• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.39-45
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• 2019

PURPOSE: We investigated the most effective way to activate the posterior oblique sling muscles by performing prone hip extension exercises. METHODS: An electromyography system was used to measure the activation of the posterior oblique sling muscles (latissimus dorsi, gluteus maximus, multifidus, and biceps femoris) in three different prone hip extension exercises of in 12 healthy individuals (6 men and 6 women): 1) prone hip extension, 2) prone hip extension with internal rotation and extension of the arm, and 3) prone hip extension with internal rotation and extension of the arm with a 1-Ib dumbbell. RESULTS: The overall muscular activation of the posterior oblique sling muscles was more increased when performing 1) prone hip extension with internal rotation and 2) prone hip extension with internal rotation and extension of the arm with a 1-Ib dumbbell as compared with that during prone hip extension except for the biceps femoris activation. There was a statistically significant difference in the activities of the contralateral multifidi among all three exercises; of the ipsilateral multifidi in PHE1) prone hip extension alone, PHE2) prone hip extension with internal rotation and extension of the arm and PHE3) prone hip extension with internal rotation and extension of the arm with 1-Ib dumbbell; and of the ipsilateral gluteus maximus among all the prone hip extension exercises. There was no significant difference in the activity of the biceps femoris among the three exercises. CONCLUSION: Prone hip extension with internal rotation and with internal rotation and extension of the arm with 1-Ib dumbbell can activate the posterior oblique sling muscles and so prevent back pain in healthy people.

• The Journal of Korean Physical Therapy
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• v.35 no.1
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• pp.13-18
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• 2023

Purpose: The purpose of this study was to investigate the effects of posterior oblique sling activation on the muscle activities of the gluteus maximus (GM), multifidus (MF), and biceps femoris (BF) during three different prone hip extension exercises in healthy male individuals. Methods: Twenty healthy subjects participated in this study. An electromyography device was used to measure the muscle activities of the GM, MF, and BF. Each subject was asked to perform three different prone hip extensions as follows: [1) Prone hip extension with knee flexion + hip abduction 30°; PHE1, 2) Prone hip extension with knee flexion + hip abduction 30° and shoulder abduction 125°; PHE2, 3) Prone hip extension with knee flexion + hip abduction 30° and shoulder abduction 125° with 1kg loading; PHE3, in random order. A one-way repeated measures analysis of the variance and a Bonferroni post hoc test were used to analyze the results. The statistical significance was set at α=0.01. Results: The muscle activity of the GM was significantly different between the three positions (P_adj<0.01). The muscle activity of the GM was significantly greater during PHE3 compared with PHE1 and PHE2 (P_adj<0.01). The BF muscle activity was significantly lower during PHE3 compared with PHE1 and PHE2 (P_adj< 0.01). There was no significant difference in the muscle activity of the MF (P_adj<0.01). The ratio of the muscle activity (ratio=GM/BF) during PHE3 was significantly greater compared to PHE1 and PHE2 (P_adj< 0.01). Conclusion: The GM activity and GM/BF ratio during the PHE3 exercise were significantly greater compared to that during PHE1 and PHE2. Therefore, the PHE3 exercise could be recommended as a selectively effective GM activation exercise while decreasing the muscle activity of the BF.

• The Journal of Korean Physical Therapy
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• v.32 no.5
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• pp.295-301
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• 2020

Purpose: The purpose of this study was to compare the electromyographic activity and onset time of the gluteus maximus (GM) and hamstring (HAM), lumbopelvic kinematics during three different prone table hip extension exercises in healthy individuals. Methods: Twenty subjects were participated. Electromyography device was used to measure the muscle activities and onset time of the GM and HAM muscles. An electromagnetic tracking motion device was used to measure lumbopelvic compensations. The subjects were asked to perform three different prone table hip extension [Prone table hip extension with the abdominal drawing-in maneuver on a chair (PTHEA), PTHEA with the ipsilateral knee flexion (PTHEAF), PTHEAF with hip 30 abduction (PTHEAFA)]. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Results: The electromyographic activity and onset time were significantly different among three conditions (PTHEA vs. PTHEAF vs. PTHEAFA)(p<0.01). The GM muscle activity and onset time were significantly greater and reduced during the PTHEAFA compared to PTHEA and PTHEAF (p<0.01). However, The HAM muscle activity and onset time were significantly smaller and delayed during the PTHEAFA compared to PTHEA and PTHEAF (p<0.01). Conclusions: PTHEAFA exercise can be recommended to facilitate the muscle activity and efficient muscle firing time of GM without HAM dominance.

