Validity and test-retest reliability of manual goniometers for measuring passive hip range of motion in femoroacetabular impingement patients.

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.

No clinical difference between large metal-on-metal total hip arthroplasty and 28-mm-head total hip arthroplasty?

“…In the literature, interobserver reliability of visual (not goniometric) measurement of hip ROM was found to be moderate (intraclass correlation coefficient (ICC) 0.48-0.56) [19]; another study calculated a goniometer internal rotation ICC of 0.48 [20]. Intraobserver reliability of the goniometer on the other hand proved excellent and similar to that of an electromagnetic tracking system: ICC for internal rotation was 0.95 and standard error (SEM) was 2.4°; flexion had the highest SEM (3.9°), concurrent validity was good [21]. Although we did not perform a reliability assessment on our data, we estimate our standard measurement error to be at least 4°.…”

LCPD: Reduced Range of Motion Resulting From Extra- and Intraarticular Impingement

“…This is even higher than the mean value of hip flexion in our normal group. An explanation for this discrepancy might be the unrecognized concomitant lumbar lordosis [14,19,28] and compensatory external rotation of the hip [7]. The only concise statement in terms of ROM refers to a limited rotation in flexion and/or extension and abduction [31].…”

Lumbopelvic motion during seated hip flexion in subjects with low-back pain accompanying limited hip flexion

“…In our study, we selected a target bar height of 20°of hip flexion from a sitting position. Although the possible range of motion of flexion in the supine position has been stated to be 120° [14,15], there is no reported study of the hip flexion range in a sitting posture for performing functional activities. Previous kinematic studies have demonstrated that high hip flexion, i.e., 95-114°, occurs in daily activities such as sitting with legs crossed, squatting, and putting on socks, in asymptomatic subjects [16,27,28].…”

“…The normal angle of hip flexion is 120°in healthy people performing functional activities [14,15], and hip flexion flexibility is required to perform many daily activities, such as squatting, putting on shoes and socks, and riding a bicycle [16][17][18][19]. Since the hip joint and lumbar spine are both adjacent to the pelvis, the hip joint moves in cooperation with the lumbar spine to provide functional movement [20][21][22].…”