Background: The gluteus medius (Gmed) plays a critical role in maintaining frontal plane stability of the pelvis during functional activities, such as one-leg lifting. Side-lying hip abduction (SHA) has been used as a dynamic test to evaluate Gmed function. However, the abduction force of the lower leg against the floor is not controlled during SHA. Therefore, hip abduction performance with contralateral adduction in the side-lying position (HAPCA) can be proposed as an alternative method to assess performance of hip abduction. If the number of HAPCA is related to the lateral pelvic shift distance, a new quantitative measurement for hip abductor function may be presented. Objects: This study aimed to investigate the relationship between the number of successful HAPCA and the lateral pelvic shift distance during one-leg lifting. Methods: Thirty healthy participants were recruited, and lateral pelvic shift distance was measured during one-leg lifting test using two-dimensional analysis. The number of successful HAPCA was counted when participants touched both target bars at the beat of a metronome. Results: There was a negative correlation between the number of HAPCA and lateral pelvic shift distance during one-leg lifting (r = –0.630, p < 0.05). The number of HAPCA accounted for 39.7% of the variance in the lateral pelvic shift distance during one-leg lifting (F = 18.454, p < 0.001). Conclusion: The number of successful HAPCA is significantly correlated with lateral pelvic shift distance during one-leg lifting. This finding suggests that HAPCA can be proposed as a new measurement for hip abductor performance and more research is needed on its relationship with hip abductor strength.

Background: Muscle activities of gluteus maximus (GM) and hamstring (HAM) have important roles in the stability and mobility of the hip joint during various functional activities including bridge and prone hip extension exercises. Objects: The purpose of this study is to investigate muscle activities of GM, multifidus (MF) and HAM during three different bridge exercises in healthy individuals. Methods: Twenty healthy subjects were participated. Electromyography device was used to measure muscle activities of GM, MF and HAM. Each subject was asked to perform three different bridge exercises with hip abduction (0°, 15°, 30°) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Statistical significance was set at α = 0.01. Results: The muscle activity of GM was significantly different among three conditions (hip abduction 0°, 15°, 30°) (adjusted p-value [Padj] < 0.01). The muscle activity of GM was significantly greater during bridge exercise with hip abduction 30° compared to 0° and 15° (Padj < 0.01). There was no significant difference in the muscle activity of MF and HAM muscle (Padj > 0.01). The ratio of muscle activity (ratio = GM/HAM) during bridge exercise with hip abduction 30° was significant greater compared to the hip abduction angles 0° and 15° (Padj < 0.01). Conclusion: Bridge exercise with hip abduction 30° can be recommended to selectively facilitate the muscle activity of GM and improve the ratio of muscle activity between GM and HAM.

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.

Background: A tight iliotibial band (ITB) may lead to lateral patellar maltracking, compression, and tilt, and dominant vatus lateralis (VL) muscle activation relative to vastus medialis oblique (VMO) can laterally displace the patella, which leads to anterior knee pain. Therefore, an effective management technique is needed to stabilize the patella in individuals with tight ITB. Increased stability during the modified Thomas test has the potential to decrease compensatory motion and thus to selectively stretch the ITB. Objects: The purpose of this study was to determine the effects of ITB stretching in the modified Thomas test position on ITB flexibility, patellar translation, and muscle activities of the VMO and VL during quadreceps-setting (QS) exercise in individuals with tight ITB. Methods: Twenty-one subjects with tight ITB were recruited. Digital inclinometer was used to measure the hip adduction angle during the modified Ober test. Universal goniometer was used to measure the hip abduction angle during the modified Thomas test. Ultrasonography was used to measure the patella-condylar distance. Electromyography was performed to collect data of muscle activities. Paired t-test was used to determine the statistical significance between pretest and posttest. Results: The range of hip adduction in modified Ober test increased (p=.04) and the range of hip abduction in the modified Thomas test decreased after ITB stretching (p<.01). There was no difference between lateral patellar translation (p=.18). VMO muscle activity significantly increased after ITB stretching during QS (p<.01). VL muscle activity had no difference after stretching. Conclusion: The ITB stretching in the modified Thomas test position can be suggested as a management method for improving ITB flexibility and VMO muscle activity in individuals with tight ITB.

