Background: The Nordic hamstring exercise is a closed-chain exercise that effectively activates all lower extremity muscles, but there is a lack of consideration of ankle joint which affects exercise effectiveness. One of the major advantages of the Nordic exercise have been known as strengthening lower extremity extensors. This manifests the exercise increases activities of the ankle plantar flexors as well as hip extensors. Objectives: To investigated the impacts of changes in ankle position on the lower extremity musculature and subjective difficulties during the Nordic hip extension exercise. Design: Cross-sectional study. Methods: Twenty the healthy male participants participated in this study. Participants perform three variations of the Nordic exercises including three ankle positions. Each Nordic exercise was defined as ankle position (neutral, dorsiflexion and plantar flexion). During the Nordic exercise, erector spine (ES), gluteus maximus (GM), biceps femoris (BF), gastrocnemius (GCM) activities and subjective difficulties (Borg RPE score) were measured. Results: Muscular activities of the biceps femoris and gastrocnemius were significantly different among the three ankle conditions, which showed controversial results (P<.05). The biceps femoris activity was significantly higher with the dorsiflexion condition, compared to the others (P<.05). On the other hand, activity of the gastrocnemius was significantly higher with the plantarflexion position compared to the others (P<.05). Conclusion: Present study suggests the ankle positional changes could affect lower muscular activities during the Nordic exercise. Although it is difficult to affirm the causes due to limited data, selective activation of the biceps femoris might accomplish with ankle dorsi flexion and that of the gastrocnemius might accomplish with the ankle plantarflexion during the Nordic exercises.

Background: Compression of the sacroiliac joint (SIJ) enables lumbo-pelvic muscles to increase pelvic stability and reduce pain. Many previous studies assessed the effects of pelvic compression belts on the stabilization of the lumbar and SIJs. However, there are a lack of studies to date on the effects of pelvic compression taping (PCT). Objectives: To investigate the effects of PCT on the muscle activity of lumbopelvic muscles during prone hip extension (PHE). Design: Pre-post test design. Methods: In total, 19 healthy male and female participants performed PHE with and without PCT. A surface electromyography system was used to record the muscle activity of multifidus, erector spinae, internal oblique abdominal, and gluteus maximus muscles, and the activities of these muscles before and after taping were compared. Results: During PHE, the activities of the multifidus and erector spinae muscles (P<.05) significantly increased after taping, while that of the internal oblique abdominal muscle significantly decreased after taping (P<.05). However, the activity of the gluteus maximums muscle did not significantly increase or decrease after taping (P>.05). Conclusion: PCT for the SIJ improves the stability of the lumbo-pelvic region, and the use of PCT with functional training would lead to positive clinical effects.

Background: Improvement of the lumbo-pelvic stability can reduce the compensatory action of the erector spinae (ES) during prone hip extension (PHE). Furthermore, the application of abdominal drawing-in (ADI) maneuver increases the action of gluteus maximus (GM) and decreases the action of ES during PHE by improving the lumbo-pelvic stability. However, the post-ADI exercise effects on PHE, not the real-time application of ADI maneuver, has not been studied. Objects: This study is aimed at investigating the post-ADI exercise effects on the muscle activities of GM and ES during PHE. Methods: A total of 24 female adults participated in the study, and they were divided into two groups: Those with normal abdominal muscles (n1=12) and those with weak abdominal muscles (WA) (n2=12). Before the intervention, the subjects’ GM and ES muscle activities during PHE were measured. Subsequently, the two groups were asked to perform the ADI exercise for 10 minutes. After the ADI exercise, the GM and ES activities were equally measured during PHE. Results: The comparison result of the ES muscle activities before intervention shows a significant difference between the two groups (p<.05); the WA group showed higher muscle activities than the normal group. For the within-group comparison, the muscle activities of the ES in the WA group significantly decreased after the ADI exercise (p<.05). For the GM muscle activity, no significant difference was observed in all comparisons (p>.05). For the changes in muscle activities before and after the ADI exercise, a significant difference exists between the two groups only for the changes in ES activities (p<.05); WA group exhibits higher changes than the normal group. By contrast, no significant difference exists between the two groups for the changes in GM activities (p>.05). Conclusion: After the ADI exercise, the compensatory action of ES in the female adults with WC is implied to decrease during PHE.

