Effect of Hip Flexion and Internal Rotation on the Hip Abductor Muscle Activity During Side-Lying Hip Abduction in Subjects With Gluteus Medius Weakness원문보기
Background: Many previous studies recommended the side-lying hip abduction (SHA) exercise for targeting the gluteus medius (Gmed) and gluteus maximus (Gmax) muscle activity while the decreasing tensor fasciae latae (TFL) activation. Mischoice of hip position and angle in SHA may increase the risk of...
Background: Many previous studies recommended the side-lying hip abduction (SHA) exercise for targeting the gluteus medius (Gmed) and gluteus maximus (Gmax) muscle activity while the decreasing tensor fasciae latae (TFL) activation. Mischoice of hip position and angle in SHA may increase the risk of lower extremity injuries and undesirable muscle activation. However, information is limited on the effect of composite hip flexion angles and hip rotation on the gluteal muscle activity during SHA. Objects: This study aimed to compare muscle activity (Gmed, TFL, and Gmax) and activity ratios (Gmed/TFL, Gmax/TFL, and Gmed/Gmax) using surface electromyography (EMG) during SHA exercise at three different hip flexion angles either with or without internal rotation (IR) in subjects with Gmed weakness. We hypothesized that applying hip flexion and IR during SHA would increase gluteal muscle activity and decrease TFL activity. Methods: Muscle activity and activity ratios in 20 volunteers with Gmed weakness during 6 different SHA were investigated with surface EMG. One-way repeated-measures analysis of variance was used to determine the statistical significance. Results: Significant differences were found among the six different exercises for Gmed ($F_{2,41}=11.817$, p<.001) and Gmax ($F_{3,52}=5.513$, p=.003) muscle activity, and Gmed/TFL ($F_{3,54}=8.735$, p<.001) and Gmax/TFL ($F_{2,37}=4.019$, p=.028) activity ratios. Conclusion: Applying hip flexion is an effective method for increasing gluteal activity, and it elicits great Gmed/TFL and Gmax/TFL activity ratios during SHA in subjects with Gmed weakness.
Background: Many previous studies recommended the side-lying hip abduction (SHA) exercise for targeting the gluteus medius (Gmed) and gluteus maximus (Gmax) muscle activity while the decreasing tensor fasciae latae (TFL) activation. Mischoice of hip position and angle in SHA may increase the risk of lower extremity injuries and undesirable muscle activation. However, information is limited on the effect of composite hip flexion angles and hip rotation on the gluteal muscle activity during SHA. Objects: This study aimed to compare muscle activity (Gmed, TFL, and Gmax) and activity ratios (Gmed/TFL, Gmax/TFL, and Gmed/Gmax) using surface electromyography (EMG) during SHA exercise at three different hip flexion angles either with or without internal rotation (IR) in subjects with Gmed weakness. We hypothesized that applying hip flexion and IR during SHA would increase gluteal muscle activity and decrease TFL activity. Methods: Muscle activity and activity ratios in 20 volunteers with Gmed weakness during 6 different SHA were investigated with surface EMG. One-way repeated-measures analysis of variance was used to determine the statistical significance. Results: Significant differences were found among the six different exercises for Gmed ($F_{2,41}=11.817$, p<.001) and Gmax ($F_{3,52}=5.513$, p=.003) muscle activity, and Gmed/TFL ($F_{3,54}=8.735$, p<.001) and Gmax/TFL ($F_{2,37}=4.019$, p=.028) activity ratios. Conclusion: Applying hip flexion is an effective method for increasing gluteal activity, and it elicits great Gmed/TFL and Gmax/TFL activity ratios during SHA in subjects with Gmed weakness.
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문제 정의
This study investigated the effect of varying hip FLX angles and IR on hip abductor activity during SHA in subjects with Gmed weakness. The Gmed and Gmax activity and the Gmed/TFL and Gmax/TFL ratios with hip FLX at 15° or 30° were significantly greater than at 0° regardless of IR.
These results partially supported our research hypotheses. To our knowledge, this study is the first to examine the effect of FLX angles and IR on hip abductor activity during SHA.
가설 설정
Particularly, we sought to ascertain which position could best activate the gluteal muscles. We hypothesized that applying hip FLX and IR during SHA would increase gluteal muscle activity and decrease TFL activity.
제안 방법
This study has several limitations. First, this work is a cross-sectional study. Longitudinal studies are warranted to determine the long-term effect of hip FLX and IR on hip abductor activity during SHA.
