Gluteal Activation Research Articles

Does a bounding exercise program prevent hamstring injuries in adult male soccer players? - A cluster-RCT.

BackgroundAlthough the Nordic Hamstring Exercise (NHE) prevents hamstring injury in soccer players effectively, the annual incidence of these injuries still increases. This may be because of poor long‐term compliance with the program. Furthermore, the timing and amplitude of gluteal and core muscle activation seem to play an important role in hamstring injury prevention, the NHE program was not designed to improve activation of these muscles. Therefore, we propose plyometric training as an alternative to reduce hamstring injuries in soccer players.PurposeTo determine the preventive effect of the Bounding Exercise Program (BEP) on hamstring injury incidence and severity in adult male amateur soccer players.Study designA cluster‐Randomized Controlled Trial.MethodsThirty‐two soccer teams competing in the first‐class amateur league were cluster‐randomized into the intervention or control group. Both groups were instructed to perform their regular training program, and the intervention group additionally performed BEP. Information about player characteristics was gathered at baseline and exposure, hamstring injuries and BEP compliance were weekly registered during one season (2016‐2017).ResultsThe data of 400 players were analyzed. In total, 57 players sustained 65 hamstring injuries. The injury incidence was 1.12/1000 hours in the intervention group and 1.39/1000 hours in the control group. There were no statistically significant differences in hamstring injury incidence (OR = 0.89, 95% CI 0.46‐1.75) or severity between the groups (P > 0.48).ConclusionIn this large cluster‐randomized controlled trial, no evidence was found for plyometric training in its current form to reduce hamstring injuries in amateur soccer players.

Muscle Activity During Aquatic and Land Exercises in People With and Without Low Back Pain

BackgroundChronic low back pain (CLBP) is the most prevalent musculoskeletal disorder. Aquatic exercises are commonly used by physical therapists for CLBP treatment and management; however, there are no data on trunk muscle activation during aquatic exercises in people with CLBP.ObjectiveWe quantified activation of trunk and gluteal muscles, exercise intensity, pain, and perceived exertion in people with and without CLBP when performing water and land exercises.DesignThe study used a cross-sectional design.MethodsTwenty participants with nonspecific CLBP and 20 healthy participants performed 15 aquatic exercises and 15 similar land exercises. Mean and peak muscle activation were measured bilaterally from erector spinae, multifidus, gluteus maximus, gluteus medius, rectus abdominis, external oblique, and internal oblique using waterproof and wireless surface electromyography. Exercise intensity (heart rate), perceived exertion (Borg scale), and, for the CLBP group, pain (visual analog scale) were recorded.ResultsThere were no significant between-group differences. Significant between-environment differences were found in heart rate (always higher on land), exertion (higher in the water for 3 exercises and on land for 6 exercises), and muscle activation (higher on land in 29% and in the water in 5% of comparisons). Pain levels were low, but pain was reported more than twice as frequently on land than in water (7.7% vs 3.7%, respectively).LimitationsPeople with high levels of disability and CLBP classification were not included.ConclusionsPeople with mild-to-moderate CLBP had similar exercise responses to healthy controls. Aquatic exercise produced sufficient muscle activation, intensity, and exertion, and should not be assumed to be less strenuous or less effective in activating trunk and pelvic muscles than exercise on land. These data can be used to inform design and prescription of rehabilitation programs and interventions.

Exploring Nonoperative Exercise Interventions for Individuals with Femoroacetabular Impingement

Pulled Text Femoroacetabular impingement (FAI) is characterized by pathologic contact during hip range of motion, with aggravating movements most noted in hip flexion, adduction, and internal rotation. Hip impingement diagnoses and surgeries are becoming an increasingly prevalent concern with today's athletes and general population. Exploration of nonoperative exercise interventions is warranted. Exercise professionals can safely improve postural alignment, core stabilization, gluteal activation, and range of motion in individuals with FAI. Morphological correction and prevention of hip osteoarthritis are often primary reasons to support arthroscopy for individuals with femoroacetabular impingement (FAI). However, exploration of nonsurgical approaches such as exercise intervention focused on postural alignment, core stabilization, and gluteal activation may improve motor control and hip stabilization strength and provide a nonoperative alternative to surgery. Apply It!

