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Cindy Y. Lin, Liang-Ching Tsai, Joel Press, Yupeng Ren, Sun G. Chung and Li-Qun Zhang

Context:

Gluteal-muscle strength has been identified as an important component of injury prevention and rehabilitation in several common knee injuries. However, many conventionally prescribed gluteal-strengthening exercises are not performed during dynamic weight-bearing activities, which is when most injuries occur.

Objectives:

To compare lower-limb muscle-activation patterns between conventional gluteal-strengthening exercises and off-axis elliptical exercises with motorized foot-plate perturbations designed to activate gluteal muscles during dynamic exercise.

Evidence Acquisition:

Twelve healthy volunteers (26.1 ± 4.7 y) participated in the study. They performed 3 conventional exercises (single-leg squat, forward lunge, and clamshell) and 3 elliptical exercises (regular, while resisting an adduction force, and while resisting an internal-rotation torque). Gluteus medius (GMed) and maximus (GMax), quadriceps, hamstrings, and gastrocnemius muscle activations during each exercise were recorded using surface electromyography (EMG) and normalized to maximal voluntary isometric contraction (MVIC).

Evidence Synthesis:

Normalized GMed EMG was the highest during the adduction-resistance elliptical exercise (22.4% ± 14.8% MVIC), significantly greater than forward lunge (8.2% ± 3.8% MVIC) and regular elliptical (6.4% ± 2.5% MVIC) and similar to clamshell (19.1% ± 8.8% MVIC) and single-leg squat (18.4% ± 7.9% MVIC). Normalized GMax EMG during adduction-resistance (11.1% ± 7.6% MVIC) and internal-rotation-resistance elliptical (7.4% ± 3.8% MVIC) was significantly greater than regular elliptical (4.4% ± 2.4% MVIC) and was similar to conventional exercises. The single-leg squat required more muscle activation from the quadriceps and gastrocnemius than the elliptical exercises.

Conclusions:

Off-axis elliptical exercise while resisting an adduction force or internal-rotation torque activates gluteal muscles dynamically while avoiding excessive quadriceps activation during a functional weight-bearing activity compared with conventional gluteal-strengthening exercises.

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Adam S. Lepley, Allison M. Strouse, Hayley M. Ericksen, Kate R. Pfile, Phillip A. Gribble and Brian G. Pietrosimone

Context:

Components of gluteal neuromuscular function, such as strength and corticospinal excitability, could potentially influence alterations in lower extremity biomechanics during jump landing.

Objective:

To determine the relationship between gluteal muscle strength, gluteal corticospinal excitability, and jump-landing biomechanics in healthy women.

Setting:

University laboratory.

Design:

Descriptive laboratory study.

Participants:

37 healthy women (21.08 ± 2.15 y, 164.8 ± 5.9 cm, 65.4 ± 12.0 kg).

Interventions:

Bilateral gluteal strength was assessed through maximal voluntary isometric contractions (MVIC) using an isokinetic dynamometer. Strength was tested in the open chain in prone and side-lying positions for the gluteus maximus and gluteus medius muscles, respectively. Transcranial magnetic stimulation was used to elicit measures of corticospinal excitability. Participants then performed 3 trials of jump landing from a 30-cm box to a distance of 50% of their height, with an immediate rebound to a maximal vertical jump. Each jump-landing trial was video recorded (2-D) and later scored for errors.

Main Outcome Measures:

MVICs normalized to body mass were used to assess strength in the gluteal muscles of the dominant and nondominant limbs. Corticospinal excitability was assessed by means of active motor threshold (AMT) and motor-evoked potentials (MEP) elicited at 120% of AMT. The Landing Error Scoring System (LESS) was used to evaluate jump-landing biomechanics.

Results:

A moderate, positive correlation was found between dominant gluteus maximus MEP and LESS scores (r = .562, P = .029). No other significant correlations were observed for MVIC, AMT, or MEP for the gluteus maximus and gluteus medius, regardless of limb.

Conclusions:

The findings suggest a moderate relationship between dominant gluteus maximus corticospinal excitability and a clinical measure of jump-landing biomechanics. Further research is required to substantiate the findings and expand our understanding of the central nervous system’s role in athletic movement.

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Damien Moore, Adam I. Semciw, Jodie McClelland, Henry Wajswelner and Tania Pizzari

trials. The 6 rehabilitation exercises (Table  1 ) were performed in a randomized order. The exercises were selected to include open- and closed-chain tasks, reflective of those commonly prescribed by clinicians to target the lateral gluteal muscles and performed in the home environment requiring use of

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Gretchen D. Oliver, Audrey Stone and Jessica Washington

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.

