Noble's test
Original Editors - Merlin Roggeman
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Search Strategy[edit | edit source]
Use the PubMed database. Use keywords “Noble AND iliotibial band”, and set limits: “link to free full text”. You’ll have two article results: “Changes in low back pain in a long distance runner after stretching the iliotibial band.” and “The treatment of iliotibial band friction syndrome”.
To find more articles you can use “google scholar” for scientific articles. Use the keywords “Noble test AND iliotibial band AND evidence based”. You’ll come up with those articles: “Evidence Based Treatment for Iliotibial Band Friction Syndrome” and “Clinical testing for extra-articular lateral knee pain. A modification and combination of traditional tests”.
Definition/Description[edit | edit source]
The Noble’s test is a provocative test of the iliotibial band, developed by Clive Noble. It is commonly used as an indication for iliotibial band syndrome; however no evidence-based research has been done yet to control the validity of this test. Other tests that could be used are the modified Ober’s test and the Renne Creak test. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Clinically Relevant Anatomy[edit | edit source]
Relevant anatomy related to the test is knowledge of the iliotibial band. It starts as the iliotibial tract, which is a thickening of the fascia lata, originating from the iliac crest. The iliotibial tract continues downward, laterally from the femur. At the greater trochanter, fibers of the tensor fascia lata muscle and gluteus maximus muscle inserts in the iliotibial tract. When approaching the knee joint, the iliotibial tract passes the lateral epicondyle of the femur and splits into two structures: the iliopatellar band, and a distal extension inserting at the Gerdy tubercle (fig 1).Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Purpose
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The purpose of this test is to detect pain, abnormalities, tightness of the iliotibial tract, which can be indicative for the iliotibial band syndrome. It helps to differentiate iliotibial band syndrome from other common causes of lateral knee pain.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Technique
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Put the patient in a supine position. Next bring the affected knee up to a 90 degree knee flexion and apply pressure with your thumb to the lateral femoral epicondyle. Afterwards the leg is extended slowly. When it is extended at approximately 30 degrees, the iliotibial band translates anteriorly over the lateral femoral epicondyle under the examiners thumb.
If the patient indicates pain at this 30 degree angle, which is similar to when the patient is active, then the test is positive and it is diagnostic for iliotibial band syndrome.
Again it must be said there has been no studies to indicate the validity of this test.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Key Research[edit | edit source]
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Resources
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add appropriate resources here
Clinical Bottom Line[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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