Detection of Gluteal Changes Using Ultrasound Imaging During Phases of Gait in Individuals With Medial Knee Displacement.

Context: Medial knee displacement (MKD) is a common risk factor for lower-extremity injury and is related to altered gluteal muscle activity. Ultrasound imaging (USI) is a reliable means to explore mechanical muscle activity; however, no information exists regarding USI of the gluteals during gait in an MKD population. Objective: To determine differences in USI gluteal muscle activity during gait in individuals with and without MKD. Design: Descriptive laboratory study. Setting: University research laboratory. Participants: Out of 28 participants, 14 exhibiting MKD unilaterally during a single-leg squat (19.36 [1.51]y, 169.73 [7.50]cm, and 62.01 [10.57]kg; 10 females) and 14 matched non-MKD subjects (20.29 [1.73]y, 167.24 [9.07]cm, and 67.53 [16.03]kg). Interventions: Bilateral B-mode USI of the gluteus maximus (Gmax) and gluteus medius (Gmed) muscles during quiet stance, heel strike, and a 10-second treadmill walking clip. Main Outcome Measures: Gluteal thickness measures normalized to quiet stance yielded activity ratios, and percentage of muscle thickness change was assessed between heel strike and quiet stance. Differences between groups were assessed with Cohen's d effect sizes with 95% confidence intervals. Activity ratios with 90% confidence intervals plotted on 10% intervals from 0% to 100% of gait were used to compare groups and limbs. A subsample of images was measured to determine intertester reliability. Results: USI revealed decreased Gmax and Gmed percent change at heel strike (%change = -9.57% [7.15%] and -8.76% [4.26%], respectively). The MKD limb compared with the contralateral limb exhibited decreased Gmed activity ratio at 30% of gait (MKD = 0.89 [0.056]; non-MKD = 1.01 [.052]). Intertester reliability was excellent for gluteus maximus (intraclass correlation coefficient = .987 [.014]) and Gmed (intraclass correlation coefficient = .989 [.013]) measurements. Conclusions: USI highlighted gluteal activity differences of MKD limbs during gait, which may contribute to inadequate hip stabilization during this daily repetitive task. These findings potentiate the use of USI as an intervention- or screening-based visual tool.

Systematic differences of gluteal muscle activation during overground and treadmill walking in healthy older adults

Guteal muscle activation during walkway and treadmill walking was compared by means of Surface EMG (SEMG). Healthy older adults (50–75 years, n = 54; 29 females, 25 males) walked on a walkway (WW) at their self-selected slow, normal, and fast walking speeds and on a treadmill (TM) at 2, 3, 4, 5, and 6 km/h. Subject-individual, best-matched speed pairs were constituted and named SLOW, NORMAL, and FAST. Hip muscle activation was measured on both sides at mid-distance between the greater trochanter and the iliac crest by applying eight equally-spaced bipolar SEMG channels from ventral to dorsal (P1–P8). Grand averaged amplitude curves and mean amplitudes over the complete stride were analyzed to compare WW and TM walking. TM walking evoked significantly elevated mean amplitude levels, particularly at the ventral positions P1 to P4, which were disproportionately increased at SLOW. In grand averaged curves, corresponding significant amplitude differences between WW and TM were observed during load acceptance (SLOW; NORMAL), mid-stance (all speeds), and late swing phase (SLOW), with the number of significant differences decreasing for all electrode positions from SLOW to FAST. Compared to WW walking, TM walking may thus require systematically elevated effort of gluteal muscles, in particular at slow walking speed.