Background: Prone hip extension (PHE) can be performed to measure the lumbopelvic motor patterns and motions. Imbalances in lumbopelvic muscle activity and muscle weakness can result in instability including pain in lumbopelvic region. The posterior oblique sling (POS) muscles contribute to dynamic lumbopelvic stability. In addition, POS are anatomically aligned with the trapezius muscle group according to shoulder positions. Objects: This study compared the electromyography (EMG) activity of POS and pelvic compensations during PHE with and without pre-activation of lower trapezius muscle (lowT). Methods: Sixteen healthy males were recruited. PHE was performed in randomized order: PHE with and without lowT pre-activation. Surface EMG signals were recorded for biceps femoris (BF), gluteus maximus (GM) (ipsilateral), lumbar multifidus (MF) (bilateral), and the lowT (contralateral). An electromagnetic tracking motion analysis was used to measure the angle of pelvic rotation and anterior tilting. Results: The ipsilateral GM and bilateral MF EMG amplitudes were greater during PHE with lowT pre-activation compared to PHE without lowT pre-activation (p<.05). The BF amplitude during PHE without lowT pre-activation was significantly greater than that during PHE with lowT pre-activation (p<.05). The angles of pelvic rotation and anterior tilting during PHE with lowT pre-activation were significantly smaller compared to PHE without lowT pre-activation (p<.05). Conclusion: PHE with lowT pre-activation, which is aligned with the POS, showed more increased MF and GM muscular activity with smaller lumbopelvic compensations in rotation and anterior tilting compared to PHE without lowT pre-activation.

The aim of this study was to investigate the effect of hip external rotation angle on pelvis and lower limb muscle activity during prone hip extension. Sixteen healthy men were recruited for this study. Each subject performed an abdominal drawing-in maneuver (ADIM) in a prone position, and extended the dominant hip at three different hip external rotation angles (0°, 20°, 40°) with a 30° hip joint abduction. Activity of the gluteus maximus (G Max), gluteus medius (G Med), and hamstring (HAM) and the G Max/HAM and G Med/HAM ratios were determined with surface electromyography (EMG). The EMG signal was normalized to 100% maximum voluntary isometric contractions (MVICs) and expressed as %MVIC. Data were analyzed by one-way repeated analysis of variance (alpha level=.05) and the Bonferroni post hoc test. Significant differences in G Max and G Med muscle activity were noted among the three different hip external rotation angles. G Max muscle activity increased significantly at both 40° (p=.006) and 20° (p=.010) compared to a 0° hip external rotation angle. G Med muscle activity increased significantly at 20° (p=.013) compared to a 40° hip external rotation angle. The G Max/HAM activity ratio increased significantly at both 40° (p=.004) and 20° (p=.014) compared to a 0° hip external rotation angle. The G Med/HAM activity ratio increased significantly at 20° (p=.013) compared to a 40° hip external rotation angle. In conclusion, 40° and 20° hip external rotation angles are recommended to increase G Max activity, and 20° hip external rotation is advocated to enhance G Med muscle activity during prone hip extension with ADIM and 30° hip abduction in healthy subjects.

The purpose of this study was to identify the effects of tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching exercise on the lumbopelvic movement patterns during active prone hip lateral rotation (HLR) in subjects with lumbar extension rotation syndrome accompanying TFL-ITB shortness. Eleven subjects (9 male and 2 female) were recruited for the two-week study. A three dimensional ultrasonic motion analysis system was used to measure the lumbopelvic movement patterns. The TFL-ITB length was measured using the modified Ober's test and was expressed as the hip horizontal adduction angle. The subjects were instructed how to perform TFL-ITB self-stretching exercise program at home. A paired t-test was performed to determine the significant difference in the angle of lumbopelvic rotation, movement onset time of lumbopelvic rotation, TFL-ITB length, and LBP intensity before and after the two-week period of performing the TFL-ITB self-stretching exercise. The results showed that after the intervention, the lumbopelvic rotation angle decreased significantly (p<.05), the movement onset time reduced significantly (p<.05), and LBP intensity decreased slightly but not significantly (p=.07). The hip horizontal adduction angle increased significantly (p<.05) after the intervention. These findings indicate that TFL-ITB stretching exercise increased TFL-ITB length, decreased lumbopelvic rotation angle, and delayed the movement onset time of lumbopelvic rotation after two-weeks. In conclusion, the TFL-ITB self-stretching exercise performed over a period of two weeks may be an effective approach for patients with lumbar extension rotation syndrome accompanying TFL-ITB shortness.

