Reliability limits of the modified Thomas test for assessing rectus femoris muscle flexibility about the knee joint
The modified Thomas test is commonly used in the clinical setting to assess flexibility about the thigh region. To evaluate the clinical reliability of the modified Thomas test for evaluating the flexibility of the rectus femoris muscle about the knee joint. Descriptive laboratory study using a test...
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| Veröffentlicht in: | Journal of athletic training 2008-09, Vol.43 (5), p.470-476 |
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| creator | Peeler, Jason D Anderson, Judy E |
| description | The modified Thomas test is commonly used in the clinical setting to assess flexibility about the thigh region.
To evaluate the clinical reliability of the modified Thomas test for evaluating the flexibility of the rectus femoris muscle about the knee joint.
Descriptive laboratory study using a test-retest design.
Institution-based clinical orthopaedic setting.
Fifty-seven individuals between the ages of 18 and 45 years with no history of trauma participated. Of those, 54 completed the study.
Three Board-certified athletic therapists with an average of 12.67 years of sport medicine expertise assessed rectus femoris flexibility using pass/fail and goniometer scoring systems. A retest session was completed 7 to 10 days later.
Parametric and nonparametric tests were used to compare participants' test-retest results.
Chance-corrected kappa values (intrarater x = 0.40, 95% confidence interval [CI] = 0.30, 0.54; interrater x = 0.33, 95% CI = 0.23, 0.41) indicated generally poor levels of reliability for pass/fail scoring. Intraclass correlation coefficient (ICC) values (intrarater x = 0.67, 95% CI = 0.55, 0.76; interrater x = 0.50, 95% CI = 0.40, 0.60) indicated fair to moderate levels of reliability for goniometer data. Measurement error values (standard error of measurement = 7 degrees , method error = 6 degrees , and coefficient of variation = 13%) and Bland-Altman plots (with 95% limits of agreement) further demonstrated the degree of intrarater variance for each examiner when conducting the test.
These results call into question the statistical reliability of the modified Thomas test and provide clinicians with important information regarding its reliability limits when used to clinically assess flexibility of the rectus femoris muscle about the knee joint in a physically active population. More research is needed to ascertain the variables that may confound the statistical reliability of this orthopaedic technique. |
| doi_str_mv | 10.4085/1062-6050-43.5.470 |
| format | Article |
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To evaluate the clinical reliability of the modified Thomas test for evaluating the flexibility of the rectus femoris muscle about the knee joint.
Descriptive laboratory study using a test-retest design.
Institution-based clinical orthopaedic setting.
Fifty-seven individuals between the ages of 18 and 45 years with no history of trauma participated. Of those, 54 completed the study.
Three Board-certified athletic therapists with an average of 12.67 years of sport medicine expertise assessed rectus femoris flexibility using pass/fail and goniometer scoring systems. A retest session was completed 7 to 10 days later.
Parametric and nonparametric tests were used to compare participants' test-retest results.
Chance-corrected kappa values (intrarater x = 0.40, 95% confidence interval [CI] = 0.30, 0.54; interrater x = 0.33, 95% CI = 0.23, 0.41) indicated generally poor levels of reliability for pass/fail scoring. Intraclass correlation coefficient (ICC) values (intrarater x = 0.67, 95% CI = 0.55, 0.76; interrater x = 0.50, 95% CI = 0.40, 0.60) indicated fair to moderate levels of reliability for goniometer data. Measurement error values (standard error of measurement = 7 degrees , method error = 6 degrees , and coefficient of variation = 13%) and Bland-Altman plots (with 95% limits of agreement) further demonstrated the degree of intrarater variance for each examiner when conducting the test.
These results call into question the statistical reliability of the modified Thomas test and provide clinicians with important information regarding its reliability limits when used to clinically assess flexibility of the rectus femoris muscle about the knee joint in a physically active population. More research is needed to ascertain the variables that may confound the statistical reliability of this orthopaedic technique.</description><identifier>ISSN: 1062-6050</identifier><identifier>EISSN: 1938-162X</identifier><identifier>DOI: 10.4085/1062-6050-43.5.470</identifier><identifier>PMID: 18833309</identifier><language>eng</language><publisher>United States: National Athletic Trainers Association</publisher><subject>Adolescent ; Adult ; Analysis of Variance ; Anthropometry ; Correlation ; Data collection ; Error of Measurement ; Examiners ; Exercise Test ; Female ; Humans ; Interrater Reliability ; Knee ; Knee Joint - physiology ; Male ; Measurement errors ; Measurement Techniques ; Medicine ; Muscle Contraction - physiology ; Muscle, Skeletal - physiology ; Muscular dystrophy ; Nonparametric Statistics ; Original Research ; Outcome Measures ; Physical Activities ; Protocol ; Quadriceps Muscle - physiology ; Range of Motion, Articular - physiology ; Reproducibility of Results ; Resistance (Psychology) ; Scoring ; Sports Medicine ; Studies ; Surveys and Questionnaires ; Thigh - physiology ; Young Adult</subject><ispartof>Journal of athletic training, 2008-09, Vol.43 (5), p.470-476</ispartof><rights>Copyright National Athletic Trainers Association Sep/Oct 2008</rights><rights>the National Athletic Trainers' Association, Inc 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c556t-571d64aa71bc47614298f6a87f35d0b2225c4ba2d6996935c51f7137d82052f93</citedby><cites>FETCH-LOGICAL-c556t-571d64aa71bc47614298f6a87f35d0b2225c4ba2d6996935c51f7137d82052f93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2547866/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2547866/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18833309$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peeler, Jason D</creatorcontrib><creatorcontrib>Anderson, Judy E</creatorcontrib><title>Reliability limits of the modified Thomas test for assessing rectus femoris muscle flexibility about the knee joint</title><title>Journal of athletic training</title><addtitle>J Athl Train</addtitle><description>The modified Thomas test is commonly used in the clinical setting to assess flexibility about the thigh region.
