{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:31:58Z","timestamp":1788845518667,"version":"build-2803163510"},"reference-count":23,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T00:00:00Z","timestamp":1673395200000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Sport Exerc Med"],"accepted":{"date-parts":[[2022,12,23]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate the interexaminer reliability of abdominal palpation and resistance tests in athletes with longstanding groin pain, and to identify the prevalence of positive clinical tests in athletes classified with inguinal-related groin pain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Male athletes (18\u201340 years) with longstanding groin pain were prospectively recruited between March 2019 and October 2020 at a sports medicine hospital. Two examiners performed history taking and standardised clinical examination (including abdominal palpation, scrotal invagination and abdominal resistance tests) blinded to each other\u2019s findings. Interexaminer reliability was calculated using Cohen\u2019s Kappa statistic (\u03ba). Examiners classified groin pain using the Doha agreement meeting terminology. A differentiation was made between \u2018defined inguinal-related groin pain\u2019 (according to recommended definition criteria) and \u2018likely inguinal-related groin pain\u2019 (expert-based application of the Doha agreement classification when not all recommended criteria were present).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 44 athletes were included (61 symptomatic sides). Interexaminer reliability of inguinal palpation pain provocation tests varied from fair to moderate (\u03ba=0.35\u20130.49). Reliability of posterior wall structure palpation (firm\/soft) was slight (\u03ba=0.01), and posterior wall bulging (yes\/no) fair (\u03ba=0.29). Reliability for abdominal resistance tests varied from fair to substantial (\u03ba=0.35\u20130.72). In athletes classified with defined inguinal-related groin pain, recognisable injury pain on palpation during scrotal invagination when athletes performed a Valsalva manoeuvre was the most prevalent positive palpation test (79%). Abdominal resistance tests were positive in 21%\u201349% of these cases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The interexaminer reliability for clinical examination tests used to classify inguinal-related groin pain in athletes varies from slight to substantial. There is no single perfect clinical examination test.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03842826\">NCT03842826<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsem-2022-001498","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T10:50:42Z","timestamp":1673434242000},"page":"e001498","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Clinical examination for athletes with inguinal-related groin pain: interexaminer reliability and prevalence of positive tests"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"nct03842826","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03842826","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03590145","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5723-8445","authenticated-orcid":false,"given":"Willem M P","family":"Heijboer","sequence":"first","affiliation":[{"name":"Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"},{"name":"Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Musculoskeletal Health and Sports, Amsterdam Movement Sciences, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zarko","family":"Vuckovic","sequence":"additional","affiliation":[{"name":"Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0861-662X","authenticated-orcid":false,"given":"Adam","family":"Weir","sequence":"additional","affiliation":[{"name":"Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"},{"name":"Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes L","family":"Tol","sequence":"additional","affiliation":[{"name":"Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"},{"name":"Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Musculoskeletal Health and Sports, Amsterdam Movement Sciences, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"H\u00f6lmich","sequence":"additional","affiliation":[{"name":"Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4308-901X","authenticated-orcid":false,"given":"Andreas","family":"Serner","sequence":"additional","affiliation":[{"name":"Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar"},{"name":"FIFA Medical, F\u00e9d\u00e9ration Internationale de Football Association, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,1,11]]},"reference":[{"key":"2025083110241785000_9.1.e001498.1","doi-asserted-by":"crossref","unstructured":"Taylor R , Vuckovic Z , Mosler A , et al . 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