Thomas Test

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Original Editor - Tyler Shultz, Aurelie Canas-Perez

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Search Strategy[edit | edit source]

Databases: Pubmed, ISI Web of Knowledge, Dynamic Chiropractic, Internet. 

Keywords: Thomas test, Iliacus test, iliopsoas muscle group length measurement.

Definition/Description[edit | edit source]

Patient should be lied on his back and must then maximally flex both knees, using both arms. One limb is then lowered toward the table. [1][2]  

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Clinically Relevant Anatomy[edit | edit source]

 Iliopsoas muscle group[3]

M.iliopsoas: Main function → thigh flexion    
                   Additional feature→external rotation

M. Rectus Femoris: Main function → thigh flexion                          
                              Additional feature→knee extension                               
M. Tensor Fascia Latae: Main function → thigh flexion    
                                    Additional feature→internal rot., abduction  

M. Sartorius: Main function → thigh flexion    
                    Additional feature→knee flexion

OsteoarthritisPurpose
[edit | edit source]

The Thomas Test or Iliacus Test is used to measure the flexibility of the iliopsoas muscle group, the M. Rectus Femoris, the M. Tensor Fascia Latae and the M. Sartorius are also used in musculoskeletal screening.[4]Measuring the flexibility of this muscle is not useful, because we don’t have a  standard meeting length of muscle. The most important aspect of this test is that the range of motion [5] of  the hip is measured as the various diseases  may shown as patellofemoral pain syndrome [6], lower back pain[7], osteoarthritis and rheumatoid arthritis[8].  

Technique[edit | edit source]

First of all the patient should be supine, using the whole length of the table. The patient must then maximally flex both knees, using both arms. This ensures that the lumbar spine is flexed and flat on the table and avoids a posterior tilt of the pelvis.[9] The patient has then to lower the  to tested limb toward the table. During the test the contralateral hip is in maximal flexion help by his arms.[10] The length of the iliopsoas is measured by the angle of the hip flexion.[11]

A modified version of the test is that the patient lies down on his back, at the very edge of the table, with both legs hanging down. The patient must then flex on his knee and pull it back to his chest as close as he can, using his both arms while doing so. The other leg can hang down.[12] The lumbar spine must remain flat and in contact with the table during the test.[13] The physiotherapist controls the opposite leg to ensure that it maintains full contact with the table.[14] 

  •  Negative result: The lower back and the sacrum should remain on the table. The hip can make a 10° posterior tilt or a  10° hip extension. The knee must be able to make a 90° flexion.[15]

patient can not maintain his lower back and sacrum against the table. Otherwise if the hip has a bigger posterior tilt or hip extension than 15°. Or if the knee is not able to make a flexion of 80°.[16][17]

Consequences: a reduced range of motion may be a sign of one of these diseases:  patellofemoral pain syndrome[18], lower back pain[19], osteoarthritis and rheumatoid arthritis[20]

Reliability of the test: Investigation into the validity of tests are important to know whether our tests are reliable or not.[21] Studies that test the reliability of the Thomas study are very limited.[22] “ One  research has  demonstrated that the modified Thomas test a very good inter-rater reliability has.[23] Another research has demonstrated that the modified Thomas test, an average of only moderate level of reliability has in the examiners at goniometer scoring and low levels of reliability in a pass / fail score.”[24] To prove or to refute the reliability of the Thomas test further research is required. 

Key Research[edit | edit source]

  • ↑ The “iliacus test”: New information for the evaluation Assessment of the flexibility of elite athletes using the modified Thomas test.
  • ↑ Iliotibial band Friction Syndrome.
  • ↑ Postural Screening using the Tomas Test- Part 1

Resources
[edit | edit source]

Pubmed and ISI Web of Knowledge, Internet. 

Clinical Bottom Line[edit | edit source]

add text here

Recent Related Research (from Pubmed)[edit | edit source]

  •  The influence of corrective exercises in a water environment on the shape of the antero-posterior curves of the spine and on the functional status of the locomotor system in children with Io scoliosis.


  •  Normative and critical criteria for iliotibial band and iliopsoas muscle flexibility.

References[edit | edit source]

see adding references tutorial.

