Reflex activation of gluteal muscles in walking. An approach to restoration of muscle function for patients with low-back pain.

Gluteal activation and pelvic stability often are decreased in chronic low-back pain sufferers, but the importance of motor control and programming in treatment has not been fully evaluated. This study investigated whether gluteal muscles could be activated more effectively by stimulating the proprioceptive mechanism during walking. Labile support, through wearing "balance shoes," offered facilitation of cerebellovestibular circuits. Electromyographic recordings of gluteus maximus and medius in 15 healthy subjects were made during barefoot and balance shoes walking before and after 1 week of facilitation. Significant increases (P < 0.0002) in gluteal activity and significant decreases (P < 0.01) in time to 75% maximum contraction, demonstrated the value of sensorimotor elicitation of subconscious and automatic responses in muscles often weakened in back pain sufferers.