Assessment of the lumbo-pelvic-hip complex mobility with the Trunk-Pelvis-Hip Angle test: intraobserver reliability and differences in ranges of motion between girls with idiopathic scoliosis and their healthy counterparts

Abstract

Introduction: The Trunk-Pelvis-Hip Angle (TPHA) test is used for assessing the mobility of lumbo-pelvic-hip complex. The aim of the research was to assess the intraobserver reliability of the TPHA test in girls with and without idiopathic scoliosis and to compare the test values obtained by the girls in both groups. Material and methods: The research included girls without scoliosis and girls with double idiopathic scoliosis aged 8-16. The trunk-pelvis-hip angle was measured three times on each body side within one session. Statistical analysis was performed with the use of ANOVA intraclass correlation coefficient for dependent groups, Kolmogorov-Smirnov test as well as non-parametric Wilcoxon signed-rank test for dependent groups and Mann-Whitney U test for independent groups. Results: The research included 49 healthy girls (aged 11.8 ± SD 2.5 years) and 49 girls with double idiopathic scoliosis (aged 12.7 ± SD 2.6 years; Cobb angle Th 27.7° ± SD 13.4° and L Cobb 25.8° ± SD 10.5°). The intraobserver reliability for the TPHA measurements was very high (ICC>0.85). In both groups the left-side TPHA value was significantly higher than the right-side value (p=0.001). The TPHA range of motion on the right side of the body was more limited in the scoliotic girls than in the healthy ones (p=0.001). Conclusions: The TPHA test is a reliable means of assessing mobility in the lumbo-pelvic-hip complex in girls by one observer. The asymmetry of movements in the lumbo-pelvic-hip complex in healthy girls needs to be observed since it may constitute one of the factors predisposing to scoliosis which limits spine rotation range of motion. The TPHA test needs further research.

An immediate effect of PNF specific mobilization on the angle of trunk rotation and the Trunk-Pelvis-Hip Angle range of motion in adolescent girls with double idiopathic scoliosis—a pilot study

“…The range of motion of the TPHAright was significantly lower not only than the range of motion of the TPHAleft in this group but also than the range of motion of the TPHAright noted in the group of healthy girls. A significant limitation of the range of motion of the TPHAright compared to the TPHAleft was also noted within the group of girls without scoliosis [ 8 ], which indicates the existence of a certain physiological asymmetry of rotational movements that increases in individuals with double scoliosis. The bilateral lower limb patterns used in unilateral mPNF were selected due to the determined direction of the limitation of the TPHAright.…”

“…The range of motion in the TPHA (test 2) was assessed with a Rippstein plurimeter (Rippstein, Switzerland). The assessment of the TPHA test reliability demonstrated excellent agreement of measurements—the inter-rater reliability for three investigators was 0.97 (THPAleft) and 0.98 (TPHAright) and the intraobserver reliability was 0.87 (TPHAleft) and 0.81 (TPHAright) [ 8 ].…”

“…The therapeutic session consisted of unilateral PNF specific muscle mobilization (mPNF), which was safe and painless. The direction of mPNF was determined on the basis of the results of previous research which revealed limitations of the range of motion in the TPHAright compared to the TPHAleft both in girls with double scoliosis and healthy girls [ 8 ]. Bilateral lower limb patterns (flexion to the right and extension to the left) were used in subjects in a supine position with a stable chest in combination with the “contract–relax” technique and stimulation of asymmetrical breathing.…”

“…It may stem from the fact that scoliotic individuals demonstrate generalized joint hypermobility significantly more often [ 4 , 5 ]. On the other hand, previous studies showed a more limited range of motion (ROM) in the transverse plane in scoliotic girls compared to their non-scoliotic peers [ 6 – 8 ]. It was noted that the limitation in the range of rotation increased with the Cobb angle [ 6 ].…”

“…The Trunk-Pelvis-Hip Angle (TPHA) measurement is a test used to assess the range of motion in the trunk-pelvis-hip complex in the transverse plane. The TPHA test showed rotational asymmetry in girls with double scoliosis [ 8 ]. According to some theories, an impairment of spine rotation is considered a factor predisposing to the development and progression of scoliosis [ 9 , 10 ].…”