Over the past couple of weeks we’ve been discussing different ways we can help patients who are dealing with OA of the hip.
Here are some relatively simple assessments you can do, which will also be great as homecare exercises!
When looking at all of these movements/tests it is recommended that you demonstrate it once to the patient, then have them do a practice run before the actual test takes place.
Sit To Stand Test
You start this with just a chair placed with the back of it against a wall. The patient sits with feet shoulder width apart and arms crossed at the chest.
You then have them rise to a standing position, then return to seated position for as many times possible for a 30 second duration.
Doing this can help give us an idea of some activity limitations the person may have. 1
4 Square Step Test
The literature recommends using four canes spread out with the handles at 90°, but I didn’t have any canes, so I just used tape on the floor.
Start the person in square 1 (whichever one you dictate that is) then in a clockwise direction stepping forward into square 2, side stepping to square 3, reverse step to square 4, then side step back into square 1.
Once the person is back in square 1, you reverse the direction going counterclockwise, side step to square 4, forward step to square 3, side step to square 2, reverse step to square 1.
This is timed to see how the person can do as quickly as possible to give us an indication of how well a person can move in different directions.1
This one is a great way to assess a persons balance.
The literature recommends a 15cm step, but I didn’t have one, so I’m just demonstrating with a platform we have at the clinic.
Have the person stand on the affected, or the test hip. With the opposite leg step up onto your elevated surface until the foot is flat on the step, then return it back down to the floor. The painful side is always the “stance” side and doesn’t move up onto the step.
See how many times the person can do this for 15 seconds.1
Timed Single Leg Stance
This is another one for assessing a persons balance.
Hands are placed on the hip. Testing side is the “stance” side, opposite leg is put into a flexion position so that hip is neutral.
Then time the person for a maximum of 30 seconds. The test stops if the hands come off the hips, they touch the stance leg with their hands, or the stance leg touches the non-stance leg.1
What I really like about all of these, is that while their intent is an assessment, each one of these could easily be a homecare exercise you recommend to anyone with hip issues. You can easily do any of these in your treatment room and it can give you a great indication of a patients progression or digression. As always don’t just give them this with no reasoning behind it, make it meaningful to the person, find out their goals and explain how these or any other exercise can help them attain that goal. Make it about them!
- Cibulka MT, Bloom NJ, Enseki KR, MacDonald CW, Woehrle J, McDonough CM. Hip pain and mobility deficits—hip osteoarthritis: revision 2017: clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy. 2017 Jun;47(6):A1-37.