Targeted gluteal exercise versus sham exercise on self-reported physical function for people with hip osteoarthritis (the GHOst trial \u2013 Gluteal exercise for Hip Osteoarthritis): a protocol for a randomised clinical trial

BackgroundClinical practice guidelines recommend exercise as the first line of management for hip osteoarthritis, yet high-quality evidence from Cochrane reviews suggest only slight benefits for pain and physical function; and no benefit on quality of life (low-quality evidence). However, the scope of physical impairments identified in people with hip osteoarthritis may not have been adequately addressed with targeted rehabilitation options in previous randomised controlled trials (RCTs). Potential targeted options include gait retraining to address spatio-temporal impairments in walking; motor control training to address deep gluteal (gluteus minimus) dysfunction; and progressive, high-intensity resistance exercises to address atrophy of the gluteal muscles. The aim of this study is to investigate the effect of a targeted gluteal rehabilitation programme that incorporates gait retraining, motor control and progressive, high-intensity resistance-strength training, to address physical activity levels and self-reported physical function in people with mild to moderate disability from hip osteoarthritis.MethodsNinety people diagnosed with mild to moderately disabling hip osteoarthritis will be recruited and randomised to receive one of two exercise programmes (sham or GHOst programme). Interventions will be 12 weeks in duration, with weekly, supervised physiotherapy sessions, and daily home exercises. Both groups will receive standardised education. Outcomes will be assessed at baseline, 7 weeks, 13 weeks (primary time-point) and 25 weeks. The primary outcome will be self-reported physical function measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes include physical activity measured with a tri-axial accelerometer, physical function tests, self-reported physical activity, isometric hip-muscle strength tests, hip-related patient-reported outcome measures, pain thoughts and depressive symptoms, quality of life, global rating of change, gluteal-muscle activity (electromyography (EMG)) and gluteal-muscle size and adiposity (magnetic resonance imaging (MRI)).DiscussionThis will be the first study to compare a targeted gluteal rehabilitation programme to a sham exercise programme. The targeted GHOst programme includes exercises designed to address gait impairments as well as gluteal-muscle atrophy and dysfunction.Trial registrationAustralian New Zealand Clinical Trials Registry, ID: ACTRN12617000970347. Registered prospectively on 5 July 2017. Protocol version 3.0.

O 039 – Determining the most effective exercise for gluteal muscle activation in children with Cerebral Palsy using surface electromyography

O 039 – Determining the most effective exercise for gluteal muscle activation in children with Cerebral Palsy using surface electromyography

Gluteal activation and increased frontal plane projection angle during a step-down test in young women

PurposeTo investigate how the activation of gluteus maximus and gluteus medius interacts with different frontal plane projection angles (FPPA) in healthy young women presenting dynamic knee valgus in one limb while performing the step-down test.MethodsThe total of 18 young women presenting FPPA > 15° during the step-down test in one limb (dynamic knee valgus) were assessed. The other limb should present less than 15° for comparisons. The amplitude of muscle activation was assessed through surface electromyography of gluteus medius and gluteus maximus during 8 subsequent weight bearing step-down tests.ResultsFPPA was positively correlated with gluteus maximus activation and with the assessed side showing FPPA > 15°, which also revealed increased activation of gluteus maximus. No differences were noted for gluteus medius. The principal component analysis explained 73% of the variance in 2 components, with gluteus maximus explaining 48% of the variance on the 1st component. Gluteus medius explained 25% on the 2nd component.ConclusionsGluteus maximus seems to be a major component to explain dynamic knee valgus in women without symptoms of patellofemoral pain, probably owing to weakness and lack of stabilization of other proximal muscles of the hip-knee complex during the task.

