1. For walking to occur, the locomotor system must be able to support body weight, maintain balance, advance the swinging leg for support, and provide power for limb movements. 2. Abnormal movements may occur due to weakness, spasticity, or compensation. Trendelenburg gait involves bending the trunk toward the supporting limb and is used to reduce forces in the abductor muscles and hip joint. 3. Trendelenburg gait can be caused by painful hip, abductor weakness, abnormal hip joint, wide base, unequal leg length, and other factors, and is differentiated from other gait patterns through observation and testing.

1. IN ORDER FOR A PERSON TO WALK, THE LOCOMOTOR SYSTEM MUST BE ABLE TO ACCOMPLISH
FOUR THINGS
1. Each leg in turn must be able to support the body weight without collapsing
2. Balance must be maintained, either statically or dynamically, during single leg stance
3.The swinging leg must be able to advance to a position where it can take over the supporting
role
4. Sufficient power must be provided to make the necessary limb movements and to advance the
trunk.

2. WHAT IS LIMP
Some degree of asymmetry

3. ABNORMAL MOVEMENT MAY BE PERFORMED FOR ONE OF TWO REASONS
1. The subject has no choice, the movement being ‘forced’ on them by weakness, spasticity or
deformity
2. The movement is a compensation, which the subject is using to correct for some other
problem, which therefore needs to be identified.

4. TRENDELENBURGGAIT

5. BENDING THE TRUNK TOWARDS THE SIDE OF THE SUPPORTING LIMB
DURING THE STANCE PHASE IS KNOWN AS LATERAL TRUNK
BENDING, IPSILATERAL LEAN OR, MORE COMMONLY, A
TRENDELENBURG GAIT.
THEPURPOSE OF THEMANEUVER ISGENERALLY TOREDUCE THEFORCES IN THEABDUCTOR MUSCLES AND
HIP JOINT DURING SINGLELEGSTANCE.

6. THE FOUR CONDITIONS WHICH MUST BE MET
1. The absence of significant pain on loading.
2. Adequate power in the hip abductors .
3. A sufficiently long lever arm for the hip abductors.
4. A solid and stable fulcrum in or around the hip joint.

7. NUMBER OF CONDITIONS IN WHICH THIS
GAIT ABNORMALITY IS ADOPTED

8. 1. PAINFUL HIP
2. HIP ABDUCTOR WEAKNESS
3. ABNORMAL HIP JOINT
4. WIDE WALKING BASE
5. UNEQUAL LEG LENGTH
6. OTHER CAUSES

9. PHYSIOTHERAPY

10. DIFFERENTIAL DIAGNOSIS
1. Observation of the patient’s gait from the side enables the examiner to detect stride and step
length deficiencies as well as motion of the trunk and lower extremity in the sagittal plane,
including the extensor or gluteus maximus lurch in which the patient thrusts the trunk
posteriorly to compensate for weak hip extensors (gluteus maximus muscle).
2. Observation from the side also enables detection of ankle dorsiflexor weakness and footdrop
leading to the inability of the foot to clear the ground, which is compensated for by excessive
lower extremity flexion to facilitate the floor clearance (steppage gait).

11. 4. BILATERALWEAKNESS OFTHE GLUTEUSMEDIUS MUSCLE:THE GAIT
SHOWSACCENTUATED SIDE-TO-SIDE MOVEMENT, RESULTING INA
WOBBLING GAIT
TRENDELENBURGGAITMUSTBEDIFFERENTIATEDFROMOTHERGAITPATTERNSINCLUDINGTHE
FOLLOWING:
SHORTLIMBGAIT
ANTALGICGAIT
EXTENSIONLURCHGAIT
HIGHSTEPPINGGAIT
STAMPINGGAIT

12. DIAGNOSIS TEST

13. THE PERSON HAS TO STAND ON ONE LEG.THE TEST IS NEGATIVE WHENTHE
HIP OF THE LEGTHAT IS LIFTED, WILLALSO GO UP , HIKING OF HIP ORTHE
PELVISTILTS UPWARDS.THE TEST IS POSITIVE, WHEN THERE ISADROPOF
THE HIPORADOWNWARDSTILTOFTHE PELVIS. X-RAYIS THE BEST WAYTO
DIAGNOSE OR CONFIRMTHETRENDELENBURGPATHOLOGY.

14. TREATMENT

15. THEMAINFOCUSOFTHETREATMENTAFTERIDENTIFICATIONOFTHEETIOLOGY
INVOLVESCORRECTIONOFTHEETIOLOGICALFACTORRESULTINGINTHE
TRENDELENBURGGAITANDVARIESACCORDINGTOTHEPATHOLOGY.
TRENDELENBURGGAITBYITSELFWEARSTHEHIPJOINT,ANDAPPROPRIATETREATMENT
ISESSENTIAL.

16. • PATIENTSWHO HAVEABDUCTOR WEAKNESSAFTERAN
ARTHROPLASTYREQUIRE SPECIFIC EXERCISESWHICH
INCLUDE:
NON-WEIGHT BEARING STANDINGABDUCTION
WEIGHT-BEARING STANDINGABDUCTION
SIDE-LYINGABDUCTION
RESISTED SIDE-STEPPING EXERCISES

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