Do Ober Tests Reflect Iliotibial Band Stiffness? A Preliminary Shear Wave Elastography Study

Clinical tests, such as the Ober, and modified Ober tests are commonly used to assess iliotibial band (ITB) stiffness. Whether these tests can be used to evaluate ITB stiffness in vivo, or whether alternatives are available remains unclear. We aimed to investigate whether commonly used and alternative clinical tests reflect ITB stiffness in vivo.

Cross-sectional.

Thirty-five healthy males underwent the traditional Ober and modified versions of the Ober tes, including variations performed with the tested hip in extension, as well as a hip extension test with tibial external rotation. We defined positive cutoff values as < 0° of hip adduction for the Ober test and Ober test with the tested hip in extension, <10° of hip adduction for the modified Ober test and modified Ober test with the tested hip in extension, and <0° of hip extension for the hip extension test with tibial external rotation. Shear wave elastography was used to assess the stiffness of the ITB, rectus femoris, tensor fascia lata, gluteus medius, and gluteus minimus. Multivariable logistic regression analyses were performed to investigate associations between positive clinical test findings and tissue stiffness.

Higher ITB stiffness was associated with positive findings in the modified Ober test performed with the tested hip in extension (odds ratio = 1.03, 95% confidence interval = 1.00-1.06, P = .04) and the hip extension test with tibial external rotation (odds ratio = 1.04, 95% confidence interval = 1.00-1.07, P = .03). The traditional Ober and modified Ober tests were not associated with ITB stiffness.

Traditional Ober-based tests may have limited utility for evaluating ITB stiffness in vivo. Modified testing positions, particularly the modified Ober test with the tested hip in extension and the hip extension test with tibial external rotation, may better reflect ITB stiffness.