DOI QR코드

DOI QR Code

Electromyographic Analysis of Gluteus Maximus, Gluteus Medius, Hamstring and Erector Spinae Muscles Activity During the Bridge Exercise With Hip External Rotation in Different Knee Flexion Angles in Healthy Subjects

  • Lee, Kyung-eun (Dept. of Physical Therapy, The Graduate School, Yonsei University) ;
  • Baik, Seung-min (Dept. of Physical Therapy, The Graduate School, Yonsei University) ;
  • Yi, Chung-hwi (Dept. of Physical Therapy, College of Health Science, Yonsei University) ;
  • Kim, Seo-hyun (Dept. of Physical Therapy, The Graduate School, Yonsei University)
  • Received : 2019.08.01
  • Accepted : 2019.09.05
  • Published : 2019.09.17

Abstract

Background: The bridge exercise targets the gluteus maximus (Gmax) and gluteus medius (Gmed). However, there is also a risk of dominant hamstring (HAM) and erector spinae (ES) muscles. Objects: To analyze the muscle activity the of Gmax, Gmed, HAM and ES during the bridge exercise with and without hip external rotation in different degrees of knee flexion. Methods: Twenty-three subjects were participated. The electormyography (EMG) activity of the Gmax, Gmed, HAM and ES muscles was recorded during the exercise. The subjects performed the bridge exercise under four different conditions: (a) with $90^{\circ}$ knee flexion, without hip external rotation (b) with $90^{\circ}$ knee flexion, with hip external rotation (c) with $135^{\circ}$ knee flexion, without hip external rotation (d) with $135^{\circ}$ knee flexion, with hip external rotation. Results: There was no significant interaction effect between the degree of knee flexion and hip external rotation. There was a significant main effect for degree of knee flexion in Gmax, HAM muscles activity. Gmax muscle activity was significantly greater in the $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p<.001). While HAM muscle activity was significantly less in $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p<.001). ES muscle activity was significantly less in the $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p=.002). The activity of both the Gmax and Gmed muscles was significantly greater with hip external rotation (p<.001 and p=.005, respectively). Conclusion: For patients performing the bridge exercise, positioning the knee in $135^{\circ}$ of flexion with hip external rotation is effective for improving Gmax and Gmed muscle activity while decreasing HAM, and ES muscle activity.

