Rani Babina, Sharma Shivam, Berwal Prerana, Shree Ritu, Dhillon Mandeep S
Department of Physical & Rehabilitation Medicine (Physiotherapy), Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Department of Neurology, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
J Orthop. 2023 May 22;41:33-38. doi: 10.1016/j.jor.2023.05.005. eCollection 2023 Jul.
Gluteus maximus (GM) dysfunction is associated with spinal/lower extremity musculoskeletal conditions. Studies on weightbearing GM exercises that can be used earlier in rehabilitation is limited. Utilizing GM isometric contraction and load transmission to thoracolumbar fascia during trunk straightening under unilateral stance, we for the first time describe Wall Touch Single Limb Stance (WT-SLS) exercise. Specific exercise prescription may be rationalised using knowledge of how upper and lower fibres of GM (UGM, LGM) respond during novel WT-SLS.
Surface EMG signals from UGM and LGM were compared among WT-SLS, Step up (SU) and Unilateral wall squat (UWS) in healthy subjects (N = 24). Raw data was normalized and expressed as percentage of maximum voluntary isometric contraction (%MVIC). Relative easiness in performing the exercises was scored using Borg's CR10 scale. Statistical significance was defined as p < 0.05.
WT-SLS had the highest %MVIC for both UGM and LGM (p < 0.0001), suggesting maximum activation of GM in healthy adults by our novel exercise. WT-SLS generated more motor unit action potentials, and had significantly greater activity for UGM than LGM (p = 0.0429). Remaining exercises had no differential activation of UGM and LGM. WT-SLS was perceived as only 'slight' exertion.
WT-SLS depicted the greatest muscle activation, suggesting possible better clinical and functional outcomes considering GM activation and strengthening. UGM was preferentially activated during WT-SLS, but not during SU and UWS. Therefore, targeting GM with our novel exercise may improve gluteal weakness and dysfunction in lumbar radiculopathy, knee ligament injuries; as preventive measure for injury; or for postural correction.
臀大肌(GM)功能障碍与脊柱/下肢肌肉骨骼疾病相关。关于可在康复早期使用的负重GM锻炼的研究有限。在单腿站立时躯干伸直过程中,利用GM等长收缩和向胸腰筋膜的负荷传递,我们首次描述了靠墙触摸单腿站立(WT-SLS)锻炼。使用关于GM上、下纤维(UGM、LGM)在新型WT-SLS中如何反应的知识,可能会使特定的运动处方更加合理。
在健康受试者(N = 24)中,比较了WT-SLS、上台阶(SU)和单腿靠墙深蹲(UWS)时UGM和LGM的表面肌电信号。原始数据进行了归一化处理,并表示为最大自主等长收缩的百分比(%MVIC)。使用Borg的CR10量表对进行锻炼的相对难易程度进行评分。统计学显著性定义为p < 0.05。
WT-SLS的UGM和LGM的%MVIC均最高(p < 0.0001),表明我们的新型锻炼能使健康成年人的GM得到最大程度的激活。WT-SLS产生了更多的运动单位动作电位,并且UGM的活动明显大于LGM(p = 0.0429)。其余锻炼对UGM和LGM没有差异激活。WT-SLS仅被认为是“轻微”用力。
WT-SLS显示出最大的肌肉激活,考虑到GM的激活和强化,这表明可能会有更好的临床和功能结果。在WT-SLS过程中UGM被优先激活,但在SU和UWS过程中则不然。因此,用我们的新型锻炼针对GM可能会改善腰椎神经根病、膝关节韧带损伤中的臀肌无力和功能障碍;作为损伤的预防措施;或用于姿势矫正。