Summary of Trendelenburg Gait

Written by Kenneth LeeSeptember 12, 2020

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Trendelenburg Gait Pattern Example

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What is a Trendelenburg walk

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Trendelenburg Test

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Trendelenburg Test.
Purpose: To detect gluteus medius tendon tears or weakness in the hip abductors..
Test Position: Standing..
Performing the Test: Patient stands on one leg. There are two types of positive tests. A compensated trendelenburg occurs when the patient’s trunk leans ipsilaterally to the side of the stance leg.An uncompensated trendelenburg occurs when the examiner observes contralateral pelvic drop. A normal test result is when the patient is able to maintain a level pelvis without either of these substitutions. It should be noted that a hip hike is not a true trendelenburg. The examiner should also watch for any deviations in the transverse plane, which could signify mobility impairments..
Diagnostic Accuracy: Sensitivity:722; Specificity:769 (“Prospective evaluation of magnetic resonance imaging and physical examination findings in patients with greater trochanter pain syndrome”)..
Importance of Test: A very common gait abnormality seen in public is trendelenburg gait. Either the hip drops or we see compensatory trunk motion to make up for the weakness of the hip abductors. During stance phase of the gait cycle, the hip abductors (the gluteus medius is one of the main ones used in gait) are responsible for maintaining a level pelvis, while standing on one leg. If the muscle is weak or its innervation poor, we often see the result as an individual walking with their opposite hip dropping or their trunk leaning to the ipsilateral side to make up for the weakness.

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Trendelenburg Test | Hip Abductor Weakness

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This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. In this short demonstration, Kai talks about the Trendellenburg-Test..
The test is designed for detecting weakness in the Hip-Abductors. The patient stands on one leg and if the Abductors are not strong enough to keep the hip balanced, the pelvis is going to drop down on the opposite side. This is called the Trendellenburg-sign..
Additionally you could palpate the posterior superior iliac spine while performing the test..
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tags: Physio, therapy, Physiotherapy, assessment, tutorial, student, ESP, European school of physiotherapy, HVA, amsterdam, tutors, video, HD, Trendellenburg,Test,sign,abductor,glutei,gluteus,dropping,Gluteal Muscles (Anatomical Structure)

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The Trendelenberg Sign [HD]

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In this animation, Dr. Eric Laywell, Associate Professor at the Florida State University College of Medicine, discusses how injury to the gluteus medius and minimus muscles can result in Trendelenberg Sign, a gait in which the patient leans toward the side of the injury. In the animation, Dr. Laywell explains the mechanics of joint movement and clarifies common misconceptions about the Trendelenberg Sign, and demonstrates clinical assessment of the gluteal muscles..
This animation was directed and produced by Jodi Slade, certified medical illustrator at the FSU College of Medicine..
This animation and all content is ©2014 The Florida State University College of Medicine

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Trendelenburg Sign and Trendelenburg Lurch

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Trendelenburg to assess gluteus medius. Find more assessment content in the orthopedics section at www.pthaven.com.

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Trendelenburg Gait Demonstration

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Trendelenburg Gait Everything You Need To Know Dr. Nabil Ebraheim

