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 (ΔcPD), 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 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. 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.
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 (ΔcPD), 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 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. 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.
Authors: Kerri A Graber; Kari L Loverro; Mark Baldwin; Erika Nelson-Wong; Joshua Tanor; Cara L Lewis Journal: J Appl Biomech Date: 2021-05-29 Impact factor: 1.606
Authors: Luke McCarney; Alexander Andrews; Phoebe Henry; Azharuddin Fazalbhoy; Isaac Selva Raj; Noel Lythgo; Julie C Kendall Journal: Chiropr Man Therap Date: 2020-10-19
Authors: Miguel Sá; Rita Graça; Hugo Reis; José Miguel Cardoso; José Sampaio; Célia Pinheiro; Duarte Machado Journal: Braz J Anesthesiol Date: 2017-05-24