The Effects of Kinesio Taping® on Muscle Interplay within the Lumbo-Pelvic-Hip Complex: A Randomized Placebo-Controlled Trial.

Coordination of muscle activity is determined by the recruitment order of agonists and synergists that results from their onset times. Motor recruitment deficits are possible. This study examined the acute and prolonged effects of three different techniques of the kinesio taping method in optimizing the intermuscular coordination within the lumbo-pelvic-hip complex. The sample consisted of 56 healthy participants of both genders, randomly divided into equal groups by kinesio taping muscle facilitation, muscle inhibition and functional correction technique, and placebo kinesio taping condition. The onsets of the ipsilateral and contralateral erector spinae muscles, in relation to the semitendinosus muscle of the tested leg, were measured using the surface electromyography, during the active performance of the prone hip extension test. Time span was also determined. Measurements were performed at baseline, 60 min, and 48 h post-intervention. For the control group, we did not find statistically significant differences in the onset between the measurement points (p > 0.05), while in the experimental groups, there was a significant delay in the onset of the contralateral erector spinae (p < 0.001) in the second and third measurement points. These results indicate that the kinesio taping method can optimize the intermuscular coordination, with the potential for primary injury prevention.

The inter-rater reliability of clinical observation of prone hip extension and association between aberrant movement and chronic low back pain.

BACKGROUND: Clinical observation of aberrant movement patterns during prone hip extension (PHE) is commonly used in clinical practice to identify patients with low back pain. It could be clinically useful to identify individuals with chronic low back pain during remission (CLBPremission) to provide proactive intervention to prevent exacerbation of low back symptoms. OBJECTIVES: This study aimed to establish inter-rater reliability of clinical observation of PHE and association between aberrant movement pattern and CLBPremission. DESIGN: A cross-sectional study. METHOD: Twenty-six participants with CLBPremission and 18 participants without history of low back pain (NoLBP) performed 3 repetitions of active PHE, while 2 examiners concurrently observed and independently rated the movements as "presence" or "absence" of aberrant movement. Kappa statistics were used to establish inter-rater reliability based on rating data from 2 examiners, while chi-square tests were used to determine the association between aberrant movement and CLBPremission based on ratings (presence and absence) and known groups (CLBPremission and NoLBP). RESULTS: Kappa values ranged from fair to moderate (Kappa = 0.36-0.58). Result also demonstrated a significant association (P < 0.05) between presence of aberrant movement and CLBPremission. Findings indicate fair to moderate inter-rater reliability which are sufficient for clinical practice. The findings also indicated presence of aberrant movement patterns during active PHE was associated with CLBPremission. CONCLUSIONS: These findings suggested the usefulness of clinical observation of aberrant movement pattern during PHE to identify CLBPremission. The detection of aberrant movement would help clinicians to provide preventive program to minimize the risk of recurrent episodes of low back symptoms.

Effects of abdominal drawing-in maneuver with or without prior iliopsoas stretching on gluteus maximus activity during prone hip extension.

BACKGROUND: Prone hip extension (PHE) has been investigated to strengthen the hip joint and back extensor muscles. However, it has not been compared with various PHE exercises in individuals with iliopsoas shortness. OBJECTIVE: This study compared pelvic compensation and hip and back extensor muscle activities in individuals with iliopsoas shortness during prone hip extension (PHE) using the abdominal drawing-in maneuver alone (PHEA) and after iliopsoas stretching (PHEAS). METHODS: Twenty-five individuals with iliopsoas shortness were included in the study. Electromyography was used to investigate bilateral erector spinae (ES) and ipsilateral gluteus maximus (GM), biceps femoris (BF), and semitendinosus (ST) muscles during PHE, PHEA, and PHEAS. Pelvic anterior tilting and rotation angles were measured during each PHE exercise via electromagnetic motion tracking. A modified Thomas test was used to examine the hip extension angle before and after iliopsoas stretching. One-way repeated-measures analysis of variance was used to investigate differences in pelvic anterior tilting and rotation angle and in hip and back extensor muscle activities among PHE, PHEA, and PHEAS. The level of statistical significance was set at α= 0.01. RESULTS: GM muscle activity was significantly greater with PHEAS, compared to PHE and PHEA (p< 0.01). Bilateral ES and ipsilateral BF and ST muscle activities were significantly reduced with PHEAS, compared to PHE and PHEA (p< 0.01). Anterior pelvic tilting and rotation angles were significantly reduced with PHEAS, compared to PHE and PHEA (p< 0.01). CONCLUSIONS: PHEAS is recommended to selectively strengthen GM muscles with minimal BF and ST muscle activities and pelvic compensation in individuals with iliopsoas shortness. The abdominal drawing-in maneuver (ADIM) after iliopsoas stretching is more efficient than ADIM alone during PHE, especially in individuals with iliopsoas shortness.

