Concurrent Validation and Reference Values of Gluteus Medius Clinical Test.

CONTEXT: The hip abductor muscles, mainly the gluteus medius, are responsible for controlling hip adduction in a closed kinetic chain. Frontal plane knee alignment, assessed during functional activities such squatting, jumping and running, may overload joint structures, like the anterior cruciate ligament and patellofemoral joint. The hand-held dynamometer is reliable and effective for testing the muscular strength of the hip abductors. OBJECTIVES: 1. To assess the concurrent validity between the gluteus medius clinical test and a maximum isometric force test of the hip abductors using the hand-held dynamometer; (2) to determine the intra and inter-examiner reliability for the application of the gluteus medius clinical test; and (3) to describe reference values of gluteus medius clinical test on a population of youth athletes. DESIGN: Cross-sectional. METHODS: Thirty healthy individuals were recruited for validity and reliability testing. On the first day, participants performed the maximal isometric test of the hip abductors, measured via hand-held dynamometry. On the following week, the gluteus medius clinical test was performed. Intraclass correlation coefficients (ICC2,2) were computed for the reliability analysis, with a 95% confidence interval. To generate reference values, the gluteus medius clinical test was performed on 273 athletes. RESULTS: The results of this study indicated a weak positive correlation (r = 0.436, p = 0.001) between tests, which indicates that they examine different domains of gluteus medius muscle function, likely endurance and muscle strength. The magnitude of computed ICCs (>0.95) indicates excellent intra- and inter-examiner reliability. CONCLUSION: The findings of the current study indicate that the gluteus medius clinical test is reliable and examines a domain of muscular function not fully captured by HHD. The clinical test developed in this study is low-cost and can be included for gluteus medius assessment. LEVEL OF EVIDENCE: Level 3.

Reliability of a Low-Cost Assessment of Tibial Torsion and Transverse-Plane Posture of the Lower Limb and Pelvis Using a Smartphone Compass.

OBJECTIVES: The purpose of this study was to investigate intra- and interrater reliability and minimal detectable change (MDC) of clinical measures proposed to assess tibial torsion and the posture of the lower limbs and pelvis in the transverse plane. METHODS: Twenty-five able-bodied and asymptomatic participants (mean age 27 ± 4.03, 12 women) were assessed during relaxed standing with a compass application on a smartphone coupled to a caliper. Two trained examiners measured tibial torsion and angular postures of the pelvis, hip, femur, and tibia. Intraclass correlation coefficients (ICC) were used to investigate reliabilities, and MDCs were calculated. RESULTS: The results showed predominantly good-to-excellent reliability for the measures of the femur, hip, and tibia postures and tibial torsion (0.77 < ICC < 0.94), including some moderate-to-good reliability (0.65 < ICC < 0.75). The pelvic posture measure was predominantly moderate to good (0.55 < ICC < 0.86). MDCs have been reported (2.14°-7.86°) to assist clinicians in identifying postural changes that are within or outside the random measure variation. CONCLUSION: The use of a smartphone digital compass coupled to a caliper showed to be a reliable method to assess tibial torsion and transverse-plane postures of the lower limb and pelvis.