• 대한물리의학회지
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• 제10권1호
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• pp.71-82
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• 2015

PURPOSE: The aim of this study is to compare changes in the thickness of the gluteus medius muscle fiber between chronic low back pain(clbp) with gluteus medius weakness and healthy subject. METHODS: Ultrasound imaging was used to measure in the thickness of each fiber of the gluteus medius muscle based on maximal muscle contraction during abduction motion of the hip joint in a healthy group (11 subjects) and a chronic CLBP group (21 subjects). An independent t-test was performed to analyze the difference of thickness in each fiber of the gluteus medius muscle and the rate of changes in the fibers in the two groups. RESULTS: The fiber thickness changes in the gluteus medius muscle were significantly lower for the posterior fiber in the CLBP group compared to the healthy group (p<0.01). The changes in rate of difference of thickness the posterior part of the gluteus medius muscle was significantly lower in the CLBP group than in the healthy group (p<0.05). CONCLUSION: The findings of this study CLBP patients with weakness of the gluteus medius muscle that lower for the posterior fiber's difference of thickness and rate of change in the CLBP group compared to the healthy group. Indicate that rehabilitation of CLBP patients with weakness of the gluteus medius muscle should consider the functions of posterior fiber of the gluteus medius muscle.

• 대한물리의학회지
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• 제12권3호
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• pp.59-66
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• 2017

PURPOSE: This study was to evaluate the muscle activity of gluteus medius, tensor fascia latae, and quadratus lumborum during side-lying abduction exercise in various pelvic tilting positions. METHODS: We measured the activity of three muscles in three pelvic tilt positions for 17 normal subjects with performing the side-lying hip abduction. Three pelvic tilt positions were posterior tilt, neutral tilt and anterior tilt. We used the mean value after participants performed the hip abduction three times each position. RESULTS: The activity of gluteus medius within three pelvic positions showed the highest activity in pelvic posterior tilt position and the lowest in pelvic neutral tilt position (p = .04). The activity of tensor fascia latae showed the lowest in pelvic posterior tilt position and the highest in pelvic posterior tilt position (p = .00). The activity of quadratus lumborum revealed the lowest activity in pelvic neutral tilt position and the highest in pelvic anterior tilt position (p = .00). The activity of selective gluteus medius activation according to pelvic displacement showed the highest activity in pelvic neutral tilt position and lowest in pelvic anterior tilt position (p = .00). CONCLUSION: Hip abduction with Pelvic posterior tilt position may be effective in increasing gluteus medius and may be effective in strengthening exercise program for the gluteus medius. In addition, Hip abduction with pelvic neutral position may have an effect on the selective gluteus medius, which is considered to be effective in the exercise program for muscle reeducation training of the gluteus medius.

• 한국전문물리치료학회지
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• 제18권3호
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• pp.67-75
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• 2011

The purpose of this study was to assess the agreement of manual muscle testing (MMT) and test-retest reliability of a hand held dynamometer for the posterior gluteus medius muscle, with and without lumbar stabilization, using a pressure biofeedback unit for patients with low back pain. The pressure biofeedback unit was used to minimize the substitute motion of the lumbopelvic region during hip abduction in patients lying on their side. Fifteen patients with low back pain participated in this study. A tester determined the MMT grades of the posterior gluteus medius with and without the pressure biofeedback unit. Active hip abduction range of motion with an inclinometer and the strength of their posterior gluteus medius using a hand held dynamometer were measured with and without the pressure biofeedback unit in the MMT position. The agreement of the grade of muscle strength in the MMT, and intra-rater reliability of both the active hip abduction range of motion and the strength of posterior gluteus medius were analyzed using the weighted kappa and intraclass correlation coefficient (ICC), respectively. The agreement of MMT with the pressure biofeedback unit (weighted kappa=.92) was higher than the MMT (weighted kappa=.34)(p<.05). The inclinometer with pressure biofeedback unit measurement of the active hip abduction range of motion had an excellent intra-rater reliability (ICC=.90). Also, the hand held dynamometer with pressure biofeedback unit measure of strength of the posterior gluteus medius had a good intra-rater reliability (ICC=.85). Therefore, the test for muscle strength with pressure biofeedback unit will be a reliable method for the determination of the MMT grades or amount of posterior gluteus medius muscle strength and the measurement of the range of motion for hip abduction in patients with low back pain.

