In the last course I was in, when the speaker did before and after repeats of the Hruska Adduction Lift Test, I saw a significant compensation when going from level 1 to 2 and then 2 to a level 3. In other words, he would give someone a score of 3 or more after repositioning or applying a certain exercise, yet I would still observe them roll their pelvis back or trunk forward when attempting to lift from their original level 1 to 2. Basically, I wouldn’t see much improvement from before to after. Are we looking more at degree in which they need to compensate? Example….did they not need to roll their pelvis back as far as the first time? Where he would have given a score of 3 or 4, I still would have seen them at no more than a level 1.
The Hruska Adduction Lift Test allows for a small amount of pelvic and torso associated movement, but it should not be excessive. I’ve never seen the full home study course videos but I was the one doing the testing, so the best I can do is just share my thoughts and guidelines for test scoring. If they’ve moved out of left AF IR during level 2 testing into a position at the hips and pelvis that more represents left AF ER, then obviously they have compensated much more than they should have. We want to watch their movements closely and help them coordinate the correct sequence of movements without very much compensation. Having said so, we have to be a little bit flexible or we may never allow anybody to score past a 0 or a 1. I like your eye for detail and specificity, but know that a little bit of shifting or rotating may need to be allowed in order to see how how well they can integrate the progressive steps of the test. Whatever you do, be consistent and try to see in each step you test the appropriate phase of the gait cycle. I hope some of these thoughts are helpful.
- James Anderson, MPT, PRC