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Thomas Test

Thomas Test


Name
Purpose1,2
Description1,3
Sensitivity, Specificity
Reliability
Likelihood Ratio +/-
Thomas Test
In general it is used to check for hip flexion contractures; more specifically it tests for anterior or lateral capsular restrictions or hip flexor tightness. 
The patient is asked to lie supine. The examiner checks for lordosis which is a predictor of a tight hip flexor. The examiner then flexes one hip bringing the knee to the chest and asks the patient to hold the knee to help stabilize the pelvis and flatten out the lumbar region. If the leg that is being tested (the leg on the table) does not have a hip flexion contraction it will remain on the testing table. If a contracture is present the leg will raise off of the table. This is often measured if present. The test can also be performed with the starting position of both knees fully flexed to the chest and slowly lowering the leg being tested to see if the leg makes it to the table. Lack of Full hip extension with knee flexion less than 45° indicates iliopsoas tightness. If full extension is reached in this position it would indicates rectus femoris tightness. If any hip external rotation is observed it may indicate ITB tightness
 
 
Values for pass/fail scoring for range of motion of the hip.
 
intra-rater =0.47,
 
inter-rater =0.39
 
ICC values
 
intra-rater =0.52,
 
inter-rater =0.60
 

1.       Magee DJ.  Orthopedic Physical Assessment. 5th ed. St. Louis, MO: Saunders Elsevier; 2008.
2.       Cook CE, Hegedus EJ. Orthopedic Physical examination Tests: An evidence based approach. Upper Saddle River, NJ: PEARSON Prentice Hall; 2008. 
3.       Konin JG, Wiksten DL, Isear Jr. JA, Brader H. Special Test for Orthopedic Examination 3rd ed. Thorofare, NJ: SLACK incorporated; 2006.
4.       Peeler J, Anderson JE. Reliability of the Thomas test for assessing range of motion about the hip. Phys Ther Sport. 8(1):14-21;2007