No Difference in Gluteus Medius Activation in Women With Mild Patellofemoral Pain

2012 ◽  
Vol 21 (2) ◽  
pp. 110-118 ◽  
Author(s):  
Kieran O’Sullivan ◽  
Ellen Herbert ◽  
David Sainsbury ◽  
Karen McCreesh ◽  
Amanda Clifford
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Muscle Activation ◽  
Weight Bearing ◽  
Pain Syndrome ◽  
Gluteus Medius ◽  
Patellofemoral Pain ◽  
Stair Climbing ◽  
Convenience Sample ◽  
Healthy Participants

Context:The gluteus medius (Gmed) is proposed to consist of 3 functional subdivisions (anterior, middle, and posterior). Gmed weakness and dysfunction have been implicated in numerous lower extremity disorders, including patellofemoral pain syndrome (PFPS). PFPS is a knee condition that frequently occurs in females and is associated with activities such as squatting and stair climbing. There is a lack of evidence for the role of the subdivisions of the Gmed in females with and without PFPS.Objective:To compare muscle activation in the 3 Gmed subdivisions during 4 weight-bearing exercises in women with and without PFPS.Design:Single-session, repeated-measures observational study.Setting:University research laboratory.Participants:Convenience sample of 12 women with PFPS and 12 age- and gender-matched asymptomatic controls.Intervention:Participants performed 4 weight-bearing exercises (wall press, pelvic drop, step-up-and-over, and unilateral squat) 3 times while surface electromyography (sEMG) activity of the Gmed segments was recorded.Main Outcome Measures:sEMG muscle activity for each functional subdivision of the Gmed during each weight-bearing exercise was analyzed using a mixed between–within-subjects ANOVA (post hoc Bonferroni).Results:No statistically significant differences in muscle activation were found between the PFPS and healthy participants (P = .97). Furthermore, there were no statistically significant differences between the exercises (P = .19) or muscle fibers (P = .36) independent of group analyzed. However, the activation of the subdivisions varied according to the exercise performed (P = .003).Conclusions:Similar levels of muscle activation were recorded in the Gmed subdivisions of the PFPS and healthy participants during the different exercises. This is the first study to examine all 3 Gmed subdivisions in PFPS. Future studies using larger sample sizes should also investigate onset and duration of muscle activation in all Gmed subdivisions in both healthy individuals and those with PFPS.

Muscle Activation Levels of the Gluteus Maximus and Medius During Standing Hip-Joint-Strengthening Exercises Using Elastic-Tubing Resistance

2014 ◽  
Vol 23 (1) ◽  
pp. 1-11 ◽  
Author(s):  
James W. Youdas ◽  
Kady E. Adams ◽  
John E. Bertucci ◽  
Koel J. Brooks ◽  
Meghan M. Nelson ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Outcome Measures ◽  
Hip Joint ◽  
Repeated Measures ◽  
Muscle Activation ◽  
Gluteus Maximus ◽  
Gluteus Medius ◽  
Muscle Recruitment ◽  
Gluteus Medius Muscle ◽  
The Cross

Context:No published studies have compared muscle activation levels simultaneously for the gluteus maximus and medius muscles of stance and moving limbs during standing hip-joint strengthening while using elastic-tubing resistance.Objective:To quantify activation levels bilaterally of the gluteus maximus and medius during resisted lower-extremity standing exercises using elastic tubing for the cross-over, reverse cross-over, front-pull, and back-pull exercise conditions.Design:Repeated measures.Setting:Laboratory.Participants:26 active and healthy people, 13 men (25 ± 3 y) and 13 women (24 ± 1 y).Intervention:Subjects completed 3 consecutive repetitions of lower-extremity exercises in random order.Main Outcome Measures:Surface electromyographic (EMG) signals were normalized to peak activity in the maximum voluntary isometric contraction (MVIC) trial and expressed as a percentage. Magnitudes of EMG recruitment were analyzed with a 2 × 4 repeated-measures ANOVA for each muscle (α = .05).Results:For the gluteus maximus an interaction between exercise and limb factor was significant (F3,75 = 21.5; P < .001). The moving-limb gluteus maximus was activated more than the stance limb's during the back-pull exercise (P < .001), and moving-limb gluteus maximus muscle recruitment was greater for the back-pull exercise than for the cross-over, reverse cross-over, and front-pull exercises (P < .001). For the gluteus medius an interaction between exercise and limb factor was significant (F3,75 = 3.7; P < .03). Gluteus medius muscle recruitment (% MVIC) was greater in the stance limb than moving limb when performing the front-pull exercise (P < .001). Moving-limb gluteus medius muscle recruitment was greater for the reverse cross-over exercise than for the cross-over, front-pull, and back-pull exercises (P < .001).Conclusions:From a clinical standpoint there is no therapeutic benefit to selectively activate the gluteus maximus and gluteus medius muscles on the stance limb by resisting sagittal- and frontal-plane hip movements on the moving limb using resistance supplied by elastic tubing.

