Assessing movement quality using the hip and lower limb movement screen: Development, reliability and potential applications

Abstract

Background: An active lifestyle has many health benefits but intensive exercise and low grade repetitive trauma may impact the health of joints. Good quality, controlled movement, may reduce abnormal loading on joints and help prevent injury or when injuries do occur, prevent post-Traumatic osteoarthritis. Screening tools to visually assess movement quality can be used to prescribe appropriate exercise interventions to improve movement quality. An assessment tool that focuses on hip movement control is needed for use in clinical and field environments. Purpose: To describe a new screening tool that assesses control of the hip, pelvis and lower limbs, the Hip and Lower Limb Movement Screen (HLLMS), and test its intra-and inter-rater reliability. Methods: The HLLMS includes five tests: small knee bend (SKB), standing hip flexion to 110â , side-lying hip abduction with the leg laterally rotated, SKB with trunk rotation and deep squat. Reliability was tested in two samples of young footballers aged 16-19 years; intra-rater in n=20 and inter-rater reliability in n=34. Percentage agreement (PA) and First-Order Coefficient (AC1) were calculated. Results: Intra-rater reliability was excellent with almost perfect agreement for the overall HLLMS (PA 96%; AC1 0.93), with strong inter-rater reliability (PA 88%; AC1 0.82). Conclusions: The HLLMS can identify movement quality reliably in young community footballers. Poor movement patterns identified using the HLLMS are intended to inform the design of targeted exercise programs to improve movement quality and reduce injuries or prevent the progression of injuries to post-Traumatic OA.