Reliability of Hip Examination Tests for Femoroacetabular Impingement

Ratzlaff, C.; Simatovic, Jacqueline; Wong, Hubert; Li, Linda; Ezzat, Allison M; Langford, Dolores; Esdaile, John M.; Kennedy, Carol N.; Embley, Patrick; Caves, Darryl; Hopkins, Trish; Cibere, Jolanda

doi:10.1002/acr.22036

Cited by 26 publications

(15 citation statements)

References 36 publications

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“…Prior to the study, CR (an experienced researcher and PT) led a training session with 7 PTs and two rheumatologists, which introduced a standardized description of each test, a standardized script for asking patient questions, demonstration of each test, and practice with feedback. In a previously reported interrater reliability study, which included 4 of the 9 PTs participating in the current study, we found overall agreement of 0.76 (0.66-0.91), negative agreement of 0.79 (0.60-0.93), and positive agreement of 0.73 (0.58-0.89), indicating that the test was reliable [31].…”

Section: Accepted Articlesupporting

confidence: 67%

“…Physical examination plays an important role in the definition of FAIS and several impingement tests have been described in the literature [16,33,36]. For the current study, we selected the FADIR test because it has been recommended by an international panel of experts [16], is reliable [31,36,33], and commonly used by clinicians [16,30]. However, prevalence of a positive FADIR test in the general population is not well established.…”

Section: Discussionmentioning

confidence: 99%

“…As part of the physical exam, we performed the flexion-adduction-internal-rotation (FADIR) test on both hips [31,36]. Following the assessment protocol [31], the subject was in a supine position and aligned to the lateral edge of exam table. The examiner was standing on the ipsilateral side of the hip to be examined and passively flexed the hip and knee to 90°.…”

Section: Accepted Articlementioning

confidence: 99%

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Prevalence of Femoroacetabular Impingement Syndrome among Young and Middle-aged White Adults

et al. 2019

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Objective The purpose of the study was to determine the prevalence of femoroacetabular impingement syndrome (FAIS) in white adults 20 to 49 years of age. Methods Participants were white men and women aged 20–49 years, recruited through random digit dialing from the population of Metro Vancouver, British Columbia, Canada. Participants filled out a self-administered questionnaire and underwent a physical examination and radiographs of both hips. FAIS was defined as a combination of hip symptoms, physical signs of impingement, and radiological findings of cam or pincer morphology as recommended by the Warwick Agreement. All analyses were weighted to reflect the population from which the sample was drawn. Results Data were obtained for 500 participants. In the study population, 48.9% were males and the age distribution was 32.2%, 31.4%, and 36.4% in the groups 20–29, 30–39, and 40–49 years, respectively. The physical signs of impingement correlated significantly with symptoms, but there was no significant association between either symptoms or physical examination with radiographic findings. FAIS on either side was found in 3.0% (95% CI 1.5–4.5) of the population. Conclusion In this study, FAIS was present in 3% of whites aged 20–49 years. Further research is needed to develop consistent criteria for assessing hip symptoms, physical signs, and hip joint morphology, and to better understand the relationships between them.

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Section: Accepted Articlesupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Accepted Articlementioning

confidence: 99%

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Prevalence of Femoroacetabular Impingement Syndrome among Young and Middle-aged White Adults

et al. 2019

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“…If muscular restriction is present, specific techniques including stretching, soft-tissue work as well as using the entire ROM in sports-specific tasks during the end phase of rehabilitation should be considered. Articular restriction may be less likely to change with these interventions, and end range loading may even provoke symptoms [46]. This may partly explain why addressing flexibility specifically (e.g.…”

Section: Discussionmentioning

confidence: 99%

Movement Patterns and Muscular Function Before and After Onset of Sports-Related Groin Pain: A Systematic Review with Meta-analysis

