Kristian Thorborg's Phd Thesis

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lower arms between the feet of the subject to hold them apart. The feet of the subject point straight up, and the subject presses them together with maximal force, without lifting the legs or pelvis (Figure 5).[42] Similar testing procedures, such as the squeeze test, have been introduced.[45] The squeeze test is quantified by using the cuff of a sphygmomanometer, which is placed between the knees, and the athletes are then instructed to squeeze the cuff as hard as they can using both legs. The highest pressure displayed on the sphygmomanometer dial (to the nearest 5 mmHg) during the test is then recorded.[45] Malliaris et al.,[45] showed that athletes with groin pain had reduced hip adduction pressure (force) in the squeeze test of approximately 20%, compared to healthy controls. However, when applying the squeeze test the measured pressure is produced by hip adduction of both legs. By testing each leg individually, it would be possible to achieve a greater depiction of the actual muscle strength in hip ADD in both the injured and uninjured limb, therefore, a unilateral and reliable quantitative strength assessment method seems warranted for physically active patients with hip and groin pain. The hand-held dynamometer (HHD) is a quantitative measurement method for assessing muscle strength that has been used since the 1940’s.[54] It is a portable measurement device, and it has previously been used for assessing hip muscle strength [48,55-57] The procedure is inexpensive and easy to administer, which makes it suitable for the clinical setting (Figure 6). HHD is a valid measure of muscle strength,[58,59] but different factors have been shown to influence the reliability of HHD when assessing muscle strength. Mechanically, HHD is reliable,[60] and the experienced tester will produce good intra-tester reliability.[61-63] However, if the strength of the person being tested exceeds the tester’s strength, reliability is compromised.[64,65] Furthermore, the testing position and the lever arm used for testing also seem to influence the reliability of the procedure.[66] 16
Figure 6. Hip ADD strength testing (make test, isometric contraction) using a hand-held dynamometer,[67] with permission When using HHD, both isometric testing (make-test, Figure 6) and eccentric testing (break test, Figure 7) can be performed.[68] The reliability between make and break tests have been investigated in different studies with conflicting results. Bohannon[62] did not find a clear difference between the relative reliability of the two procedures while testing elbow flexion strength, while Stratford et al.,[59] showed that the relative reliability of the break test (ICC 2.1= Figure 7. Hip ABD strength testing (break test, eccentric contraction),[70] with permission 0.87) was lower than for the make test (ICC 2.1=0.95) when testing elbow flexor strength (p
Page 1 and 2: F A C U L T Y O F H E A L T H S C I
Page 3 and 4: I shall be telling this with a sigh
Page 5 and 6: ACKNOWLEDGEMENTS First of all I wou
Page 7 and 8: LIST OF PUBLICATIONS 2 ABBREVIATION
Page 9 and 10: ABBREVIATIONS ABD Abduction ADD Add
Page 11 and 12: Patient-Reported Outcome (PRO) A PR
Page 13 and 14: THESIS AT A GLANCE Study Question M
Page 15 and 16: playing organised football, and tha
Page 17: evaluated in these studies (Table 1
Page 20 and 21: Muscle strength testing Muscle stre
Page 24 and 25: Eccentric strength testing has show
Page 26 and 27: from patients about a health condit
Page 28 and 29: AIMS AND HYPOTHESES The overall aim
Page 30 and 31: Study selection Two reviewers (KT a
Page 32 and 33: Characteristics of studies and inst
Page 34 and 35: the reviewers had overlooked specif
Page 36 and 37: Figure 10. Flowchart of the study p
Page 38 and 39: Figure 11. Clinical study profile I
Page 40 and 41: term “hip and/or groin”, we bel
Page 42 and 43: test-retest ICC should be � 0.70
Page 44 and 45: Floor and ceiling effects are prese
Page 46 and 47: Table 7. Baseline characteristics 4
Page 48 and 49: item, and/or a test-retest reliabil
Page 50 and 51: Testing the final version of HAGOS
Page 52 and 53: Responsiveness As hypothesized, cha
Page 54 and 55: STUDY III Clinical assessment of hi
Page 56 and 57: etest. Relative reliability is the
Page 58 and 59: external rotation-sitting position
Page 60 and 61: andomised before the testing sessio
Page 62 and 63: Hip torque values are shown in Figu
Page 64 and 65: DISCUSSION This thesis is based on
Page 66 and 67: Development of a new patient-report
Page 68 and 69: Construct validity (HAGOS) Validati
Page 70 and 71: minimal change, the estimates fall
Page 72 and 73:
without causing stabilisation probl
Page 74 and 75:
Groin pain affecting muscle strengt
Page 76 and 77:
CONCLUSION � Reliable, valid and
Page 78 and 79:
SUMMARY Clinical outcome measures f
Page 80 and 81:
assessment of symptoms, activity li
Page 82 and 83:
undersøgelse (studie III) var form
Page 84 and 85:
REFERENCES 1. Mokkink LB, Terwee CB
Page 86 and 87:
30. Birrell F, Lunt M, Macfarlane G
Page 88 and 89:
59. Stratford PW, Balsor BE. A comp
Page 90 and 91:
89. Martin RL, Irrgang JJ, Burdett
Page 92 and 93:
115. Thorborg K, Roos E, Bartels EM
Page 94 and 95:
143. Byrd JW, Jones KS. Arthroscopi
Page 96 and 97:
168. Lequesne MG, Mery C, Samson M,
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Kristian Thorborg's Phd Thesis

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