When I was a student, I was similarly confused about this, since different
textbooks seemed to contradict.
See the book by Anne Parry (the physio assessment one - can't remember what
it's called but it's small and green and goes through basic assessments). I
think I remember her doing a diagram with:-
a tilt of the pelvis to the non-weightbearing side because of the weakness
of the weightbearing abductors, with a corresponding compensatory lateral
flexion to the weightbearing side.
I think (but don't quote me on this) that the other diagram showed a
compensatory trunk side flexion to the non-weightbearing side (can't
remember why exactly but I assume it might have been another compensatory
method of maintaining pelvic alignment!).
Anyway, she called them both "Trendelenburg gait".
Certainly Palastanga et al's anatomy and movement book explain the
tilting/rotational properties of the glutei on the opposite side of the
pelvis.
In any case, despite the theorising, I know that if you wrote that the
patient had this gait, I would automatically assume you meant they had
reduced lateral control of the pelvis because of hip abductor weakness (also
measured later in the assessment in isolation), despite the goings on in
their trunk!
If your desperate for the title of that Anne Parry book, let me know!
>From: Trew Marion <[log in to unmask]>
>Reply-To: [log in to unmask]
>To: "[log in to unmask]" <[log in to unmask]>
>Subject: Trendelenberg gait
>Date: Tue, 11 Jan 2000 15:20:29 -0000
>
>Dear colleagues
>
>I would value a little help with the definition of Trendelenberg gait.
>According to my medical dictionaries, this gait is caused by weakness of
>gluteus medius and is characterised by a 'listing to the affected side'
>during the stance phase of walking.
>
>In some of these patients however, weakness of the hip abductors can lead
>to
>the opposite movement. The patient's pelvis, when he or she is standing on
>the affected side, drops to the unaffected side. This causes a deviation
>of
>the trunk to the unaffected (non weight-bearing) side.
>
>Is this still classified as a Trendelenberg gait or does it have another
>name? My textbooks don't give me the answer, in fact some of the
>orthopaedic books I looked at contradicted each other.
>
>Regards
>
>Marion Trew
>University of Brighton
>UK
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