Comparison of the electromyographic recruitment of the posterior oblique sling muscles during prone hip extension among three different shoulder positions.

Objective: We examined the effects of three different shoulder positions on the electromyography (EMG) activity of the posterior oblique sling and pelvic rotational angle during right prone hip extension (PHE).Methods: Fifteen healthy males (mean age, 25.4 ± 1.2 years) participated in this study. Three different left shoulder positions (0°, 90°, 125° of abduction) were assessed during right PHE. Surface EMG signals were recorded for the left latissimus dorsi, left middle trapezius, left lower trapezius, lumbar multifidus, right gluteus maximus, and right biceps femoris. An electromagnetic tracking motion analysis device was used to monitor compensatory pelvic rotation during right PHE. Significant differences in muscle activity and pelvic rotation angle among the three different shoulder abductions were assessed using one-way repeated measures analysis of variance and the Bonferroni post hoc test.Results: The bilateral multifidus and right gluteus maximus EMG amplitudes increased with increasing shoulder abduction angle during PHE (padj < 0.01). The degree of pelvic rotation during PHE decreased with increasing shoulder abduction angle (padj < 0.01).Conclusions: We found that PHE with 125° of left shoulder abduction increased the selective activation of lumbopelvic stabilizing muscles such as the multifidus and gluteus maximus.

Effect of abdominal drawing-in maneuver with prone hip extension on muscle activation of posterior oblique sling in normal adults.

[Purpose] There have been many studies on ipsilateral erector spinae in regard of prone hip extension (PHE). However, mediating methods have been focusing on the reinforcement of gluteus. Hereupon, this study is intended to identify how an increase of abdominal drawing-in maneuver influences on posterior oblique sling (POS) and suggest a mediating method to effectively reinforce them. [Participants and Methods] This study has been conducted on normal male (10) and female (10), and participants were asked to prove PHE exercise and abdominal drawing-in maneuver prone hip extension exercise (ADIM PHE). Surface electromyography (EMG) was recorded from the contralateral latissimus dorsi, ipsilateral erector spinae, ipsilateral gluteus maximus, and ipsilateral biceps femoris. A pared t-test was used to compare muscle activity POS. [Results] EMG activity of the contralateral latissimus dorsi, ipsilateral gluteus maximus was significantly greater performed ADIM PHE than PHE. As for ipsilateral erector spinae muscle, ipsilateral biceps femoris activation was lower in ADIM PHE than PHE. [Conclusion] According to the results of this study, abdominal drawing-in maneuver seems to be an important factor that influences on muscular activation of POS.

Relationship Between Lumbar Motor Control Ability and Spinal Curvature in Elderly Individuals.

This study aimed to clarify the relationship between spine curvature and the movement pattern/motor control ability of the lumbar and hip joints during prone hip extension in elderly individuals. The participants were 14 elderly people who attended a community health class. We measured the motion angle, motion ratio (movement pattern), and motor control ability of the lumbar and hip joints during prone hip extension. In addition, the lumbar lordosis angle and thoracic kyphosis angle were measured in the standing position. There was no correlation between the spinal curvature in the standing position and the lumbar/hip joint movement pattern and motor control ability during prone hip extension. When evaluating the lumbar spine, it is necessary to perform a comprehensive evaluation by interpreting static evaluations such as spinal alignment or dynamic evaluations such as movement patterns and motor control abilities.

