Electromyographic analysis of gluteus medius and gluteus maximus during rehabilitation exercises

Purpose/background: Previous research studies by Bolga, Ayotte, and Distefano have examined the level of muscle recruitment of the gluteal muscles for various clinical exercises; however, there has been no cross comparison among the top exercises from each study. The purpose of this study is to compare top exercises from these studies as well as several other commonly performed clinical exercises to determine which exercises recruit the gluteal muscles, specifically the gluteus medius and maximus, most effectively.

Methods: Twenty-six healthy subjects participated in this study. Surface EMG electrodes were placed on gluteus medius and maximus to measure muscle activity during 18 exercises. Maximal voluntary muscle contraction (MVIC) was established for each muscle group in order to express each exercise as a percentage of MVIC and allow standardized comparison across subjects. EMG data were analyzed using a root-mean-square algorithm and smoothed with a 50 millisecond time reference. Rank ordering of the exercises was performed utilizing the average percent MVIC peak activity for each exercise.

Results: Twenty-four subjects satisfied all eligibility criteria and consented to participate in the research study. Five of the exercises produced greater than 70%MVIC of the gluteus medius muscle. In rank order from highest EMG value to lowest, these exercises were: side plank abduction with dominant leg on bottom (103%MVIC), side plank abduction with dominant leg on top (89%MVIC), single limb squat (82%MVIC), clamshell (hip clam) progression 4 (77%MVIC), and font plank with hip extension (75%MVIC). Five of the exercises recruited gluteus maximus with values greater than 70%MVIC. In rank order from highest EMG value to lowest, these exercises were: front plank with hip extension (106%MVIC), gluteal squeeze (81%MVIC), side plank abduction with dominant leg on top (73%MVIC), side plank abduction with dominant leg on bottom (71%MVIC), and single limb squat (71%MVIC). Four of the exercises produced greater than 70%MVIC for both gluteus maximus and medius muscles.

Conclusions: Higher %MVIC values achieved during performance of exercises correlate to muscle hypertrophy.(20,22) By knowing the %MVIC of the gluteal musculature that occurs during various exercises, potential for strengthening of the gluteal muscles can be inferred. Additionally, exercises may be rank ordered to appropriately challenge the gluteal musculature during rehabilitation.