Morrissey

Small

et al. 2016

Sports Med

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BackgroundSports-related groin pain (SRGP) is a common entity in rotational sports such as football, rugby and hockey, accounting for 12–18 % of injuries each year, with high recurrence rates and often prolonged time away from sport.ObjectiveThis systematic review synthesises movement and muscle function findings to better understand deficits and guide rehabilitation.Study SelectionProspective and retrospective cross-sectional studies investigating muscle strength, flexibility, cross-sectional area, electromyographic activation onset and magnitude in patients with SRGP were included.Search MethodsFour databases (MEDLINE, Web of Knowledge, EBSCOhost and EMBASE) were searched in June 2014. Studies were critiqued using a modified version of the Downs and Black Quality Index, and a meta-analysis was performed.ResultsSeventeen studies (14 high quality, 3 low quality; 8 prospective and 9 retrospective) were identified. Prospective findings: moderate evidence indicated decreased hip abduction flexibility as a risk factor for SRGP. Limited or very limited evidence suggested that decreased hip adduction strength during isokinetic testing at ~119°/s was a risk factor for SRGP, but no associations were found at ~30°/s or ~210°/s, or with peak torque angle. Decreased hip abductor strength in angular velocity in ~30°/s but not in ~119°/s and ~210°/s was found as a risk factor for SRGP. No relationships were found with hip internal or external rotation range of movement, nor isokinetic knee extension strength. Decreased isokinetic knee flexion strength also was a potential risk factor for SRGP, at a speed ~60°/s. Retrospective findings: there was strong evidence of decreased hip adductor muscle strength during a squeeze test at 45°, and decreased total hip external rotation range of movement (sum of both legs) being associated with SRGP. There was strong evidence of no relationship to abductor muscle strength nor unilateral hip internal and external rotation range of movement. Moderate evidence suggested that increased abduction flexibility and no change in total hip internal rotation range of movement (sum of both legs) were retrospectively associated with SRGP. Limited or very limited evidence (significant findings only) indicated decreased hip adductor muscle strength during 0° and 30° squeeze tests and during an eccentric hip adduction test, but a decrease in the isometric adductors-to-abductors strength ratio at speed 120°/s; decreased abductors-to-adductors activation ratio in the early phase in the moving leg as well as in all three phases in the weight-bearing leg during standing hip flexion; and increased hip flexors strength during isokinetic and decrease in transversus abdominis muscle resting thickness associated with SRGP.ConclusionsThere were a number of significant movement and muscle function associations observed in athletes both prior to and following the onset of SRGP. The strength of findings was hampered by the lack of consistent terminology and diagnostic criteria, with there being clear guides for futur...

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“…The participants will have the FABER (Flexion, ABduction, and External Rotation) test and the anterior impingement test at 90 and 120° of hip flexion performed, as described by Ratzlaff et al . 36 A positive test is indicated by pain in the upper/inner thigh or groin.…”

Section: Methodsmentioning

confidence: 99%

The Horsens-Aarhus Femoro Acetabular Impingement (HAFAI) cohort: outcome of arthroscopic treatment for femoroacetabular impingement. Protocol for a prospective cohort study

et al. 2015

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IntroductionDuring the past decade, it has become increasingly more common to offer hip arthroscopic surgery when treating people with femoroacetabular impingement (FAI). Nevertheless, the latest reviews conclude that it still remains to be properly investigated how surgery affects the patients. Specifically, detailed information on the functional, muscular and mechanical impact of surgery in larger groups is lacking. Furthermore, the long-term outcome of the surgery is still to be investigated.Methods and analysisIn this prospective cohort study, a total of 60 patients with FAI scheduled for arthroscopic surgery will be followed and tested preoperatively, and again after 3, 6, 9 and 12 months. Assessment includes isokinetic dynamometry evaluating hip flexion and extension; evaluation of functional capacity in a three-dimensional motion laboratory; pain assessment; self-reported function, quality of life, expectation and satisfaction with the surgery; recording of previous and present sporting activities and accelerometry. In addition, data on surgical procedure, rehabilitation progress, adverse events and failure will be recorded. Patients will be compared with an age-matched and gender-matched reference group of 30 persons with no hip, knee, ankle or back problems. Long-term follow-up of this cohort may evaluate possible reoperations and development of hip osteoarthritis. Furthermore, analysis on how subgroups respond to the treatment could be performed together with identification of possible “non-responders”.Ethics and disseminationThe study is approved by the Central Denmark Region Committee on Biomedical Research Ethics (Journal No 1-10-72-239-14). The results from this study will be presented at national and international congresses and published in peer-reviewed journals.Trial registration numberNCT02306525.

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Reliability of Hip Examination Tests for Femoroacetabular Impingement

Cited by 26 publications

References 36 publications

Prevalence of Femoroacetabular Impingement Syndrome among Young and Middle-aged White Adults

Prevalence of Femoroacetabular Impingement Syndrome among Young and Middle-aged White Adults

Movement Patterns and Muscular Function Before and After Onset of Sports-Related Groin Pain: A Systematic Review with Meta-analysis

The Horsens-Aarhus Femoro Acetabular Impingement (HAFAI) cohort: outcome of arthroscopic treatment for femoroacetabular impingement. Protocol for a prospective cohort study

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