Rehabilitation Exercises for the Gluteus Minimus Muscle Segments: An Electromyography Study

in Journal of Sport Rehabilitation
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Context: The gluteus minimus (GMin) muscle consists of 2 uniquely oriented segments that have potential for independent function and have different responses to pathology and aging. For healthy young adults, it is unknown that which rehabilitation exercises specifically target the individual segments. Objective: To quantify segmental GMin activity for 6 common lower-limb rehabilitation exercises in healthy young adults and determine if significant differences exist in segmental activity levels between the exercises. Method: Six common lower-limb rehabilitation exercises were performed by 10 healthy young adults with fine-wire electromyography (EMG) electrodes inserted into the anterior and posterior segments of the GMin muscle. Main Outcome Measures: Electromyography signals were recorded, and median normalized exercise activity levels were reported and compared for each GMin segment across the 6 exercises. Results: High activity levels were generated in the anterior segment by the resisted hip abduction–extension exercise (51% maximum voluntary isometric contraction [MVIC]), whereas for the posterior segment, high activity levels were produced by the single-leg bridge (49% MVIC), the side-lie hip abduction (43% MVIC), the resisted hip abduction–extension exercise (43% MVIC), and the single-leg squat (40% MVIC). There were significant differences (P < .05) in the median electromyography activity levels for the anterior GMin segment but not for the posterior GMin segment across some of the exercises with large effect sizes. Conclusion: Targeted rehabilitation exercises graded by exercise intensity can be prescribed specifically for the anterior and posterior GMin segments to aid in restoration of hip function following injury or aging.

Moore, McClelland, Wajswelner, and Pizzari are with College of Science, Health and Engineering, La Trobe University, Bundoora, VIC, Australia. Semciw is with the School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.

Moore (damkmoore@hotmail.com) is corresponding author.
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References
  • 1.

    Retchford THCrossley KMGrimaldi AKemp JLCowan SM. Can local muscles augment stability in the hip? A narrative literature review. J Musculoskelet Neuronal Interact. 2013;13(1):112. PubMed ID: 23445909

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Al-Hayani A. The functional anatomy of hip abductors. Folia Morphol. 2009;68(2):98103. PubMed ID: 19449297

  • 3.

    Flack NANicholson HDWoodley SJ. A review of the anatomy of the hip abductor muscles, gluteus medius, gluteus minimus, and tensor fascia lata. Clin Anat. 2012;25(6):697708. PubMed ID: 22109658 doi:10.1002/ca.22004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Gottschalk FKourosh SLeveau B. The functional anatomy of tensor fasciae latae and gluteus medius and minimus. J Anat. 1989;166:179189. PubMed ID: 2621137

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Beck MSledge JBGautier EDora CFGanz R. The anatomy and function of the gluteus minimus muscle. J Bone Joint Surg Br. 2000;82(3):358363. PubMed ID: 10813169 doi:10.1302/0301-620X.82B3.10356

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Correa TACrossley KMKim HJPandy MG. Contributions of individual muscles to hip joint contact force in normal walking. J Biomech. 2010;43(8):16181622. PubMed ID: 20176362 doi:10.1016/j.jbiomech.2010.02.008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Neumann DA. Kinesiology of the hip: a focus on muscular actions. J Orthop Sports Phys Ther. 2010;40(2):8294. PubMed ID: 20118525 doi:10.2519/jospt.2010.3025

  • 8.

    Dieterich APetzke FPickard CDavey PFalla D. Differentiation of gluteus medius and minimus activity in weight bearing and non-weight bearing exercises by M-mode ultrasound imaging. Man Ther. 2015;20(5):715722. PubMed ID: 25697631 doi:10.1016/j.math.2015.01.006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Kumagai MShiba NHiguchi FNishimura HInoue A. Functional evaluation of hip abductor muscles with use of magnetic resonance imaging. J Orthop Res. 1997;15(6):888893. PubMed ID: 9497815 doi:10.1002/jor.1100150615

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Muller MTohtz SWinkler TDewey MSpringer IPerka C. MRI findings of gluteus minimus muscle damage in primary total hip arthroplasty and the influence on clinical outcome. Arch Orthop Trauma Surg. 2010;130(7):927935. PubMed ID: 20221834 doi:10.1007/s00402-010-1085-4

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Pfirrmann CWNotzli HPDora CHodler JZanetti M. Abductor tendons and muscles assessed at MR imaging after total hip arthroplasty in asymptomatic and symptomatic patients. Radiology. 2005;235(3):969976. PubMed ID: 15860673 doi:10.1148/radiol.2353040403

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Wilson GLCapen EKStubbs NB. A fine-wire electromyographic investigation of the gluteus minimus and gluteus medius muscles. Res Q. 1976;47(4):824828. PubMed ID: 1070757

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Semciw AIGreen RAMurley GSPizzari T. Gluteus minimus: an intramuscular EMG investigation of anterior and posterior segments during gait. Gait Posture. 2014;39(2):822826. PubMed ID: 24314814 doi:10.1016/j.gaitpost.2013.11.008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Sparks N. The Detailed Anatomy of the Hip Abductor Muscles and Their Role in Lateral Hip Pain. Dunedin, New Zealand: University of Otago; 2011.