Evaluating gluteus maximus maximal voluntary isometric contractions for EMG normalization in male rugby players.

[Purpose] The aim of this study was to determine the highest electromyography (EMG) amplitude of the gluteus maximus from closed and open kinetic gluteal maximal voluntary isometric contractions (MVICs). [Participants and Methods] Ten healthy male rugby players performed three MVIC techniques that included, in random order: single leg squat, prone hip extension and standing gluteal squeeze. EMG signals were recorded from the inferior and superior regions of gluteus maximus of the dominant leg, and were normalized to the prone hip extension. [Results] For statistical analysis the EMG of both gluteus maximus regions were pooled together. The standing gluteal squeeze revealed a significantly lower EMG compared to single leg squat and prone hip extension. However, there was no significant difference in gluteal EMG activity between single leg squat and prone hip extension. [Conclusion] There is no distinct advantage for either single leg squat or prone hip extension in eliciting maximum EMG activity. Future research should compare the present positions with other MVICs that are commonly prescribed or have been demonstrated to produce high EMG amplitudes.

Influence of muscle activation of posterior oblique sling from changes in activation of gluteus maximus from exercise of prone hip extension of normal adult male and female.

[Purpose] There have been many study ipsilateral erector spinae in regard of prone hip extension (PHE). However, mediating methods have been focusing on the reinforcement of gluteus. Hereupon, this study is intended to identify how an increase of gluteus maximus influences on posterior oblique sling (POS) and suggest a mediating method to effectively reinforce them. This study shows the seclective POS strength exercise. [Participants and Methods] This study has been conducted on normal male (13) and female (13), and participants were asked to proceed PHE exercise and prone hip extension with hip abduction with knee flexion (PHEAKF). Surface electromyography (EMG) was recorded from the contralateral latissimus dorsi, contralateral erector spinae, ipsilateral erector spinae, ipsilateral gluteus maximus, and ipsilateral biceps femoris. A paried t-test was used to compare muscle activity POS. [Results] EMG activity of the contralateral latissimus dorsi, ipsilateral erector spinae, and ipsilateral gluteus maximus was significantly greater performed PHEAKF than PHE. As for ipsilateral biceps femoris, muscle activation was lower in PHEAKF than PHE. [Conclusions] According to the results of this study, increase in muscular activation from the direction of muscular fiber and posterior oblique sling seems to be an important factor that influencontralateral crector spinae on muscular activation of POS.

Comparison of hip extensor muscle activity including the adductor magnus during three prone hip extension exercises.

OBJECTIVES: This study compared the role of the adductor magnus muscle (Amag) as a hip extensor while performing active prone hip extension (PHE), PHE with hip adduction (PHE-ADD), and PHE with hip abduction (PHE-ABD) with the gluteus maximus (Gmax) and hamstrings. METHODS: The study recruited 22 healthy participants. Electromyography data were recorded from the Amag, Gmax, and medial and lateral hamstrings during PHE, PHE-ADD, and PHE-ABD. Normalized electromyographic data were examined using one-way, repeated-measures analyses of variance. RESULTS: The magnitude of the Amag, Gmax, and hamstring activations did not differ significantly while performing PHE (p = 0.41). Furthermore, the Amag and hamstring activations were significantly greater than the Gmax activation when performing PHE-ADD (p < 0.05). The Gmax showed significantly greater activation during PHE-ABD than the Amag and medial and lateral hamstrings (p < 0.05). CONCLUSIONS: Based on these results, we advocate including the Amag as a hip extensor during the PHE test or exercise. Our preliminary results have the potential to be applied directly to the PHE test, for investigating the muscle-activation pattern of the Amag with the Gmax and hamstrings in patients with hip or lower back pain.

Lumbar lordosis in prone position and prone hip extension test: comparison between subjects with and without low back pain.

