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James W. Youdas, Sara T. Mraz, Barbara J. Norstad, Jennifer J. Schinke and John H. Hollman

Context:

Hip abductor muscle weakness is related to many lower extremity injuries. A simple procedure, the Trendelenburg test, may be used to assess hip abductor performance in patient populations.

Objective:

To describe the minimal detectable change (MDC) in pelvic-on-femoral (P-O-F) position of the stance limb during the Trendelenburg test.

Setting:

Laboratory.

Participants:

45 healthy women (28 ± 8 years) and 45 healthy men (33 ± 11 years).

Main Outcome Measures:

P-O-F position in degrees in single-leg stance. Results: Baseline P-O-F position (hip adduction) was 83° ± 3° with a range from 76° to 94°. The intratester reliability (ICC3,1 for measurement of P-O-F position using a universal goniometer was 0.58 with a standard error of measurement (SEM) of 2°. The minimal detectable change (MDC) was calculated to be 4°.

Conclusions:

If a person’s P-O-F position changes less than 4° between measurements, then the P-O-F position is within measurement error and it can be determined that there has been no change in the performance of the hip abductor muscles when examined by the Trendelenburg test.

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Karen D. Kendall, Christie Schmidt and Reed Ferber

Context:

It has been theorized that a positive Trendelenburg test (TT) indicates weakness of the stance hip-abductor (HABD) musculature, results in contralateral pelvic drop, and represents impaired load transfer, which may contribute to low back pain. Few studies have tested whether weakness of the HABDs is directly related to the magnitude of pelvic drop (MPD).

Objective:

To examine the relationship between HABD strength and MPD during the static TT and during walking for patients with nonspecific low back pain (NSLBP) and healthy controls (CON). A secondary purpose was to examine this relationship in NSLBP after a 3-wk HABD-strengthening program.

Design:

Quasi-experimental.

Setting:

Clinical research laboratory.

Participants:

20 (10 NSLBP and 10 CON).

Intervention:

HABD strengthening.

Main Outcome Measures:

Normalized HABD strength, MPD during TT, and maximal pelvic frontal-plane excursion during walking.

Results:

At baseline, the NSLBP subjects were significantly weaker (31%; P = .03) than CON. No differences in maximal pelvic frontal-plane excursion (P = .72), right MPD (P = 1.00), or left MPD (P = .40) were measured between groups. During the static TT, nonsignificant correlations were found between left HABD strength and right MPD for NSLBP (r = −.32, P = .36) and CON (r = −.24, P = .48) and between right HABD strength and left MPD for NSLBP (r = −.24, P = .50) and CON (r = −.41, P = .22). Nonsignificant correlations were found between HABD strength and maximal pelvic frontal-plane excursion for NSLBP (r = −.04, P = .90) and CON (r = −.14, P = .68). After strengthening, NSLBP demonstrated significant increases in HABD strength (12%; P = .02), 48% reduction in pain, and no differences in MPD during static TT and maximal pelvic frontal-plane excursion compared with baseline.

Conclusions:

HABD strength was poorly correlated to MPD during the static TT and during walking in CON and NSLBP. The results suggest that HABD strength may not be the only contributing factor in controlling pelvic stability, and the static TT has limited use as a measure of HABD function.

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Ann L. Livengood, Mario A. DiMattia and Tim L. Uhl

Column-editor : Carl G. Mattacola

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Mario A. DiMattia, Ann L. Livengood, Tim L. Uhl, Carl G. Mattacola and Terry R. Malone

Context:

The Trendelenburg and single-leg-squat (SLS) tests are purported measures of hip-abduction strength that have not been previously validated.

Objective:

To correlate isometric hip-abduction strength to frontal-plane hip motion during an SLS and determine the criterion validity of a clinical-observation-analysis method to grade an SLS against 2-dimensional kinematic analysis.

Design:

Single-measure, concurrent validity.

Setting:

Biodynamics research laboratory.

Participants:

50 uninjured participants.

Main Outcome Measures:

Hip-abduction strength and hip and knee kinematic data during a Trendelenburg test and an SLS.

Results:

A weak, positive correlation between hip-abduction strength and hip-adduction angle was found during both the Trendelenburg (r = .22, P = .13) and the SLS (r = .21, P = .14) tests. The observation-analysis method revealed a low sensitivity, .23, and a higher specificity, .86, when compared with the kinematic data.

Conclusion:

The usefulness of the Trendelenburg and SLS test in screening hip-abductor strength in a healthy physically active population is limited. The origin of observable deficits during SLS requires further objective assessment.

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Hannah Horris, Barton E. Anderson, R. Curtis Bay and Kellie C. Huxel Bliven

a simulated breathing pattern . Int J Osteopath Med . 2009 ; 12 ( 3 ): 86 – 91 , 86p. doi:10.1016/j.ijosm.2008.10.002 10.1016/j.ijosm.2008.10.002 22 Roussel NA , Nijs J , Truijen S , Smeuninx L , Stassijns G . Low back pain: clinimetric properties of the Trendelenburg test, active

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Hae-rim Han, Chung-hwi Yi, Sung-hyun You, Heon-seock Cynn, One-bin Lim and Jae-ik Son

appears as poor single-leg balance with altered lateral pelvic tilt or translation, such as the Trendelenburg gait pattern. 12 , 15 Thus, further research will be required to compare these results with a control group that do not have a weak GMED. The SLS exercises require greater recruitment from not

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Alexandra F. DeJong, L. Colby Mangum, Jacob E. Resch and Susan A. Saliba

TL . “Dynamic Trendelenburg”: single-leg squat test for gluteus medius strength . Athl Ther Today . 2004 ; 9 ( 1 ): 24 – 25 . doi:10.1123/att.9.1.24 10.1123/att.9.1.24 37. Dieterich A , Petzke F , Pickard C , Davey P , Falla D . Differentiation of gluteus medius and minimus activity