Data Sources: The Cumulative Index to Nursing and Allied Health Literature; PubMed; Index to Chiropractic Literature; and Science Direct were searched from 1989 to 2009. Limits were set to English language and human studies. Search terms included prone hip extension or prone leg extension and their combination with muscle activation patterns.
Study Selection: After the abstracts were reviewed, studies that investigated the order of ipsilateral gluteus maximus (IGM), ipsilateral hamstring (IHAM), ipsilateral erector spinae (IES), and contralateral erector spinae (CES) muscle activation during the PHE or prone leg extension (PLE) were included for analysis. Of 120 citations identified, 11 were determined to be relevant for this review.
Data Synthesis: Overall, the studies retrieved lacked consistency, which made it difficult to obtain comprehensive conclusions. No clear muscle activation pattern was evident for the HAM, CES and IES during the PHE test. The GM was consistently the last muscle to activate. In subjects with low back pain, altered lumbopelvic kinematics or ankle sprain injury the GM activation was significantly delayed compared with the control groups.
Conclusion: The literature suggests that the PHE test may be a useful tool for: (1) detecting “abnormal” kinematic deviations of the lumbar spine; (2) determining whether the GM is a potential ‘‘weak link’’ in lumbopelvic-hip motor control, and therefore could be used an indicator for treatment prescription aimed at restoring ‘‘normal’’ motor control. Further research involving larger, methodologically improved, randomized controlled and clinical trials, as well as observational and clinical studies are both required and warranted.
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