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Damien Moore, Tania Pizzari, Jodie McClelland and Adam I. Semciw

Context: Many different rehabilitation exercises have been recommended in the literature to target the gluteus medius (GMed) muscle based mainly on single-electrode, surface electromyography (EMG) measures. With the GMed consisting of 3 structurally and functionally independent segments, there is uncertainty on whether these exercises will target the individual segments effectively. Objective: To measure individual GMed segmental activity during 6 common, lower-limb rehabilitation exercises in healthy young adults, and determine if there are significant differences between the exercises for each segment. Method: With fine-wire EMG electrodes inserted into the anterior, middle, and posterior segments of the GMed muscle, 10 healthy young adults performed 6 common, lower-limb rehabilitation exercises. Main Outcome Measures: Recorded EMG activity was normalized, then reported and compared with median activity for each of the GMed segments across the 6 exercises. Results: For the anterior GMed segment, high activity was recorded for the single-leg squat (48% maximum voluntary isometric contraction [MVIC]), the single-leg bridge (44% MVIC), and the resisted hip abduction–extension exercise (41% MVIC). No exercises recorded high activity for the middle GMed segment, but for the posterior GMed segment very high activity was recorded by the resisted hip abduction–extension exercise (69% MVIC), and high activity was generated by the single-leg squat (48% MVIC) and side-lie hip abduction (43% MVIC). For each of the GMed segments, there were significant differences (P < .05) in the median EMG activity levels between some of the exercises and the side-lie clam with large effect sizes favoring these exercises over the side-lie clam. Conclusions: Open-chain hip abduction and single-limb support exercises appear to be effective options for recruiting the individual GMed segments with selection dependent on individual requirements. However, the side-lie clam does not appear to be effective at recruiting the GMed segments, particularly the anterior and middle segments.

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Alexandra F. DeJong, L. Colby Mangum, Jacob E. Resch and Susan A. Saliba

center of the patella is observed to move past the first ray of the foot of the ipsilateral limb in the frontal plane. 1 , 12 , 13 The presence of MKD is indicative of poor lower-extremity muscle strength, specifically with gluteal muscle strength defecits. 14 , 15 The gluteal muscles are part of the

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Mark A. Sutherlin and Joseph M. Hart

Context:

Individuals with a history of low back pain (LBP) may present with decreased hip-abduction strength and increased trunk or gluteus maximus (GMax) fatigability. However, the effect of hip-abduction exercise on hip-muscle function has not been previously reported.

Objective:

To compare hip-abduction torque and muscle activation of the hip, thigh, and trunk between individuals with and without a history of LBP during repeated bouts of side-lying hip-abduction exercise.

Design:

Repeated measures.

Setting:

Clinical laboratory.

Participants:

12 individuals with a history of LBP and 12 controls.

Intervention:

Repeated 30-s hip-abduction contractions.

Main Outcome Measures:

Hip-abduction torque, normalized root-mean-squared (RMS) muscle activation, percent RMS muscle activation, and forward general linear regression.

Results:

Hip-abduction torque reduced in all participants as a result of exercise (1.57 ± 0.36 Nm/kg, 1.12 ± 0.36 Nm/kg; P < .001), but there were no group differences (F = 0.129, P = .723) or group-by-time interactions (F = 1.098, P = .358). All participants had increased GMax activation during the first bout of exercise (0.96 ± 1.00, 1.18 ± 1.03; P = .038). Individuals with a history of LBP had significantly greater GMax activation at multiple points during repeated exercise (P < .05) and a significantly lower percent of muscle activation for the GMax (P = .050) at the start of the third bout of exercise and for the biceps femoris (P = .039) at the end of exercise. The gluteal muscles best predicted hip-abduction torque in controls, while no consistent muscles were identified for individuals with a history of LBP.

Conclusions:

Hip-abduction torque decreased in all individuals after hip-abduction exercise, although individuals with a history of LBP had increased GMax activation during exercise. Gluteal muscle activity explained hip-abduction torque in healthy individuals but not in those with a history of LBP. Alterations in hip-muscle function may exist in individuals with a history of LBP.

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Daniel Gilfeather, Grant Norte, Christopher D. Ingersoll and Neal R. Glaviano

–reconstructed patients. 7 Poor neuromuscular function of the gluteal muscles has also been related to altered frontal hip and knee plane motion 2 , 3 and decreased subjective knee function. 8 Due to their relationship between gluteal weakness and poor subjective and objective functional measurements, optimizing

Open access

Marcie Fyock, Nelson Cortes, Alex Hulse and Joel Martin

. Experimental and control groups ran in front of a mirror. Control group received no verbal feedback other than encouragement to keep running. Verbal feedback Verbal feedback to stay within 1 SD of HADD and to contract their gluteal muscles and attempt to run with their knee pointing straight ahead, while

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Gretchen D. Oliver, Jessica K. Washington, Sarah S. Gascon, Hillary A. Plummer, Rafael F. Escamilla and James R. Andrews

%–55% of the total energy and transfer it through the LPHC to the upper-extremity. 2 , 5 , 6 For this proximal-to-distal sequencing to occur, LPHC stability is required through proper muscle activation of the LPHC musculature. 4 , 6 A relationship between gluteal muscle activation and throwing mechanics