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- Title
Resisted adduction in hip neutral is a superior provocation test to assess adductor longus pain: An experimental pain study.
- Authors
Drew, M. K.; Palsson, T. S.; Izumi, M.; Hirata, R. P.; Lovell, G.; Chiarelli, P.; Osmotherly, P. G.; Graven‐Nielsen, T.
- Abstract
The criterion of long-standing groin pain diagnoses in athletes usually relies on palpation and clinical tests. An experimental pain model was developed to examine the clinical tests under standardized conditions. Pain was induced by hypertonic saline injected into the proximal adductor longus ( AL) tendon or rectus femoris ( RF) tendon in 15 healthy male participants. Isotonic saline was injected contralaterally as a control. Pain intensity was assessed on a visual analog scale ( VAS). Resisted hip adduction at three different angles and trunk flexion were completed before, during, and after injections. Pain provocation in the presence of experimental pain was recorded as a true positive compared with pain provocation in the non-pain conditions. Similar peak VAS scores were found after hypertonic saline injections into the AL and RF and both induced higher VAS scores than isotonic saline ( P < 0.01). Adduction at 0° had the greatest positive likelihood ratio (+LR = 2.8, 95%CI: 1.09-7.32) with 45° (−LR = 0.0, 95%CI: 0.00-1.90) and 90° (−LR = 0.0, 95%CI: 0.00-0.94) having the lowest negative LR. This study indicates that the 0° hip adduction test resisted at the ankles optimizes the diagnostic procedure without compromising diagnostic capacity to identify experimental groin pain. Validation in clinical populations is warranted.
- Subjects
GROIN pain; COMPARATIVE studies; CONFIDENCE intervals; CROSSOVER trials; DIAGNOSTIC errors; EXERCISE tests; HIP joint; RANGE of motion of joints; ADDUCTION; MUSCLE contraction; PROBABILITY theory; QUESTIONNAIRES; RESEARCH funding; STATISTICS; DATA analysis; PAIN measurement; TORSO; VISUAL analog scale; PREDICTIVE tests; BLIND experiment; RECEIVER operating characteristic curves; DATA analysis software; DESCRIPTIVE statistics; ONE-way analysis of variance; DIAGNOSIS
- Publication
Scandinavian Journal of Medicine & Science in Sports, 2016, Vol 26, Issue 8, p967
- ISSN
0905-7188
- Publication type
Article
- DOI
10.1111/sms.12529