scholarly journals Gluteus Medius Muscle Activation During Isometric Muscle Contractions

2011 ◽  
Vol 20 (2) ◽  
pp. 174-186 ◽  
Author(s):  
Catriona O’Dwyer ◽  
David Sainsbury ◽  
Kieran O’Sullivan
Keyword(s):  
Internal Rotation ◽  
Outcome Measures ◽  
Lower Limb ◽  
Repeated Measures ◽  
Muscle Activation ◽  
External Rotation ◽  
Gluteus Medius ◽  
Isometric Contractions ◽  
Main Effect

Context:Functional subdivisions are proposed to exist in the gluteus medius (GM) muscle. Dysfunction of the GM, in particular its functional subdivisions, is commonly implicated in lower limb pathologies. However, there is a lack of empirical evidence examining the role of the subdivisions of the GM.Objectives:To compare the activation of the functional subdivisions of the GM (anterior, middle, and posterior) during isometric hip contractions.Design:Single-session, repeated-measures observational study.Setting:University research laboratory.Participants:Convenience sample of 15 healthy, pain-free subjects.Intervention:Subjects performed 3 maximal voluntary isometric contractions for hip abduction and internal and external rotation on an isokinetic dynamometer with simultaneous recording of surface electromyography (sEMG) activity of the GM subdivisions.Main Outcome Measures:sEMG muscle activity for each functional subdivision of the GM during each hip movement was analyzed using a 1-way repeated-measures ANOVA (post hoc Bonferroni).Results:The response of GM subdivisions during the 3 different isometric contractions was significantly different (interaction effect; P = .003). The anterior GM displayed significantly higher activation across all 3 isometric contractions than the middle and posterior subdivisions (main effect; both P < .001). The middle GM also demonstrated significantly higher activation than the posterior GM across all 3 isometric contractions (main effect; P = .027). There was also significantly higher activation of all 3 subdivisions during both abduction and internal rotation than during external rotation (main effect; both P < .001).Conclusions:The existence of functional subdivisions in the GM appears to be supported by the findings. Muscle activation was not homogeneous throughout the entire muscle. The highest GM activation was found in the anterior GM subdivision and during abduction and internal rotation. Future studies should examine the role of GM functional subdivisions in subjects with lower limb pathologies.

Effects of Different Hip Rotations on Gluteus Medius and Tensor Fasciae Latae Muscle Activity During Isometric Side-Lying Hip Abduction

2013 ◽  
Vol 22 (4) ◽  
pp. 301-307 ◽  
Author(s):  
Ji-hyun Lee ◽  
Heon-seock Cynn ◽  
Sil-ah Choi ◽  
Tae-lim Yoon ◽  
Hyo-jung Jeong
Keyword(s):  
Outcome Measures ◽  
Analysis Of Variance ◽  
Muscle Activity ◽  
Repeated Measures ◽  
Muscle Activation ◽  
Activity Ratio ◽  
Gluteus Medius ◽  
Repeated Measures Analysis ◽  
Hip Abduction ◽  
Tensor Fasciae Latae