• Physical Therapy Korea
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• v.18 no.3
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• pp.1-7
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• 2011

The effects of an abdominal drawing-in maneuver (ADIM) using a pressure bio-feedback unit (PBFU) were compared to the effects of a pelvic belt (PB) on the muscle activities of the hip and back extensor muscles during hip extension in the prone position. Fifteen healthy male participants all performed prone hip extensions under three conditions: 1) preferred hip extension (PHE), 2) performing an ADIM, and 3) using a PB. The muscle activities of the erector spinae, the gluteus maximus, and the medial hamstring on the right side were recorded by surface electromyography. The muscle activity of the erector spinae was significantly lower while performing an ADIM during prone hip extension than during PHE or with a PB (p<.05). Gluteus maximus muscle activity was significantly higher while performing an ADIM (p<.05). No significant difference was found for the medial hamstring muscle among the three conditions (p>.05). We concluded that the internal stabilization of the pelvis and lumbar spine afforded by the ADIM using a PBFU could be more effective than the external stabilization provided by a PB in terms of increasing selectively gluteus maximus activation during prone hip extension.

• PNF and Movement
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• v.17 no.2
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• pp.293-302
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• 2019

Purpose: The purpose of this study was to investigate the effects of plank exercises involving the contraction of the adductor muscle of the hip joint on core muscle thickness and to propose an effective plank exercise method. Methods: A total of 30 healthy young adults (17 males, 13 females) voluntarily participated in the study. The subjects were randomized to the prone plank exercise with hip adductor contraction (n=10), the prone plank exercise (n=10), and the supine plank exercise (n=10) groups. Muscle thickness measurements were taken prior to starting the exercise program and after completing the program at the end of a 4-week period. The muscle thickness of the rectus abdominis (RA), multifidus (MF), external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) muscles were measured using ultrasonography. Each group performed the stipulated plank exercise five times a week as follows: 5 sets of 20 seconds during the first week, 5 sets of 30 seconds in the second week, 5 sets of 40 seconds in the third week, and 5 sets of 40 seconds in the last week. Results: The three different types of plank exercises all showed significantly increased thickness of the RA, MF, EO, IO, and TrA (P<0.05). Furthermore, changes in the thickness of both the MF and TrA were statistically more significant in the groups that did the prone plank exercise with the hip adductor contraction and the supine plank exercise than in the prone plank exercise group (P<0.05). Conclusion: The study results suggest that the prone plank exercise with hip adductor contraction is a more effective method for overall activation of the RA, MF, EO, IO, and TrA than the prone plank exercise and the supine plank exercise.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.123-129
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• 2018

PURPOSE: This study was conducted to investigate the influence of hip abduction angle on the muscle activity of the Gluteus Maximus (GM), Biceps Femoris (BF) and Tensor Fascia Lata (TFL) during Knee Flexed Prone Hip Extension exercise. METHODS: The subjects of this study were 42 healthy individuals. All participant consented to participate in this study. Subjects performed exercise, using the Knee Flexed Prone Hip Extension exercise in three hip abduction position $0^{\circ}$, $15^{\circ}$ and $30^{\circ}$. Subjects rested two minutes, between changing hip abduction position. Data were analyzed using a Noraxon MR-XP 1.08 Master Edition EMG to determine average amplitude, for each angle and muscle. All data were processed by Multivariate analysis of variance (MANOVA). There were a total of three groups. the GM muscle, BF muscle, TFL muscle. RESULTS: GM muscle activity was greatest in the $30^{\circ}$ hip abduction position (p<.05), followed by $0^{\circ}$. Between $0^{\circ}$ and $30^{\circ}$ has significant difference in muscle activity. However, the BF and TFL amplitude were greatest at $0^{\circ}$ hip abduction position followed by $30^{\circ}$. Moreover, the TFL differed significantly between $0^{\circ}$ and $30^{\circ}$, but, BF did not (p<.05). CONCLUSION: Hip abduction at $30^{\circ}$ was found to be the most appropriate position for GM muscle activity.

• Physical Therapy Korea
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• v.13 no.4
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• pp.56-63
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• 2006

This study examined the effects of the abdominal drawing-in (ADI) maneuver using a pressure biofeedback on muscle recruitment pattern of erector spinae and hip extensors and anterior pelvic tilt during hip extension in the prone position. Fourteen able-bodied volunteers, who had no medical history of lower extremity or lumbar spine disease, were recruited for this study. The muscle onset time of erector spinae, gluteus maximus, and medial hamstring and angle of anterior pelvic tilt during hip extension in prone position were measured in two conditions: ADI maneuver condition and non-ADI maneuver condition. Muscle onset time was measured using a surface electromyography (EMG). Kinematic data for angle of anterior pelvic tilt were measured using a motion analysis system. The muscle onset time and angle of anterior pelvic tilt were compared using a paired t-test. The study showed that in ADI maneuver during hip extension in prone position, the muscle onset time for the erector spinae was delayed significantly by a mean of 43.20 ms (SD 43.12), and the onset time for the gluteus maximus preceded significantly by a mean of -4.83 ms (SD 14.10) compared to non-ADI maneuver condition (p<.05). The angle of anterior pelvic tilt was significantly lower in the ADI maneuver condition by a mean of 7.03 degrees (SD 2.59) compared to non-ADI maneuver condition (15.01 degrees) (p<.05). The findings of this study indicated that prone hip extension with the ADI maneuver was an effective method to recruit the gluteus maximus earlier than erector spinae and to decrease anterior pelvic tilting.

