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Faculty Advisor(s)

Joaquin Barrios, PT, PhD

Description

Purpose: Hip region extension mobility is commonly assessed in physical therapy practice, most commonly performed using the modified Thomas test (MTT). The validity of the MTT using 3D motion capture methods has been evaluated in only a study evaluating only healthy young males. Further, this study utilized a blood pressure cuff at 60 mm Hg under the lumbar lordosis to control the pelvis and trunk, further modifying the MTT and limiting clinical translation. Therefore, the purpose of this ongoing 3D motion capture study was to acquire criterion reference data for the traditional modified Thomas test without use of blood pressure cuff and in a more heterogeneous sample including both males and females as well as those with a history of knee surgeries. We hypothesized that moderate strength correlations would be observed between the tests.

Subjects: 17 participants with knee extension deficits per goniometric screening (11 females, 10 post-surgical, height = 1.75±0.11 m, weight = 80.5±12.5 kg, age = 22.8±1.9 years) completed all testing.

Methods/Materials: An established 3D anatomical marker set was used to establish the position and orientation of the pelvis, thigh, shanks and foot segments in static standing. In order to track the pelvis segment during the MTT, the associated tracking marker set was altered such that the iliac crests rather than a sacral marker were used. For the MTT, the traditional method by Kendall and McCreary was used. In brief, the participant stood perched on the edge of a plinth and then reclined with assistance. They grasped the contralateral limb in full flexion. The examiner then lowered the cantilevered test limb into maximal hip extension for the goniometric measure angle measure. The 3D data and the goniometer data were acquired during the same trials. Pearson product moment correlation coefficients were used for the criterion validation assessment.

Results: The correlation coefficient between the goniometric and reference 3D joint angle during the MTT was r = 0.42.

Conclusion: A moderate strength correlation was observed for the traditional MTT with criterion reference data from a 3D Euler angle data.

Clinical Relevance: The use of MTT in traditional clinical practice should be questioned. Further modifications and/or alternative assessments for hip joint extensibility should be explored.

Publication Date

5-8-2025

Disciplines

Physical Therapy | Rehabilitation and Therapy

Comments

Presented on February 13, 2025 at APTA Combined Sections Meeting

A Criterion Reference Validity Study for the Modified Thomas Test for Hip Extension Mobility Using Three-Dimensional Motion Capture

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