Complications of trans arterial embolization during the resuscitation of pelvic fractures

IntroductionTrans arterial embolization (TAE) can stem uncontrolled bleeding associated with pelvic fractures, but is associated with potential complications. This study investigated and compared the early to midterm complications in two patient cohorts: one who did and one who did not undergo TAE. MethodologyThe results of 14 patients who underwent TAE in the resuscitation phase, and then had their pelvic fractures managed non-operatively, the study group (Group 1), were compared with those of a control group (Group 2) of 14 patients matched for age, sex, injury and management, that did not undergo TAE. All patients were examined clinically and answered a questionnaire on bowel and urinary function, pain and limp. Gluteus medius structure and volume were assessed on MRI. The hip girdle muscle function was assessed using a hand held dynamometer, surface electromyography as well as quantitative gait analysis. ResultsSeven patients in Group 1 (50%), but none in Group 2, had persistent urological dysfunctions, in the absence of any recognized previous pathology or urologic trauma at the time of injury. No gluteal muscle demonstrated fibrosis or fatty infiltration. The median gluteal muscle volume was not significantly decreased compared with the uninjured side in either group (P=0.421). The muscle strengths of gluteus maximus, gluteus medius, tensor fasciae latae and iliopsoas when compared to the uninjured side were significantly less in Group 1 compared to Group 2. However, no patient had a discernable limp and gait analysis showed no significant differences between the left and right sides in the study and control groups in the gluteal activation timing (p=0.171 and 0.354) and duration (p=0.622 and 0.435). There were no skin complications, and no patient reported any persistent bowel dysfunction. ConclusionTAE was associated with a high rate of persistent urological dysfunction. TAE could lead to decreased hip muscles strength, however this does not seem to affect gait.

Inducing slight hip discomfort reduces hip extension in gait

Background: Recent developments in the measurement of electromyographic (EMG) activity of the deep gluteal muscles has advanced knowledge of the role of these muscles in hip function and dysfunction. The EMG techniques require the insertion, via needles, of intramuscular electrodes into the gluteus minimus (GMin) and the gluteus medius (GMed). It is not known if this somewhat invasive technique alters the kinematics of movement that could, in turn, alter EMG activity. Therefore, the aim of this study was to compare trunk and lower limb kinematics before and after the insertion of intramuscular electrodes into the deep gluteal muscles.

Effect of a gluteal activation warm-up on explosive exercise performance

ObjectivesTo evaluate the effect of a gluteal activation warm-up on the performance of an explosive exercise (the high hang pull (HHP)).MethodsSeventeen professional rugby union players performed one set of three...

Proximal Neuromuscular Control Protects Against Hamstring Injuries in Male Soccer Players: A Prospective Study With Electromyography Time-Series Analysis During Maximal Sprinting

Background: With their unremittingly high incidence rate and detrimental functional repercussions, hamstring injuries remain a substantial problem in male soccer. Proximal neuromuscular control (“core stability”) is considered to be of key importance in primary and secondary hamstring injury prevention, although scientific evidence and insights on the exact nature of the core-hamstring association are nonexistent at present. Hypothesis: The muscle activation pattern throughout the running cycle would not differ between participants based on injury occurrence during follow-up. Study Design: Case-control study; Level of evidence, 3. Methods: Sixty amateur soccer players participated in a multimuscle surface electromyography (sEMG) assessment during maximal acceleration to full-speed sprinting. Subsequently, hamstring injury occurrence was registered during a 1.5-season follow-up period. Hamstring, gluteal, and trunk muscle activity time series during the airborne and stance phases of acceleration were evaluated and statistically explored for a possible causal association with injury occurrence and absence from sport during follow-up. Results: Players who did not experience a hamstring injury during follow-up had significantly higher amounts of gluteal muscle activity during the front swing phase (P = .027) and higher amounts of trunk muscle activity during the backswing phase of sprinting (P = .042). In particular, the risk of sustaining a hamstring injury during follow-up lowered by 20% and 6%, with a 10% increment in normalized muscle activity of the gluteus maximus during the front swing and the trunk muscles during the backswing, respectively (P < .024). Conclusion: Muscle activity of the core unit during explosive running appeared to be associated with hamstring injury occurrence in male soccer players. Higher amounts of gluteal and trunk muscle activity during the airborne phases of sprinting were associated with a lower risk of hamstring injuries during follow-up. Hence, the present results provide a basis for improved, evidence-based rehabilitation and prevention, particularly focusing on increasing neuromuscular control of the gluteal and trunk muscles during sport-specific activities (eg, sprint drills, agility drills).

