• Journal of International Academy of Physical Therapy Research
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• v.10 no.3
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• pp.1818-1822
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• 2019

Background: Ipsilateral pelvic elevation has been reported as a common compensatory movement during side-lying hip abduction. It has been reported that pelvic elevation inhibits sufficient contraction of gluteus medius. However, few studies have identified the effects of controlled pelvic elevation on the trunk and hip muscles. Objective: To examine the effects of controlled pelvic elevation using visual biofeedback on the muscle activity of the trunk and hip muscles. Design: Crossover study. Methods: Twelve healthy males performed side-lying hip abduction exercises with and without visual biofeedback for pelvic elevation. Electromyography (EMG) activities of the gluteus medius, quadratus lumborum, and multifidus were analyzed using a wireless EMG system while the ipsilateral pelvic elevation angle was measured using a motion sensor during side-lying hip abduction exercises. Results: EMG activities of the gluteus medius (p = .002), quadratus lumborum (p = .022), and multifidus (p = .020) were significantly increased and ipsilateral pelvic elevation was significantly decreased (p = .001) during side-lying hip abduction with visual biofeedback compared to without visual biofeedback. Conclusions: The results of this study suggest that the application of biofeedback for pelvic motion could improve the trunk and hip muscle activation pattern and decrease compensatory pelvic motion during side-lying hip abduction exercise.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.127-137
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• 2016

PURPOSE: This study aimed to compare the effects of side-lying hip abduction exercise with and without vibration on pain, disability, strength and balance in individuals with low back pain. METHODS: 30 participants enrolled in this study were randomly assigned to an experimental group (EG, n=15) for side-lying hip abduction with vibration and a control group (CG, n=15) for side-lying hip abduction without vibration. Both groups were treated 3 times per week for 4 weeks. Pain (Numeric Rating Scale), disability (Korean Oswestry Disability Index), hip abductor muscle strength, and static balance were measured in both groups before and after the program. Results were analyzed using paired t-test for comparing the difference within the group and independent t-test for comparing the difference between two groups. RESULTS: Compared to the CG, the EG showed significantly greater reductions in pain and disability (p<.05). There was a significant difference in all balance categories of both the painful and non-painful sides within the EG (p<.05). Balance showed a significant decrease except the envelope area (ENV) on the non-painful side within the CG (p<.05). There was a significant increase in all balance categories except ENV of non-painful side between the two groups (p<.05). Balance increased on both the painful and non-painful sides in the EG. Balance improved on the painful side in the CG, but significantly decreased on the non-painful side (p<.05). CONCLUSION: Side-lying hip abduction exercise with vibration is considered an effective treatment for pain, disability and balance in individuals with low back pain.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.3
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• pp.59-66
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• 2017

PURPOSE: This study was to evaluate the muscle activity of gluteus medius, tensor fascia latae, and quadratus lumborum during side-lying abduction exercise in various pelvic tilting positions. METHODS: We measured the activity of three muscles in three pelvic tilt positions for 17 normal subjects with performing the side-lying hip abduction. Three pelvic tilt positions were posterior tilt, neutral tilt and anterior tilt. We used the mean value after participants performed the hip abduction three times each position. RESULTS: The activity of gluteus medius within three pelvic positions showed the highest activity in pelvic posterior tilt position and the lowest in pelvic neutral tilt position (p = .04). The activity of tensor fascia latae showed the lowest in pelvic posterior tilt position and the highest in pelvic posterior tilt position (p = .00). The activity of quadratus lumborum revealed the lowest activity in pelvic neutral tilt position and the highest in pelvic anterior tilt position (p = .00). The activity of selective gluteus medius activation according to pelvic displacement showed the highest activity in pelvic neutral tilt position and lowest in pelvic anterior tilt position (p = .00). CONCLUSION: Hip abduction with Pelvic posterior tilt position may be effective in increasing gluteus medius and may be effective in strengthening exercise program for the gluteus medius. In addition, Hip abduction with pelvic neutral position may have an effect on the selective gluteus medius, which is considered to be effective in the exercise program for muscle reeducation training of the gluteus medius.

