The Trendelenburg test is useful for identifying weakness or instability of the lateral hip musculature, specifically gluteus medius weakness or pathology.
How to Perform Trendelenburg Test
Position of Patient: The patient should be standing with feet shoulder width apart.
Performance: The examiner should instruct the patient to stand on one leg. It is ok to allow the patient to hold onto something if they feel unsteady.
How to Interpret Trendelenburg Test
Positive Finding: The examiner should observe the patient’s hip level to watch for compensatory dropping of the pelvis. The test is considered positive if the pelvis drops on the unsupported side or if the trunk shifts towards the stance leg. A positive trendelenburg sign may also be present during gait analysis.
The trendelenburg test can also be used in gait analysis. As part of most physical therapy exams, observing gait impairments is a key component of documenting baseline status. Observation of a drop in the hip or the trendelenburg sign while the patient ambulates or navigates stairs can lean the examiner to suspect hip musculature weakness. Typically, the compensatory drop in the hip suggests weakness in the gluteus medius muscle. Further muscle testing should be performed to confirm suspect muscle weakness.
Test Accuracy / Reliability / Evidence:
κ = .36 (prestandardization)
κ = .06 (poststandardization
Source: Cibere J, Thorne A, Bellamy N, et al: Reliability of the hip examination in osteoarthritis: effect of standardization. Arthritis Rheum 2008; 59: pp. 373-381
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