously measured with a conventional goniometer and an electromagnetic tracking system (ETS) on two different testing sessions. A total of 15 patients and 15 sex- and age-matched healthy controls participated in the study.ResultsThe goniometer provided greater hip ROM values compared to the ETS (range 2.0-18.9 degrees; P < 0.001); good concurrent validity was only achieved for hip abduction and internal rotation, with intraclass correlation coefficients (ICC) of 0.94 and 0.88, respectively. Both devices detected lower hip abduction ROM in patients compared to controls (P < 0.01). Test-retest reliability was good with ICCs higher 0.90, except for hip adduction (0.82-0.84). Reliability estimates did not differ between the goniometer and the ETS.ConclusionsThe present study suggests that goniometer-based assessments considerably overestimate hip joint ROM by measuring intersegmental angles (e.g., thigh flexion on trunk for hip flexion) rather than true hip ROM. It is likely that uncontrolled pelvic rotation and tilt due to difficulties in placing the goniometer properly and in performing the anatomically correct ROM contribute to the overrating of the arc of these motions. Nevertheless, conventional manual goniometers can be used with confidence for longitudinal assessments in the clinic.
Highlights
The aims of this study were to evaluate the construct validity, concurrent validity and test-retest reliability of manual goniometers to measure passive hip range of motion (ROM) in femoroacetabular impingement patients and healthy controls
External rotation as measured with both devices did not differ significantly between femoroacetabular impingement (FAI) patients and healthy controls, a trend towards lower ROM was noted in the patient group
Concurrent validity Since intraclass correlation coefficients (ICC) scores were comparable between FAI patients and controls, all concurrent validity analyses were completed for the whole group of subjects (n = 30)
Summary
The aims of this study were to evaluate the construct validity (known group), concurrent validity (criterion based) and test-retest (intra-rater) reliability of manual goniometers to measure passive hip range of motion (ROM) in femoroacetabular impingement patients and healthy controls. Hip joint range of motion (ROM) is a basic clinical parameter for diagnosing hip diseases, such as osteoarthritis [1,2] or femoroacetabular impingement (FAI) [3,4], and for monitoring the efficacy of a treatment [5]. Hip joint ROM is widely assessed using low-technology tools such as manual goniometers or inclinometers. Bohannon et al [8] showed that in the hip flexion movement, as measured in a clinical setting, more than a quarter of the ROM can be attributed to pelvic tilt, leading to an immense misinterpretation of this movement due to the insensitivity of manual goniometers for secondary pelvic movement. Elson and Aspinall [9] proposed a new method for measuring range of hip flexion by palpating the lumbosacral junction to allow early identification of lumbar spine flexion which accompanies hip flexion
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