Clam Exercise Research Articles

Effects of differences in femoral anteversion and hip flexion angle on hip abductor muscles activity during clam exercise in females.

This study aimed to determine differences in the hip abductor muscle activity during clam exercise at different hip flexion and femoral anteversion angles. Thirty healthy females were divided into two groups based on the femoral anteversion angle: the excessive femoral anteversion group and the normal group. Clam exercise was performed at three different hip flexion angles (60°, 45°, and 30°). Tensor fascia latae, gluteus medius, and superior portion of gluteus maximus activities were measured during the exercise, and the results were normalized to the activity during maximum voluntary isometric contraction to calculate the gluteal-to-tensor fascia latae muscle activation index. The superior portion of gluteus maximus activities at a hip flexion of 60° and 45° were greater than that at 30°. The excessive femoral anteversion group had a lower gluteal-to-tensor fascia latae muscle activation index than the normal group; the gluteal-to-tensor fascia latae muscle activation index for hip flexion at 60° was higher than that at 45°, and the gluteal-to-tensor fascia latae muscle activation index for hip flexion at 60° and 45° were higher than that at 30°. Therefore, the femoral anteversion angle and hip joint position were related to the activity of the hip abductor muscles during clam exercise. These findings may provide a rationale for instructing exercises to maximize the activity of the hip abductor muscles in individuals with an excessive femoral anteversion angle.

Effect of Manual Resistance and Elastic Band on Muscle Activity of Hip Joint Muscles during Clam Exercise<sup>*</sup>

Effect of Manual Resistance and Elastic Band on Muscle Activity of Hip Joint Muscles during Clam Exercise<sup>*</sup>

Changes in Muscle Activity of Hip Joint Muscles during Clam Exercise after Abdominal Draw-in Exercise in Men with Weak Abdominal Muscles

Changes in Muscle Activity of Hip Joint Muscles during Clam Exercise after Abdominal Draw-in Exercise in Men with Weak Abdominal Muscles

Examination of hip function and muscle activity during clam exercise.

[Purpose] Clam exercise is commonly used to strengthen hip abductor muscles. This study aimed to classify the directions of greater trochanter movement during clam exercise and examine whether this classification reveals any differences in the characteristics of muscle activities. [Participants and Methods] Twenty healthy male participants were included and were divided into three groups according to the direction of greater trochanter movements during clam exercise: diagonally upward, backward, and upward. Muscle activity of the gluteus medius, gluteus maximus, tensor fascia lata, and external oblique was measured during clam exercise, along with the direction of greater trochanter movement and maximum muscle strength in the clam exercise limb position. [Results] In the diagonally upward group, the gluteus medius muscles showed higher activity than the other three muscles, and their activity was higher in the diagonally upward and backward groups than in the upward group. [Conclusion] The tension and action vector of the muscles changed due to differences in the direction of the greater trochanter movement caused by the movement pattern of each participant. The muscle activity around the hip joint changes with the direction of greater trochanter movement during clam exercise.

Comparison of Gluteus Medius and Tensor Fasciae Latae Muscle Activities during Pilates Clam Exercise Variations

The purpose of this study was to compare three clam exercises (clam, modified clam 1, and modified clam 2) used in the Pilates physical fitness system, to examine the activity of the gluteus medius and tensor fascia latae and to determine which of the three exercises maximizes the activity of the gluteus medius while minimizing the activity of the tensor fascia latae. Twenty healthy volunteers participated in this study. Surface electromyography (sEMG) was used to measure the electrical activities of the gluteus medius (GMed) and tensor fascia latae (TFL). This study showed significant differences between GMed and TFL muscle activities according to each of the three clam exercises (p < 0.05). The gluteus medius showed the highest activity during modified clam 2 and the lowest in clam (p < 0.05). Tensor fascia latae showed the lowest activity during clam and the highest in modified clam 2 (p < 0.05). The gluteus medius to tensor fascia latae ratio was the highest in modified clam 1 and the lowest in modified clam 2 (p < 0.05). Therefore, these findings inform clinicians and Pilates instructors that the appropriate exercise to maximize the activity of the gluteus medius while minimizing the activity of the tensor facia latae is modified clam 1.

