Steps toward the validation of the Trendelenburg Test : the effect of experimentally reduced hip abductor muscle function on frontal plane mechanics

Kendall, Karen, Patel, Chirag, Preston, Wiley, J., Pohl, Michael B., Emery, Carolyn A., & Ferber, Reed (2013) Steps toward the validation of the Trendelenburg Test : the effect of experimentally reduced hip abductor muscle function on frontal plane mechanics. Clinical Journal of Sport Medicine, 23(1), pp. 45-51.

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Objective: To investigate the validity of the Trendelenburg test (TT) using an ultrasound-guided nerve block (UNB) of the superior gluteal nerve and determine whether the reduction in hip abductor muscle (HABD) strength would result in the theorized mechanical compensatory strategies measured during the TT.

Design: Quasi-experimental.

Setting: Hospital.

Participants: Convenience sample of 9 healthy men. Only participants with no current or previous injury to the lumbar spine, pelvis, or lower extremities, and no previous surgeries were included.

Interventions: Ultrasound-guided nerve block.

Main Outcome Measures: Hip abductor muscle strength (percent body weight [%BW]), contralateral pelvic drop (cPD), change in contralateral pelvic drop (Delta cPD), ipsilateral hip adduction, and ipsilateral trunk sway (TRUNK) measured in degrees.

Results: The median age and weight of the participants were 31 years (interquartile range [IQR], 22-32 years) and 73 kg (IQR, 67-81 kg), respectively. An average 52% reduction of HABD strength (z = 2.36, P = 0.02) resulted after the UNB. No differences were found in cPD or Delta cPD (z = 0.01, P = 0.99, z = 20.67, P = 0.49, respectively). Individual changes in biomechanics showed no consistency between participants and nonsystematic changes across the group. One participant demonstrated the mechanical compensations described by Trendelenburg.

Conclusions: The TT should not be used as a screening measure for HABD strength in populations demonstrating strength greater than 30% BW but should be reserved for use with populations with marked HABD weakness. Clinical Relevance: This study presents data regarding a critical level of HABD strength required to support the pelvis during the TT.

Impact and interest:

8 citations in Scopus
6 citations in Web of Science®
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ID Code: 60043
Item Type: Journal Article
Refereed: Yes
Keywords: Trendelenburg test, ultrasound-guided nerve block, hip abductor muscle strength, frontal plane mechanics
DOI: 10.1097/JSM.0b013e31825e66a1
ISSN: 1050-642X
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Schools > School of Exercise & Nutrition Sciences
Copyright Owner: Copyright 2013 Lippincott Williams & Wilkins
Deposited On: 03 Jul 2013 00:57
Last Modified: 06 Jan 2014 01:45

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