Progressive hip rehabilitation: the effects of resistance band placement on gluteal activation during two common exercises.

Background: A critical issue for constructing a progressive rehabilitation program is the knowledge of muscle activation levels across exercises and within exercise modifications. Many exercises are offered to enhance gluteal muscle activation during functional rehabilitation but little data exists to guide the progression of exercise intensity during rehabilitation. The objective of this paper was to examine the effects of altering resistance band placement during 'Monster Walks' and 'Sumo Walks.'

Methods: Nine healthy male volunteers formed a convenience sample. Sixteen electromyography channels measured neural drive of selected muscles of the right hip and torso muscles. Three resistance band placements (around the knees, ankles and feet) during the two exercises were utilized to provide a progressive resistance to the gluteal muscles while repeated measures ANOVA with Bonferroni adjustment was used to assess differences in mean EMG. The presentation of exercises and band placement were randomized.

Findings: Examining muscle activation profiles in the three hip muscles of interest revealed the progressive nature of the neural drive when altering band placement. Tensor fascia latae (TFL) demonstrated a progressive activation moving the band from the knee to the distal band placement, but not between the ankle and foot placements. Gluteus medius demonstrated a progressive activation moving distally between band placements. Gluteus maximus was preferentially activated only during the foot placement.

Interpretation: The band placements offered a progressive increase in resistance for hip rehabilitation, specifically the gluteal muscles. The added benefit of placing the band around the forefoot was selective enhancement of the gluteal muscles versus TFL presumably by adding an external rotation effort to the hips. This information may assist those who address gluteal activation patterns for patients suffering hip and back conditions where gluteal activation has been affected.