BACKGROUND: Prone hip extension (PHE) is a common and widely accepted test used for assessment of the lumbo-pelvic movement pattern. Considerable increased in lumbar lordosis during this test has been considered as impairment of movement patterns in lumbo-pelvic region. The purpose of this study was to investigate the change of lumbar lordosis in PHE test in subjects with and without low back pain (LBP). METHOD: A two-way mixed design with repeated measurements was used to investigate the lumbar lordosis changes during PHE in two groups of subjects with and without LBP. An equal number of subjects (N = 30) were allocated to each group. A standard flexible ruler was used to measure the size of lumbar lordosis in prone-relaxed position and PHE test in each group. RESULT: The result of two-way mixed-design analysis of variance revealed significant health status by position interaction effect for lumbar lordosis (P < 0.001). The main effect of test position on lumbar lordosis was statistically significant (P < 0.001). The lumbar lordosis was significantly greater in the PHE compared to prone-relaxed position in both subjects with and without LBP. The amount of difference in positions was statistically significant between two groups (P < 0.001) and greater change in lumbar lordosis was found in the healthy group compared to the subjects with LBP. CONCLUSIONS: Greater change in lumbar lordosis during this test may be due to more stiffness in lumbopelvic muscles in the individuals with LBP.

Greater trochanter location measurement using a three-dimensional motion capture system during prone hip extension.

[Purpose] The greater trochanter (GT) is an important structure in biomedical research, but the measurement methods require development. This study presents data from a new measurement method that does not use GT-marker-based measurement (No GT-m) in comparison with GT-marker based measurement (GT-m). [Subjects and Methods] We recruited 20 healthy subjects, who were asked to perform and maintain a prone position and then move to the prone hip extension. A motion capture system collected the kinematic data and the location of the GT was calculated by two measurements. [Results] GT migration distance differed significantly between the two measurements and the coefficient of the variation value was lower for the No GT-m method. Thigh lengths of the No GT-m method were comparable to the original lengths. There were significant differences between the GT-m and the other methods. [Conclusions] These data suggest that the GT-m method yielded a lower precision with a smaller GT migration distance. In the comparison of thigh length, the No GT-m method was in close agreement with the original length. We suggest that determining the location of the GT using the No GT-m has greater accuracy than the GT-m method.

Comparison of gluteus maximus and hamstring electromyographic activity and lumbopelvic motion during three different prone hip extension exercises in healthy volunteers.

OBJECTIVE: To compare the surface electromyography (EMG) amplitude of the hip joint, including the gluteus maximus (GM), biceps femoris (BF), and semitendinosus (ST) muscles generated by three different exercises: prone hip extension (PHE), prone table hip extension (PTHE), and prone table hip extension with 90° knee flexion (PTHEK), with compensatory pelvic motions. DESIGN: Repeated-measure within-subject intervention. PARTICIPANTS: Sixteen-healthy males (mean age = 23.4 ± 2.2 years). MAIN OUTCOME MEASURES: EMG was used to collect EMG signals from the GM, erector spinae (ES), BF, and ST muscles. Furthermore an electromagnetic tracking motion analysis was also performed to measure the compensations. RESULTS: EMG amplitude differed significantly among the three conditions (PHE vs. PTHE vs. PTHEK) (p < 0.05). The mean GM muscle activity increased significantly during the PTHEK (70.93% and 13.75% increases in %MVIC compared with the PHE and PTHE, respectively) (p < 0.01). However, there was no significant difference in the kinematic data for rotation or anterior tilting angle of the pelvis among the three conditions (p > 0.05). CONCLUSIONS: These results suggest that the PTHEK can be recommended as an effective method to strengthen the GM muscle without increased BF or ES muscle activities and without compensatory pelvic motions.

Onset and maximum values of electromyographic amplitude during prone hip extension after neurodynamic technique in patients with lumbosciatic pain: A pilot study.

