Exercises without the need for special equipment
Progressions to gradually increase or decrease load demands
Weight- and non-weight bearing exercises
Optimal gluteal muscle function is important as dysfunction is associated with pain at the ankle, knee, hip and lower back. One may think “a little gluteal strengthening a day may keep those symptoms away”. But which exercises for gluteal strengthening to use and how do we progress load? This systematic review summarized the muscular activation of the gluteus medius and minimus through a different range of exercises.
A systematic review with meta-analysis was conducted according to the PRISMA guidelines. Studies measuring healthy participants through intramuscular or surface EMG were included. The EMG had to be converted to a maximal voluntary isometric contraction (MVIC) as this was previously found to be the most reliable method to compare muscle activity. The levels of muscle activation were determined as follows:
To minimize fatigue most studies randomized the exercises and used a restricted number of trials. Participants were allowed to rest between exercises. Therefore we believe fatigue did not interfere with the obtained results. The use of surface EMG in most of the included studies may be subject to artefacts of overlying tissue and movement. However, as it is a non-invasive measurement method, these results may more closely resemble clinical practice than in case invasive methods and very strict protocols would have been used.
Activity in the gluteus minimus muscle was also examined, however, since all but one of these results came from non-pooled analyses, we decided not to include them in this research review and to focus on the results from the pooled analyses. Large variations in the exercises did exist and mostly comprised exercise technique, positioning, number of repetitions and the addition of external resistance. Yet, study results were mostly unanimous, which makes us believe that this division into increasing load is an adequate representation of reality.
Interestingly, this study only included a range of exercises that can be done without the need for special equipment. Therefore these exercises and progressions can be easily implemented in clinical practice and may be scheduled in for example home work-out programs. These progressions can be used in the acute injury phase or after surgery to gradually increase or decrease load demands. In case patients aren’t allowed to bear weight for example, the non-weight bearing exercises can be progressed from low to high activation until weight bearing is allowed.
Link to the paper: https://pubmed.ncbi.nlm.nih.gov/33344003/