On the Adduction Drop Test Positioning
One of my colleagues has started the Myokinematic Restoration home study course and we were discussing some of the testing. One question that came up was: Why are we putting the patient in the start position with the bottom leg in hip and knee flexion for the Adduction Drop Test?
The ADT is a modified version of an Ober’s test. The original test was described in 1935 (Dr. Frank Ober) as a means to correlate back pain and hip mobility. The Ober Test is taught differently now in PT curricula as a test for IT band tightness, but that is an erroneous interpretation of the intent of the test.
Putting the patient in a flexed position to start satisfies a couple of purposes. First, it helps the patient feel stable (balanced) and therefore they aren’t actively working to hold themselves steady while you are trying to move them (better able to rest when at rest). More importanty, it clears the bottom leg out of the way to test true adduction. From a PRI perspective, the ADT is a key test for determining an AIC pattern. A Left AIC pattern is a position of right stance / left swing or right hip straight / left hip flexed and is caused by an overactive chain of muscles on the front of the left side of the lower body (from the diaphragm down). A Left AIC patterned individual will have difficulty with proper left stance and right swing and when you test the left side you are placing their FAs into the L stance/R swing positions. If the Left AIC musculature will not let go (cannot be inhibited), then the patient will not be able to passively adduct their leg (as a result of bony limitation (reference Myokinematic Restoration manual)). - Josh Olinick, DPT, MS, PRC