한국전문물리치료학회지 (Physical Therapy Korea)

  • 제30권1호
  • /
  • Pages.68-77
  • /
  • 2023
  • /
  • 1225-8962(pISSN)
  • /
  • 2287-982X(eISSN)
한국전문물리치료학회 (Korean Research Society of Physical Therapy)
권호 표지
DOI QR코드

DOI QR Code

The Application of Thera-band on Non-weight Bearing Leg Influence Hip Abductor Activities During Pelvic Drop Exercise in Patients With Gluteus Medius Weakness

  • Su-hwan Cha (Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Seok-hyun Kim (Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Seung-min Baik (Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Heon-seock Cynn (Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University)
  • 투고 : 2022.11.17
  • 심사 : 2022.12.22
  • 발행 : 2023.02.20
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: The weakness of the gluteus medius (GM) is associated with various musculoskeletal disorders. The increasing GM activity without synergistic dominance should be considered when prescribing pelvic drop exercise (PD). Isometric hip extension or flexion of the non-weight bearing leg using thera-band at the ankle during PD may influence hip abductor activities. Objects: To determine how isometric hip extension or flexion of the non-weight bearing leg using thera-band at the ankle during PD influences the activities of three subdivisions of GM (anterior, GMa; middle, GMm; posterior, GMp), tensor fasciae latae (TFL), contralateral quadratus lumborum (QL), and GMp/TFL, GMm/QL activity ratios in patients with GM weakness. Methods: Twenty-three patients with GM weakness were recruited. Three types of PD were performed: PD, PD with an isometric hip extension of the non-weight bearing leg (PDE), and PD with an isometric hip flexion of the non-weight bearing leg (PDF). Surface electromyography (SEMG) was used to measure hip abductor activities. One-way repeated-measures analysis of variance was used to assess the statistical significance of muscle activities and muscle activity ratios. Results: GMa, GMm, and GMp activities were significantly greater during PDF than during PD and PDE (p < 0.001, p = 0.001; p = 0.001, p = 0.005; p = 0.004, p = 0.004; respectively). TFL activity was significantly greater during PDE than during PD and PDF (p < 0.001, p < 0.001, respectively). QL activity was significantly greater during PDF than during PD (p = 0.003). GMp/TFL activity ratio was significantly lower during PDE than during PD and PDF (p = 0.001, p = 0.001, respectively). There were no significant differences in the GMm/QL activity ratio. Conclusion: PDF may be an effective exercise to increase the activities of all three GM subdivisions while minimizing the TFL activity in patients with GM weakness.

