Thomas Test: Difference between revisions
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and rheumatoid arthritis<ref>John Crawford Adams, David L. Hamblen; Outline of orthopaedics; Churchill Livingstone, 13th edition, 2001 - 459 pagina's</ref></span></span><span lang="EN-US">.<span style="mso-spacerun:yes"> </span></span> | and rheumatoid arthritis<ref>John Crawford Adams, David L. Hamblen; Outline of orthopaedics; Churchill Livingstone, 13th edition, 2001 - 459 pagina's</ref></span></span><span lang="EN-US">.<span style="mso-spacerun:yes"> </span></span> | ||
== Technique == | == Technique == | ||
<span lang="EN" style="mso-ansi-language:EN">First of all the patient should | <span lang="EN" style="mso-ansi-language:EN">First of all the patient should | ||
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flex both knees, using both arms. This ensures that the lumbar spine is flexed | flex both knees, using both arms. This ensures that the lumbar spine is flexed | ||
and flat on the table and avoids a posterior tilt of the pelvis.<ref>↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.</ref><sup> </sup>The | and flat on the table and avoids a posterior tilt of the pelvis.<ref>↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.</ref><sup> </sup>The | ||
patient has then to lower the<span style="mso-spacerun:yes"> </span>to tested limb toward the table. During the test the contralateral hip is in maximal flexion help by his arms.<ref>Jeff G. Konin, Holly Brader. Lumbar Spine Special tests for orthopedic examination. Third edition. USA. Slack Incorporated. 2006.p170</ref> The length of the iliopsoas is measured by the angle of the hip flexion.<ref>↑ Jeffrey Tucker, DC, DACRB. The Psoas and Iliacus: Functional Testing. Dynamic Chiropractic. September 24, 2007, Vol. 25, Issue 20.</ref | patient has then to lower the<span style="mso-spacerun:yes"> </span>to tested limb toward the table. During the test the contralateral hip is in maximal flexion help by his arms.<ref>Jeff G. Konin, Holly Brader. Lumbar Spine Special tests for orthopedic examination. Third edition. USA. Slack Incorporated. 2006.p170</ref> The length of the iliopsoas is measured by the angle of the hip flexion.<ref>↑ Jeffrey Tucker, DC, DACRB. The Psoas and Iliacus: Functional Testing. Dynamic Chiropractic. September 24, 2007, Vol. 25, Issue 20.</ref></span> | ||
<span lang="EN" style="mso-ansi-language:EN">A modified version of the test is | <span lang="EN" style="mso-ansi-language:EN">A modified version of the test is | ||
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contact with the table during the test<sup>.<ref>↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.</ref></sup> The physiotherapist | contact with the table during the test<sup>.<ref>↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.</ref></sup> The physiotherapist | ||
controls the opposite leg to ensure that it maintains full contact with the | controls the opposite leg to ensure that it maintains full contact with the | ||
table</span><span lang="EN" style="font-size:14.0pt;mso-bidi-font-size:12.0pt; | table</span><span lang="EN" style="font-size:14.0pt;mso-bidi-font-size:12.0pt; mso-ansi-language:EN">.<ref>↑ DAVID C. ELAND, DO; TIFFANI N. SINGLETON, BS; ROBERT R. CONASTER, MS; JOHN N. HOWELL, PHD; ALFRED M. PHELEY, PHD; MELYNDA M. KARLENE, DO; JOYNITA M. ROBINSON, DO. The “iliacus test”: New information for the evaluation of hip extension dysfunction. J Am Osteopath Assoc. 2002 Mar;102(3):130-42.</ref></span><span class="wordentry"><span lang="EN-US"> The lower back and the sacrum should remain on the table. The hip | ||