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Educational video describing the condition Trendelenburg gate..
During the stance phase of the gait cycle, the gluteus medius work to maintain both hips at the same level. Trendelenburg gait is an abnormal gait that is usually found in people with weak abductor muscle of the hip which is supplied by the superior gluteal nerve. The patient cannot abduct the affected hip due weakness of the abductor muscles on the affected side. If the patient has weakness on one side of the pelvis and when the patient stands on that side, the pelvis on the contralateral side will drop. This is called Trendelenburg sign. The gluteus medius is very important during the stance phase of the gait cycle in order to maintain both hips at the same level. The stance phase accounts for about 60% of the gait cycle. Three times the body weight is transmitted to the hip joint during the stance e phase. The hip abductor actions account for 2/3 of that body weight. We identify the weakness stance phase if the pelvis drops to the opposite side..
Weakness can also occur in patients with L5 radiculopathy or avulsion of the abductor muscle tendon which occurs with increasing frequency after hip replacement surgery. The superior gluteal nerve injury is a major factor in this gait..
A positive Trendelenburg sign occurs when there is dysfunction of the abductor muscles and the body is unable to maintain the center of gravity on the side of the stance leg The patient will show an excessive lateral lean to keep the center of the gravity over the stance leg. The patient will show an excessive lateral lean to keep the center of gravity over the stance leg. With bilateral weakness of the abductor muscles, the patient will have dropping of the pelvis on both sides during walking which leads to a waddling motion. This gait is seen in patients with myopathies..
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These include: having pinched nerves walking with pain, stiffness, or grinding in your hips losing significant range of motion in your hips and gait losing the ability to walk, which may then require you to use a walker or wheelchair becoming paralyzed in your lower body having death of bone tissue.Trendelenburg gait is associated with the trunk leaning towards the same side as the leg you’re standing on with contralateral pelvic drop. People with this gait step with the right, have to lean over to the right due to right hip pain or weakness, causing the pelvis to drop to the left.

The Trendelenburg gait, named after Friedrich Trendelenburg, is an abnormal gait (as with walking) caused by weakness or ineffective action of the abductor muscles of the lower limb, gluteus medius and gluteus minimus. Gandbhir and Rayi point out that the biomechanical action involved comprises a Class 3 lever, where the lower limb’s weight is the load, the hip joint is the fulcrum, and the lateral glutei, which attach to the ante.Trendelenburg Gait A positive Trendelenburg gait (gluteus medius gait/lurching gait) is generally indicative of hip abductor weakness. The classic Trendelenburg’s gait pattern is seen when the stance phase hip abductors cannot resist the pull of gravity on the unsupported swing phase lower extremity.

Trendelenburg Gait or Hip drop is actually a deficiency or hip muscle weakness seen mostly in the runner, which occurs when the entire body weight falls on one leg and it is that particular leg, which requires supporting the full body weight during the stance phase of running.Nerve damage or dysfunction in the gluteal minimus and medius muscles. Osteoarthritis, which is a form of arthritis characterized by the wearing away of joint cartilage. Poliomyelitis, a condition that is linked to the poliovirus. Cleidocranial dysostosis, which is a condition that people can have.

Trendelenburg gait is an abnormal gait that is usually found in people with weak abductor muscle of the hip which is supplied by the superior gluteal nerve.What is a Trendelenburg Gait? Quick History Lesson: In 1895 Freidrich Trendelenburg described the Trendelenburg sign as weakness of hip abductor muscles in reference to congenital dislocations of the hip and progressive muscular atrophy.

Fast forward to today: most orthopedic and physiotherapy textbooks describe this sign as a test of hip function.Trendelenberg test A positive Trendelenburg test demonstrates that the hip abductors are not functioning owing to weakness or pain inhibition, and are unable to perform their role of stabilising the pelvis on the weight-bearing leg. To perform the test the patient stands.Obligate signs and symptoms include progressive ataxic gait, cerebellar dysfunction with tremor and dysmetria, dysarthria, decreased proprioception or vibratory sense (or both), muscle weakness, and absent deep tendon reflexes.

Gait summary. The distinctive P448L gait is readily distinguishable (see S1 Movie of mice on a treadmill). It is also consistent with a Trendelenburg gait [26, 27, 37] that commonly develops with different muscular dystrophies and myopathies and results from weakened muscles of the hip abductors as in LGMD2i patients [2, 24, 38].

The Trendelenburg gait, named after Friedrich Trendelenburg, is an abnormal gait (as with walking) caused by weakness of the abductor muscles of the lower limb, gluteus medius and gluteus minimus. People with a lesion of superior gluteal nerve have weakness of abducting the thigh at the hip.How to Fix a Hip Drop when Running 3 Exercises for Trendelenburg Gait Running Technique Duration: 5:58.

