EMG activity of the serratus anterior and trapezius muscles during the different phases of the push-up plus exercise on different support surfaces and different hand positions

Abstract

[Purpose] The appropriate exercise prescription is crucial for achieving scapular stability and providing successful rehabilitation, and the Push-up Plus (PuP) exercise has an important role in shoulder rehabilitation. Consequently, this study examined the effect of support surface stability, hand positioning, and phase of exercise, on the trapezius and serratus anterior muscle contractions as well as on the EMG ratio of the upper/lower trapezius. [Subjects and Methods] Thirteen healthy male volunteers participated in this study. The subjects performed the PuP exercise on stable and unstable supporting surfaces with three different hand orientations. During the PuP exercise, the muscle activities of the upper (UT) and lower (LT) trapezius, as well as the serratus anterior (SA) were measured and expressed as percentages of maximum voluntary isometric contraction (%MVIC). [Results] The EMG activities of UT and LT were statistically greater during the push-up phase compared to the plus phase of the exercise. The contrary was recorded for the activity of the SA. SA was affected by the support surface as well as by the hand positioning. [Conclusion] The results suggest that different phases of the PuP exercise require different muscle stability actions with corresponding activations of appropriate muscle fibers. A detailed prescription of the required phase of the exercise can more effectively activate the scapula-thoracic musculature.

Serratus Anterior and Upper Trapezius Electromyographic Analysis of the Push-Up Plus Exercise: A Systematic Review and Meta-Analysis

“…Investigators 29,49 have also demonstrated that lower extremity a Each item was scored as 1 (yes) or 0 (no or not stated) based on whether the study included information about the criterion. higher pectoralis major and triceps activity 30% wider shoulder width: higher UT : LT ratio Gioftsos et al 15 (2016)…”

“…Seven articles discussed the effects of PUP variations (eg, different upper extremity, 31,47,48,50 lower extremity, 29,49 and PUP 8 positions) on training the SA and UT. Eleven articles 9,[15][16][17][18][19][20][21][22][23]52 focused on the effects of the base of support for PUP exercises. From our systematic review, we determined a suitable exercise prescription for training the SA and UT using PUP variations.…”

“…Twelve articles focused on the effects of the base of support during PUP exercises. 9,[15][16][17][18][19][20][21][22][23]51,52 After further checking for the meta-analysis, 1 article was excluded due to insufficient data for the means and standard deviations. 51 Therefore, 11 articles were included in this meta-analysis for analyzing the differences in SA and UT muscle activity during the PUP performed on stable and unstable surfaces.…”

“…51 Therefore, 11 articles were included in this meta-analysis for analyzing the differences in SA and UT muscle activity during the PUP performed on stable and unstable surfaces. 9,[15][16][17][18][19][20][21][22][23]52 Quality Assessment…”

“…[12][13][14] After finding that the standard PUP (SPP) and knee PUP exercises induced the highest SA and lowest UT : SA EMG measures, Ludewig et al 8 recommended these exercises for selective SA strengthening. Researchers 5,9,[15][16][17][18][19][20][21][22][23][24][25][26] have investigated whether the PUP exercise performed on different unstable bases stimulated mechanoreceptors and increased SA EMG activity, thereby enhancing shoulder-joint stabilization. The use of unstable or stable surfaces during the PUP exercise is under debate.…”