Gluteus medius muscle activation in chronic low back pain patients during single leg stance

Penney, Tracy (2012) Gluteus medius muscle activation in chronic low back pain patients during single leg stance. Masters thesis, Memorial University of Newfoundland.

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Abstract

Lumbopelvic dynamic stability is often evaluated by clinicians using the single leg stance (SLS) test when assessing patients with chronic low back pain (CLBP). One of the main stabilizing muscles that is thought to be dysfunctional when there is an inability to maintain lumbopelvic stability during SLS is the gluteus medius. Clinicians often note dysfunction of this hip muscle in patients with CLBP and treat these apparent muscle imbalances. However, there is insufficient evidence to support these clinical findings and the treatment approach. There is evidence of gluteus maximus, abdominal and back muscles contribution to lumbopelvic stability. These muscles contract in anticipation to movement to maintain equilibrium and stability of the spine. With CLBP, the deep stabilizing spinal muscles appear to become weak or have delayed recruitment and the superficial stabilizing muscles appear to become overactive. Other evidence supports the altered recruitment of the agonists/ antagonists and superficial/ deep muscle groups with CLBP compared to their healthy counterparts. As CLBP is heterogeneous in nature, a diverse pattern of motor recruitment has also been found in the gluteus maximus from weakness, poor endurance, and delay in recruitment to over activation. However, there are very few studies that examine the gluteus medius function and its relation to LBP. Weak hip abductors and coordination of right and left gluteus medius have been associated with the development of LBP in healthy subjects. However, there are no studies that examine gluteus medius recruitment and strength in a CLBP population.

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