Effects of pressure biofeedback application location for subjects with lumbar instability on pelvic rotation and hip joint abductor muscle activity during the Clam exercise.

Effects of pressure biofeedback application location for subjects with lumbar instability on pelvic rotation and hip joint abductor muscle activity during the Clam exercise.

The Effects of Clam Exercise on the Trunk Control and Balance of Stroke Patients

Purpose: The purpose of this study was to verify the effect of applying clam exercise on improving trunk control and balance ability in stroke patients. Based on this, we tried to provide clinical information. Methods: In this study, 18 patients with chronic stroke were recruited from a rehabilitation hospital. The patients were divided into two groups: a clam exercise group (9 patients) and a control group (9 patients). After 30 minutes of neuro-development therapy, they performed clam exercise or bridge exercise for 3 weeks, 5 times a week for 30 minutes. A trunk impairment scale (TIS) and a postural assessment scale for stroke patients-trunk control (PASS-TC) were performed to evaluate the subjects’ ability to control trunk before and after intervention. Balance ability was measured by Balancia before and after intervention. Results: After the training periods, area 95% COP and weight distribution of the affected side were significantly different from the clam exercise group compared to the control group (p<0.05). Conclusion: Based on the results of this study, in can be seen that the clam exercise is effective in improving the balance ability compared to the bridge exercise. Maintaining the standing posture requires muscle strength of the hip abduction and extension, which is the result of the clam exercise selectively strengthening these muscles. Therefore, if you want to provide intervention to improve the balance of stroke patients, it is recommended to perform a clam exercise

THE EFFECTS OF PRESSURE BIOFEEDBACK UNIT IN CLAM EXERCISE ON THE WALKING ABILITY OF STROKE PATIENTS

Purpose: The purpose of this study was to compare the walking ability in stroke patients following either clam exercise with pressure biofeedback unit or clam exercise. Thereby identifying which element actually influences changes in walking ability. Methods: Fourteen patients diagnosed with strokes at the rehabilitation hospital in Korea. The subjects were divided into two groups: a feedback group (7 subjects) and a control group (7 subjects). They received 30 minutes of neuro-developmental therapy and clam exercise for 15 minutes, five times a week for three weeks. Walking ability were measured before and after the training period. Walking ability were measured by the Biodex Gait trainer 2 treadmill system. Results: After the training periods, the feedback group showed a significant improvement walking speed and step length of the unaffected side, time on each foot of the affected side (p

Effect of Modified Clamshell Exercise on Gluteus Medius, Quadratus Lumborum and Anterior Hip Flexor in Participants with Gluteus Medius Weakness

PURPOSE: This study compared the effects of three different clamshell exercises (CLAM) on the gluteus medius (GMED), quadratus lumborum (QL), anterior hip flexor (AHF), gluteus medius/quadratus lumborum ratio, and gluteus medius/anterior hip flexor ratio by studying the activities of participants with GMED weakness. METHODS: Eleven subjects with weak GMED participated in this study. Subjects performed CLAM under three different conditions (standard, and modified 1 and 2). Surface electromyography was then used to measure the muscle activity and one-way repeated-measures analysis of variance was used to assess the statistical significance of the measured variables. RESULTS: GMED and the QL muscle activities did not differ significantly between the standard CLAM and the modified CLAM with the 2 different foot positions (F=4.74, P=.02; F=4.57, P=.02, respectively). AHF activity was significantly different in the two different foot positions when compared to the standard CLAM (F=11.17, P=.00). However, there was no significant difference between the AHF activities for the two different foot positions (P=.09). Finally, GMED/QL and GMED/AHF ratios were not significantly different between the three different CLAM exercises (F= .63, P=.55; F=.82, P=.45, respectively). CONCLUSION: Modified CLAM can be recommended as a good method to minimize AHF activity while maintaining GMED activity in subjects with weak GMED.