James Dunne 10,621 views. 5:58.Similar to the compensation for Trendelenburg gait, this abnormality could indicate weak hip abductors on the ipsilateral side or an inappropriately short prosthesis.

Occasionally, a person who has undergone a TF amputation can have an awkward downward movement of the upper body over the prosthesis, especially during fast walking.On this page: Antalgic Gait Ataxic Gait Apraxic Gait Trendelenburg Gait Spastic Gait Festinating Gait Short Leg Gait Assessing a patient’s gait can be a useful screening tool for identifying pathology affecting mobility. Impairment of gait may be due to pain, weakness, deformity or joint instability.

List of related literature:

Other Hindlimb Gait Deficits Other unusual unexplained gait deficits affecting one or both hindlimbs are observed occasionally, and they often have characteristics similar to those seen with stringhalt, fibrotic myopathy, upward fixation of the patella, and shivers.
from Diagnosis and Management of Lameness in the Horse E-Book by Michael W. Ross, Sue J. Dyson Elsevier Health Sciences, 2010
Postural abnormalities that contribute to the development of a festinating gait pattern should be documented (i.e., flexed, stooped posture).
from Physical Rehabilitation by Susan B O’Sullivan, Thomas J Schmitz, George Fulk F.A. Davis Company, 2019
Examples of gait phenomenologies will be briefly discussed below and illustrated in detail in the accompanying video segment.
from Movement Disorders Phenomenology by Steven J. Frucht Springer International Publishing, 2020
Balasubramanian and colleagues (2009) explored temporal and spatial gait characteristics for an agematched healthy control group and post-stroke groups of varying severity (severe, moderate, mild), step symmetry (longer, shorter, symmetrical) and fall risk (Dynamic Gait Index (DGI) 19 and DGI >19).
from Whittle’s Gait Analysis E-Book by David Levine, Jim Richards, Michael W. Whittle Elsevier Health Sciences, 2012
Primary criteria initially proposed for the diagnosis of FRDA included progressive gait ataxia without remission, dysarthria, loss of joint position sense in the lower limbs, muscle weakness, deep tendon areflexia in the lower limbs, and onset before the age of 20 years.
from Encyclopedia of Movement Disorders by Katie Kompoliti, Leonard Verhagen Elsevier Science, 2010
In mild cases, only a Trendelenburg gait is found – characteristic dipping of the pelvis towards the leg that is off the ground.
from A System of Orthopaedic Medicine E-Book by Ludwig Ombregt Elsevier Health Sciences, 2013
Ten years after the onset of the disease, pronounced gait abnormalities are present in both the LGMD2B and the Miyoshi myopathy phenotypes; the foot leaves the ground with a double flexion of the knee and the hip.
from Swaiman’s Pediatric Neurology E-Book: Principles and Practice by Kenneth F. Swaiman, Stephen Ashwal, et. al. Elsevier Health Sciences, 2011
Gait differences between individuals with post-stroke hemiparesis and non-disabled controls at matched speeds.
from Stroke Recovery and Rehabilitation by Richard L. Harvey, MD, Richard F. Macko, MD, et. al. Springer Publishing Company, 2008
Anatomical factors that cause an increased tension of the ITB, predisposing to the development of the disease, are the varus knee, the excessive internal rotation of the tibia, and the foot pronation during running (Rougraff et al. 1996).
from Muscle and Tendon Injuries: Evaluation and Management by Gian Luigi Canata, Pieter d’Hooghe, Kenneth J. Hunt Springer Berlin Heidelberg, 2017
Trendelenburg gait is characterized by an inability to sustain a level pelvis during the stance phase of the gait cycle.
from Surgery of the Hip E-Book by Daniel J. Berry, Jay Lieberman Elsevier Health Sciences, 2012