mso-ansi-language:EN">.<ref>↑ DAVID C. ELAND, DO; TIFFANI N. SINGLETON, BS; ROBERT R. CONASTER, MS; JOHN N. HOWELL, PHD; ALFRED M. PHELEY, PHD; MELYNDA M. KARLENE, DO; JOYNITA M. ROBINSON, DO. The “iliacus test”: New information for the evaluation of hip extension dysfunction. J Am Osteopath Assoc. 2002 Mar;102(3):130-42.</ref></span | |||
can make a 10° posterior tilt or a 10° hip extension. The knee must be able to | can make a 10° posterior tilt or a 10° hip extension. The knee must be able to | ||
make a 90° flexion.<ref>↑ Mark McKean. Postural Screening using the Thomas Test – Part 1. Pistol Australia. P11-13.</ref></span></span> | make a 90° flexion.<ref>↑ Mark McKean. Postural Screening using the Thomas Test – Part 1. Pistol Australia. P11-13.</ref></span></span> | ||
<!--[if !supportLists]--><span lang="EN" style="font-family: | <!--[if !supportLists]--><span lang="EN" style="font-family: Wingdings;mso-fareast-font-family:Wingdings;mso-bidi-font-family:Wingdings; mso-ansi-language:EN"><span style="mso-list:Ignore">Ø<span> | ||
Wingdings;mso-fareast-font-family:Wingdings;mso-bidi-font-family:Wingdings; | </span></span></span><!--[endif]--><span class="wordentry"><span lang="EN-US">[http://www.netterimages.com/image/8349.htm Positive result]: When the | ||
mso-ansi-language:EN"><span style="mso-list:Ignore">Ø<span | |||
</span></span></span><!--[endif]--><span class="wordentry"><span lang="EN-US | |||
patient can not maintain his lower back and sacrum against the table. Otherwise | patient can not maintain his lower back and sacrum against the table. Otherwise | ||
if the hip has a bigger posterior tilt or hip extension than 15°. Or if the | if the hip has a bigger posterior tilt or hip extension than 15°. Or if the | ||
knee is not able to make a flexion of 80°.<ref>↑ Mark McKean. Postural Screening using the Thomas Test – Part 1. Pistol Australia. P11-13.</ref><ref>↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.</ref></span></span> | knee is not able to make a flexion of 80°.<ref>↑ Mark McKean. Postural Screening using the Thomas Test – Part 1. Pistol Australia. P11-13.</ref><ref>↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.</ref></span></span> | ||
<u><span lang="EN" style="mso-ansi-language:EN">Consequences:</span></u><sup><span lang="EN" style="mso-ansi-language:EN"> </span></sup><span lang="EN" style="mso-ansi-language:EN">a reduced range of motion may be a sign of one of | <u><span lang="EN" style="mso-ansi-language:EN">Consequences:</span></u><sup><span lang="EN" style="mso-ansi-language:EN"> </span></sup><span lang="EN" style="mso-ansi-language:EN">a reduced range of motion may be a sign of one of | ||
these diseases:<span style="mso-spacerun:yes"> </span></span><span class="wordentry"><span lang="EN-US | these diseases:<span style="mso-spacerun:yes"> </span></span><span class="wordentry"><span lang="EN-US">patellofemoral | ||
pain syndrome<ref>↑ Tyler TF, Nicholas SJ, Mullaney MJ, McHugh MP. The role of hip muscle function in the treatment of patellofemoral pain syndrome. Am J Sports Med. 2006 Apr; 34(4):630-6.</ref></span></span><span lang="EN" style="mso-ansi-language: | pain syndrome<ref>↑ Tyler TF, Nicholas SJ, Mullaney MJ, McHugh MP. The role of hip muscle function in the treatment of patellofemoral pain syndrome. Am J Sports Med. 2006 Apr; 34(4):630-6.</ref></span></span><span lang="EN" style="mso-ansi-language: EN">, l</span><span class="apple-style-span"><span lang="EN-US" style="color:#212121">ower | ||
EN">, l</span><span class="apple-style-span"><span lang="EN-US" style="color:#212121">ower | back pain<ref>↑ G. Marrè-Brunenghi, R. Camoriano, M. Valle and S. Boero; The psoas muscle as cause of low back pain in infantile cerebral palsy; J Orthop Traumatol. 2008 March; 9(1): 43–47.</ref>, osteoarthritis and rheumatoid arthritis<ref>John Crawford Adams, David L. Hamblen; Outline of orthopaedics; Churchill Livingstone, 13th edition, 2001 - 459 pagina's</ref></span></span> | ||
