Objective: We compared a self-performed diagnostic test that we have been using since 1987, with other commonly used clinical tests for biceps femoris muscle-strain injuries.
Setting: Private practice focusing on sports injuries.
Patients: One-hundred forty professional male soccer players (ages 17 to 33 years) with a history and clinical findings of a pulled hamstring muscle (patients with direct trauma were excluded) had an ultrasound-proven grade I or II biceps femoris muscle injury.
Interventions: In these ultrasound-positive patients, the “taking off the shoe” test (TOST) was performed by the patient himself on both the affected and unaffected legs; and the physician then performed the resisted range of motion, passive range of motion, and active range of motion tests.
Results: The TOST had a sensitivity and specificity of 100%, and a positive predictive value and an negative predictive value of 100% for biceps femoris injury as found on ultrasound. The other muscle tests had an average sensitivity of 57%, specificity of 100%, accuracy of 79%, and negative predictive value of 70%.
Conclusion: This preliminary, nonblinded observational study of the TOST found it to be more reliable than other commonly used clinical tests for hamstring tears. The clinical value of this easy-to-perform test should be evaluated in a prospective fashion.
*Center for Orthopaedics and Sports Traumatology, Karsiyaka, Izmir, Turkey
†Department of Orthopaedics and Traumatology, University of Baskent, Zubeyde Hanim Hospital, Karsiyaka, Izmir, Turkey
Received for publication January 19, 2005
accepted November 28, 2005
Reprints: Haluk H. Oztekin, MD, Department of Orthopaedics and Traumatology, University of Baskent, Zubeyde Hanim Hospital, Karsiyaka, Izmir, Turkey (e-mail: firstname.lastname@example.org)