키워드

참고문헌

  1. Al-Hayani A. The functional anatomy of hip abductors. Folia Morphol (Warsz) 2009;68(2):98-103. 
  2. Gottschalk F, Kourosh S, Leveau B. The functional anatomy of tensor fasciae latae and gluteus medius and minimus. J Anat 1989;166:179-89. 
  3. Standring S. Gray's Anatomy, 39th edition: the anatomical basis of clinical practice. AJNR Am J Neuroradiol 2005;26(10):2703-4. 
  4. Beckman SM, Buchanan TS. Ankle inversion injury and hypermobility: effect on hip and ankle muscle electromyography onset latency. Arch Phys Med Rehabil 1995;76(12):1138-43.  https://doi.org/10.1016/S0003-9993(95)80123-5
  5. Lewis CL, Foley HD, Lee TS, Berry JW. Hip-muscle activity in men and women during resisted side stepping with different band positions. J Athl Train 2018;53(11):1071-81.  https://doi.org/10.4085/1062-6050-46-16
  6. Earl JE. Gluteus medius activity during 3 variations of isometric single-leg stance. J Sport Rehabil 2005;14(1):1-11.  https://doi.org/10.1123/jsr.14.1.1
  7. Piran RJ, Babakhani F, Balochi R, Hatefi M. The effect of isometric hip external rotation on lower extremity muscles activities during pelvic drop with different positions of the hip rotation in subjects with and without genu valgum: controlled laboratory study. Res Sq 2022. [Epub]. https://doi.org/10.21203/rs.3.rs-1216844/v1. 
  8. Schmitz RJ, Riemann BL, Thompson T. Gluteus medius activity during isometric closed-chain hip rotation. J Sport Rehabil 2002;11(3):179-88.  https://doi.org/10.1123/jsr.11.3.179
  9. O'Dwyer C, Sainsbury D, O'Sullivan K. Gluteus medius muscle activation during isometric muscle contractions. J Sport Rehabil 2011;20(2):174-86.  https://doi.org/10.1123/jsr.20.2.174
  10. O'Sullivan K, Smith SM, Sainsbury D. Electromyographic analysis of the three subdivisions of gluteus medius during weight-bearing exercises. Sports Med Arthrosc Rehabil Ther Technol 2010;2:17. 
  11. Ju SK, Yoo WG. Electromyographic analysis of gluteus medius subdivisions during hip abductor strengthening exercises. Isokinet Exerc Sci 2016;24(2):91-8.  https://doi.org/10.3233/IES-150605
  12. McCurdy K, O'Kelley E, Kutz M, Langford G, Ernest J, Torres M. Comparison of lower extremity EMG between the 2-leg squat and modified single-leg squat in female athletes. J Sport Rehabil 2010;19(1):57-70.  https://doi.org/10.1123/jsr.19.1.57
  13. Han HR, Yi CH, You SH, Cynn HS, Lim OB, Son JI. Comparative effects of 4 single-leg squat exercises in subjects with gluteus medius weakness. J Sport Rehabil 2018;27(6):513-9.  https://doi.org/10.1123/jsr.2016-0193
  14. Monteiro RL, Facchini JH, de Freitas DG, Callegari B, Joao SM. Hip rotations' influence of electromyographic activity of gluteus medius muscle during pelvic-drop exercise. J Sport Rehabil 2017;26(1):65-71.  https://doi.org/10.1123/jsr.2015-0097
  15. Reiman MP, Bolgla LA, Loudon JK. A literature review of studies evaluating gluteus maximus and gluteus medius activation during rehabilitation exercises. Physiother Theory Pract 2012;28(4):257-68.  https://doi.org/10.3109/09593985.2011.604981
  16. Cools AM, Dewitte V, Lanszweert F, Notebaert D, Roets A, Soetens B, et al. Rehabilitation of scapular muscle balance: which exercises to prescribe? Am J Sports Med 2007;35(10):1744-51.  https://doi.org/10.1177/0363546507303560
  17. Anwer S, Jeelani SI, Khan SA, Quddus N, Kalra S, Alghadir AH. Effects of TheraBand and Theratube eccentric exercises on quadriceps muscle strength and muscle mass in young adults. Biomed Res Int 2021;2021:5560144. 
  18. Ayotte NW, Stetts DM, Keenan G, Greenway EH. Electromyographical analysis of selected lower extremity muscles during 5 unilateral weight-bearing exercises. J Orthop Sports Phys Ther 2007;37(2):48-55.  https://doi.org/10.2519/jospt.2007.2354
