Hip Abductor Strengthening With Proprioceptive Neuromuscular Facilitation

Objectives: To compare effectiveness of strengthening hip abductors with Proprioceptive Neuromuscular Facilitation (PNF) technique and Range Of Motion (ROM) exercises on core endurance and functional performance in healthy adults using theraband.

Methods: 66 sedentary healthy, male volunteers between ages 20-26 (mean age 21,68± 1,37 years) participated in study. PNF, ROM exercises applied with theraband include intervention groups. Theraband strengthening exercises were applied 3 days a week for 6 weeks, a total of 18 sessions. Intervention groups were compared with healthy control group. Participants hip abductor muscle strength was assessed with hand held dynamometer, lower extremity balance with y test, core endurance with flexor, extensor, right, left side endurance tests, global core stability with single leg squat test at baseline and at 6 weeks after exercise program.

This study was designed as a randomized controlled trial and conducted according to the Declaration of Helsinki and was approved by the Ethics Committee of Clinical Trials (21.05.2019/10). All participants were informed about the study and their written consent was obtained. Participants were randomly divided into three groups using the sealed envelope method (on the evaluation day, participants chose one of the sealed envelopes and determined the treatment group). Group I comprised the Proprioceptive Neuromuscular Facilitation (PNF) group, Group II the Range of Motion(ROM) group, and Group III the Control (CG) group. Evaluations were made at baseline and at sixth week. Male participants between the ages of 20 and 26 years, were included in the study. Participants age, body mass index (BMI), dominant extremity were recorded as descriptive data.

Muscle strength assessment: Bilateral hip abductor isometric strength was assessed using a Hand-held Dynamometer (HHD) (Commander Power Track II; JTECH Medical Industries, Salt Lake City, UT) using the maximal isometric strength standard protocol. The participant was asked to 30 degree hip abduct by stabilizing the pelvis in the side lying position. Three measurements were made by placing the dynamometer pad 10 cm proximal to the lateral epicondyle of the femur, and the average value was recorded in kilograms.

Balance assesment: It was done with Y balance test. While maintaining their balance on the dominant extremity on the test platform, the participants were asked to reach out in 3 directions (anterior-posterior, postero-medial and postero-lateral) with the tip of the other foot. 3 repetitions were made for each direction, and rest intervals of 15 seconds were given. The mean score was recorded in cm. The lower extremity length of the participants was determined by measuring the distance between the anterior superior spina iliaca and the medial malleolus with a tape measure in the supine position. Composite scoring was obtained by multiply with one hundred the reach in all directions and dividing by three leg lengths.

Global (functional) core assessment: It was done with the single leg squat test. Participants were asked to perform one-leg squats at 45 degree knee flexion in 30 seconds, and the number of squats was recorded.

Core endurance assessment: Participants were evaluated with trunk flexion endurance, extension endurance and lateral bridge endurance tests, and the results were recorded in seconds.

Eligibility Criteria:
inclusion criteria:

* Not having any known and diagnosed health problems
* Not exercising regularly
* Not having a lower/upper extremity injury in the last three months
* Volunteering to participate in the study

exclusion criteria:

* Not to participate in exercise training more than three sessions
* Want to leave the training voluntarily
* Have experienced serious orthopedic/systemic discomfort during the training