  1. ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
  2. ↑ Jeff G. Konin, Holly Brader. Lumbar Spine Special tests for orthopedic examination. Third edition. USA. Slack Incorporated. 2006.p170
  3. ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
  4. ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
  5. ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
  6. ↑ ↑ Tyler TF, Nicholas SJ, Mullaney MJ, McHugh MP. The role of hip muscle function in the treatment of patellofemoral pain syndrome. Am J Sports Med. 2006 Apr; 34(4):630-6.
  7. ↑ ↑ G. Marrè-Brunenghi, R. Camoriano, M. Valle and S. Boero; The psoas muscle as cause of low back pain in infantile cerebral palsy; J Orthop Traumatol. 2008 March; 9(1): 43–47.
  8. ↑ John Crawford Adams, David L. Hamblen; Outline of orthopaedics; Churchill Livingstone, 13th edition, 2001 - 459 pagina's
  9. ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
  10. ↑ Jeff G. Konin, Holly Brader. Lumbar Spine Special tests for orthopedic examination. Third edition. USA. Slack Incorporated. 2006.p170
  11. ↑ ↑ Jeffrey Tucker, DC, DACRB. The Psoas and Iliacus: Functional Testing. Dynamic Chiropractic. September 24, 2007, Vol. 25, Issue 20.
  12. ↑ ↑ Jeffrey Tucker, DC, DACRB. The Psoas and Iliacus: Functional Testing. Dynamic Chiropractic. September 24, 2007, Vol. 25, Issue 20.
  13. ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
  14. ↑ ↑ DAVID C. ELAND, DO; TIFFANI N. SINGLETON, BS; ROBERT R. CONASTER, MS; JOHN N. HOWELL, PHD; ALFRED M. PHELEY, PHD; MELYNDA M. KARLENE, DO; JOYNITA M. ROBINSON, DO. The “iliacus test”: New information for the evaluation of hip extension dysfunction. J Am Osteopath Assoc. 2002 Mar;102(3):130-42.
  15. ↑ ↑ Mark McKean. Postural Screening using the Thomas Test – Part 1. Pistol Australia. P11-13
  16. ↑ ↑ Mark McKean. Postural Screening using the Thomas Test – Part 1. Pistol Australia. P11-13.
  17. ↑ ↑ D Harvey. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998 32: 68-70.
  18. ↑ ↑ Tyler TF, Nicholas SJ, Mullaney MJ, McHugh MP. The role of hip muscle function in the treatment of patellofemoral pain syndrome. Am J Sports Med. 2006 Apr; 34(4):630-6.
  19. ↑ ↑ G. Marrè-Brunenghi, R. Camoriano, M. Valle and S. Boero; The psoas muscle as cause of low back pain in infantile cerebral palsy; J Orthop Traumatol. 2008 March; 9(1): 43–47.
  20. ↑ John Crawford Adams, David L. Hamblen; Outline of orthopaedics; Churchill Livingstone, 13th edition, 2001 - 459 pagina's
  21. ↑ Phyllis A Clapis, PT, DHSc, OCS1, Susan Mercik Davis and Ross Otto Davis; Reliability of inclinometer and goniometric measurements of hip extension flexibility using the modified Thomas test; Physiotherapy Theory and Practice ; 2008, Vol. 24, No. 2 , Pages 135-141
  22. ↑ Belinda J Gabbea, Kim L Bennellb, Henry Wajswelnerc, Caroline F Fincha; Reliability of common lower extremity musculoskeletal screening tests; Physical Therapy in Sport, Volume 5, Issue 2, Pages 90-97 (May 2004).
  23. ↑ Belinda J Gabbea, Kim L Bennellb, Henry Wajswelnerc, Caroline F Fincha; Reliability of common lower extremity musculoskeletal screening tests; Physical Therapy in Sport, Volume 5, Issue 2, Pages 90-97 (May 2004).
  24. ↑ Phyllis A Clapis, PT, DHSc, OCS1, Susan Mercik Davis and Ross Otto Davis; Reliability of inclinometer and goniometric measurements of hip extension flexibility using the modified Thomas test; Physiotherapy Theory and Practice ; 2008, Vol. 24, No. 2 , Pages 135-141
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