Versus Arthritis Centre for Sport, Exercise and Osteoarthritis
University of Nottingham

Hip and Lower Limb Movement Screen (HLLMS): Utilisation in Patients with Hip and Knee Osteoarthritis to Identify the Quality of Movement Control 


Osteoarthritis (OA) is the second most common diagnosis made in older people consulting their general practitioner (GP). Disability from OA has increased by 16% since the 1990’s and is set to rise with the growing ageing population. The knee, hand, and hip are the most common joints that are affected by OA.  

Movement screening determines physical capability and quality of movement of joints.  Nadine Booysen and colleagues in the Centre, developed a hip and lower limb movement screening tool (HLLMS), allowing us to: 

  1. Assess movement quality 
  2. Assess physical performance 
  3. Identify painful movement 

The GLA:D ® programme* will be used as an intervention and consists of three education sessions and 12 sessions of exercise. The supervised NEuroMuscular Exercise (NEMEX) programme will be delivered twice weekly for 6 weeks (60min/session). Participants will be divided randomly in two groups (Intervention and Control Groups). The control group will follow standard care for the management of Knee and hip OA. Both groups will be screened pre and post intervention by HLLMS tool, to see if the NEMEX exercises are more effective than standard care for improving movement quality.  

*The GLA:D ® programme is an initiative from the Research Unit for musculoskeletal Function and Physiotherapy at the University of Southern Denmark.  The programme began in 2013.  

Aims and Objectives:

The overall aim of this study is to assess and improve movement quality in hip and knee OA patients by using the Hip and Lower Limb Movement screen (HLLMS) and neuromuscular control exercises. 
Longer-term, this research project aims to impact directly on clinical services treating patients with joint degenerative disease. The Hip and Lower Limb Movement Screening tool will enable clinicians to assess joint movement quality abnormalities, which in turn help inform the decision for the best care pathway e.g. surgical and non-surgical. 


  • Booysen N, Wilson DA, Lewis CL, Warner MB, Gimpel M, Mottram S, Comerford M, Stokes M. Assessing movement quality using the hip and lower limb movement screen: development, reliability and potential applications. J Musculoskel Res 2020; 
Work Package Stratified Care and Personalised Medicine: Care
Objective   1.3
Lead Umer Sheikh  
Investigators Maria Stokes, Danielle Lambrick, Nadine Booysen and James Gavin, Overseas Advisor: Ewa Roos (Denmark) 
Institution University of Southampton
Man leg stretching HLLMS 240x150