To evaluate the clinical reliability of the modified Thomas test for evaluating the flexibility of the rectus femoris muscle about the knee joint.
Descriptive laboratory study using a test-retest design.
Institution-based clinical orthopaedic setting.
Fifty-seven individuals between the ages of 18 and 45 years with no history of trauma participated. Of those, 54 completed the study.
Three Board-certified athletic therapists with an average of 12.67 years of sport medicine expertise assessed rectus femoris flexibility using pass/fail and goniometer scoring systems. A retest session was completed 7 to 10 days later.
Parametric and nonparametric tests were used to compare participants' test-retest results.
Chance-corrected kappa values (intrarater x = 0.40, 95% confidence interval [CI] = 0.30, 0.54; interrater x = 0.33, 95% CI = 0.23, 0.41) indicated generally poor levels of reliability for pass/fail scoring. Intraclass correlation coefficient (ICC) values (intrarater x = 0.67, 95% CI = 0.55, 0.76; interrater x = 0.50, 95% CI = 0.40, 0.60) indicated fair to moderate levels of reliability for goniometer data. Measurement error values (standard error of measurement = 7 degrees , method error = 6 degrees , and coefficient of variation = 13%) and Bland-Altman plots (with 95% limits of agreement) further demonstrated the degree of intrarater variance for each examiner when conducting the test.
These results call into question the statistical reliability of the modified Thomas test and provide clinicians with important information regarding its reliability limits when used to clinically assess flexibility of the rectus femoris muscle about the knee joint in a physically active population. More research is needed to ascertain the variables that may confound the statistical reliability of this orthopaedic technique.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Analysis of Variance</subject><subject>Anthropometry</subject><subject>Correlation</subject><subject>Data collection</subject><subject>Error of Measurement</subject><subject>Examiners</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Humans</subject><subject>Interrater Reliability</subject><subject>Knee</subject><subject>Knee Joint - physiology</subject><subject>Male</subject><subject>Measurement errors</subject><subject>Measurement Techniques</subject><subject>Medicine</subject><subject>Muscle Contraction - physiology</subject><subject>Muscle, Skeletal - physiology</subject><subject>Muscular dystrophy</subject><subject>Nonparametric Statistics</subject><subject>Original Research</subject><subject>Outcome Measures</subject><subject>Physical Activities</subject><subject>Protocol</subject><subject>Quadriceps Muscle - physiology</subject><subject>Range of Motion, Articular - physiology</subject><subject>Reproducibility of Results</subject><subject>Resistance (Psychology)</subject><subject>Scoring</subject><subject>Sports Medicine</subject><subject>Studies</subject><subject>Surveys and Questionnaires</subject><subject>Thigh - physiology</subject><subject>Young Adult</subject><issn>1062-6050</issn><issn>1938-162X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkk1rFTEUhoNYbL36B1xIcKGruebzZLIRSrEqFAqlgruQySS9uc5MapIR--87t71qdaGrBPKcN5yXB6EXlKwFaeVbSoA1QCRpBF_LtVDkETqimrcNBfbl8XL_CRyip6VsCaFManiCDmnbcs6JPkLlwg_RdnGI9QYPcYy14BRw3Xg8pj6G6Ht8uUmjLbj6UnFIGdtSfClxusLZuzoXHPyYcix4nIsbPA6D_xH3kbZLc72L-zp5j7cpTvUZOgh2KP75_lyhz6fvL08-NmfnHz6dHJ81TkqojVS0B2Gtop0TCqhgug1gWxW47EnHGJNOdJb1oDVoLp2kQVGu-pYRyYLmK_TuPvd67kbfOz_VbAdzneNo841JNpo_X6a4MVfpu2FSqBZgCXizD8jp27ysb8ZYnB8GO_k0F6OE1ISxpcoVev1PEjQwDQT-C1ItmBBSLeCrv8BtmvO09GUYAZCc3H3L7iGXUynZh1_LUWJ2jpidAmangBHcSLM4sgy9fFjL75G9FPwWLvG4Sg</recordid><startdate>20080901</startdate><enddate>20080901</enddate><creator>Peeler, Jason D</creator><creator>Anderson, Judy E</creator><general>National Athletic Trainers Association</general><general>The National Athletic Trainers' Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>4U-</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88G</scope><scope>8A4</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0P</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20080901</creationdate><title>Reliability limits of the modified Thomas test for assessing rectus femoris muscle flexibility about the knee joint</title><author>Peeler, Jason D ; Anderson, Judy E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c556t-571d64aa71bc47614298f6a87f35d0b2225c4ba2d6996935c51f7137d82052f93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Analysis of Variance</topic><topic>Anthropometry</topic><topic>Correlation</topic><topic>Data collection</topic><topic>Error of Measurement</topic><topic>Examiners</topic><topic>Exercise Test</topic><topic>Female</topic><topic>Humans</topic><topic>Interrater Reliability</topic><topic>Knee</topic><topic>Knee Joint - physiology</topic><topic>Male</topic><topic>Measurement