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Published in R. C. Richard Davison, Paul M. Smith, James Hopker, Michael J. Price, Florentina Hettinga, Garry Tew, Lindsay Bottoms, Sport and Exercise Physiology Testing Guidelines: Volume I – Sport Testing, 2022
David Leith, Helen M. Collins, Audrey Duncan
Modified Thomas test (Figure 8.2.1A), which assesses flexibility of the hip flexors: The athlete sits on the end of a plinth before rolling back to supine, pulling both knees into the chest, ensuring a flat lumbar spine and posteriorly rotated pelvis;Holding the contralateral hip in maximal flexion, the test limb is lowered towards the floor;Hip flexion, knee flexion and hip abduction angles are measured reflecting iliopsoas, quadriceps and tensor fascia lata/iliotibial band length, respectively.FABER Test (Figure 8.2.1B), which assesses multidirectional hip ROM: With the athlete supine, the lateral ankle is rested on the contralateral thigh, proximal to the knee, in a figure-4 position;Stabilising the contralateral anterior superior iliac spine, light overpressure is applied to the ipsilateral medial knee until end ROM is met;The perpendicular distance from the lateral femoral epicondyle to the table is measured.
Hip and knee
Published in Ian Mann, Alastair Noyce, The Finalist’s Guide to Passing the OSCE, 2021
Two tests that you may wish to perform are: Trendelenburg test — With the patient standing, ask them to raise one leg for 30 seconds, so that the knee is level with the hip. Repeat on the other side. The test is positive if the iliac crest on the side of the raised leg drops below horizontal. For example, if the patient’s left leg was raised when the iliac crest on that side dropped, this would indicate weakness to the right hip abductors/gluteal weakness. It may also occur in osteoarthritis, due to pain.Thomas’ test — If the patient has a prosthetic hip, this test should not be performed for fear of dislocation. Thomas’ test measures fixed flexion deformities of the hip. Lay the patient on a hard surface. Place one hand, palm up, under the patient’s lumbar spine. Passively flex both of the patient’s knees and hips as far as possible. Maintaining the non-test hip fully flexed (indicated by the loss of the lumbar curvature), straighten the other leg (test hip). If there is incomplete extension, this indicates a fixed flexion deformity. Repeat for the other side.
Hugh Owen Thomas (1834–1891)
Published in Neil Metcalfe, 100 Notable Names from General Practice, 2018
Thomas was a busy general practitioner at Nelson Street and he was dedicated to his patients. In 1873, Thomas nephew, Robert Jones (1857–1933), also a doctor, wrote an account of Thomas typical day. He stated that it would begin at 6am and continue until midnight. Thomas would do his rounds in the morning, visit patients at home to adjust any of their splints or treatments, see patients in his consulting rooms and perform surgery during the afternoon; he would see urgent cases in the early evening before spending hours in his workshop developing new ideas and methods. Thomas could see up to 160 patients a day. During this time he developed the Thomas splint and Thomas test, his most significant contributions to orthopaedics. The Thomas splint consisted of two rigid rods attached to a ring that fitted around the thigh, used to immobilise the thigh to treat fractures of the femur. The Thomas test determined whether there was flexion contracture of the hip.
Comparison of the electromyographic recruitment of the posterior oblique sling muscles during prone hip extension among three different shoulder positions
Published in Physiotherapy Theory and Practice, 2021
The Thomas test was performed to measure hip extension flexibility by testing iliopsoas muscles (Kendall, McCreary Kendall, Provance, and McIntyre Rodgers, 2005). It was performed with the involved leg dangled off the edge of the table, which allowed the examiner to measure the hip trunk–thigh angle. A positive test result was indicated by the inability of the hip to extend to a neutral position and suggested tightness of the one-joint hip flexors (Kendall, McCreary Kendall, Provance, and McIntyre Rodgers, 2005). For the Thomas test, hip extension below the horizontal plane was recorded as a positive number, and hip extension above the horizontal plane was recorded as a negative number (Kendall, McCreary Kendall, Provance, and McIntyre Rodgers, 2005). The dominant leg of each subject, defined as the preferred leg for kicking a soccer ball, was used during all exercises (Bolgla and Uhl, 2005). The right leg was dominant for all subjects. Therefore, the subjects were asked to raise their right leg after the initial position was maintained for 5 seconds. The hip extension was held for at least 5 seconds with the bar touched. Each exercise was performed for three consecutive repetitions with 3 min of rest between exercises to minimize muscle fatigue (Sykes and Wong, 2003).
Comparison of hip extensor muscle activity including the adductor magnus during three prone hip extension exercises
Published in Physiotherapy Theory and Practice, 2019
Han-i Ko, Seung-yeon Jeon, Si-hyun Kim, Kyue-nam Park
22 healthy individuals (11 men, 11 women; age range, 19–26 years) attended the clinical screening and constituted this study’s sample. Participants were recruited from Jeonju university. Participants were excluded from the study if they had: 1) a history of pain/injury in the lower back or lower extremities within the last 6 months; 2) tightness of the hip flexors using the modified Thomas test which was defined as hip extension range of motion (ROM) > 0° above the horizontal in the supine position (Mills et al., 2015); 3) tightness of the hip abductors, as determined on the Ober test, which was defined as hip adduction ROM < 15° while lying on one side (Tenney, Boyle, and DeBord, 2013); or 4) any neurological deficit or difficulty in performing three PHE exercises. None of the participants was excluded in this clinical screening, all 22 subjects ultimately participated in this study. Tightness of the hip flexors and abductors can restrict ROM in PHE and PHE-ADD, respectively. The purpose of modified Thomas test and Ober test was to exclude participants who were unable to perform PHE and PHE-ADD due to tightness of both hip flexors and abductors. Modified Thomas test and Ober test were performed by a trained examiner with three years’ experience using muscle length test at the time of the study. Before participating in the study, participants were informed about its objectives, and the experimental and safety procedures, and each participant provided written informed consent. This study was approved by the Jeonju University Institutional Review Board for Human Investigations (number: jjIRB-2015–0403).
Altered muscle strength and flexibility among a subgroup of women with chronic nonspecific low back pain: Cross-sectional case-control study
Published in Physiotherapy Theory and Practice, 2023
Sima Vatandoost, Rahman Sheikhhoseini, Behnam Akhbari, Mahyar Salavati, Mohammadreza Pourahmadi, Maryam Farhang, Kieran O’Sullivan
While some deficits in flexibility (range 3◦ to 9◦) were observed in our study among those with LBP, these did not reach statistical significance. Despite the widespread use of hip flexor flexibility in the assessment of lumbar and hip conditions, there are concerns about the reliability and validity of tests such as the Thomas test used in our study (Vigotsky et al., 2016). Our results for hip flexor flexibility reflect the inconsistent nature of previous research, with some data suggesting an association between reduced hip flexor flexibility and LBP-related dysfunction (Nourbakhsh, Arabloo, and Salavati, 2006; Prather et al., 2017) but others finding no such association (Avman, Osmotherly, Snodgrass, and Rivett, 2019).