Does short-term gluteal activation enhance muscle performance?

ABSTRACTA reduction in gluteus maximus (GM) strength may contribute to the etiology of musculoskeletal impairments and lower-extremity injuries. Currently, there is a paucity of evidence regarding the efficacy of implementing a short-term gluteal activation programme to improving muscle performance. Twenty four semi-professional rugby males were assigned randomly to a gluteal activation group (GLUTE) or a control group (CON). During the 6-week training intervention, the GLUTE and CON groups performed the same training, however that GLUTE group performed seven gluteal activation exercises three times weekly prior to their normal training sessions. Whilst the CON group performed the conventional training with no gluteal activation exercises. Electromyography (EMG) was measured during a maximal isometric unilateral squat (MVIC) and unilateral hip extension force from the left and right vastus lateralis, gluteus maximus, and biceps femoris. After 6 weeks of training there was no significant main or interaction effect (p > 0.05) of EMG and peak force for MVIC and hip extension between GLUTE and CON. The current gluteal activation programme did not enhance EMG activity and hip extension force therefore, the body-weight exercises may not have been sufficient to elicit the appropriate changes.

PROXIMAL NEUROMUSCULAR CONTROL PROTECTS AGAINST HAMSTRING INJURY IN MALE FOOTBALL PLAYERS: A PROSPECTIVE STUDY WITH EMG TIME-SERIES ANALYSIS DURING MAXIMAL SPRINTING

BackgroundHamstring injuries remain a substantial problem in male football. Proximal neuromuscular control (‘core stability’) is considered to be of key importance in hamstring injury prevention, although scientific evidence regarding the...

A comparison of gluteus medius, gluteus minimus and tensor facia latae muscle activation during gait in post-menopausal women with and without greater trochanteric pain syndrome

The effect of greater trochanteric pain syndrome (GTPS) on gluteus medius (GMed) and minimus (GMin) activation in post-menopausal women is unknown. The aim of this study was to compare segmental muscle activation and variability of the GMed, GMin and tensor fascia latae (TFL) during gait in post-menopausal women with and without GTPS.Intramuscular electrodes were inserted into segments of GMin (x2) and GMed (x3) and a surface electrode placed on TFL. Ten control participants and 8 with GTPS completed six walking trials. Peak amplitude, average amplitude and time to peak from each phase of the gait cycle (0–30%, 30%- toe off (TO), total stance and swing) were compared between groups using independent t-tests and effect-size (ES) calculations. Variability of muscle activation was calculated using the mean coefficient of variation (CV). Reversal of anterior GMin electromyographic burst pattern and greater average muscle activity was found in the GTPS group compared to controls: 0-TO for anterior GMin (p<0.05), anterior and middle GMed (p<0.01); 0–30% for posterior GMin (p<0.01) and GMed (p<0.05). No significant differences were identified in TFL. Overall, this study found increased segmental gluteal muscle activation, decreased hip abduction strength, and reduced variability in muscle activation in post-menopausal women with GTPS, compared with controls.

Gluteal Muscle Activity and Patellofemoral Pain

Gluteal Muscle Activity and Patellofemoral Pain

Performance Effects of Repetition Specific Gluteal Activation Protocols on Acceleration in Male Rugby Union Players.

