A Study on the Effects of Gluteal Muscle Activation on the Electromyography of Lower Limb Muscles in Young Male Patients With Patellofemoral Pain Syndrome

Yue Wu , Shuang Ren , Hongshi Huang , Yingfang Ao , Bo Gou

Orthopaedic Surgery ›› 2025, Vol. 17 ›› Issue (3) : 744 -752.

PDF
Orthopaedic Surgery ›› 2025, Vol. 17 ›› Issue (3) : 744 -752. DOI: 10.1111/os.14320
CLINICAL ARTICLE

A Study on the Effects of Gluteal Muscle Activation on the Electromyography of Lower Limb Muscles in Young Male Patients With Patellofemoral Pain Syndrome

Author information +
History +
PDF

Abstract

Objective: Patellofemoral pain syndrome (PFPS) is a common knee issue, and hip joint function significantly affects knee health. Gluteus activation exercises are a promising treatment for PFPS. This study aims to investigate the impact of gluteal muscle activation exercises on the muscle involvement and movement patterns of young male patients with PFPS.

Methods: Our study was a randomized controlled clinical trial study from June 2020 to December 2021, included 18 young male patients with PFPS, randomly divided into two groups: the gluteus activation group (GAG) and control group (CON), with nine cases in each group. The GAG underwent gluteal muscle activation exercises for 40 min per session, three times per week, for 6 weeks; the CON received no intervention. At baseline and after 6 weeks, the integrated electromyography (IEMG), contribution rates (CRs), and activation times (ATs) of the gluteus maximus (GM), vastus medialis (VM), rectus femoris (RF), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) muscles of the affected lower limb during stair-climbing exercise were assessed. Additionally, the explosive power (EP) of the lower limbs and the visual analog scale (VAS) pain value of the knee joint were evaluated. Paired sample t-tests and independent sample t-tests were used to compare the differences within and between groups.

Results: After 6 weeks, the GAG showed a significant increase in the IEMG of GM by 118 ± 67.09 µVs compared to CON (p < 0.05), and an increase in the CR of the GM by 6.75% (p < 0.05). Additionally, the AT of the GM and BF was significantly reduced (p < 0.05), and the lower limb EP increased by 14.66% compared to the CON (p < 0.05). Concurrently, there was a very significant reduction in the knee VAS pain score (p < 0.01). The CON exhibited no significant changes in the EMG indices of the lower limbs, EP, and VAS before and after the 6 weeks (p > 0.05).

Conclusion: A 6-week gluteal muscle activation training program for patients with PFPS can adjust and optimize the IEMG, CR, and firing order of the lower limb muscle groups, enhance EP, and alleviate pain.

Keywords

electromyography / gluteus activation / patellofemoral pain syndrome / young male

Cite this article

Download citation ▾
Yue Wu, Shuang Ren, Hongshi Huang, Yingfang Ao, Bo Gou. A Study on the Effects of Gluteal Muscle Activation on the Electromyography of Lower Limb Muscles in Young Male Patients With Patellofemoral Pain Syndrome. Orthopaedic Surgery, 2025, 17(3): 744-752 DOI:10.1111/os.14320

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

V. Duong, W. M. Oo, C. Ding, A. G. Culvenor, and D. J. Hunter, “Evaluation and Treatment of Knee Pain: A Review,” Journal of the American Medical Association 330 (2023): 1568–1580,

[2]

C. J. Barton and K. M. Crossley, “Sharing Decision-Making Between Patient and Clinician: The Next Step in Evidence-Based Practice for Patellofemoral Pain?,” British Journal of Sports Medicine 50 (2016): 833–834,

[3]

M. A. Rothermich, N. R. Glaviano, J. Li, and J. M. Hart, “Patellofemoral Pain,” Clinics in Sports Medicine 34 (2015): 313–327,

[4]

H. R. C Screen, J. Selfe, D. Thacker, et al., “Incidence and Prevalence of Patellofemoral Pain: A Systematic Review and Meta-Analysis,” PLoS One 13 (2018): e0190892,

[5]

S. H. Kunene, S. Ramklass, and N. P. Taukobong, “Anterior Knee Pain and Its Intrinsic Risk Factors Among Runners in Under-Resourced Communities in Ekurhuleni, Gauteng,” South African Journal of Physiotherapy 74, no. 1 (2018): 452,