• Physical Therapy Korea
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• v.21 no.3
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• pp.1-10
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• 2014

The aim of this study was to investigate the effect of hip external rotation angle on pelvis and lower limb muscle activity during prone hip extension. Sixteen healthy men were recruited for this study. Each subject performed an abdominal drawing-in maneuver (ADIM) in a prone position, and extended the dominant hip at three different hip external rotation angles ($0^{\circ}$, $20^{\circ}$, $40^{\circ}$) with a $30^{\circ}$ hip joint abduction. Activity of the gluteus maximus (G Max), gluteus medius (G Med), and hamstring (HAM) and the G Max/HAM and G Med/HAM ratios were determined with surface electromyography (EMG). The EMG signal was normalized to 100% maximum voluntary isometric contractions (MVICs) and expressed as %MVIC. Data were analyzed by one-way repeated analysis of variance (alpha level=.05) and the Bonferroni post hoc test. Significant differences in G Max and G Med muscle activity were noted among the three different hip external rotation angles. G Max muscle activity increased significantly at both $40^{\circ}$ (p=.006) and $20^{\circ}$ (p=.010) compared to a $0^{\circ}$ hip external rotation angle. G Med muscle activity increased significantly at $20^{\circ}$ (p=.013) compared to a $40^{\circ}$ hip external rotation angle. The G Max/HAM activity ratio increased significantly at both $40^{\circ}$ (p=.004) and $20^{\circ}$ (p=.014) compared to a $0^{\circ}$ hip external rotation angle. The G Med/HAM activity ratio increased significantly at $20^{\circ}$ (p=.013) compared to a $40^{\circ}$ hip external rotation angle. In conclusion, $40^{\circ}$ and $20^{\circ}$ hip external rotation angles are recommended to increase G Max activity, and $20^{\circ}$ hip external rotation is advocated to enhance G Med muscle activity during prone hip extension with ADIM and $30^{\circ}$ hip abduction in healthy subjects.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.29-37
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• 2019

PURPOSE: Prone hip extension (PHE) has been used for assessment of lumbo-pelvic movement and strengthening exercise for weakness of the hip joint muscles in patients with chronic low back pain (CLBP). On the other hand, few studies have examined which are the best PHE exercises to activate the gluteus maximus (GM) selectively in physical therapy practice. To aim of this study compared the muscle activity of the GM, rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA) during these four different prone hip extensions, PHE, PHE with quadriceps activation (PHEQA), PHE with ankle dorsiflexion (PHEAD), and PHE with ankle plantarflexion (PHEAP), in subjects with CLBP. METHODS: Nineteen subjects with low back pain participated in this study. Subject performed four PHE exercises and surface electromyography (EMG) was used to evaluate the muscle activity. Data were analyzed by one-way repeated-measures analysis of variance (${\alpha}=.05/3=.017$) and a Bonferroni adjustment was performed if a significant difference was found. RESULTS: The muscle activities recorded by EMG showed significant among the four exercises. The muscle activity of the GM increased significantly during PHEQA than during PHEAP (P=.012). CONCLUSION: PHEQA is the most effective exercise for eliciting greater GM muscle activation among the four PHE exercises in subjects with CLBP.

• PNF and Movement
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• v.18 no.3
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• pp.375-382
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• 2020

Purpose: The purpose of this study was to investigate the muscle contraction onset time characteristics of the gluteus maximus, semitendinosus, and biceps femoris muscles at different knee flexion angles in individuals with shortened or over-lengthened hamstrings performing prone hip extension. Methods: Twenty-six participants were divided into a hamstring shortened group (n = 12) and hamstring lengthened group (n = 14). Wireless surface electromyography was used to verify the muscle onset time of the gluteus maximus, semitendinosus, and biceps femoris when performing prone hip extension at different knee flexion angles. Results: There were significant differences in the muscle onset times of the semitendinosus and biceps femoris between the hamstring shortened group and hamstring lengthened group (p < 0.05). In addition, there was a significant difference in the muscle contraction onset times among of the gluteus maximus, semitendinosus, and biceps femoris muscles when performing prone hip extension at a knee flexion of 90° in the hamstring shortened group (p < 0.05) and a knee flexion angle of 0° in the hamstring lengthened group (p < 0.05). Conclusion: In all groups, there was no effect on the onset time of the gluteus maximus muscle according based on the knee angle. In addition, the knee flexion angles affected the onset time of the muscle contraction of the gluteus maximus muscle in the hamstring shortened group and hamstring lengthened group with an abnormal length of the hamstring muscle.