Background: Strengthening and activation of the gluteus maximus and gluteus medius while minimizing the contribution of the tensor fascia latae are important components in the treatment of many lower limb injuries. Previous researchers have evaluated a myriad of exercises that activate the gluteus maximus (GMax) and gluteus medius (GMed), however, limited research has been performed describing the role of the addition of elastic resistance to commonly used exercises. Purpose: The primary purpose of this study was to determine the gluteal-to-tensor fascia latae muscle activation (GTA index) and compare electromyographic muscle activation of the GMax, GMed, and TFL while performing 13 commonly prescribed exercises designed to target the GMax and GMed. The secondary purpose of this study was to compare muscle activation of the GMax, GMed, and TFL while performing a subgroup of three matched exercises with and without elastic resistance. Study Design: Repeated measures cohort study Methods: A sample of 11 healthy, physically active male and females, free of low back pain and lower extremity injuries, were recruited for the study. Surface electromyography was used to quantify the normalized EMG activation of the gluteus maximus, gluteus medius, and tensor fascia latae while performing 13 exercises. Three of these exercises were performed with and without elastic resistance. The maximal voluntary isometric contraction was established for each muscle and order in which the exercises were performed was randomized to minimize the effect of fatigue. Results: The relative activation of the gluteal muscles were compared to the tensor fascia latae and expressed as the GTA index. Clams with and without resistance, running man gluteus maximus exercise on the stability trainer, and bridge with resistance, generated the highest GTA index respectively. Significant differences in activation of the TFL occurred between clams with and without resistance. Conclusions: The findings are consistent with those of previous investigators who reported that the clam exercise optimally activated the gluteal muscles while minimizing tensor fascia latae activation.
Background: Annually, $30%-50% of adults will experience some form of debilitating neck pain. One approach to treating neck pain is cervical manipulation. This treatment modality has, at times, been reported to result in a short-term increase in pain, which in turn has been linked to reduced neck range of motion (ROM). Elastic therapeutic tape (ETT) has been shown to reduce musculoskeletal pain, although limited research has been conducted to determine if ETT can mitigate pain and facilitate neck ROM following cervical manipulation. Purpose: The purpose of this study is to compare the pain and neck ROM among patients with acute neck pain who do and do not receive ETT following cervical manipulation. Methods: A convenience sample of 50 patients between 18 and 64 years of age presented with acute noncomplicated neck pain was recruited from an outpatient chiropractic clinic. Patients were randomly assigned to 2 groups. In the tape group (n = 27), ETT was applied to their neck immediately following cervical manipulation for neck pain. In the control group (n = 23), cervical manipulation was performed with no application of ETT following the procedure. Pain and neck ROM were recorded at the following 3 different intervals: pre-cervical manipulation (T1), within 5 minutes of cervical manipulation (T2), and 24-48 hours after manipulation (T3). In total, 6 cervical ROM values were recorded with dual inclinometers. Pain was measured by asking of each patient to rate their neck pain using the numeric pain rating scale from 0 to 10. Results: The tape group demonstrated a significant decline (P < 0.00) in pain between T1 (x = 6.15) and T2 (x = 5.37) and between T1 and T3 (x = 4.89). The control group did not report significant changes in their pain over the duration of the study. Neither group reported any significant change in any measure of neck ROM over the duration of the study. Clinical Relevance: Results from this study support the use of ETT to reduce pain immediately and 24-48 hours following cervical manipulation among patients presenting with acute neck pain.
Background: Cryotherapy has since long been used by physical therapists and chiropractors in the management of acute pain; more recently, its use has been shown to be effective in managing chronic pain. Multiple studies have shown that both ice and menthol reduce blood flow to the affected area and help control pain; however, there is limited research to determine the form of cryotherapy that works better on individual patients. Purpose: The purpose of this study was to compare the effect of a cold pack and menthol topical gel on reports of pain among individuals with neck pain. Methods: In this randomized study, 51 individuals in the age range of 19-65 years (37 6 11.2 years) with bilateral, nonradicular, acute neck pain (myalgia) were included. Cold packs and Biofreeze ® , a topical analgesic, were applied on either side of the neck (ie, ice on one side and Biofreeze on the other). The patients were asked to rate their pain on a 0-10 visual analog scale for either side of the neck both before and immediately following the 10-minute treatment. In addition, the patients were asked to answer 2 questions about which modality they would prefer to use in the future for pain management and their level of comfort with each modality during its application and to rate their answers on a 5-point scale (1 = very unlikely or very uncomfortable and 5 = very likely or very comfortable). On the next day of treatment with cold packs and Biofreeze, patients were asked to choose their preferred mode of treatment among the two and the modality that had a longer-lasting effect. Results: Overall, when asked to rate the comfort and preference, patients preferred Biofreeze 8:1 (P = .000). The average score on the 5-point Likert scale was 4.20 and 2.57 for Biofreeze and cold pack, respectively. In addition, 9 out of 10 patients reported that the effect of Biofreeze lasted longer than that of ice (P = .000). Further, the average score for Biofreeze and ice was 4.47 to 2.63, respectively. For actual levels of pain relief, the
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