OBJECTIVE: The mechanisms underlying the effects of neurodynamic techniques are still unknown. Therefore, the aim of this study was to provide a starting point for future research on explaining why neurodynamic techniques affect muscular activities in patients with sciatic pain. METHODS: A double-blind trial was conducted in 12 patients with lumbosciatica. Surface electromyography activity was assessed for different muscles during prone hip extension. Pre- and post-intervention values for muscle activity onset and maximal amplitude signals were determined. RESULTS: There was a significant reduction in the surface electromyography activity of maximal amplitude in the erector spinae and contralateral erector spinae (p < 0.05). Additionally, gluteus maximus (p < 0.05) activity onset was delayed post-intervention. CONCLUSIONS: Self-neurodynamic sliding techniques modify muscular activity and onset during prone hip extension, possibly reducing unnecessary adaptations for protecting injured components. Future work will analyze the effects of self-neurodynamic sliding techniques during other physical tasks.

Effect of initial position on the muscle activity of the hip extensors and amount of pelvic tilt during prone hip extension.

[Purpose] The aim of this study was to identify the effects of initial position of the hip joint with changes in the hip joint angle on the respective muscle activities of the bilateral erector spinae (ES), unilateral gluteus maximus (GM), and biceps femoris (BF) and the amount of pelvic anterior tilt during prone hip extension (PHE). [Subjects] Fifteen healthy volunteers were enrolled in this study. [Methods] The subjects performed PHE in three positions: neutral, 20°, and 45° flexed hip joint. The activities of the ES, GM, and BF were measured using surface electromyography, and kinematic values for pelvic anterior tilt were calculated using a motion capture system. [Results] There was a significant decrease in muscle activity of the contralateral ES at 45°, and an increase in the GM muscle activity and decrease in the BF muscle activity at 20°. The amount of pelvic anterior tilt was lower at 20°. [Conclusion] These results suggest that a hip flexion position of 20° would have an advantage over the other measured positions.

Individuals with chronic low back pain demonstrate delayed onset of the back muscle activity during prone hip extension.

Prone hip extension (PHE) is commonly used in the evaluation of the stability of the lumbopelvic region. There is little evidence of difference in muscle activity onset timing between healthy individuals and individuals with chronic low back pain (CLBP) during PHE. The purpose of this study was to determine if individuals with and without CLBP differ in the onset time of the trunk and hip extensor muscles activity during PHE. The participants were 20 patients with CLBP and 20 healthy individuals. Electromyography data of the erector spinae, multifidus, gluteus maximus, and semitendinosus were collected during PHE using a surface electromyograph. Relative differences in the onset times between each muscle and the prime mover (i.e., the semitendinosus) were calculated. The onsets of the bilateral multifidus and contralateral erector spinae were significantly delayed in the CLBP group compared with the healthy group (p<0.001), despite the onset timings of leg movement not being significantly different between the groups. The onset times of the gluteus maximus and ipsilateral erector spinae showed no significant differences between the groups. These results suggest that individuals with CLBP use an altered, and possibly inadequate, trunk muscle recruitment pattern.

Effects of abdominal drawing-in during prone hip extension on the muscle activities of the hamstring, gluteus maximus, and lumbar erector spinae in subjects with lumbar hyperlordosis.

[Purpose] The purpose of this study was to compare the effects of an abdominal drawing-in maneuver (ADIM), measured using a pressure bio-feedback unit, on the activities of the hamstring, gluteus maximus, and erector spinae muscles during prone hip extension. [Subjects and Methods] Thirty healthy adult subjects (14 male, 16 female), were recruited. Subjects' lumbar lordosis and pelvic tilt angles were measured, and based on the results, the subjects were divided into two groups: a hyperlordotic lumbar angle (HLLA) group (n=15) and a normal lordotic lumbar angle (NLLA) group (n=15). The muscle activities of the hamstring and gluteus maximus, and of the erector spinae on the right side of the body, were recorded using surface electromyography. [Results] When performing ADIM with prone hip extension, the muscle activity of the gluteus maximus of the HLLA group significantly improved compared with that the NLLA group. [Conclusion] This study demonstrated that ADIM with prone hip extension was more effective at eliciting gluteus maximus activity in the HLLA group than in the NLLA group. Therefore, ADIM with prone hip extension may be useful for increasing the gluteus maximus activity of individuals with lumbar hyperlordosis.