[6]

B. S. Neal, S. D. Lack, N. E. Lankhorst, A. Raye, D. Morrissey, and M. van Middelkoop, “Risk Factors for Patellofemoral Pain: A Systematic Review and Meta-Analysis,” British Journal of Sports Medicine 53 (2019): 270–281,

[7]

C. N. Fick, C. Grant, and F. T. Sheehan, “Patellofemoral Pain in Adolescents: Understanding Patellofemoral Morphology and Its Relationship to Maltracking,” American Journal of Sports Medicine 48 (2019): 341–350,

[8]

D. M Bazett-Jones, B. S. Neal, C. Legg, H. F. Hart, N. J. Collins, and C. J. Barton, “Kinematic and Kinetic Gait Characteristics in People With Patellofemoral Pain: A Systematic Review and Meta-Analysis,” Sports Medicine 53 (2022): 519–547,

[9]

C. M. Powers, “The Influence of Altered Lower-Extremity Kinematics on Patellofemoral Joint Dysfunction: A Theoretical Perspective,” Journal of Orthopaedic and Sports Physical Therapy 33 (2003): 639–646,

[10]

G. S. Vasconcelos, G. S. Nunes, R. F. Munhoz, et al., “Is Strength and Power Training Targeting Hip and Knee Muscles Superior to Strength Training in Individuals With Patellofemoral Pain? Proof of Concept Study,” Scientific Reports 14 (2024): 27450,

[11]

D. Ramskov, C. Barton, R. O. Nielsen, and S. Rasmussen, “High Eccentric Hip Abduction Strength Reduces the Risk of Developing Patellofemoral Pain Among Novice Runners Initiating a Self-Structured Running Program: A 1-Year Observational Study,” Journal of Orthopaedic and Sports Physical Therapy 45 (2015): 153–161,

[12]

V. Scheer and B. J. Krabak, “Musculoskeletal Injuries in Ultra-Endurance Running: A Scoping Review,” Frontiers in Physiology 12 (2021): 664071,

[13]

J. R. de Souza Júnior, L. W. Gaudette, C. D. Johnson, et al., “Interaction of Biomechanical, Anthropometric, and Demographic Factors Associated With Patellofemoral Pain in Rearfoot Strike Runners: A Classification and Regression Tree Approach,” Sports Medicine -Open 10 (2024): 5,

[14]

T. H. Nakagawa, E. T. Moriya, C. D. Maciel, and F. V. Serrão, “Trunk, Pelvis, Hip, and Knee Kinematics, Hip Strength, and Gluteal Muscle Activation During a Single-Leg Squat in Males and Females With and Without Patellofemoral Pain Syndrome,” Journal of Orthopaedic and Sports Physical Therapy 42 (2012): 491–501,

[15]

A. A. Zadpoor, A. Phinyomark, B. A. Hettinga, S. T. Osis, and R. Ferber, “Gender and Age-Related Differences in Bilateral Lower Extremity Mechanics During Treadmill Running,” PLoS One 9 (2014): e105246,

[16]

D. Y. Gaitonde, A. Ericksen, and R. C. Robbins, “Patellofemoral Pain Syndrome,” American Family Physician 99 (2019): 88–94.

[17]

S. McClinton, G. Donatell, J. Weir, and B. Heiderscheit, “Influence of Step Height on Quadriceps Onset Timing and Activation During Stair Ascent in Individuals With Patellofemoral Pain Syndrome,” Journal of Orthopaedic and Sports Physical Therapy 37 (2007): 239–244,

[18]

A. Rodrigues, L. Janssens, D. Langer, et al., “Semi-Automated Detection of the Timing of Respiratory Muscle Activity: Validation and First Application,” Frontiers in Physiology 12 (2021): 794598,

[19]

S. Wang, S. Miao, P. Zhuang, Y. Chen, H. Liu, and H. Zuo, “Assessment of Surface Electromyographic Clinical Analysis of Selective Femoral Neurotomy on Cerebral Palsy With Stiff Knee,” Journal of Neuroscience Methods 199 (2011): 98–102,

[20]

I. M. Fiebert, N. I. Spielholz, E. B. Applegate, et al., “Comparison of EMG Activity of Medial and Lateral Hamstrings During Isometric Contractions at Various Cuff Weight Loads,” Knee 8 (2001): 145–150,

[21]