One-way repeated-measures analysis of variance was used to test the differences in the EMG activity (Gmed, TFL, and Gmax) and activity ratios (Gmed/TFL, Gmax/TFL, and Gmed/Gmax) among the six different exercises (SHA-NF 0, 15, and 30 and SHA-IRF 0, 15, and 30). The statistical significance level was set to α=.
The subjects were asked to internally rotate the hip as far as possible, flex it at 15° or 30° until it is close to the reference bar, and perform SHA (Figure 1D).
Moreover, we could not confirm any study considering SHA with FLX and IR together. This study aimed to compare Gmed, TFL, and Gmax muscle activity and activity ratios (Gmed/TFL, Gmax/TFL and Gmed/Gmax) using surface EMG during SHA exercise at three different FLX angles either with or without IR in subjects with Gmed weakness. Particularly, we sought to ascertain which position could best activate the gluteal muscles.
This study measured the Gmed, TFL, and Gmax muscle activity and the Gmed/TFL, Gmax/TFL, and Gmed/Gmax muscle activity ratios to demonstrate the effect of varying hip FLX angles and IR during SHA on subjects with Gmed weakness. The Gmed and Gmax activity and the Gmed/TFL and Gmax/TFL activity ratios with hip FLX at 15° or 30° during SHA were significantly greater than those at 0° regardless of IR.
To perform these exercises, the subjects were positioned in the same way as in SHA-NF 0 and asked to flex test hip at 15° or 30° in each exercise, respectively, before starting the SHA.
대상 데이터
2, Franz Faul, University of Kiel, Kiel, Germany). A total of 86 subjects took the manual muscle testing (MMT) to determine Gmed weakness, and 20 subjects (6 males and 14 females) voluntarily participated in this study. Through MMT by Kendall’s muscle grading, the subjects that were graded 3/5 or less were considered to have Gmed weakness (Bewyer et al, 2009; Kendall et al, 2005).
Surface EMG (TeleMyo DTS, Noraxon Inc., Scottsdale, AZ, USA) with a wireless telemetry system was used. Disposable bipolar electrodes (Ag/AgCl) were adhered with a 2 ㎝ inter-electrode distance after skin preparation to reducing skin impedance (Cram et al, 1998).
데이터처리
(CI: confidence interval, Gmed: gluteus medius, TFL: tensor fasciae latae, Gmax: gluteus maximus, NF 0, 15, and 30: side-lying hip abduction with neutral hip and flexion 0°, 15°, and 30°, IRF 0, 15, and 30: side-lying hip abduction with hip internal rotation and flexion 0°, 15°, and 30°), *denoted a significant difference on one-way repeated-measures analysis of variance with Holm-Bonferroni method.
성능/효과
But the results could not make sure that these were caused by hip IR or FLX. Although no statistical difference was found, most of the average values during SHA-IRF (except Gmax activity and Gmax/TFL ratio during SHA-IRF 15 and 30) tended to increase compared with those during SHA-NF in terms of each FLX angle. According to previous studies, an increment in hip FLX increases IR and causes a potential switching of the moment arm of the gluteal muscles (Delp et al, 1999; Neumann, 2010).
The Gmed and Gmax activity and the Gmed/TFL and Gmax/TFL ratios with hip FLX at 15° or 30° were significantly greater than at 0° regardless of IR. The findings revealed that the application of SHA-F could increase the gluteal activity and activity ratios to the TFL. These results partially supported our research hypotheses.
The gluteal activity and activity ratios of Gmed/TFL and Gmax/TFL during SHA-IRF 15 or 30 significantly increased compared with those during SHA-IRF 0 and were similar to those during SHA-NF except the Gmax/TFL ratio during SHA-IRF 15. The average value of Gmax/TFL ratio during SHA-IRF 15 (.
The TFL is primary hip abductor (Gottschalk et al, 1989). There were no statistical significances of the TFL activity among the SHA-F 0, 15, and 30, however the activity ratios of Gmed/TFL and Gmax/TFL during SHA-F significantly increased. Although we did not compare contribution levels of each muscle among 6 SHA exercises, our results clearly show that the TFL was activated to a lesser extent than the Gmed or Gmax.
후속연구
Finally, This study compared gluteal muscle activity during SHA; however, we could not ensure that applying hip FLX is an effective method to induce gluteal activation in a closed chain position. Future research should compare the effect of hip FLX and IR on the hip abductor activity between open chain and closed chain exercises.
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