• 대한통합의학회지
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• 제2권3호
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• pp.57-63
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• 2014

Purpose : The purpose of this study was to identify the muscle activity of leg during stair down in the subjects with flatfoot and normal foot. Methods : The fourteen subjects with the flatfoot group and the fifteen subjects with the normal foot group volunteered for this study. All subjects descended the stairs that the height was 20cm and consisted 25 stairs. The target muscles for recording muscle activity were posterior fiber of gluteus medius, vastus medialis and vastus lateralis oblique, semitendinosus and biceps femoris, tibialis anterior, and medial and lateral fiber of gastrocnemius muscles. The muscle activity was recorded using the wireless EMG system. Results : The flatfoot group had significantly lower the muscle activity of posterior fiber of gluteus medius than the normal foot group in stance phase during stair down(p<.05). The flatfoot group had significantly higher the muscle activity of biceps femoris and tibialis anterior than the normal foot group in swing phase during stair down(p<.05). Conclusions : This study proposed that the subject with flatfoot should train the strengthening exercise for posterior fiber of gluteus medius.

• Korean Journal of Acupuncture
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• 제25권4호
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• pp.17-29
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• 2008

Objectives : This study was carried out to investigate the correlation of meridian system in oriental medicine and muscular system in western medicine. Methods : Muscles were assigned to meridians by their main functions and the acupoints on them. New mutual relationships between meridians in lower limb were studied based on the muscular function. Results : In gluteal & femoral region, iliopsoas & quadratus femoris are assigned to spleen & stomach meridians, gluteus maximus & hamstrings to urinary bladder & kidney meridians, adductor muscle groups to liver meridian, gluteus medius & minimus & iliotibial tract to gall bladder meridian. In crural region, anterior crural muscles are assigned to stomach meridian, lateral crural muscles to gall bladder meridian, suferficial posterior crural muscles to urinary bladder (& kidney) meridian, deep posterior crural muscles to liver, spleen, kidney meridians. In lower limb, urinary bladder meridian and stomach meridian lead the muscular functions and correspond to each other, while spleen meridian assists stomach meridian, and kidney meridian assists urinary bladder meridian. Conclusions : Muscles may be assigned to meridians by their functions and the acupoints on them. From the view of muscular function, Yang meridians lead Yin meridians in lower limb.

• 한국전문물리치료학회지
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• 제23권2호
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• pp.67-74
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• 2016

Background: Lumbar stabilization (LS) improve the thickness of the quadratus lumborum (QL) muscle and muscle activity of the gluteus medius (GM) muscle during hip abduction in a side-lying position in patients with low back pain (LBP). Objects: The purpose of this study was to assess the effects of LS on muscle thickness of QL and muscle activity of GM during hip abduction in side-lying in patients with LBP. Methods: The study included 32 patients with LBP, who were randomly divided into the control group and experimental group, each with 16 patients. All subjects performed $35^{\circ}$ preferred hip abduction (control group) and $35^{\circ}$ hip abduction with LS (experimental group) during side-lying. An ultrasonography and a surface electromyography were used to measure the thickness of the QL muscle, and the muscle activities of the GM muscle respectively. Independent t-test was used to compare the muscle thickness of the QL and the muscle activity of the GM muscle, respectively. Results: Anterio-posterior diameter in the muscle thickness of QL muscle was decreased significantly in hip abduction with LS more than in preferred hip abduction (p<.001), but medio-lateral diameter in the muscle thickness of QL muscle was not significantly different between in preferred hip abduction and in hip abduction with LS (p=.06). The muscle activity of GM was increased significantly in hip abduction with LS more than in preferred hip abduction (p<.001). Conclusion: These findings suggest that hip abduction with LS could be recommended as a hip abduction for LS and a prevention unwanted compensatory pelvic lateral tilting movement.