errors</topic><topic>Measurement Techniques</topic><topic>Medicine</topic><topic>Muscle Contraction - physiology</topic><topic>Muscle, Skeletal - physiology</topic><topic>Muscular dystrophy</topic><topic>Nonparametric Statistics</topic><topic>Original Research</topic><topic>Outcome Measures</topic><topic>Physical Activities</topic><topic>Protocol</topic><topic>Quadriceps Muscle - physiology</topic><topic>Range of Motion, Articular - physiology</topic><topic>Reproducibility of Results</topic><topic>Resistance (Psychology)</topic><topic>Scoring</topic><topic>Sports Medicine</topic><topic>Studies</topic><topic>Surveys and Questionnaires</topic><topic>Thigh - physiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peeler, Jason D</creatorcontrib><creatorcontrib>Anderson, Judy E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>University Readers</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Education Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Education Periodicals</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Education Collection</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Education Database</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Education</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of athletic training</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peeler, Jason D</au><au>Anderson, Judy E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reliability limits of the modified Thomas test for assessing rectus femoris muscle flexibility about the knee joint</atitle><jtitle>Journal of athletic training</jtitle><addtitle>J Athl Train</addtitle><date>2008-09-01</date><risdate>2008</risdate><volume>43</volume><issue>5</issue><spage>470</spage><epage>476</epage><pages>470-476</pages><issn>1062-6050</issn><eissn>1938-162X</eissn><abstract>The modified Thomas test is commonly used in the clinical setting to assess flexibility about the thigh region.
To evaluate the clinical reliability of the modified Thomas test for evaluating the flexibility of the rectus femoris muscle about the knee joint.
Descriptive laboratory study using a test-retest design.
Institution-based clinical orthopaedic setting.
Fifty-seven individuals between the ages of 18 and 45 years with no history of trauma participated. Of those, 54 completed the study.
Three Board-certified athletic therapists with an average of 12.67 years of sport medicine expertise assessed rectus femoris flexibility using pass/fail and goniometer scoring systems. A retest session was completed 7 to 10 days later.
Parametric and nonparametric tests were used to compare participants' test-retest results.
Chance-corrected kappa values (intrarater x = 0.40, 95% confidence interval [CI] = 0.30, 0.54; interrater x = 0.33, 95% CI = 0.23, 0.41) indicated generally poor levels of reliability for pass/fail scoring. Intraclass correlation coefficient (ICC) values (intrarater x = 0.67, 95% CI = 0.55, 0.76; interrater x = 0.50, 95% CI = 0.40, 0.60) indicated fair to moderate levels of reliability for goniometer data. Measurement error values (standard error of measurement = 7 degrees , method error = 6 degrees , and coefficient of variation = 13%) and Bland-Altman plots (with 95% limits of agreement) further demonstrated the degree of intrarater variance for each examiner when conducting the test.
These results call into question the statistical reliability of the modified Thomas test and provide clinicians with important information regarding its reliability limits when used to clinically assess flexibility of the rectus femoris muscle about the knee joint in a physically active population. More research is needed to ascertain the variables that may confound the statistical reliability of this orthopaedic technique.</abstract><cop>United States</cop><pub>National Athletic Trainers Association</pub><pmid>18833309</pmid><doi>10.4085/1062-6050-43.5.470</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of athletic training, 2008-09, Vol.43 (5), p.470-476 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection; Free E- Journals |
| subjects | Adolescent Adult Analysis of Variance Anthropometry Correlation Data collection Error of Measurement Examiners Exercise Test Female Humans Interrater Reliability Knee Knee Joint - physiology Male Measurement errors Measurement Techniques Medicine Muscle Contraction - physiology Muscle, Skeletal - physiology Muscular dystrophy Nonparametric Statistics Original Research Outcome Measures Physical Activities Protocol Quadriceps Muscle - physiology Range of Motion, Articular - physiology Reproducibility of Results Resistance (Psychology) Scoring Sports Medicine Studies Surveys and Questionnaires Thigh - physiology Young Adult |
| title | Reliability limits of the modified Thomas test for assessing rectus femoris muscle flexibility about the knee joint |
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