RT Journal Article
SR Electronic
T1 Reliability and validity of three pain provocation tests used for the diagnosis of chronic proximal hamstring tendinopathy
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP 883
OP 887
DO 10.1136/bjsports-2011-090325
VO 46
IS 12
A1 Angelo Cacchio
A1 Fabrizio Borra
A1 Gabriele Severini
A1 Andrea Foglia
A1 Frank Musarra
A1 Nicola Taddio
A1 Fosco De Paulis
YR 2012
UL http://bjsm.bmj.com/content/46/12/883.abstract
AB Background The clinical assessment of chronic proximal hamstring tendinopathy (PHT) in athletes is a challenge to sports medicine. To be able to compare the results of research and treatments, the methods used to diagnose and evaluate PHT must be clearly defined and reproducible. Objective To assess the reliability and validity of three pain provocation tests used for the diagnosis of PHT. Methods Ninety-two athletes with (N=46) and without (N=46) PHT were examined by one physician and two physiotherapists, who were trained in the examination techniques before the study. The examiners were blinded to the symptoms and identity of the athletes. The three pain provocation tests examined were the Puranen–Orava, bent-knee stretch and modified bent-knee stretch tests. Intraclass correlation coefficients (ICCs) based on the repeated measures analysis of variance were used to analyse the intraexaminer and interexaminer reliability, while sensitivity, specificity, predictive values and likelihood ratios were used to determine the validity of the three tests. Results The ICC values in all three tests revealed a high correlation (range 0.82 to 0.88) for the interexaminer reliability and a high-to-very high correlation (range 0.87 to 0.93) for the intraexaminer reliability. All three tests displayed a moderate-to-high validity, with the highest degree of validity being yielded by the modified bent-knee stretch test. Conclusion All three pain provocation tests proved to be of potential value in assessing chronic PHT in athletes. However, we recommend that they be used in conjunction with other objective measures, such as MRI.