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Open Access Highly Accessed Research article

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

Silvio Nussbaumer12, Michael Leunig3, Julia F Glatthorn1, Simone Stauffacher12, Hans Gerber2 and Nicola A Maffiuletti1*

Author Affiliations

1 Neuromuscular Research Laboratory, Schulthess Clinic, Zurich, Switzerland

2 Institute for Biomechanics, ETH Zurich, Switzerland

3 Hip Service, Schulthess Clinic, Zurich, Switzerland

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BMC Musculoskeletal Disorders 2010, 11:194  doi:10.1186/1471-2474-11-194

Published: 31 August 2010

Abstract

Background

The 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.

Methods

Passive 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.

Results

The 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.

Conclusions

The 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.