Evaluation of leg muscles
Purpose: The test is carried out to assess the tone of the large and medium gluteal muscles , assess the risk of fall for elderly, as well to assess balance of the body and related symptoms.
Protocol of execution: The patient stands in front of the complex with legs spread shoulder width apart (10 — 12 cm) an his arms positioned along the body. The patients should be asked to stand on one leg, without indicating on which leg and how high the knee should be raised. The patient normally will choose the more stable leg, and other leg will be raised to comfortable height. The test is held for 20 seconds for closed eyes and 40 min for open.
Evaluation of the results: If the centre of gravity has changed its position for more than 10 cm – the test is not passed.
Instability of the posture or active work of the toes of the supporting leg (you can ask to exhale for the test) may indicate instability of the foot or insufficient stability in the supporting leg with possible delay of gluteus maximus muscle.
Rotation of the raised foot or pelvis also indicates on decrease of strength of the gluteus maximus muscle.
Pay attention to the Trendelenburg symptom (i.e. if the pelvis is lowered or raised) – it is symptom of a decrease of strength of the gluteus maximus muscle. In addition to real muscle weakness (due to dystrophy), a positive Trendelenburg symptom is detected at congenital hip dislocation, polio, damage of spinal nerve root (paralysis of the upper gluteal nerve – level L5) or fracture of greater trochanter (distal attachment position of the gluteus medius muscle).
Consider the movement of chest and breathing when performing the test: raising the chest or holding the breath may indicate poor performance of the internal stabilizing subsystem of ISS (consists of 4 muscles: diaphragm, transversal abdominal, multifidus and pelvic floor).
If during the test the patient’s gaze was not straight ahead, it can indicate on a neck trauma (eye muscle fasciculation).