The purpose of this study was to compare the muscle activity of the abdominal and lumbar multifidus during unilateral prone hip extension on the floor and on a round foam roll. Fifteen healthy participants were recruited. They were instructed to perform a unilateral hip extension on the floor and on a round foam roll in the prone position. Surface electromyography (EMG) signals were recorded from bilateral lumbar multifidus (LM), external oblique (EO), and internal oblique (IO) muscles. A paired t-test was used to compare muscle activity, with the level of significance set at =.05. The results showed that bilateral LM, EO, IO EMG activity during right-hip extension on a round foam roll was greater than that on the floor, and EMG activity of bilateral LM, right EO, and left IO during left-hip extension on a round foam roll was greater than that on the floor (p<.05). These findings suggest that the unilateral hip-extension exercise on a round foam roll can be used to activate the lumbar multifidus and abdominal oblique muscles and causes a different increasing pattern between the two lifting sides.

The effects of an abdominal drawing-in maneuver (ADIM) using a pressure bio-feedback unit (PBFU) were compared to the effects of a pelvic belt (PB) on the muscle activities of the hip and back extensor muscles during hip extension in the prone position. Fifteen healthy male participants all performed prone hip extensions under three conditions: 1) preferred hip extension (PHE), 2) performing an ADIM, and 3) using a PB. The muscle activities of the erector spinae, the gluteus maximus, and the medial hamstring on the right side were recorded by surface electromyography. The muscle activity of the erector spinae was significantly lower while performing an ADIM during prone hip extension than during PHE or with a PB (p<.05). Gluteus maximus muscle activity was significantly higher while performing an ADIM (p<.05). No significant difference was found for the medial hamstring muscle among the three conditions (p>.05). We concluded that the internal stabilization of the pelvis and lumbar spine afforded by the ADIM using a PBFU could be more effective than the external stabilization provided by a PB in terms of increasing selectively gluteus maximus activation during prone hip extension.

This study examined the effects of the abdominal drawing-in (ADI) maneuver using a pressure biofeedback on muscle recruitment pattern of erector spinae and hip extensors and anterior pelvic tilt during hip extension in the prone position. Fourteen able-bodied volunteers, who had no medical history of lower extremity or lumbar spine disease, were recruited for this study. The muscle onset time of erector spinae, gluteus maximus, and medial hamstring and angle of anterior pelvic tilt during hip extension in prone position were measured in two conditions: ADI maneuver condition and non-ADI maneuver condition. Muscle onset time was measured using a surface electromyography (EMG). Kinematic data for angle of anterior pelvic tilt were measured using a motion analysis system. The muscle onset time and angle of anterior pelvic tilt were compared using a paired t-test. The study showed that in ADI maneuver during hip extension in prone position, the muscle onset time for the erector spinae was delayed significantly by a mean of 43.20 ms (SD 43.12), and the onset time for the gluteus maximus preceded significantly by a mean of -4.83 ms (SD 14.10) compared to non-ADI maneuver condition (p<.05). The angle of anterior pelvic tilt was significantly lower in the ADI maneuver condition by a mean of 7.03 degrees (SD 2.59) compared to non-ADI maneuver condition (15.01 degrees) (p<.05). The findings of this study indicated that prone hip extension with the ADI maneuver was an effective method to recruit the gluteus maximus earlier than erector spinae and to decrease anterior pelvic tilting.

