Houston Methodist. Leading Medicine



We are really concerned that Dad's hip range-of-motion is getting worse instead of better. He has fairly severe hip arthritis. Each time a therapist measures him, it seems to slip a few degrees. What can we do to help him at least maintain his motion?


The first thing to be sure is that the testing is accurate. Testing joint motion can be very subjective depending on how it is done and who does it. If the same person measures joint motion each time, intrarater reliability of the test is important. Intrarater reliability refers to the ability of a single individual to complete the test the same each time. If different people are testing your father's hip joint motion, then interrater reliability is important. This refers to the test being done the same way from person to person. Interrater reliability is the term used to describe test-retest when performed by different individuals on the same patient. Patient pain levels can vary from day-to-day, too. A measurement on one day may not be the same as on the next if the pain goes up or down. Assuming there is a true general trend of joint motion loss, the first step is to see his doctor. There may be an adjustment needed in medication that can help make a difference. Or there could be some other explanation for what's going on. If no medical treatment is warranted, then referral to a physical therapist may be needed. The therapist is well acquainted with ways to help arthritis patients maintain and even regain range of motion. Not only that, but they will pay attention to strength, motor control, and joint proprioception (sense of joint position). Each of these components is important to function and preventing disability. Yong-Hao Pua, BSc, et al. Intrarater Test-Retest Reliability of Hip Range of Motion and Hip Muscle Strength Measurements in Persons With Hip Osteoarthritis. In Archives of Physical Medicine and Rehabilitation. June 2008. Vol. 89. No. 6. Pp. 1146-1154.

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