  19. Fredericson M, White JJ, Macmahon JM, Andriacchi TP. Quantitative analysis of the relative effectiveness of 3 iliotibial band stretches. Arch Phys Med Rehabil 2002;83(5):589-92.  https://doi.org/10.1053/apmr.2002.31606
  20. Kendall FP, McCreary EK, Provance PG, Rodgers MM, Romani WA. Muscles: testing and function with posture and pain. Baltimore (MD): Lippincott Williams & Wilkins; 2005. 
  21. Troiano RP, Flegal KM. Overweight children and adolescents: description, epidemiology, and demographics. Pediatrics 1998;101(3 Pt 2):497-504.  https://doi.org/10.1542/peds.101.S2.497
  22. Cooper NA, Scavo KM, Strickland KJ, Tipayamongkol N, Nicholson JD, Bewyer DC, et al. Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. Eur Spine J 2016;25(4):1258-65.  https://doi.org/10.1007/s00586-015-4027-6
  23. Park KM, Cynn HS, Choung SD. Musculoskeletal predictors of movement quality for the forward step-down test in asymptomatic women. J Orthop Sports Phys Ther 2013;43(7):504-10.  https://doi.org/10.2519/jospt.2013.4073
  24. Bolgla L, Cook N, Hogarth K, Scott J, West C. Trunk and hip electromyographic activity during single leg squat exercises do sex differences exist? Int J Sports Phys Ther 2014;9(6):756-64. 
  25. Decker MJ, Hintermeister RA, Faber KJ, Hawkins RJ. Serratus anterior muscle activity during selected rehabilitation exercises. Am J Sports Med 1999;27(6):784-91.  https://doi.org/10.1177/03635465990270061601
  26. Criswell E. Cram's introduction to surface electromyography. Sudbury (MA): Jones & Bartlett Publishers; 2010. 
  27. Letafatkar A, Hatefi M, Babakhani F, Abbaszadeh Ghanati H, Wallace B. The influence of hip rotations on muscle activity during unilateral weight-bearing exercises in individuals with and without genu varum: a cross-sectional study. Phys Ther Sport 2020;43:224-9.  https://doi.org/10.1016/j.ptsp.2020.03.009
  28. Soderberg GL, Knutson LM. A guide for use and interpretation of kinesiologic electromyographic data. Phys Ther 2000;80(5):485-98.  https://doi.org/10.1093/ptj/80.5.485
  29. Nakagawa TH, Moriya ET, Maciel CD, Serrao FV. Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single-leg squat in males and females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther 2012;42(6):491-501.  https://doi.org/10.2519/jospt.2012.3987
  30. Neumann DA. Kinesiology of the hip: a focus on muscular actions. J Orthop Sports Phys Ther 2010;40(2):82-94.  https://doi.org/10.2519/jospt.2010.3025
  31. Youdas JW, Adams KE, Bertucci JE, Brooks KJ, Nelson MM, Hollman JH. Muscle activation levels of the gluteus maximus and medius during standing hip-joint strengthening exercises using elastic-tubing resistance. J Sport Rehabil 2014;23(1):1-11.  https://doi.org/10.1123/JSR.2012-0082
  32. Youdas JW, Adams KE, Bertucci JE, Brooks KJ, Steiner MM, Hollman JH. Magnitudes of gluteus medius muscle activation during standing hip joint movements in spiral-diagonal patterns using elastic tubing resistance. Physiother Theory Pract 2015;31(6):410-7.  https://doi.org/10.3109/09593985.2015.1004769
  33. Andersson EA, Grundstrom H, Thorstensson A. Diverging intramuscular activity patterns in back and abdominal muscles during trunk rotation. Spine (Phila Pa 1976) 2002;27(6):E152-60.  https://doi.org/10.1097/00007632-200203150-00014
  34. Park RJ, Tsao H, Cresswell AG, Hodges PW. Anticipatory postural activity of the deep trunk muscles differs between anatomical regions based on their mechanical advantage. Neuroscience.2014;261:161-72.  https://doi.org/10.1016/j.neuroscience.2013.12.037
  35. Phillips S, Mercer S, Bogduk N. Anatomy and biomechanics of quadratus lumborum. Proc Inst Mech Eng H 2008;222(2):151-9.  https://doi.org/10.1243/09544119JEIM266
  36. Park RJ, Tsao H, Cresswell AG, Hodges PW. Differential activity of regions of the psoas major and quadratus lumborum during submaximal isometric trunk efforts. J Orthop Res 2012;30(2):311-8. https://doi.org/10.1002/jor.21499