    • Search Google Scholar
    • Export Citation
  • 15.

    Flack NANicholson HDWoodley SJ. The anatomy of the hip abductor muscles. Clin Anat. 2014;27(2):241253. PubMed ID: 23625344 doi:10.1002/ca.22248

  • 16.

    Semciw AIGreen RAPizzari TBriggs C. Verification of a standardized method for inserting intramuscular EMG electrodes into uniquely oriented segments of gluteus minimus and gluteus medius. Clin Anat. 2013;26(2):244252. PubMed ID: 22374796 doi:10.1002/ca.22055

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Grimaldi ARichardson CStanton WDurbridge GDonnelly WHides J. The association between degenerative hip joint pathology and size of the gluteus medius, gluteus minimus and piriformis muscles. Man Ther. 2009;14(6):605610. PubMed ID: 19695944 doi:10.1016/j.math.2009.07.004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Zacharias APizzari TEnglish DJKapakoulakis TGreen RA. Hip abductor muscle volume in hip osteoarthritis and matched controls. Osteoarthritis Cartilage. 2016;24(10):17271735. PubMed ID: 27163446 doi:10.1016/j.joca.2016.05.002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Woodley SJNicholson HDLivingstone Vet al. Lateral hip pain: findings from magnetic resonance imaging and clinical examination. J Orthop Sports Phys Ther. 2008;38(6):313328. PubMed ID: 18515960 doi:10.2519/jospt.2008.2685

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Chi ASLong SSZoga ACet al. Prevalence and pattern of gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI. Skeletal Radiol. 2015;44(12):17271733. PubMed ID: 26260535 doi:10.1007/s00256-015-2220-7

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Kiyoshige YWatanabe E. Fatty degeneration of gluteus minimus muscle as a predictor of falls. Arch Gerontol Geriatr. 2015;60(1):5961. PubMed ID: 25440137 doi:10.1016/j.archger.2014.07.013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Semciw AI. It’s not just the size that counts, but how you use it: research into the anterior gluteus minimus. Sports Health. 2014;32:5055.

    • Search Google Scholar
    • Export Citation
  • 23.

    Bennell KLEgerton TMartin Jet al. Effect of physical therapy on pain and function in patients with hip osteoarthritis: a randomized clinical trial. JAMA. 2014;311(19):19871997. PubMed ID: 24846036 doi:10.1001/jama.2014.4591

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Foroughi NSmith RMLange AKBaker MKFiatarone Singh MAVanwanseele B. Lower limb muscle strengthening does not change frontal plane moments in women with knee osteoarthritis: a randomized controlled trial. Clin Biomech. 2011;26(2):167174. PubMed ID: 20888096 doi:10.1016/j.clinbiomech.2010.08.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Bennell KLHunt MAWrigley TVet al. Hip strengthening reduces symptoms but not knee load in people with medial knee osteoarthritis and varus malalignment: a randomised controlled trial. Osteoarthritis Cartilage. 2010;18(5):621628. PubMed ID: 20175973 doi:10.1016/j.joca.2010.01.010

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Semciw AIPizzari TGreen RA. Technical application and the level of discomfort associated with an intramuscular electromyographic investigation into gluteus minimus and gluteus medius. Gait Posture. 2013;38(1):157160. PubMed ID: 23127355 doi:10.1016/j.gaitpost.2012.10.010

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Ganderton CPizzari TCook JSemciw A. Gluteus minimus and gluteus medius muscle activity during common rehabilitation exercises in healthy post-menopausal women. J Orthop Sports Phys Ther. 2017;47(12):914922. PubMed ID: 29034801 doi:10.2519/jospt.2017.7229

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Tegner YLysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985(198):4349. PubMed ID: 4028566

    • Search Google Scholar
    • Export Citation
  • 29.

    Bullock-Saxton JEWong WJHogan N. The influence of age on weight-bearing joint reposition sense of the knee. Exp Brain Res. 2001;136(3):400406. PubMed ID: 11243482 doi:10.1007/s002210000595

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Ayotte NWStetts DMKeenan GGreenway EH. Electromyographical analysis of selected lower extremity muscles during 5 unilateral weight-bearing exercises. J Orthop Sports Phys Ther. 2007;37(2):4855. PubMed ID: 17366959 doi:10.2519/jospt.2007.2354

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Bolgla LAUhl TL. Electromyographic analysis of hip rehabilitation exercises in a group of healthy subjects. J Orthop Sports Phys Ther. 2005;35(8):487494. PubMed ID: 16187509 doi:10.2519/jospt.2005.35.8.487