Electromyographic Analysis of Gluteus Maximus, Gluteus Medius, and Tensor Fascia Latae During Therapeutic Exercises With and Without Elastic Resistance

Strengthening and activation of the gluteus maximus and gluteus medius while minimizing the contribution of the tensor fascia latae are important components in the treatment of many lower limb injuries. Previous researchers have evaluated a myriad of exercises that activate the gluteus maximus (GMax) and gluteus medius (GMed), however, limited research has been performed describing the role of the addition of elastic resistance to commonly used exercises. The primary purpose of this study was to determine the gluteal-to-tensor fascia latae muscle activation (GTA index) and compare electromyographic muscle activation of the GMax, GMed, and TFL while performing 13 commonly prescribed exercises designed to target the GMax and GMed. The secondary purpose of this study was to compare muscle activation of the GMax, GMed, and TFL while performing a subgroup of three matched exercises with and without elastic resistance. Repeated measures cohort study. A sample of 11 healthy, physically active male and females, free of low back pain and lower extremity injuries, were recruited for the study. Surface electromyography was used to quantify the normalized EMG activation of the gluteus maximus, gluteus medius, and tensor fascia latae while performing 13 exercises. Three of these exercises were performed with and without elastic resistance. The maximal voluntary isometric contraction was established for each muscle and order in which the exercises were performed was randomized to minimize the effect of fatigue. The relative activation of the gluteal muscles were compared to the tensor fascia latae and expressed as the GTA index. Clams with and without resistance, running man gluteus maximus exercise on the stability trainer, and bridge with resistance, generated the highest GTA index respectively. Significant differences in activation of the TFL occurred between clams with and without resistance. The findings are consistent with those of previous investigators who reported that the clam exercise optimally activated the gluteal muscles while minimizing tensor fascia latae activation. Level 2b.

Abdominal muscle recruitment and its effect on the activity level of the hip and posterior thigh muscles during therapeutic exercises of the hip joint

Abdominal exercise has been advocated to improve the protection of the spine and neuromuscular efficiency of the limb movements. The purpose of this study was to examine the effect of enhanced contraction of internal oblique and transversus abdominis (IO/TrA) on the activity level of the hip and posterior thigh muscles during therapeutic hip exercises. Twenty healthy females were required to perform eight hip exercises under two conditions, natural versus enhanced IO/TrA contraction conditions. Muscle activity of gluteus maximus, gluteus medius, tensor fasciae latae and biceps femoris of the exercising leg was measured by surface electromyography during hip exercises, and expressed in percentage normalized to the maximal voluntary isometric contraction (%MVIC). The activity levels of the gluteal and posterior thigh muscles recorded under natural and enhanced IO/TrA conditions were compared. IO/TrA was found to have activated at the range of 2.7%-16.1% and 6.3%-24.1% of MVIC when hip exercises were executed under natural and enhanced conditions respectively. Enhanced IO/TrA contraction resulted in significantly greater activity in gluteus maximus, gluteus medius and bicep femoris at various phases of hip extension and clam exercises, single leg sit-to-stand and pelvic drop exercise (increased by 1.7–7.2% of MVIC). These findings indicate the presence of coactivation of the abdominal and hip muscles when performing the free active hip exercises. Further studies are recommended to investigate the efficacy of this muscle coactivation in improving the clinical outcome of therapeutic hip exercises.

The effects of therapeutic hip exercise with abdominal core activation on recruitment of the hip muscles

