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Steps Toward the Validation of the Trendelenburg Test

2012; Lippincott Williams & Wilkins; Volume: 23; Issue: 1 Linguagem: Inglês

10.1097/jsm.0b013e31825e66a1

1536-3724

Karen D. Kendall, Chirag Patel, J. Preston Wiley, Michael B. Pohl, Carolyn A. Emery, Reed Ferber,

Lower Extremity Biomechanics and Pathologies

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.Quasi-experimental.Hospital.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.Ultrasound-guided nerve block.Hip abductor muscle strength (percent body weight [%BW]), contralateral pelvic drop (cPD), change in contralateral pelvic drop (ΔcPD), ipsilateral hip adduction, and ipsilateral trunk sway (TRUNK) measured in degrees.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 ΔcPD (z = 0.01, P = 0.99, z = -0.67, 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.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.This study presents data regarding a critical level of HABD strength required to support the pelvis during the TT.