Which gait abnormality is classically associated with weakness of the gluteus medius?

Which gait abnormality is classically associated with weakness of the gluteus medius?

• A. Spastic gait
• B. Ataxic gait
• C. Waddling gait
• D. Trendelenburg sign

Answer: (D)

Gluteus medius is a primary hip abductor that keeps the pelvis level during single-leg stance in gait. When this muscle is weak on one side, it can’t hold the pelvis level as that leg bears weight. The result is a drop of the pelvis on the opposite (unloaded) side while standing on the affected leg, and the patient may compensate by leaning the trunk toward the stance leg to try to maintain balance. This pattern is captured clinically as a positive Trendelenburg sign, and the corresponding gait pattern is described as Trendelenburg gait. The other gait patterns reflect different problems (spastic gait from upper motor neuron disease, ataxic gait from cerebellar issues, and waddling gait from bilateral hip girdle weakness) and don’t specifically indicate unilateral gluteus medius weakness.

Gluteus medius is a primary hip abductor that keeps the pelvis level during single-leg stance in gait. When this muscle is weak on one side, it can’t hold the pelvis level as that leg bears weight. The result is a drop of the pelvis on the opposite (unloaded) side while standing on the affected leg, and the patient may compensate by leaning the trunk toward the stance leg to try to maintain balance. This pattern is captured clinically as a positive Trendelenburg sign, and the corresponding gait pattern is described as Trendelenburg gait. The other gait patterns reflect different problems (spastic gait from upper motor neuron disease, ataxic gait from cerebellar issues, and waddling gait from bilateral hip girdle weakness) and don’t specifically indicate unilateral gluteus medius weakness.