BackgroundCore stabilization has been utilized for rehabilitation and prevention of lower limb musculoskeletal injuries. Previous studies showed that activation of the abdominal core muscles enhanced the hip muscle activity in hip extension and abduction exercises. However, the lack of the direct measurement and quantification of the activation level of the abdominal core muscles during the execution of the hip exercises affect the level of evidence to substantiate the proposed application of core exercises to promote training and rehabilitation outcome of the hip region. The aim of the present study was to examine the effects of abdominal core activation, which is monitored directly by surface electromyography (EMG), on hip muscle activation while performing different hip exercises, and to explore whether participant characteristics such as gender, physical activity level and contractile properties of muscles, which is assessed by tensiomyography (TMG), have confounding effect to the activation of hip muscles in enhanced core condition.MethodsSurface EMG of bilateral internal obliques (IO), upper gluteus maximus (UGMax), lower gluteus maximus (LGMax), gluteus medius (GMed) and biceps femoris (BF) of dominant leg was recorded in 20 young healthy subjects while performing 3 hip exercises: Clam, side-lying hip abduction (HABD), and prone hip extension (PHE) in 2 conditions: natural core activation (NC) and enhanced core activation (CO). EMG signals normalized to percentage of maximal voluntary isometric contraction (%MVIC) were compared between two core conditions with the threshold of the enhanced abdominal core condition defined as >20%MVIC of IO.ResultsEnhanced abdominal core activation has significantly promoted the activation level of GMed in all phases of clam exercise (P < 0.05), and UGMax in all phases of PHE exercise (P < 0.05), LGMax in eccentric phases of all 3 exercises (P < 0.05), and BF in all phases of all 3 exercises except the eccentric phase of PHE exercise (P < 0.05). The %MVIC of UGMax was significantly higher than that of LGMax in all phases of clam and HABD exercises under both CO and NC conditions (P < 0.001) while the %MVIC of LGMax was significantly higher than UGMax in concentric phase of PHE exercise under NC condition (P = 0.003). Gender, physical activity level and TMG parameters were not major covariates to activation of hip muscles under enhanced core condition.ConclusionsAbdominal core activation enhances the hip muscles recruitment in Clam, HABD and PHE exercises, and this enhancement is correlated with higher physical activity and stiffer hip muscle. Our results suggest the potential application of abdominal core activation for lower limb rehabilitation since the increased activation of target hip muscles may enhance the therapeutic effects of hip strengthening exercises.

Effect of feedback techniques for lower back pain on gluteus maximus and oblique abdominal muscle activity and angle of pelvic rotation during the clam exercise

ObjectivesThis study was conducted in order to determine the effect of feedback tools on activities of the gluteus maximus (Gmax) and oblique abdominal muscles and the angle of pelvic rotation during clam exercise (CE). DesignComparative study using repeated measures. SettingUniversity laboratory. ParticipantsSixteen subjects with lower back pain. Main outcome measuresEach subject performed the CE without feedback, the CE using a pressure biofeedback unit (CE-PBU), and the CE with palpation and visual feedback (CE-PVF). Electromyographic (EMG) activity and the angles of pelvic rotation were measured using surface EMG and a three-dimensional motion-analysis system, respectively. One-way repeated-measures ANOVA followed by the Bonferroni post hoc test were used to compare the EMG activity in each muscle as well as the angle of pelvic rotation during the CE, CE-PBU, and CE-PVF. ResultsThe results of post-hoc testing showed a significantly reduced angle of pelvic rotation and significantly more Gmax EMG activity during the CE-PVF compared with during the CE and CE-PBU. ConclusionThese findings suggest that palpation and visual feedback is effective for activating the Gmax and controlling pelvic rotation during the CE in subjects with lower back pain.

The effect of manipulating root mean square window length and overlap on reliability, inter-individual variability, statistical significance and clinical relevance of electromyograms

Numerous ways exist to process raw electromyograms (EMGs). However, the effect of altering processing methods on peak and mean EMG has seldom been investigated. The aim of this study was to investigate the effect of using different root mean square (RMS) window lengths and overlaps on the amplitude, reliability and inter-individual variability of gluteus maximus EMGs recorded during the clam exercise, and on the statistical significance and clinical relevance of amplitude differences between two exercise conditions. Mean and peak RMS of 10 repetitions from 17 participants were obtained using processing window lengths of 0.01, 0.15, 0.2, 0.25 and 1 s, with no overlap and overlaps of 25, 50 and 75% of window length. The effect of manipulating window length on reliability and inter-individual variability was greater for peak EMG (coefficient of variation [CV] <9%) than for mean EMG (CV <3%), with the 1 s window generally displaying the lowest variability. As a consequence, neither statistical significance nor clinical relevance (effect size [ES]) of mean EMG was affected by manipulation of window length. Statistical significance of peak EMG was more sensitive to changes in window length, with lower p-values generally being recorded for the 1 s window. As use of different window lengths has a greater effect on variability and statistical significance of the peak EMG, then clinicians should use the mean EMG. They should also be aware that use of different numbers of exercise repetitions and participants can have a greater effect on EMG parameters than length of processing window.

