Modified Thomas Test

The Thomas test is named after British orthopaedic surgeon Dr. Hugh Owen Thomas (1834-1891). Described below is the Modified Thomas test, used to obtain measures of flexibility for the iliopsoas and quadriceps muscles (Harvey,1998).

purpose: to assess hip flexibility, specifically of the iliopsoas and quadriceps muscles

equipment required: goniometer with extended arms and spirit level (optional), and a firm table.

pre-test: Explain the test procedures to the subject. Perform screening of health risks and obtain informed consent. Perform an appropriate warm-up. See more details of pre-test procedures.

procedure: The subject sits at the very edge of a bench, then rolls back onto the bench while pulling both knees to the chest. This is to ensure that the lumbar spine is flat on the bench and the pelvis is posteriorly rotated. The subject then holds the opposite hip in maximum flexion with the arms, while the limb to be tested is lowered towards the floor. For each side, two angles are measured using a goniometer. The first angle to be measured the angle of hip flexion (reflecting the length of the iliopsoas). The stationary arm of the goniometer is aligned with the lateral midline of the pelvis. The moving arm is aligned with the midline of the femur using the lateral epicondyle as a reference point. The second angle to be measured the knee flexion angle (reflecting the length of the rectus femoris). For this measure, the stationary arm of the goniometer is aligned with the lateral midline of the thigh, using the greater trochanter as a reference point. The fulcrum is placed over the lateral epicondyle of the femur. The moving arm is aligned with the lateral midline of the fibula, using the lateral malleolus as a reference point. Repeat this procedure with the opposite side.

scoring: Each angle is measured by the goniometer, two different angles for each leg. The measurement unit is degrees.

comments: The opposite leg must be held firmly to the chest by the subject.

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