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Semciw AIPizzari TMurley GSGreen RA. Gluteus medius: an intramuscular EMG investigation of anterior, middle and posterior segments during gait. J Electromyogr Kinesiol. 2013;23(4):858864. PubMed ID: 23587766 doi:10.1016/j.jelekin.2013.03.007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Vera-Garcia FJMoreside JMMcGill SM. MVC techniques to normalize trunk muscle EMG in healthy women. J Electromyogr Kinesiol. 2010;20(1):1016. PubMed ID: 19394867 doi:10.1016/j.jelekin.2009.03.010

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Burden A. How should we normalize electromyograms obtained from healthy participants? What we have learned from over 25 years of research. J Electromyogr Kinesiol. 2010;20(6):10231035. PubMed ID: 20702112 doi:10.1016/j.jelekin.2010.07.004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Semciw AIFreeman MKunstler BEMendis MDPizzari T. Quadratus femoris: an EMG investigation during walking and running. J Biomech. 2015;48(12):34333439. PubMed ID: 26116043 doi:10.1016/j.jbiomech.2015.05.029

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    O’Sullivan KSmith SMSainsbury D. Electromyographic analysis of the three subdivisions of gluteus medius during weight-bearing exercises. Sports Med Arthrosc Rehabil Ther Technol. 2010;2:17. PubMed ID: 20624291 doi:10.1186/1758-2555-2-17

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Escamilla RFLewis CBell Det al. Core muscle activation during Swiss ball and traditional abdominal exercises. J Orthop Sports Phys Ther. 2010;40(5):265276. PubMed ID: 20436242 doi:10.2519/jospt.2010.3073

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    DiGiovine NMJobe FWPink MPerry J. An electromyographical analysis of the upper extremity in pitching. J Shoulder Elbow Surg. 1992;1(1):1525. PubMed ID: 22958966 doi:10.1016/S1058-2746(09)80011-6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39.

    Demsar J. Statistical comparisons of classifiers over multiple data sets. J Mach Learn Res. 2006;7:130.

  • 40.

    Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, MI: Lawrence Erlbaum; 1988.

  • 41.

    Dostal WFSoderberg GLAndrews JG. Actions of hip muscles. Phys Ther. 1986;66(3):351361. PubMed ID: 3952148 doi:10.1093/ptj/66.3.351

  • 42.

    Cambridge EDSidorkewicz NIkeda DMMcGill SM. Progressive hip rehabilitation: the effects of resistance band placement on gluteal activation during two common exercises. Clin Biomech. 2012;27(7):719724. PubMed ID: 22464817 doi:10.1016/j.clinbiomech.2012.03.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 43.

    Andersen LLMagnusson SPNielsen MHaleem JPoulsen KAagaard P. Neuromuscular activation in conventional therapeutic exercises and heavy resistance exercises: implications for rehabilitation. Phys Ther. 2006;86(5):683697. PubMed ID: 16649892

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Kraemer WJRatamess NA. Fundamentals of resistance training: progression and exercise prescription. Med Sci Sports Exerc. 2004;36(4):674688. PubMed ID: 15064596 doi:10.1249/01.MSS.0000121945.36635.61

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Beckman SMBuchanan TS. Ankle inversion injury and hypermobility: effect on hip and ankle muscle electromyography onset latency. Arch Phys Med Rehabil. 1995;76(12):11381143. PubMed ID: 8540791 doi:10.1016/S0003-9993(95)80123-5

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Brindle TJMattacola CMcCrory J. Electromyographic changes in the gluteus medius during stair ascent and descent in subjects with anterior knee pain. Knee Surg Sports Traumatol Arthrosc. 2003;11(4):244251. PubMed ID: 12695878 doi:10.1007/s00167-003-0353-z

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Cowan SMCrossley KMBennell KL. Altered hip and trunk muscle function in individuals with patellofemoral pain. Br J Sports Med. 2009;43(8):584588. PubMed ID: 18838402 doi:10.1136/bjsm.2008.053553

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 48.

    Giphart JEStull JDLaprade RFWahoff MSPhilippon MJ. Recruitment and activity of the pectineus and piriformis muscles during hip rehabilitation exercises: an electromyography study. Am J Sports Med. 2012;40(7):16541663. PubMed ID: 22523373 doi:10.1177/0363546512443812

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 49.

    Hodges PWMcLean LHodder J. Insight into the function of the obturator internus muscle in humans: observations with development and validation of an electromyography recording technique. J Electromyogr Kinesiol. 2014;24(4):489496. PubMed ID: 24788026 doi:10.1016/j.jelekin.2014.03.011

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 50.

    Philippon MJDecker MJGiphart JETorry MRWahoff MSLaPrade RF. Rehabilitation exercise progression for the gluteus medius muscle with consideration for iliopsoas tendinitis: an in vivo electromyography study. Am J Sports Med. 2011;39(8):17771786. PubMed ID: 21566069 doi:10.1177/0363546511406848

    • Crossref
    • Search Google Scholar
    • Export Citation
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