References

  1. Bishop BN, Greenstein J, Etnoyer Slaski, JL, et al. Electromyographic analysis of gluteus maximus, gluteus medius, and tensor fascia latae during therapeutic exercises with and without elastic resistance. J Sports Phys. 2018:13(4);668-675.
  2. Bolgla LA, Malone TR, Umberger BR et al. Comparison of hip and knee strength and neuromuscular activity in subjects with and without patellofemoral pain syndrome. J Sports Phys. 2011;6(4);285-296.
  3. Choi SA, Cynn HS, Yi CH, et al. Isometric hip abduction using a Thera-Band alters gluteus maximus muscle activity and the anterior pelvic tilt angle during bridging exercise. J Electromyogr Kinesiol. 2015;25(2):310-315. https://doi.org/10.1016/j.jelekin.2014.09.005
  4. Criswell E. Cram's Introduction to Surface Electromyography. 2nd ed. Jones & Bartlett Publishers, 2010.
  5. Earl JE, Hertel J, Denegar CR. Patterns of dynamic malalignment, muscle activation, joint motion, and patellofemoral-pain syndrome. J Sport Rehabil. 2005;14(3):216-233. https://doi.org/10.1123/jsr.14.3.216
  6. Ekstrom RA, Donatelli RA, Carp KC. Electromyographic analysis of core trunk, hip, and thigh muscles during 9 rehabilitation exercises. J Orthop Sports Phys Ther. 2007;37(12)754-762. https://doi.org/10.2519/jospt.2007.2471 https://doi.org/10.2519/jospt.2007.2471
  7. Ito J, Moriyama H, Inikuchi S, et al. Human lower limb muscles: An evaluation of weight and fiber size. Okajimas Folia Anat Jpn. 2003;80(2.3):47-56. https://doi.org/10.2535/ofaj.80.47
  8. Jonkers I, Stewart C, Spaepen A. The complementary role of the plantarflexors, hamstrings and gluteus maximus in the control of stance limb stability during gait. Gai Posture. 2003;17(3):264-272. https://doi.org/10.1016/S0966-6362(02)00102-9
  9. Kendall FP, McCreary EK, Provance PG, et al. Muscles: Testing and Function with Posture and Pain. 5th ed. Baltimore: Williams & Wilkins, 2005.
  10. Kisner C, Colby LA, Borstad J. Therapeutic Exercise: Foundations and Techniques. 7th ed. FA Davis, 2017.
  11. Lee JH, Cynn HS, Kwon OY et al. Different hip rotations influence hip abductor muscles activity during isometric side-lying hip abduction in subjects with gluteus medius weakness. J Electromyogr Kinesiol. 2014;24(2):318-324. https://doi.org/10.1016/j.jelekin.2014.01.008 https://doi.org/10.1016/j.jelekin.2014.01.008
  12. Lehecka BJ, Edwards M, Haverkamp R et al. Building a better gluteal bridge: Electromyographic analysis of hip muscle activity during modified single-leg bridges. Int J Sports Phys Ther. 2017;12(4):543-549.
  13. Marshall AR, Noronha MD, Zacharias A, et al. Structure and function of the abductors in patients with hip osteoarthritis: Systematic review and meta-analysis. J Back Musculoskelet Rehabil. 2006;29(2):191-204. https://doi.org/10.3233/BMR-150614 https://doi.org/10.3233/BMR-150614
  14. Marshall PW, Patel H, Callaghan JP. Gluteus medius strength, endurance, and co-activation in the development of low back pain during prolonged standing. Hum Mov Sci. 2011;30(1):63-73. https://doi.org/10.1016/j.humov.2010.08.017 https://doi.org/10.1016/j.humov.2010.08.017
  15. Massoud Arab A, RezaNourbakhsh M, Mohammadifar A. The relationship between hamstring length and gluteal muscle strength in individuals with sacroiliac joint dysfunction. J Man Manip Ther. 2011;19(1):5-10. https://doi.org/10.1179/106698110X12804993426848 https://doi.org/10.1179/106698110X12804993426848
  16. Nelson-Wong E, Flynn T, Callaghan JP. Development of active hip abduction as a screening test for identifying occupational low back pain. J Orthop Sports Phys Ther. 2009;39(9):649-657. https://doi.org/10.2519/jospt.2009.3093 https://doi.org/10.2519/jospt.2009.3093
  17. Neumann DA. Kinesiology of the hip: A focus on muscular actions. J Orthop Sports Phys Ther. 2010a;40(2):82-94. https://doi.org/10.2519/jospt.2010.3025 https://doi.org/10.2519/jospt.2010.3025
  18. Neumann DA. Kinesiology of the Musculoskeletal System: Foundation for Rehabilitation. 2nd ed. Mosby, 2010b:364-365.
  19. Powers CM. The influence of abnormal hip mechanics on knee injury: A biomechanical perspective. J Orthop Sports Phys Ther. 2010:40(2);42-51. https://doi.org/10.2519/jospt.2010.3337 https://doi.org/10.2519/jospt.2010.3337
  20. Sahrmann S. Diagnosis and Treatment of Movement Impairment Syndromes. Elsevier Health Sciences, 2001.
  21. Tanamas S, Hanna FS, Cicuttini FM, et al. Does knee malalignment increase the risk of development and progression of knee osteoarthritis? A systematic review. Arthritis Rheum. 2009;61(4):459-467. https://doi.org/10.1002/art.24336 https://doi.org/10.1002/art.24336