U. F. Ervilha, L. Mochizuki, A. Figueira, Jr., and J. Hamill, “Are Muscle Activation Patterns Altered During Shod and Barefoot Running With a Forefoot Footfall Pattern?,” Journal of Sports Sciences 35 (2017): 1697–1703,

[22]

T. J. Suchomel, S. Nimphius, C. R. Bellon, and M. H. Stone, “The Importance of Muscular Strength: Training Considerations,” Sports Medicine 48 (2018): 765–785,

[23]

N. Gaja-Capdevila, N. Hernández, D. Zamanillo, et al., “Neuroprotective Effects of Sigma 1 Receptor Ligands on Motoneuron Death After Spinal Root Injury in Mice,” International Journal of Molecular Sciences 22 (2021): 6956,

[24]

X. M. Lin, M. H. Pan, J. Sun, et al., “Membrane Phospholipid Peroxidation Promotes Loss of Dopaminergic Neurons in Psychological Stress-Induced Parkinson’s Disease Susceptibility,” Aging Cell 22 (2023): e13970,

[25]

O. Ozlu and E. Atilgan, “The Effect of High-Intensity Laser Therapy on Pain and Lower Extremity Function in Patellofemoral Pain Syndrome: A Single-Blind Randomized Controlled Trial,” Lasers in Medical Science 39 (2024): 103,

[26]

B. S. Neal, C. J. Barton, R. Gallie, P. O’Halloran, and D. Morrissey, “Runners With Patellofemoral Pain Have Altered Biomechanics Which Targeted Interventions Can Modify: A Systematic Review and Meta-Analysis,” Gait & Posture 45 (2016): 69–82,

[27]

M. M. Kalytczak, P. R. G. Lucareli, A. C. dos Reis, et al., “Kinematic and Electromyographic Analysis in Patients With Patellofemoral Pain Syndrome During Single Leg Triple Hop Test,” Gait & Posture 49 (2016): 246–251,

[28]

A. C. Hislop, N. J. Collins, K. Tucker, M. Deasy, and A. I. Semciw, “Does Adding Hip Exercises to Quadriceps Exercises Result in Superior Outcomes in Pain, Function and Quality of Life for People With Knee Osteoarthritis? A Systematic Review and Meta-Analysis,” British Journal of Sports Medicine 54 (2020): 263–271,

[29]

K. R. Baker, M. E. Nelson, D. T. Felson, J. E. Layne, R. Sarno, and R. Roubenoff, “The Efficacy of Home Based Progressive Strength Training in Older Adults With Knee Osteoarthritis: A Randomized Controlled Trial,” Journal of Rheumatology 28 (2001): 1655–1665.

[30]

M. Emamvirdi, M. Hosseinzadeh, A. Letafatkar, et al., “Comparing Kinematic Asymmetry and Lateral Step-Down Test Scores in Healthy, Chronic Ankle Instability, and Patellofemoral Pain Syndrome Female Basketball Players: A Cross-Sectional Study,” Scientific Reports 13 (2023): 12412,

[31]

E. A. Sled, L. Khoja, K. J. Deluzio, S. J. Olney, and E. G. Culham, “Effect of a Home Program of Hip Abductor Exercises on Knee Joint Loading, Strength, Function, and Pain in People With Knee Osteoarthritis: A Clinical Trial,” Physical Therapy 90 (2010): 895–904,

[32]

N. Rabelo and P. R. G. Lucareli, “Do Hip Muscle Weakness and Dynamic Knee Valgus Matter for the Clinical Evaluation and Decision-Making Process in Patients With Patellofemoral Pain?,” Brazilian Journal of Physical Therapy 22 (2018): 105–109,

[33]

S. M. Cowan, K. M. Crossley, and K. L. Bennell, “Altered Hip and Trunk Muscle Function in Individuals With Patellofemoral Pain,” British Journal of Sports Medicine 43 (2009): 584–588,

[34]

M. B. Pohl, C. Patel, J. P. Wiley, and R. Ferber, “Gait Biomechanics and Hip Muscular Strength in Patients With Patellofemoral Osteoarthritis,” Gait & Posture 37 (2013): 440–444,

RIGHTS & PERMISSIONS

2025 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.

AI Summary AI Mindmap
PDF

209

Accesses

0

Citation

Detail

Sections
Recommended

AI思维导图

/