Exploring the Perth Hamstring Assessment Tool and Lower Extremity Functional Scale in a Proximal Hamstring Avulsion...

Area of Science:

• Orthopedics
• Sports Medicine
• Rehabilitation Science

Background:

• The primary goal in treating proximal hamstring avulsion (PHA) is achieving both objective muscle restoration and subjective patient satisfaction, ensuring a pain-free recovery.
• Current evaluation methods for PHA recovery include various self-reported and performance-based outcome measures, yet their validity remains insufficiently investigated.

Purpose of the Study:

• To examine the correlation between the Perth Hamstring Assessment Tool (PHAT) and the Lower Extremity Functional Scale (LEFS).
• To determine the extent to which physical dysfunction, assessed via performance-based tests, explains self-reported outcome scores.
• To evaluate the ability of performance-based tests to differentiate between injured and uninjured lower extremities.
• To identify activity limitations perceived by patients years after PHA.

Main Methods:

• A cohort study including 50 patients diagnosed with PHA between 2007 and 2016.
• Patients completed questionnaires (PHAT, LEFS, PSFS) and underwent physical performance tests (hop tests, step-down test, strength tests).
• Data analysis focused on correlations between outcome measures and the discriminative ability of performance tests.

Main Results:

• A strong correlation (r=0.832) was found between PHAT and LEFS scores.
• Performance-based tests showed weak correlations with LEFS and PHAT, with only peak torque significantly discriminating between extremities.
• Running was the most frequently reported activity limitation (32%) in the Patient-Specific Functional Scale.

Conclusions:

• While patient-reported outcome measures like PHAT and LEFS show strong agreement, functional performance tests have limited correlation with these subjective reports.
• Most performance-based tests were unable to differentiate between the injured and uninjured lower extremity in PHA patients at long-term follow-up.
• Despite reporting few limitations, running difficulties are a common residual issue for patients following PHA.