Warm-up protocols have the potential to cause an acute enhancement of dynamic sprinting performance. The purpose of this study was to evaluate the effects of three repetition specific gluteal activation warm-up protocols on acceleration performance in male rugby union players. Forty male academy rugby union players were randomly assigned to one of 4 groups (control, 5, 10 or 15 repetition gluteal activation group) and performed 10 m sprints at baseline and 30 s, 2, 4, 6 and 8 min after their specific intervention protocol. Five and ten meter sprint times were the dependent variable and dual-beam timing gates were used to record all sprint times. Repeated measures analysis of variance found no significant improvement in 5 and 10 m sprint times between baseline and post warm-up scores (p ≥ 0.05) for all groups. There were no reported significant differences between groups at any of the rest interval time points (p ≥ 0.05). However, when individual responses to the warm-up protocols were analyzed, the 15 repetition gluteal activation group had faster 10 m times post-intervention and this improvement was significant (p = 0.021). These results would indicate that there is no specific rest interval for any of the gluteal interventions that results in a potentiation effect on acceleration performance. However, the individual response analysis would seem to indicate that a 15 repetition gluteal activation warm-up protocol has a potentiating effect on acceleration performance provided that the rest interval is adequately and individually determined.

A hip abduction exercise prior to prolonged standing increased movement while reducing cocontraction and low back pain perception in those initially reporting low back pain

Persons who develop low back pain from prolonged standing exhibit increased muscle cocontraction, decreased movement and increased spine extension. However, it is unclear how these factors relate to pain development. The purpose of this study was to use hip abductor fatigue to manipulate muscle activity patterns and determine its effects on standing behaviours and pain development. Forty participants stood for two hours twice, once following a hip abductor fatigue exercise (fatigue), and once without exercise beforehand (control). Trunk and gluteal muscle activity were measured to determine cocontraction. Lumbo-pelvic angles and force plates were used to assess posture and movement strategies. Visual analog scales differentiated pain (PDs) and non-pain developers (NPDs). PDs reported less low back pain during the fatigue session, with females having earlier reductions of similar scale than males. The fatigue session reduced gluteal and trunk cocontraction and increased centre of pressure movement; male and female PDs had opposing spine posture compensations. Muscle fatigue prior to standing reduced cocontraction, increased movement during standing and reduced the low back pain developed by PDs; the timing of pain reductions depended on spine postures adopted during standing.

Hamstring and Gluteal Muscle Activation During the Assessment of Dynamic Movements

Recently, sports medicine professionals have shown interest in using dynamic movement assessments to help identify biomechanical risk factors for musculoskeletal injury. Thus the purpose of this study was to propose two movements (single leg step down and single leg lateral hop) that could predict injury and determine if these proposed movements elicited muscle activation of the hamstrings and gluteals. Surface electromyography was employed and muscle activations of the hamstrings and gluteus medius muscles were classified as strong during both the single leg step down (SLSD) and single leg lateral hop (SLLH). Both the hamstrings and gluteus medius muscles are associated with musculoskeletal injury. The SLSD and SLLH cause significantly high muscle activation of both these muscle groups and should be considered for use in dynamic movement assessments.

The effects of performing a one-legged bridge with use of a sling on trunk and gluteal muscle activation

Objective: The purpose of this study was to compare the activation of trunk and gluteal muscles during bridge exercises with a sling (BS), single-legged bridge exercise with a sling (SBS), single-legged bridge exercise (SB), and general bridge exercise (GB). Design: Cross-sectional study. Methods: Twenty-five healthy participants (19 males and 6 females, aged 27.8 [4.78]) voluntarily participated in this study. In the bridging exercise, each subject lifted their pelvis with their legs and feet in contact with the sling or normal surface. The electrical activities of the erector spinae (ES), gluteus maximus (GM), external oblique (EO), and internal oblique (IO) muscles during the bridging exercises on the 2 surfaces were measured using surface electromyography. Subjects practiced each of the four bridge condition three times in random order and average values were obtained. Results: On the ipsilateral side, activities of the IO, EO, and ES during SBS was significantly higher than those during BS, SB, and GB (p