• 한국전문물리치료학회지
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• 제30권1호
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• pp.68-77
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• 2023

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.

• 한국전문물리치료학회지
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• 제17권4호
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• pp.1-7
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• 2010

The aim of this study was to investigate the effects of lumbar stabilization on both trunk and lower limb muscle activity and center of pressure (COP) in single leg standing. Surface electromyography (EMG) was used to collect muscle activity data, the mean velocity of COP was measured using a force plate, and a pressure biofeedback unit was used for lumbar stabilization training. The findings of this study are summarized as follows: 1) The EMG activity of the erector spinae decreased significantly and the activity of the rectus abdominis, internal oblique, external oblique, gluteus maximus, and gluteus medius increased significantly with lumbar stabilization single leg standing. 2) No differences in activity in the tibialis anterior, medial gastrocnemius, rectus femoris, and medial hamstrings were found with single leg standing. 3) The mean velocity of COP in the antero-posterior and medio-lateral directions in the lumbar stabilization single leg standing decreased significantly compared with the preferred single leg standing. The findings of this study therefore indicate that lumbar stabilization can facilitate the co-activation of deep stabilization and global muscles that improve postural control capability during single leg standing.

• 척추신경추나의학회지
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• 제5권2호
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• pp.9-16
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• 2010

Objectives : This study is planned to classify different biomechanics of men and women, from the comparison of normal range and hip internal rotation angle in chronic low back pain patients. Methods : We measured the hip internal rotation angle of the 30 men and 30 women patients with low back pain that has been over 3 months in BuCheon Jaseng Hospital of Oriental medicine. We set 35-45 degrees as normal range, and found the patients with exceeding normal range, the patients with normal range, and the patients with under normal range. Results : Men appeared to have less hip internal rotation angle than women. Especially, the men's left hip internal rotation angle was less than normal range. On the other hand, women's right hip internal rotation angle was often larger than normal range which was stastically significant. Conclusions : Contraction of hip external rotation muscle including gluteus maxius muscle and piriformis muscle in men, or relaxation of posterior gluteus medius, gluteus maxius and piriformis muscle with contraction of tensor fasciae latae, a part of hip internal rotation muscle, in women seems to be the basis for biomechanics of chronic low back pain.

• 대한물리의학회지
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• 제13권4호
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• pp.131-138
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• 2018

PURPOSE: This study was conducted to compare the muscle activity of the proximal muscles of the lower limb according to the distance between the front and rear foot during lunge and to determine the most effective foot position for activation of the proximal muscle in the limb. METHODS: A total of 49 young adults were enrolled in this study. All subjects performed lunge by positioning the big toe of the back foot and the heel of the front foot at intervals of 40%, 60%, and 80% of the subject's own leg length. Muscle activity of the vastus medialis oblique, rectus femoris (RF), vastus lateralis oblique (VLO), gluteus medius, biceps femoris, and semitendinosus (ST) was then measured during three intervals of lunge operation. Each operation was measured three times for 10 seconds each, after which the average value was calculated and analyzed. RESULTS: There were significant differences in muscle activities of RF, VLO, and ST among the three intervals of the foot (p<.05). Post hoc, comparisons revealed lunge at 40% intervals resulted in higher RF and VLO activity than at 60% and 80% intervals (p<.05). In the semitendinosus muscle, 80% leg length intervals showed higher muscle activity than 40% (p<.05). CONCLUSION: Strengthening of the proximal muscles of the lower extremities during lunge exercise is considered to be most effective when placing the fore- and rear foot at intervals corresponding to 40% of the leg length.