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Determining Trendelenburg test validity and reliability using 3-dimensional motion analysis and muscle dynamometry
Journal article   Open access   Peer reviewed

Determining Trendelenburg test validity and reliability using 3-dimensional motion analysis and muscle dynamometry

Luke McCarney, Alexander Andrews, Phoebe Henry, Azharuddin Fazalbhoy, Isaac Selva Raj, Noel Lythgo and Julie C Kendall
Chiropractic & Manual Therapies, Vol.28, 53
2020
DOI: https://doi.org/10.1186/s12998-020-00344-3
PMID: 33076947
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Determining Trendelenburg test validity and reliability using 3-dimensional motion analysis and muscle dynamometry3.02 MBDownloadView
Published (Version of Record)CC BY V4.0,  Open Access
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https://doi.org/10.1186/s12998-020-00344-3View
Published (Version of Record)

Abstract

Background The hip abductor muscle group stabilises the pelvis during gait to prevent excessive pelvic drop. Hip abductor weakness has been linked to musculoskeletal conditions such as chronic low-back pain. As such, it is important that practitioners can correctly diagnose hip abductor weakness in a clinical setting. Although the Trendelenburg test is commonly used by practitioners, the validity of this test to assess hip abductor weakness in the absence of musculoskeletal injury remains questionable. The aim of this study was to determine the validity of the Trendelenburg test, as observed by a practitioner, to assess frontal plane pelvic motion and hip abductor strength in a population without intra-articular hip disorders. Methods This study was performed between June 14th and October 16th 2019. Eighteen participants were recruited for this study. Peak normalised isometric and isokinetic hip abductor torque were measured bilaterally (n = 36) using the Biodex System 4 isokinetic dynamometer. Each participant performed the Trendelenburg test bilaterally (n = 36) while a graduate year chiropractic practitioner assessed for a “positive” or “negative” sign. The test was simultaneously recorded using Vicon 3-Dimensional motion capture to measure frontal plane pelvic motion and elevation. Correlation analyses were performed between the measures of peak hip abductor torque and pelvic motion to determine if any relationship existed. Agreement between the practitioner and 3-Dimensional analysis was calculated using the kappa (κ) statistic. Results Weak, non-significant correlations were found between hip abductor strength and pelvic motion before outlier removal. Significant (p < 0.05) yet weak correlations were found after outlier removal, except for isometric hip abductor strength. Weak agreement was found between the chiropractic practitioner and 3-Dimesnional analysis for the Trendelenburg test assessment (κ = 0.22–0.25). Conclusions This study found no significant relationship between normalised peak isometric and isokinetic hip abductor torque and frontal plane pelvic motion during the Trendelenburg test in a healthy young adult population. There was also poor agreement between the practitioner and pelvic motion assessments. Caution should be used when using this test, in the absence of intra-articular hip pathology, to assesses hip abductor weakness. Before any definitive conclusion can be made, studies with a larger sample size should be performed.

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Citation topics
1 Clinical & Life Sciences
1.34 Orthopedics
1.34.1305 Hip Disorders
Web Of Science research areas
Rehabilitation
ESI research areas
Clinical Medicine
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