Background

The Trendelenburg test has been used to assess hip abductor muscle function. A standardized evaluation of the test requires an assessment of both pelvis and trunk coronal plane alignment as the patient stands on one leg for 30 s. Coronal plane biomechanics using motion analysis allows for development of objective criteria to grade the test response. The aim of this study was to develop biomechanical criteria of the pelvis and trunk coronal plane kinematics.

Methods

The video of 39 subjects with acetabular hip dysplasia performing the test while instrumented with a full-body modified Plug-In-Gait marker set for three-dimensional kinematic analysis, were evaluated by two orthopedic surgeons and one senior level biomechanist. Reviewers as a group assessed whether the subject had a positive test and noted the reason using guidelines outlined in the literature. Coronal plane trunk and pelvic angles of all subjects were analyzed and Receiver Operating Characteristic curves were used to determine optimal kinematic cutoff values for each positive Trendelenburg test reason.

Findings

There were 26/39 patients who reviewers identified as having a positive test. Area under the curve of the receiver operating characteristic curve for trunk and pelvis mean/minimum were greater than 0.75. The curve was used to identify the optimal cut-offs of trunk lean and pelvic obliquity mean/minimum.

Interpretation

The biomechanical criteria developed includes clinically derived coronal plane kinematic cut-offs of the pelvic and trunk angles. The criteria can be used within a motion capture setting for the standardization of the grading of the test response.

中文翻译：

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趋势德伦堡检验的临床衍生生物力学标准。

背景

Trendelenburg测试已用于评估髋外展肌功能。当患者单腿站立30 s时，对测试的标准化评估需要评估骨盆和躯干冠状面的对齐方式。使用运动分析的冠状平面生物力学可以制定客观标准来对测试反应进行评分。这项研究的目的是开发骨盆和躯干冠状平面运动学的生物力学标准。

方法

由两名整形外科医生和一名高级生物力学专家对39名髋臼髋关节发育异常的受试者进行了视频测试，并在他们的全身修饰的“步态”标记集进行三维运动学分析的同时进行了测试。作为一个整体的审阅者评估了受试者是否有阳性测试，并使用文献中概述的指导原则指出了原因。分析所有受试者的冠状面躯干和骨盆角度，并使用接收器工作特征曲线来确定每个正特伦德伦堡试验原因的最佳运动学截止值。

发现

有26/39例经审查者鉴定为阳性的患者。躯干和骨盆平均值/最小值的接收器工作特性曲线的曲线下面积大于0.75。该曲线用于确定躯干倾斜和骨盆倾斜平均/最小值的最佳截止值。

解释

制定的生物力学标准包括临床上得出的骨盆角和躯干角的冠状面运动学截止值。可以在运动捕获设置中使用该标准，以对测试响应的等级进行标准化。