Hip muscle activation and knee frontal plane motion during weight bearing therapeutic exercises.

PURPOSE/
BACKGROUND: Hip abduction strengthening exercises may be critical in the prevention and rehabilitation of both overuse and traumatic injuries where knee frontal plane alignment is considered to be important. The purpose of the current investigation was to examine the muscular activation of the gluteus maximus and gluteus medius during the double-leg squat (DLS), single-leg squat (SLS), or front step-up (FSU), and the same exercises when an added load was used to pull the knee medially.
METHODS: Eighteen healthy females (ages 18-26) performed six exercises: DLS, DLS with load, FSU, FSU with load, SLS, and SLS with load. Integrated and peak surface electromyography of gluteus maximus and gluteus medius of the dominant leg were recorded and normalized. Motion analysis was used to measure knee abduction angle during each exercise.
RESULTS: SLS had the highest integrated and peak activation for both muscles, regardless of load. Adding load, only increased DLS integrated gluteus maximus activation (p=0.019). Load did not increase integrated gluteus medius or peak gluteus maximus activation. Adding load decreased SLS peak gluteus medius activation (p=0.003). Adding load increased peak knee abduction angle during DLS (p=0.013), FSU (p=0.000), and SLS (p=0.011).
CONCLUSIONS: Overall, the SLS was most effective exercise for activating the gluteus maximus and gluteus medius. Applied knee load does not appear to increase muscle activation during SLS and FSU. DLS with an applied load may be more beneficial in activating the gluteus maximus. Overall, the use of applied loads appears to promote poorer musculoskeletal alignment in terms of peak knee valgus angle. LEVEL OF EVIDENCE: 3.