• Physical Therapy Korea
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• v.19 no.1
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• pp.19-27
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• 2012

The purpose of this study was to determine the effect of contralateral hip adduction (CHA) on thickness of lumbar stabilizers during hip abduction in side-lying. Twenty healthy subjects without back pain were recruited for this study. The thickness of transverse abdominis (TrA), internal oblique (IO) and quadratus lumborum (QL) were measured by ultrasonography. Pelvic lateral tilting motion was measured using a three-dimensional motion analysis system. Measurements were performed at rest position (RP), $35^{\circ}$preferred hip abduction (PHA) and $35^{\circ}$abduction with $10^{\circ}$contralateral hip adduction (CHA) in side-lying at the end of expiration. During the measurements, subjects were asked to maintain steady trunk alignment without hand support. Thickness of TrA and IO was significantly greater in CHA than in PHA and RP conditions. There was no significant difference in thickness of TrA and IO between PHA and RP conditions. Medio-lateral (M-L) thickness of QL was not significant between PHA and CHA conditions. Anterio-posterior (A-P) thickness of QL in PHA and CHA significantly decreased compared to RP condition. Angle of pelvic lateral tilting was significantly decreased in CHA compared to PHA condition. In conclusion, CHA can be recommended for increasing trunk stability without compensatory pelvic motion during hip abduction exercise in side-lying.

• Physical Therapy Korea
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• v.23 no.3
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• pp.57-67
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• 2016

Background: Many previous studies recommended the side-lying hip abduction (SHA) exercise for targeting the gluteus medius (Gmed) and gluteus maximus (Gmax) muscle activity while the decreasing tensor fasciae latae (TFL) activation. Mischoice of hip position and angle in SHA may increase the risk of lower extremity injuries and undesirable muscle activation. However, information is limited on the effect of composite hip flexion angles and hip rotation on the gluteal muscle activity during SHA. Objects: This study aimed to compare muscle activity (Gmed, TFL, and Gmax) and activity ratios (Gmed/TFL, Gmax/TFL, and Gmed/Gmax) using surface electromyography (EMG) during SHA exercise at three different hip flexion angles either with or without internal rotation (IR) in subjects with Gmed weakness. We hypothesized that applying hip flexion and IR during SHA would increase gluteal muscle activity and decrease TFL activity. Methods: Muscle activity and activity ratios in 20 volunteers with Gmed weakness during 6 different SHA were investigated with surface EMG. One-way repeated-measures analysis of variance was used to determine the statistical significance. Results: Significant differences were found among the six different exercises for Gmed ($F_{2,41}=11.817$, p<.001) and Gmax ($F_{3,52}=5.513$, p=.003) muscle activity, and Gmed/TFL ($F_{3,54}=8.735$, p<.001) and Gmax/TFL ($F_{2,37}=4.019$, p=.028) activity ratios. Conclusion: Applying hip flexion is an effective method for increasing gluteal activity, and it elicits great Gmed/TFL and Gmax/TFL activity ratios during SHA in subjects with Gmed weakness.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.105-110
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• 2016

PURPOSE: The aim of this study was to investigate the influence of hip abduction velocity and position change on the relative onset times of the gluteus medius, the tensor fascia latae, and the quadratus lumborum in healthy subjects. METHODS: For this study, 15 healthy young adults were recruited. The subjects were asked to move their hip joints up to 35 degrees of abduction at a speed of $70^{\circ}/sec$ and $17.5^{\circ}/sec$ in the supine and side-lying positions. Electromyography data was collected for the gluteus medius, tensor fascia latae, and quadratus lumborum to determine the onset times. RESULTS: There were significant differences between the fast speed ($70^{\circ}/sec$) and the slow speed ($17.5^{\circ}/sec$) in hip abduction in a supine position and in a side-lying position, relatively. The onset time of the gluteus medius was faster than that of the tensor fascia latae and the quadratus lumborum in the side-lying position at the speed of $70^{\circ}/sec$ and $17.5^{\circ}/sec$. CONCLUSION: The findings of this study indicated that hip abduction in a side-lying position is an effective method to recruit the gluteus medius earlier than the tensor fascia latae and the quadratus lumborum. Thus, the exercise position is considered necessory in the purpose of rehabilitation for gluteus medius muscle strengthening program.

• Physical Therapy Korea
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• v.20 no.4
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• pp.16-21
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• 2013

The purpose of this study was to determine the effect of contralateral hip adduction (CHA) on the muscle activity of lumbar stabilizers and the angle of pelvic lateral tilting during hip abduction in side lying. Twenty healthy male subjects with no medical history of lower extremity or lumbar spine disorders were recruited for the study. Subjects randomly performed preferred hip abduction (PHA) and hip abduction with contralateral hip adduction in side lying. The muscle activities of the dominant side rectus abdominis, external oblique, internal oblique, quadratus lumborum, gluteus medius, and non-dominant side hip adductor longus were measured during PHA and CHA by using a surface electromyography (EMG) system. Pelvic lateral tilting motion was measured by using a three-dimensional motion analysis system. Data on EMG and pelvic motion were collected at the same time during PHA and CHA. A paired t-test was used to compare EMG activity and the angle of pelvic lateral tilting in the two exercises. The study found that the EMG activities of all muscles were more increased significantly in CHA than PHA condition. The angle of pelvic lateral tilting was more decreased significantly in CHA than PHA condition. These findings suggest that CHA could be recommended as a hip abduction exercise for activating lumbar stabilizers and decreasing compensatory pelvic lateral tilting motion.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.3
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• pp.323-330
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• 2011

