FABER Test

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Original Editor - Tyler Shultz, Maxim De Clippele

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Search Strategy[edit | edit source]

Checking for useful (medical) articles on web of knowledge, PEDro and PubMed turned out to be very helpful. The best outcome was from web of knowledge and PubMed. I also used the university’s link to check if the found articles were available for me. Using the keywords FABER test and in combination with some additional words to specify like hip, Patrick’s test, pathology, clinical test, reliability and/or sensitivity I got some great articles that you can find under references. (eg. Faber test hip, faber hip, clinical test hip,…)

Definition/Description[edit | edit source]

The (Patrick’s) FABER Test stands for Flexion, Abduction and External Rotation. These three motions combined result in a clinical pain provocation test to find pathologies at the hip, lumbar and sacroiliac region. [1]

Clinically Relevant Anatomy[edit | edit source]

A (basic) knowledge of the hip, lumbar spine and sacroiliac region anatomy is recommended. The hip joint is a ball en socket joint formed by the connection of the head (ball) of the femur (thigh bone) to the hip bone in the hip socket. The hip (also called iliofemoral) joints are deep in the pelvis, located on each side of the groin area. The top part of the ischium, the top part of the pubis, and the lower part of the ilium come together is an area called the acetabulum (hip socket). The head of the femur fits into this socket to form the hip joint, which is enclosed by thick cartilage called the joint capsule and held together by ligaments and muscles. [2]
More information on the hip or human anatomy you can find by clicking on the anatomy link under references. [3]

Purpose
[edit | edit source]

This test is used to identify the presence of hip pathology by attempting to reproduce pain in the hip, lumbar spine and sacroiliac region. The FABER test is a passive screening tool for musculoskeletal pathologies in the middle region of the human body, like hip, lumbar, or SI joint dysfunction, or an iliopsoas spasm.[4][1]

Technique
[edit | edit source]

The patient is positioned in supine. The leg is placed in a figure-4 position (hip flexed and abducted with the lateral ankle (malleolus) resting on the contralateral thigh just above (/proximal to) the knee). [5] While stabilizing the opposite side of the pelvis at the anterior superior iliac spine, an external rotation, abduction and posterior directed force is then slightly applied to the ipsilateral knee until the end range of motion (ROM) is achieved. Further a couple of small-amplitude oscillations can be applied to check for pain provocation at the end range of motion. [6] A positive test is one that reproduces the patient's pain or limits their ROM. [5]

A video of the FABER test perform you can find by clicking on the link under references. [7]

Evidence[edit | edit source]

  • • Sensitivity for identification of hip pathology identified with arthroscopy: 0.89[8]
    • Correlation of positive test with OA on radiographs: r = 0.54[9]
    • Kappa (95% Confidence interval): 0.63 (0.43-0.83), Kappa Maximum: 0.83, Percent agreement: 84%, Prevalence: 0.37, Bias: 0.07[1]
    • Diagnostic value of FABER test compared to MR arthrogra¬phy in labral tear diagnostics: sensitivety: 41%, specificity: 100%, positive predictive value: 100%, negative predictive value: 9%[6]
    • The validity and reliability of the FABER test is very contradictory, some say it is an invalid and unreliable test[10] , while others are staying in disagreement about the outcome.[11]
    •Sensitivity       specificity            Kappa (Inter-tester         population examined  [11]
                                                                    reliability)
    0.40-0.70             0.99                             0.54                        consecutive pregnant
                                                                  0.42-0.62                    pregnant (without pelvic girdle pain)
    0.41-0.44                                                                                  pregnant

Key Research[edit | edit source]

add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)

Resources[edit | edit source]

A1: Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B.European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008 Jun;17(6):794-819. Epub 2008 Feb 8.

A1: Cattley P, Winyard J, Trevaskis J, Eaton S. Validity and reliability of clinical tests for the sacroiliac joint. A review of literature. Australas Chiropr Osteopathy. 2002 Nov;10(2):73-80.

B: Troelsen A, Mechlenburg I, Gelineck J, Bolvig L, Jacobsen S, Søballe K. What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics? Acta Orthop. 2009 Jun;80(3):314-8.