The purpose of this study was to investigate the effects of hip extension velocity (7.5 degree/second, 30 degree/second) on the relative onset time of the gluteus maximus in relation to the hamstring during hip extension in prone position. Thirteen healthy male subjects (mean age=22.6 years [SD=1.8], mean weight=73.4 kg [SD=10.3], mean height=176.1 cm [SD=6.3]) voluntarily participated in this study. Electromyographic data was collected on the gluteus maximus and hamstring to determine onset time. Statistical analyses were performed with the paired t-test. The results showed that the onset time of the hamstring was significantly faster than that of the gluteus maximus in both fast and slow hip extension velocity. The gluteus maximus began contraction .079 seconds later following the contraction of the hamstring. The onset time of the hamstring was significantly faster in fast hip extension velocity compared with slow hip extension velocity. In conclusion, it was determined that the onset time of the gluteus maximus was faster with fast hip extension velocity compared with slow hip extension velocity. There was a statistically significant difference between the onset times of the gluteus maximus and hamstring in relation to the two velocities (p<.05). Further study is needed to examine whether the velocity of hip extension can influence the onset time in a similar fashion in patients with low back pain.

This study examined the muscle recruitment order during extension of the hip joint in normal subjects, and evaluated whether the external support obtained from wearing a lumbosacral corset had an effect on muscle recruitment leading to increased lumbar stability. The subjects were 40 normal adults (32 male, 8 female) with no history of low back pain and no pathological findings in the nervous or musculoskeletal systems. All subjects extended their hip joints under 3 positions (prone, sidelying, standing). During extension, the onsets of contraction of the rectus abdominis, gluteus maximus, and semitendinosus muscles were measured. Electromyographic activity was measured using a surface electrode, and the muscle contraction onset time was designated as the point exceeding a threshold of 25 ms, using a mean plus twice of the standard deviation. To compare the average order of muscle contraction onset time, a Freedman two-way analysis of variance by ranks was used. The relative difference between muscle contraction onset time wearing and not wearing a lumbosacral corset was measured using a paired t-test. A difference in the average muscle contraction onset order for the rectus abdominis, gluteus maximus, and semitendinosus muscles was observed (p<.05) among three positions. However, wearing a lumbosacral corset did not. change the contraction order. In addition, wearing a lumbosacral corset produced a significant difference (p<.05) in the relative onset time between the rectus abdominis and gluteus maximus in the standing position, but no difference was observed for the other muscles or positions. In the future, patients suffering from low back pain should be compared with normal subjects to determine the effectiveness of a lumbosacral corset in changing muscle recruitment order.

The purpose of this study was to compare the onset times of muscle activities and the order of muscle firing in hamstring gluteus maximus, and lumbar erector spinae muscle during active hip extension between subjects with low back pain (LBP) and healthy subjects. Thirty subjects, 15 with LBP and 15 healthy subjects, participated in this study. Electromyographic activity was recorded during active hip extension in prone and standing position. Relative onset times of these muscle activities were determined. Similar muscle firing order in hamstring, gluteus maximus, and lumbar erector spinae muscle showed in both groups and positions. However, the onset time of gluteus maximus was significantly later in prone and standing active hip extension in subjects with LBP than in healthy subjects. The onset time of lumber erector spinae muscle activity was significantly delayed in subjects with LBP in standing active hip extension, The delayed onset times of gluteus maximus and lumbar erector spinae muscles' activities were probably related to LBP. Further studies are needed to identify whether the delayed onset times of gluteus maximus and lumbar erector spinae muscle activities are the contributing factors to LBP.

The purpose of this study was to determine whether the vastus medialis oblique muscle(VMO) had greater electrical activity than the vastus lateralis muscle(VL) when hip adduction and knee extension exercise were performed. Electrical activity of the VMO and VL was measured on 42 healthy subjects (28 men, 14 women) during maximal voluntary isometric contractions of hip adduction and knee extension by an EMG-BIOFEEDBACK. The results showed that the electromyographic activity of the VMO was significantly greater than that of the VL during the hip adduction exercise. Differences noted with knee extension by performing hip adduction exercises. Isometric hip adduction exercises, therefore, may be advisable in the treatment of patients with patellofemoral pain.