The Influence of Varying Hip Angle and Pelvis Position on Muscle Recruitment Patterns of the Hip Abductor Muscles During the Clam Exercise

Within-subject, repeated-measures design. To determine the influence of pelvis position and hip angle on activation of the hip abductors while performing the clam exercise. Therapeutic exercises are regularly employed to strengthen the hip abductors to improve lower-limb and pelvis stability. While previous studies primarily have compared the activity of hip abductor muscles between various exercises, few studies have examined the influence of varying the techniques of particular exercises on the relative activation of hip abductor muscles. Such information could be used to facilitate appropriate exercise instruction. Muscle activation in 17 healthy, asymptomatic volunteers during 6 variations of the clam exercise was analyzed with surface electromyography. Electromyographic signals were recorded from the gluteus maximus, gluteus medius, and tensor fasciae latae. Normalized data were examined using 2-way, repeated-measures analyses of variance. The magnitude of gluteus maximus and gluteus medius activation was significantly greater when the pelvis was in neutral rather than reclined. Furthermore, gluteus medius activation was greatest when the hip was flexed to 60°. Activation of the tensor fasciae latae was not influenced by pelvis position or hip angle. A neutral pelvis position is advocated to optimize recruitment of the gluteus maximus and gluteus medius during the clam exercise. Increasing the hip flexion angle increases activation of the gluteus medius. Tensor fasciae latae activity was relatively low and generally unaffected by variations of the clam exercise.

Rehabilitation Exercise Progression for the Gluteus Medius Muscle with Consideration for Iliopsoas Tendinitis

Background It is common for hip arthroscopy patients to demonstrate significant gluteus medius muscle weakness and concurrent iliopsoas tendinitis. Restoration of gluteus medius muscle function is essential for normal hip function. Hypothesis A progression of hip rehabilitation exercises to strengthen the gluteus medius muscle could be identified that minimize concurrent iliopsoas muscle activation to reduce the risk of developing or aggravating hip flexor tendinitis Study Design Descriptive laboratory study. Methods Electromyography (EMG) signals of the gluteus medius and iliopsoas muscles were recorded from 10 healthy participants during 13 hip rehabilitation exercises. The indwelling fine-wire EMG electrodes were inserted under ultrasound guidance. The average and peak EMG amplitudes, normalized by the peak EMG amplitude elicited during maximum voluntary contractions, were determined and rank-ordered from low to high. The ratio of iliopsoas to gluteus medius muscle activity was calculated for each exercise. Exercises were placed into respective time phases based on average gluteus medius EMG amplitude, except that exercises involving hip rotation were avoided in phase I (phase I, initial 4 or 8 weeks; phase II, subsequent 4 weeks; phase III, final 4 weeks). Results A continuum of hip rehabilitation exercises was identified. Resisted terminal knee extension, resisted knee flexion, and double-leg bridges were identified as appropriate for phase I and resisted hip extension, stool hip rotations, and side-lying hip abduction with wall-sliding for phase II. Hip clam exercises with neutral hips may be used with caution in patients with hip flexor tendinitis. Prone heel squeezes, side-lying hip abduction with internal hip rotation, and single-leg bridges were identified for phase III. Conclusion/Clinical Relevance This study identified the most appropriate hip rehabilitation exercises for each phase to strengthen the gluteus medius muscle after hip arthroscopy and those to avoid when iliopsoas pain or tendinitis is a concern.