Effect of abduction and external rotation of the hip joint on muscle onset time during prone hip extension with knee flexion.

[Purpose] This study investigated the effect of hip position on muscle onset time during prone hip extension with knee flexion. [Subjects] The study included 21 healthy male volunteers. [Methods] Muscle onset times of the right gluteus maximus, right hamstrings, bilateral lumbar erector spinae, and bilateral lumbar multifidus were measured using surface electromyography during right hip extension with knee flexion in the prone position. Measurements were made with the hip in 3 positions: (1) neutral, (2) abduction, and (3) abduction and external rotation. [Results] Gluteus maximus onset relative to the hamstrings was significantly earlier with hip abduction and with hip abduction and external rotation compared with that with the hip in the neutral position. Gluteus maximus onset relative to the hamstrings was significantly earlier with hip abduction and external rotation compared with that with hip abduction. The bilateral multifidus and left lumbar erector spinae onset times relative to the hamstrings were significantly earlier with hip abduction and external rotation compared with those with hip abduction and with the hip in the neutral position. [Conclusion] Abduction and external rotation of the hip during prone hip extension with knee flexion is effective for advancing the onset times of the gluteus maximus, bilateral multifidus, and contralateral lumbar erector spinae.

EMG activity and force during prone hip extension in individuals with lumbar segmental instability.

The goal of the current study was to investigate potential differences in back and hip extensor muscle activity and hip extension force during prone hip extension (PHE) in individuals with lumbar segmental instability (LSI) and asymptomatic subjects. Thirty-six subjects with LSI and 26 asymptomatic volunteers participated in this study. Muscle activity of the erector spinae, gluteus maximus, and biceps femoris was recorded using electromyography (EMG), and hip extension force was measured by a digital force gauge. Muscle activity was significantly greater in subjects with LSI than in asymptomatic subjects during PHE (p < 0.05). Hip extension force was significantly lower in the subjects with LSI than in asymptomatic subjects during PHE (p < 0.05). These findings suggest that during PHE, subjects with LSI have differences in back and hip extensor muscle activity and hip extension force compared to asymptomatic individuals.

Task-specificity of bilateral anticipatory activation of the deep abdominal muscles in healthy and chronic low back pain populations.

STUDY DESIGN: Cross-sectional study of lumbopelvic muscle activation during rapid limb movements in chronic low back pain (CLBP) patients and healthy controls. INTRODUCTION: Controversy exists over whether bilateral anticipatory activation of the deep abdominal muscles represents a normal motor control strategy prior to all rapid limb movements, or if this is simply a task-specific strategy appropriate for only certain movement conditions. OBJECTIVE: To assess the onset timing of the transversus abdominis/internal oblique muscles (TrA/IO) during two rapid limb movement tasks with different postural demands - bilateral shoulder flexion in standing, unilateral hip extension in prone lying - as well as differences between CLBP and controls. METHODS: Twelve CLBP and 13 controls performed the two tasks in response to an auditory cue. Surface EMG was acquired bilaterally from five muscles, including TrA/IO. RESULTS: In both groups, 50% of bilateral shoulder flexion trials showed bilateral anticipatory TrA/IO activation. This was rare, however, in unilateral hip extension for which only the TrA/IO contralateral to the moving leg showed anticipatory activation. The only significant difference in lumbo-pelvic muscle onset timing between CLBP and controls was a delay in semitendinosus activation during bilateral shoulder flexion in standing. CONCLUSION: Our data suggest that bilateral anticipatory TrA/IO activation is a task-specific motor control strategy, appropriate for only certain rapid limb movement conditions. Furthermore, the presence of altered semitendinosus onset timing in the CLBP group during bilateral shoulder flexion may be reflective of other possible lumbo-pelvic motor control alterations among this population.