back pain<ref>↑ G. Marrè-Brunenghi, R. Camoriano, M. Valle and S. Boero; The psoas muscle as cause of low back pain in infantile cerebral palsy; J Orthop Traumatol. 2008 March; 9(1): 43–47.</ref>, osteoarthritis and rheumatoid arthritis<ref>John Crawford Adams, David L. Hamblen; Outline of orthopaedics; Churchill Livingstone, 13th edition, 2001 - 459 pagina's</ref></span></span> | |||
<u><span lang="EN" style="mso-ansi-language:EN">Reliability | <u><span lang="EN" style="mso-ansi-language:EN">Reliability | ||
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that test the reliability of the Thomas study are very limited.<ref>Belinda J Gabbea, Kim L Bennellb, Henry Wajswelnerc, Caroline F Fincha; Reliability of common lower extremity musculoskeletal screening tests; Physical Therapy in Sport, Volume 5, Issue 2, Pages 90-97 (May 2004).</ref><sup> </sup>“ | that test the reliability of the Thomas study are very limited.<ref>Belinda J Gabbea, Kim L Bennellb, Henry Wajswelnerc, Caroline F Fincha; Reliability of common lower extremity musculoskeletal screening tests; Physical Therapy in Sport, Volume 5, Issue 2, Pages 90-97 (May 2004).</ref><sup> </sup>“ | ||
One <sup><span style="mso-spacerun:yes"> </span></sup>research has<span style="mso-spacerun:yes"> </span>demonstrated that the modified Thomas test a very good inter-rater reliability has.<ref>Belinda J Gabbea, Kim L Bennellb, Henry Wajswelnerc, Caroline F Fincha; Reliability of common lower extremity musculoskeletal screening tests; Physical Therapy in Sport, Volume 5, Issue 2, Pages 90-97 (May 2004).</ref><span style="mso-spacerun:yes"> </span>Another research has demonstrated that the modified Thomas test, an average of only moderate level of reliability has in the examiners at goniometer scoring and low levels of reliability in a pass / fail score.”<ref>Phyllis A Clapis, PT, DHSc, OCS1, Susan Mercik Davis and Ross Otto Davis; Reliability of inclinometer and goniometric measurements of hip extension flexibility using the modified Thomas test; Physiotherapy Theory and Practice ; 2008, Vol. 24, No. 2 , Pages 135-141</ref></span><span lang="EN"> </span><span lang="EN" style="mso-ansi-language:EN">To prove or to refute the reliability of the | One <sup><span style="mso-spacerun:yes"> </span></sup>research has<span style="mso-spacerun:yes"> </span>demonstrated that the modified Thomas test a very good inter-rater reliability has.<ref>Belinda J Gabbea, Kim L Bennellb, Henry Wajswelnerc, Caroline F Fincha; Reliability of common lower extremity musculoskeletal screening tests; Physical Therapy in Sport, Volume 5, Issue 2, Pages 90-97 (May 2004).</ref><span style="mso-spacerun:yes"> </span>Another research has demonstrated that the modified Thomas test, an average of only moderate level of reliability has in the examiners at goniometer scoring and low levels of reliability in a pass / fail score.”<ref>Phyllis A Clapis, PT, DHSc, OCS1, Susan Mercik Davis and Ross Otto Davis; Reliability of inclinometer and goniometric measurements of hip extension flexibility using the modified Thomas test; Physiotherapy Theory and Practice ; 2008, Vol. 24, No. 2 , Pages 135-141</ref></span><span lang="EN"> </span><span lang="EN" style="mso-ansi-language:EN">To prove or to refute the reliability of the | ||
Thomas test further research is required. | Thomas test further research is required. </span> | ||
== Key Research == | == Key Research == | ||
Revision as of 19:08, 31 January 2011
Welcome to Vrije Universiteit Brussel's Evidence-based Practice project. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!