A2: Martin RL, Sekiya JK. The interrater reliability of 4 clinical tests used to assess individuals with musculoskeletal hip pain. J Orthop Sports Phys Ther. 2008 Feb;38(2):71-7. Epub 2007 Sep 21.

Clinical Bottom Line[edit | edit source]

add text here

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 Martin RL, Sekiya JK. The interrater reliability of 4 clinical tests used to assess individuals with musculoskeletal hip pain. J Orthop Sports Phys Ther. 2008 Feb;38(2):71-7. Epub 2007 Sep 21.
  2. ↑ http://www.suite101.com/content/structure-and-function-of-the-hip-joints-a190399
  3. ↑ hip anatomy link see https://catalog.ama-assn.org/MEDIA/ProductCatalog/m890153/%20Function%20%20Anatomy%20Ch%207.pdf or human anatomy http://www.innerbody.com/htm/body.html
  4. ↑ Dutton M. Orthopaedic: Examination, evaluation, and intervention. 2nd ed. New York: The McGraw-Hill Companies, Inc; 2008.
  5. ↑ 5.0 5.1 Flynn T, Cleland J, Whitman J. User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. Buckner, Kentucky: Evidence in Motion; 2008
  6. ↑ 6.0 6.1 Troelsen A, Mechlenburg I, Gelineck J, Bolvig L, Jacobsen S, Søballe K. What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics? Acta Orthop. 2009 Jun;80(3):314-8.
  7. ↑ FABER test video link http://www.myspace.com/video/vid/34178068 fckLRorfckLRhttp://www.youtube.com/watch?v=xcIQDMQZilMfckLRorfckLRhttp://www.youtube.com/watch?v=XCOD1dkcVk0&feature=related
  8. ↑ B, McCroy P, Brukner P, et al. Hip joint pathology: Clinical presentation and correlation between magnetic resonance arthrography, ultrasound, and arthroscopic findings in 25 consecutive cases. Clin J Sports Med. 2003;(13):152-156
  9. ↑ Theiler R, Stucki G, Schotz R, Hofer H, Seifert B. Parametric and non-parametric measures in the assessment of knee and hip osteoarthritis: interobserver reliability and correlation with radiology. Osteoarthritis Cartilage. 1996:35-42.
  10. ↑ Cattley P, Winyard J, Trevaskis J, Eaton S. Validity and reliability of clinical tests for the sacroiliac joint. A review of literature. Australas Chiropr Osteopathy. 2002 Nov;10(2):73-80.
  11. ↑ 11.0 11.1 Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B.European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008 Jun;17(6):794-819. Epub 2008 Feb 8.



5. ↑ Martin RL, Sekiya JK. The interrater reliability of 4 clinical tests used to assess individuals with musculoskeletal hip pain. J Orthop Sports Phys Ther. 2008 Feb;38(2):71-7. Epub 2007 Sep 21.

6. ↑ Troelsen A, Mechlenburg I, Gelineck J, Bolvig L, Jacobsen S, Søballe K. What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics? Acta Orthop. 2009 Jun;80(3):314-8.

7. ↑ Cattley P, Winyard J, Trevaskis J, Eaton S. Validity and reliability of clinical tests for the sacroiliac joint. A review of literature. Australas Chiropr Osteopathy. 2002 Nov;10(2):73-80.

8. ↑ Ross MD, Nordeen MH, Barido M. Test-retest reliability of Patrick's hip range of motion test in healthy college-aged men. J strength & cond resrch 17 (1) 156-161 Feb 2003

9. ↑ Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B.European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008 Jun;17(6):794-819. Epub 2008 Feb 8.

10. ↑ http://www.suite101.com/content/structure-and-function-of-the-hip-joints-a190399

11. ↑ FABER test video link http://www.myspace.com/video/vid/34178068
or http://www.youtube.com/watch?v=xcIQDMQZilM
or http://www.youtube.com/watch?v=XCOD1dkcVk0&feature=related

12. ↑ hip anatomy link see https://catalog.ama-assn.org/MEDIA/ProductCatalog/m890153/%20Function%20%20Anatomy%20Ch%207.pdf
or human anatomy http://www.innerbody.com/htm/body.html

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