Background: Improvement of lumbo-pelvic stability can reduce the compensatory action of the quadratus lumborum (QL) and selectively strengthen the gluteus medius (GM) during side-lying hip abduction (SHA). There are abdominal draw-in maneuver (ADIM) and abdominal bracing (AB) as active ways, and pelvic compression belt (PCB) as a passive way to increase of lumbo-pelvic stability. It is necessary to compare how these stabilization methods affect the selective strengthening of the GM. Objects: To investigate the effects of ADIM, AB, and PCB during SHA on the electromyography (EMG) activity of the GM, QL, external oblique (EO) and internal oblique (IO), and the GM/QL EMG activity ratio. Methods: A total of 20 healthy male adults participated in the study. The subjects performed three conditions in side-lying in random order: SHA with ADIM (SHA-ADIM), SHA with AB (SHA-AB), and SHA with PCB (SHA-PCB). To compare the differences among the three conditions, the EMG activities of the GM, QL, EO and IO, and GM/QL EMG activity ratio were analyzed using one-way repeated ANOVA. Results: The EMG activity of the QL was significantly higher in SHA-AB than in SHA-ADIM and SHA-PCB. The GM/QL activity ratio was significantly higher in SHA-PCB than in SHA-ADIM and SHA-AB. In addition, the figure for SHA-ADIM was significantly higher than that for SHA-AB. In the case of the EO, the figure for SHA-AB was significantly higher than corresponding values for the other two conditions. The figure for SHA-ADIM was significantly higher than that for SHA-PCB. The EMG activity of the IO was significantly higher in SHA-AH than in SHA-PCB. Conclusion: It can be suggested that wearing the PCB can more selectively strengthen the GM than to perform ADIM and AB during SHA. In addition, the ADIM can be recommended when there is a need to strengthen abdominal muscles during SHA.

Background:To improve lumbo-pelvic stability, passive support devices (i.e., a pelvic belt) are recommended clinically. Nevertheless, to understand the influence of passive support on lumbo-pelvic stability, it is necessary to examine the influence of a pelvic belt on the abdominal and hip abductor muscles.Objects:To examine the effects of a pelvic belt on the forces of the hip adductor and abductor muscles and activity of the abdominal muscles during isometric hip adduction and abduction.Methods:This study recruited 14 healthy men. All subjects performed isometric hip adduction and abduction with and without a pelvic belt in a neutral hip position. Load cells, wrapped with a non-elastic belt, were placed above the medial and lateral malleoli of the dominant leg to measure the muscle forces of the hip adductors and abductors, respectively. The forces of the hip adductors and abductors were measured using a load cell during isometric hip adduction and abduction, while the electromyographic activities of the bilateral rectus abdominis, internal oblique, and external oblique muscles were measured.Results:The forces generated by the hip adductors and abductors were significantly greater with the pelvic belt than without (p<.05). No significant differences in abdominal muscle activities between the two conditions were found (p>.05).Conclusion:These findings suggest that use of a pelvic belt could lead to effective strengthening exercise of hip muscles in individuals with sacroiliac joint pain.

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 (F2,41=11.817, p<.001) and Gmax (F3,52=5.513, p=.003) muscle activity, and Gmed/TFL (F3,54=8.735, p<.001) and Gmax/TFL (F2,37=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.

Background: Lumbar stabilization (LS) improve the thickness of the quadratus lumborum (QL) muscle and muscle activity of the gluteus medius (GM) muscle during hip abduction in a side-lying position in patients with low back pain (LBP). Objects: The purpose of this study was to assess the effects of LS on muscle thickness of QL and muscle activity of GM during hip abduction in side-lying in patients with LBP. Methods: The study included 32 patients with LBP, who were randomly divided into the control group and experimental group, each with 16 patients. All subjects performed 35° preferred hip abduction (control group) and 35° hip abduction with LS (experimental group) during side-lying. An ultrasonography and a surface electromyography were used to measure the thickness of the QL muscle, and the muscle activities of the GM muscle respectively. Independent t-test was used to compare the muscle thickness of the QL and the muscle activity of the GM muscle, respectively. Results: Anterio-posterior diameter in the muscle thickness of QL muscle was decreased significantly in hip abduction with LS more than in preferred hip abduction (p<.001), but medio-lateral diameter in the muscle thickness of QL muscle was not significantly different between in preferred hip abduction and in hip abduction with LS (p=.06). The muscle activity of GM was increased significantly in hip abduction with LS more than in preferred hip abduction (p<.001). Conclusion: These findings suggest that hip abduction with LS could be recommended as a hip abduction for LS and a prevention unwanted compensatory pelvic lateral tilting movement.

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.

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), preferred hip abduction (PHA) and abduction with 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.