Original Editor - Tyler Shultz, Aurelie Canas-Perez
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Search Strategy[edit | edit source]
Databases: Pubmed, ISI Web of Knowledge, Dynamic Chiropractic, Internet.
Keywords: Thomas test, Iliacus test, iliopsoas muscle group length measurement.
Definition/Description[edit | edit source]
Patient should be lied on his back and must then maximally flex both knees, using both arms. Then he has to lower one limb toward the table. [1][2]
Clinically Relevant Anatomy[edit | edit source]
Iliopsoas muscle group[3]
M.iliopsoas: Main
function → thigh flexion
Additional
feature→external rotation
M. Rectus Femoris: Main
function → thigh flexion
Additional
feature→knee
extension
M. Tensor Fascia Latae: Main function → thigh flexion
Additional
feature→internal rot., abduction
M. Sartorius: Main function → thigh flexion
Additional
feature→knee flexion
Purpose
[edit | edit source]
The Thomas Test or Iliacus Test is used to measure the flexibility of the iliopsoas muscle group, the M. Rectus Femoris, the M. Tensor Fascia Latae and the M. Sartorius are also used in musculoskeletal screening.[4]Measuring the flexibility of this muscle is not useful, because we don’t have a standard meeting length of muscle. The most important aspect of this test is that the range of motion [5] of the hip is measured as the various diseases may shown as patellofemoral pain syndrome [6], lower back pain[7], osteoarthritis and rheumatoid arthritis[8].
Technique[edit | edit source]
First of all the patient should be supine, using the whole length of the table. The patient must then maximally flex both knees, using both arms. This ensures that the lumbar spine is flexed and flat on the table and avoids a posterior tilt of the pelvis.[9] The patient has then to lower the to tested limb toward the table. During the test the contralateral hip is in maximal flexion help by his arms.[10] The length of the iliopsoas is measured by the angle of the hip flexion.[11]
A modified version of the test is that the patient lies down on his back, at the very edge of the table, with both legs hanging down. The patient must then flex on his knee and pull it back to his chest as close as he can, using his both arms while doing so. The other leg can hang down.[12] The lumbar spine must remain flat and in contact with the table during the test.[13] The physiotherapist controls the opposite leg to ensure that it maintains full contact with the table.[14] The lower back and the sacrum should remain on the table. The hip can make a 10° posterior tilt or a 10° hip extension. The knee must be able to make a 90° flexion.[15]
Ø Positive result: When the patient can not maintain his lower back and sacrum against the table. Otherwise if the hip has a bigger posterior tilt or hip extension than 15°. Or if the knee is not able to make a flexion of 80°.[16][17]
Consequences: a reduced range of motion may be a sign of one of these diseases: patellofemoral pain syndrome[18], lower back pain[19], osteoarthritis and rheumatoid arthritis[20]
Reliability of the test: Investigation into the validity of tests are important to know whether our tests are reliable or not.[21] Studies that test the reliability of the Thomas study are very limited.[22] “ One research has demonstrated that the modified Thomas test a very good inter-rater reliability has.[23] Another research has demonstrated that the modified Thomas test, an average of only moderate level of reliability has in the examiners at goniometer scoring and low levels of reliability in a pass / fail score.”[24] To prove or to refute the reliability of the Thomas test further research is required.
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]
add appropriate resources here
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]
see adding references tutorial.
- ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
- ↑ Jeff G. Konin, Holly Brader. Lumbar Spine Special tests for orthopedic examination. Third edition. USA. Slack Incorporated. 2006.p170
- ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
- ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
- ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
- ↑ ↑ Tyler TF, Nicholas SJ, Mullaney MJ, McHugh MP. The role of hip muscle function in the treatment of patellofemoral pain syndrome. Am J Sports Med. 2006 Apr; 34(4):630-6.
- ↑ ↑ G. Marrè-Brunenghi, R. Camoriano, M. Valle and S. Boero; The psoas muscle as cause of low back pain in infantile cerebral palsy; J Orthop Traumatol. 2008 March; 9(1): 43–47.
- ↑ John Crawford Adams, David L. Hamblen; Outline of orthopaedics; Churchill Livingstone, 13th edition, 2001 - 459 pagina's
- ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
- ↑ Jeff G. Konin, Holly Brader. Lumbar Spine Special tests for orthopedic examination. Third edition. USA. Slack Incorporated. 2006.p170
- ↑ ↑ Jeffrey Tucker, DC, DACRB. The Psoas and Iliacus: Functional Testing. Dynamic Chiropractic. September 24, 2007, Vol. 25, Issue 20.
- ↑ ↑ Jeffrey Tucker, DC, DACRB. The Psoas and Iliacus: Functional Testing. Dynamic Chiropractic. September 24, 2007, Vol. 25, Issue 20.
- ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
- ↑ ↑ DAVID C. ELAND, DO; TIFFANI N. SINGLETON, BS; ROBERT R. CONASTER, MS; JOHN N. HOWELL, PHD; ALFRED M. PHELEY, PHD; MELYNDA M. KARLENE, DO; JOYNITA M. ROBINSON, DO. The “iliacus test”: New information for the evaluation of hip extension dysfunction. J Am Osteopath Assoc. 2002 Mar;102(3):130-42.
- ↑ ↑ Mark McKean. Postural Screening using the Thomas Test – Part 1. Pistol Australia. P11-13.
- ↑ ↑ Mark McKean. Postural Screening using the Thomas Test – Part 1. Pistol Australia. P11-13.
- ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
- ↑ ↑ Tyler TF, Nicholas SJ, Mullaney MJ, McHugh MP. The role of hip muscle function in the treatment of patellofemoral pain syndrome. Am J Sports Med. 2006 Apr; 34(4):630-6.
- ↑ ↑ G. Marrè-Brunenghi, R. Camoriano, M. Valle and S. Boero; The psoas muscle as cause of low back pain in infantile cerebral palsy; J Orthop Traumatol. 2008 March; 9(1): 43–47.
- ↑ John Crawford Adams, David L. Hamblen; Outline of orthopaedics; Churchill Livingstone, 13th edition, 2001 - 459 pagina's
- ↑ Phyllis A Clapis, PT, DHSc, OCS1, Susan Mercik Davis and Ross Otto Davis; Reliability of inclinometer and goniometric measurements of hip extension flexibility using the modified Thomas test; Physiotherapy Theory and Practice ; 2008, Vol. 24, No. 2 , Pages 135-141
- ↑ Belinda J Gabbea, Kim L Bennellb, Henry Wajswelnerc, Caroline F Fincha; Reliability of common lower extremity musculoskeletal screening tests; Physical Therapy in Sport, Volume 5, Issue 2, Pages 90-97 (May 2004).
- ↑ Belinda J Gabbea, Kim L Bennellb, Henry Wajswelnerc, Caroline F Fincha; Reliability of common lower extremity musculoskeletal screening tests; Physical Therapy in Sport, Volume 5, Issue 2, Pages 90-97 (May 2004).
- ↑ Phyllis A Clapis, PT, DHSc, OCS1, Susan Mercik Davis and Ross Otto Davis; Reliability of inclinometer and goniometric measurements of hip extension flexibility using the modified Thomas test; Physiotherapy Theory and Practice ; 2008, Vol. 24, No. 2 , Pages 135-141
