Is it possible to get a 3/5 or greater on the Hruska Adduction Lift Test on patients who are not repositioned.
That would not be possible for a patient lying on their left side (Right Adduction Lift Test) for the Left AIC or true PEC patient because the left side of the pelvis is truly out of position to attain adduction and IR needed to get past a 2/5. But a patient lying on their right side (Left Adduction Lift Test) could get a 3/5 because the right side of the pelvis is not out of position to attain adduction and IR and although the left adductors would be in a long state, they could still lift the hips off the table to move from a 2 to a 3. This would not be true for a PEC with both sides of the pelvis positioned forward with both hips in some ER, but it would be true for the standard Left AIC (left pelvis forward and right pelvis back).
The exhale activity I demonstrated is an attempt to factor out their strong tendancy to cheat with their back during testing (yielding false negatives for compensatory activity, or higher scores than they were actually able to get with just their hip musculature). It doesn’t reposition the pelvis or fully shut off the AIC, but it allows the leverage deficits present because of the AIC to stand out without compensation from the back extensors. In other words, just blowing out is not going to allow a patient lying on their left side to get to a 3/5. They are going to need to get fully repositioned, demonstrate left AF IR strength and left FA IR strength with the appropriate musculature during left FA adduction before they employ the opposite adductor to left their pelvis in order to actually get a true 3/5. Just blowing out cannot afford all of that for a patient lying on their left side (although it may be possible for a patient lying on their right side because their right pelvis is not forward like the left and the right hip is positioned in more of an adducted and IR state).
James Anderson, MPT, PRC
