Clinimetric properties of observer-assessed impairment tests used to evaluate hip and groin impairments: a systematic review.

Objective: To recommend the most suitable observer-assessed impairment tests in people with hip and/or groin pathologies by conducting a systematic review of the clinimetric properties of these tests.

Methods: Electronic searches were performed in the Cochrane, PubMed, CINAHL, Embase, SPORTDiscus, and PsycINFO databases up to August 2011. Two reviewers independently rated the measurement properties of clinical tests of impairments, defined by the International Classification of Functioning, Disability and Health as problems in body structure or body function, using the Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN). "Best evidence synthesis" was made using COSMIN outcomes and the quality of findings was assessed using a purpose criteria system.

Results: Fifteen of 2,588 publications were eligible for inclusion. Impairments evaluated were range of motion (ROM; 9 studies), muscle strength (6 studies), tenderness (3 studies), leg length discrepancy (2 studies), balance (2 studies), and muscle length (2 studies) in people with hip osteoarthritis (OA), hip fractures, and mixed hip/groin pathologies. Measurement properties evaluated included reliability, measurement error, construct validity, and criterion validity. Responsiveness and interpretability were not assessed. Intrarater reliability of ROM tests (intraclass correlation coefficient [ICC] 0.82-0.97) and strength tests (ICC 0.84-0.98) for hip OA and of strength tests (ICC 0.66-0.86) and balance tests (ICC 0.73-0.94) for hip fractures was demonstrated.

Conclusion: This systematic review highlighted a paucity of literature evaluating the clinimetric properties of impairment tests for people with hip and/or groin pathology. A large number of inconclusive findings were found and as such, many clinical impairment tests should be used with caution in people with hip and/or groin pathologies until further clinimetric evidence becomes available.