Context:Gluteus medius (Gmed) weakness is associated with some lower-extremity injuries. People with Gmed weakness might compensate by activating the tensor fasciae latae (TFL). Different hip rotations in the transverse plane may affect Gmed and TFL muscle activity during isometric side-lying hip abduction (SHA).Objectives:To compare Gmed and TFL muscle activity and the Gmed:TFL muscle-activity ratio during SHA exercise with 3 different hip rotations.Design:The effects of different hip rotations on Gmed, TFL, and the Gmed:TFL muscle-activity ratio during isometric SHA were analyzed with 1-way, repeated-measures analysis of variance.Setting:University research laboratory.Participants:20 healthy university students were recruited in this study.Interventions:Participants performed isometric SHA: frontal SHA with neutral hip (frontal SHAN), frontal SHA with hip medial rotation (frontal SHA-MR), and frontal SHA with hip lateral rotation (frontal SHA-LR).Main Outcome Measures:Surface electromyography measured the activity of the Gmed and the TFL. A 1-way repeated-measures analysis of variance assessed the statistical significance of Gmed and TFL muscle activity. When there was a significant difference, a Bonferroni adjustment was performed.Results:Frontal SHA-MR showed significantly greater Gmed muscle activation than frontal SHA-N (P = .000) or frontal SHA-LR (P = .015). Frontal SHA-LR showed significantly greater TFL muscle activation than frontal SHA-N (P = .002). Frontal SHA-MR also resulted in a significantly greater Gmed:TFL muscle-activity ratio than frontal SHA-N (P = .004) or frontal SHA-LR (P = .000), and frontal SHA-N was significantly greater than frontal SHA-LR (P = .000).Conclusions:Frontal SHA-MR results in greater Gmed muscle activation and a higher Gmed:TFL muscle ratio.

scholarly journals Lower Extremity Strength and Mechanics during Jumping in Women with Patellofemoral Pain

2009 ◽  
Vol 18 (1) ◽  
pp. 76-90 ◽  
Author(s):  
John D. Willson ◽  
Irene S. Davis
Keyword(s):  
Lower Extremity ◽  
Outcome Measures ◽  
External Rotation ◽  
Weight Bearing ◽  
Pain Syndrome ◽  
Knee Extension ◽  
Patellofemoral Pain ◽  
Control Group ◽  
Trunk Flexion ◽  
Hip Abduction

Context:Lower extremity (LE) weakness might be associated with altered mechanics during weight bearing in subjects with patellofemoral pain syndrome (PFPS).Objective:To analyze LE strength, mechanics, and the association between these variables among women with and without PFPS during a simulated athletic task.Design:Case control.Setting:Motion-analysis laboratory.Subjects:20 women with PFPS and 20 healthy women.Main Outcome Measures:Peak isometric lateral trunk-flexion, hip-abduction, hip external-rotation, knee-flexion, and knee-extension strength, as well as hip- and knee-joint excursions and angular impulses during single-leg jumps.Results:PFPS subjects produced less hip-abduction, hip external-rotation, and trunk lateral-flexion force than the control group. The PFPS group also demonstrated greater hip-adduction excursion and hip-abduction impulses. The association between the strength measurements and LE mechanics was low.Conclusions:Women with PFPS demonstrate specific weaknesses and altered LE mechanics. Weakness is not, however, highly correlated with observed differences in mechanics.

The Effectiveness of Exercise in Treating Patellofemoral-Pain Syndrome

2004 ◽  
Vol 13 (4) ◽  
pp. 323-342 ◽  
Author(s):  
Janice Kaye Loudon ◽  
Byron Gajewski ◽  
Heather L. Goist-Foley ◽  
Karen Lee Loudon
Keyword(s):  
Physical Therapy ◽  
Outcome Measures ◽  
Statistical Difference ◽  
Weight Bearing ◽  
Exercise Program ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Home Exercise ◽  
Analog Scale

Objective:To determine the effect of exercise on patients with patellofemoral-pain syndrome (PFPS).Patients:29 subjects with unilateral PFPS, assigned to control, home-exercise (HE), or physical therapy (PT) group.Intervention:8-wk exercise program.Main Outcome Measures:A knee survey, visual analog scale (VAS), and 5 weight-bearing tests.Results:MANOVA indicated an overall statistical difference between groups (P< .05). The HE and PT groups experienced less pain than control, and PT experienced less pain than HE (P< .05). In overall knee function and most weight-bearing tests, HE and PT were stronger and more functional than control (P< .05). For anteromedial lunge only PT was stronger and more functional than control (P< .05).Conclusions:Intervention helps PFPS, but there appear to be no differences between home and in-clinic interventions.