Purpose : The purpose of this study was to examine the effects of using a pressure bio-feedback unit (PBFU) and a pelvic belt (PB) on the electromyographic (EMG) signal amplitude of the gluteus medius (Gmed) and the quadratus lumborum (QL) during hip abduction exercise when lying on the side. Methods : Twenty able-bodied volunteers (10 male, 10 female) were recruited for this study. The EMG signal amplitude was randomly measured during hip abduction with preferred hip abduction (PHA), with PBFU, and with PB. The surface EMG signal was recorded from the Gmed and the QL. Data were analyzed using a one-way repeated ANOVA. Results : Muscle activity of Gmed was significantly higher in PBFU and in PB than in PHA (p<.05). There were no significant difference between PBFU and PB(p>.05). Muscle activity of the QL was significantly lower in PB than in PHA(p<.05). The Gmed/QL muscle activity ratio was also significantly higher in PBFU and in PB than in PHA(p<.05), with no significant difference between PBFU and PB (p>.05). Conclusion : Based on these findings, using a PBFU and a PB is an effective method to disassociate QL use from Gmed use during hip abduction exercises when lying on the side.

• PNF and Movement
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• v.20 no.3
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• pp.341-349
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• 2022

Purpose: The purpose of this study is to compare the muscle activity of the hip abductors and the ratio between the hip abductor muscle group according to the range of hip abduction during the clam exercise. Methods: This study was conducted on 18 healthy men in their aged 20 to 29 who had not been diagnosed with spine-related diseases. The subjects performed a clam exercise without rotation of the pelvis in a state of 60° hip flexion and 90° knee joint flexion in the side-lying position. Using Myomotion equipment and EMG, the muscle activity of the hip abductor muscles and the activity ratio between the hip abductor muscle group were measured during the clam exercise by dividing the range into initial, mid-range, and terminal sections. Repeated measures analysis of variants was employed to compare the activity and use of hip abductor muscles according to range of motion during the clam exercise. Results: Gluteus medius muscle activation was significantly increased in the comparison of muscle activity in the initial, mid-range, and terminal sections of hip abduction. Tensor fasciae latae muscle activation was significantly increased in the comparison of muscle activity in all range of motion sections as well. The gluteus medius-tensor fasciae latae muscle activation ratio was significantly increased in the terminal section compared to the initial section. Conclusion: The gluteus medius and tensor fasciae latae had higher muscle activities as they approached the terminal section during the clam exercise, and the hip abduction activity ratio of the gluteus medius and tensor fasciae latae was higher as the range of motion approached the terminal section.

• The Journal of Korean Physical Therapy
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• v.31 no.1
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• pp.62-66
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• 2019

Purpose: This study examined the most efficient exercise position to activate the gluteus medius (GM) and tensor fascia latae (TFL) in hip abduction in side-lying (HA-SL), clam in side-lying (CL-SL), and sling bridging in side-lying (SB-SL), which are the most representative GM exercises. Methods: Twenty-four healthy male adults aged from 20 to 40 years, whose body mass index was under 25, participated in this experiment. While all participants conducted three different positions with a counterbalanced manner, such as in AB, CL, and BR, activation of the GM and TFL was measured using 8-channel wireless EMG. Exercise was performed for 10 seconds three times in total with a five minute-break session. Results: Significant differences in GM and TFL activation were observed among the three positions (p<0.05). The highest activation of 60.69 was observed in BR followed in order by 46.03 and 12.92 in HA-SL and CL, respectively. TFL activation in HA-SL was 42.01, followed in order by 35.98 and 14.01 in BR and CL, respectively. On the other hand, there was no significant difference in TFL muscle activation between BR and HA-SL. Conclusion: These findings suggest that both BR and HA-SL in GM can be done selectively. CL has remarkably low muscle activation in GM and TFL, which makes it less valuable in GM and TFL exercise. In conclusion, selective BR and HA-SL exercise should be applied to maximally and effectively activate the GM.