Physiotherapy theory and practice · 2025
Passive hip adduction flexibility impairment measured with the modified Ober test predicts chronicity of iliotibial band syndrome: a cross-sectional pilot study.
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Varadarajan Banumathi, Mohd Noor Syaheeda, Manickaraj Nagarajan
Аннотация
OBJECTIVES: To investigate predictive features of passive hip adduction flexibility impairment measured during modified Ober's test on chronicity of pain in runners with Iliotibial Band Syndrome (ITBS).
METHODS: Twenty male runners with ITBS were evaluated for self-reported pain characteristics and passive hip adduction angle using a digital inclinometer during the modified Ober test. The receiver operating characteristics (ROC) analysis identified the cutoff value for hip adduction angle that predicts ITBS chronicity, and linear regression determined the relationship between these two variables.
RESULTS: The average passive hip adduction measured with the modified Ober test was 7.48°±3.03°. The ROC analysis determined an optimal cutoff value of 6.35° passive hip adduction as a potential indicator of ITBS chronicity (AUC = 0.740; p = .034; SE 0.113, 95% CI 0.518 to 0.962) with good sensitivity (80%), moderate specificity (60%) in runners with ITBS (p = .034). A significant positive association existed between greater passive hip adduction and increased ITBS chronicity (R2 = 0.226; β = 0.475; p = .034).
CONCLUSION: The preliminary findings of this study suggest that passive hip adduction impairment identified during the modified Ober test may be a potential indicator of pain chronicity in male runners with ITBS, hinting at its potential benefit in treatment. While hip adduction flexibility impairment in ITBS appears to be a protective feature, it may reflect maladaptive mechanical pain sensitivity linked to changes in ITB stiffness during running. Given this is a pilot study, caution should be considered when interpreting and generalizing the identified hip adduction flexibility impairment cutoff value for clinical application.
METHODS: Twenty male runners with ITBS were evaluated for self-reported pain characteristics and passive hip adduction angle using a digital inclinometer during the modified Ober test. The receiver operating characteristics (ROC) analysis identified the cutoff value for hip adduction angle that predicts ITBS chronicity, and linear regression determined the relationship between these two variables.
RESULTS: The average passive hip adduction measured with the modified Ober test was 7.48°±3.03°. The ROC analysis determined an optimal cutoff value of 6.35° passive hip adduction as a potential indicator of ITBS chronicity (AUC = 0.740; p = .034; SE 0.113, 95% CI 0.518 to 0.962) with good sensitivity (80%), moderate specificity (60%) in runners with ITBS (p = .034). A significant positive association existed between greater passive hip adduction and increased ITBS chronicity (R2 = 0.226; β = 0.475; p = .034).
CONCLUSION: The preliminary findings of this study suggest that passive hip adduction impairment identified during the modified Ober test may be a potential indicator of pain chronicity in male runners with ITBS, hinting at its potential benefit in treatment. While hip adduction flexibility impairment in ITBS appears to be a protective feature, it may reflect maladaptive mechanical pain sensitivity linked to changes in ITB stiffness during running. Given this is a pilot study, caution should be considered when interpreting and generalizing the identified hip adduction flexibility impairment cutoff value for clinical application.