Patterns of Dynamic Malalignment, Muscle Activation, Joint Motion, and Patellofemoral-Pain Syndrome

2005 ◽  
Vol 14 (3) ◽  
pp. 216-233 ◽  
Author(s):  
Jennifer E. Earl ◽  
Jay Hertel ◽  
Craig R. Denegar
Keyword(s):  
Discriminant Function ◽  
Muscle Activation ◽  
Onset Time ◽  
Pain Syndrome ◽  
Gluteus Medius ◽  
Patellofemoral Pain ◽  
Iliotibial Band ◽  
Lower Extremity Function ◽  
Predictive Variables ◽  
Multifactorial Approach

Context:Dynamic malalignment (DM), abnormal muscle activation, and static malalignments all might lead to patellofemoral pain (PFP) but have not been examined using a multifactorial approach.Objective:To determine which measures of static malalignment, DM, and muscle-onset times best predict PFP.Design and Setting:Between-subjects, laboratory.Subjects:2 groups (PFP and uninjured) of 16 subjects each.Interventions:EMG and 3-D kinematic data were recorded during a step-down. Five static-alignment assessments were performed.Measurements:Three discriminant analyses using injury as the grouping variable and static measures, joint angles, and EMG onsets as the predictor variables. A final combined discriminant analysis using the most predictive variables from each set.Results:The static-alignment discriminant function was most predictive (81.3% correct), followed by the kinematic (69%) and the EMG (67%) functions. The final discriminant function included iliotibial-band flexibility, navicular drop, pronation, knee flexion, hip adduction, gluteus medius, and vastus medialis obliquus onset time and correctly classified 92.3% of PFP subjects.Conclusions:PFP can most accurately be predicted when multiple measures of lower extremity function are considered together.

Hip-Abduction Torque and Muscle Activation in People With Low Back Pain

2015 ◽  
Vol 24 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Mark A. Sutherlin ◽  
Joseph M. Hart
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Muscle Function ◽  
Muscle Activation ◽  
Low Back ◽  
Hip Muscle ◽  
Hip Abduction ◽  
History Of

Context:Individuals with a history of low back pain (LBP) may present with decreased hip-abduction strength and increased trunk or gluteus maximus (GMax) fatigability. However, the effect of hip-abduction exercise on hip-muscle function has not been previously reported.Objective:To compare hip-abduction torque and muscle activation of the hip, thigh, and trunk between individuals with and without a history of LBP during repeated bouts of side-lying hip-abduction exercise.Design:Repeated measures.Setting:Clinical laboratory.Participants:12 individuals with a history of LBP and 12 controls.Intervention:Repeated 30-s hip-abduction contractions.Main Outcome Measures:Hip-abduction torque, normalized root-mean-squared (RMS) muscle activation, percent RMS muscle activation, and forward general linear regression.Results:Hip-abduction torque reduced in all participants as a result of exercise (1.57 ± 0.36 Nm/kg, 1.12 ± 0.36 Nm/kg; P < .001), but there were no group differences (F = 0.129, P = .723) or group-by-time interactions (F = 1.098, P = .358). All participants had increased GMax activation during the first bout of exercise (0.96 ± 1.00, 1.18 ± 1.03; P = .038). Individuals with a history of LBP had significantly greater GMax activation at multiple points during repeated exercise (P < .05) and a significantly lower percent of muscle activation for the GMax (P = .050) at the start of the third bout of exercise and for the biceps femoris (P = .039) at the end of exercise. The gluteal muscles best predicted hip-abduction torque in controls, while no consistent muscles were identified for individuals with a history of LBP.Conclusions:Hip-abduction torque decreased in all individuals after hip-abduction exercise, although individuals with a history of LBP had increased GMax activation during exercise. Gluteal muscle activity explained hip-abduction torque in healthy individuals but not in those with a history of LBP. Alterations in hip-muscle function may exist in individuals with a history of LBP.

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