The Effect of Protonic Device on Hip Flexibility and Pelvic Alignment

The purpose of this study was examine the effect the Protonics™ device has on changing pelvic alignment through the use of repositioning exercises during a one-week time period. A secondary purpose was to determine if the Ober Test and Thomas Test are valid and reliable for assessment of pelvic alignment. Intra rater reliability of the Ober Test, Thomas Test, and PALM measurements were determined during preseason testing. Intra-rater reliability of the PALM, Thomas and Ober test was determined with Intraclass Correlation (ICC1.1) assessment. Separate 3x3 repeated measures analysis of variance was completed for group: brace, no brace, and control, and time: pre, immediate post, and post, for each assessment test: PALM, Thomas, and Ober test. Thirty (28) subjects, 6 males and 22 females, were recruited from a Division I athletic program consisting of male and female land-based running sports (e.g., soccer, basketball, field hockey, and lacrosse), (age= 20.25 +/-1.50 years, height= 171.51+/-8.76 centimeters, mass= 69.70+/- 11.65 kilograms). Subjects were counterbalanced between symptomatic and asymptomatic and assigned to one of three groups: brace, no brace, or control groups. The brace group completed suggested repositioning exercises 3 times a week for one week while wearing the Protonics™ brace. The no brace group also completed the same exercises, but without donning the brace during execution of the repositioning exercises. The control group did not perform any type of lower extremity exercises for the one- week training period. After completion of the one-week intervention protocol, the three pelvic assessment tests were performed again and compared to measurements obtained prior to the intervention period. Intraclass correlation coefficients (ICC1.1) for intra-rater reliability were high for the Thomas Test, Ober Test, PALM Frontal plane degrees, and PALM Sagittal plane degrees for each assessment test. Pearson product moment correlation coefficients revealed a significant correlation between Thomas Test (degrees) and Ober Test (degrees) (r = .666, p=.000 r = .567, p=.001) for the Pre-test and Immediate post-test respectively and between Ober Test (degrees) and PALM frontal plane (degrees) (r = .441 p=.015) for the Delayed post-test condition. A significant inverse correlation was found between Pelvic Alignment (degrees) and PALM sagittal plane (degrees) (r= -.518, p=.005). There was a significant change in Thomas test (degrees) (p=.003, F2=8.127) and Ober Test (degrees) measures (p=.000, F2=12.543) over time for all subjects. There was no significant interaction between group and time. There was no significant change in PALM Sagittal plane (degrees) measures (p=.511, F2=.609), PALM Frontal plane (degrees) measures (p=.452, F2=.806), and Pelvic Alignment (degrees) measures (p=.217, F2=1.581) over time. There was no significant interaction between group and time. Use of the Protonics device had no immediate effect on pelvic alignment as measured over time. The Thomas and Ober Tests cannot be used interchangeably with the PALM to assess bony alignment of the pelvis. Although a change in pelvic alignment was not evident, the Thomas Test, Ober Test and PALM were demonstrated to be reliable when taken by a single rater.