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Normalized EMG data. a: SA, b: PM, c: SA/PM ratio. (NP: neutral position, IRP: internally rotated position, ERP: externally rotated position, *p<.05)

Normalized EMG data. a: SA, b: PM, c: SA/PM ratio. (NP: neutral position, IRP: internally rotated position, ERP: externally rotated position, *p<.05)

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This study was designed to investigate the effect of different hand positions on scapulothorcic muscle activities during push-up plus exercises. Fourteen healthy males performed push-up plus exercises under three conditions (neutral, internally rotated, and externally rotated hand positions), during which the activities of the serratus anterior, pe...

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... These changes likely originate from moment arm lengths, which shorten for pectoralis major and increase for anterior deltoid at lower arm positions (Kuechle et al., 1997). An externally rotated hand position yields the highest serratus anterior/pectoralis major ratio (Yoon et al., 2010). Complementary evidence indicated that external humeral rotation increased pectoralis major, supraspinatus, infraspinatus and serratus anterior activation while an internal humeral rotation increased lower trapezius activation and decreased pectoralis major involvement (Cho et al., 2014). ...
... Each phase lasted one second, totalling 4 s per PUP (Ludewig et al., 2004) and 8 s for the 2 repetitions. Participants maintained a 60 bpm cadence as informed by a metronome (Yoon et al., 2010). Participants then performed two consecutive trials for all conditions in a random order. ...
... Exercises with a low pectoralis major/serratus activation ratio are ideal for selective serratus strengthening in patients with scapular winging , as excessive pectoralis activation may lead to glenohumeral and scapulothoracic pathologies (Konrad et al., 2006;Labriola et al., 2005). Contrary to previous findings, we observed no effect of humeral rotation on serratus anterior activity (Cho et al., 2014;Yoon et al., 2010). These different findings may be related to different hand stability scenarios and using greater humeral rotation angles (Cho et al., 2014;Yoon et al., 2010). ...
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Push-ups are regularly adapted for specific muscular demands. The push-up plus (PUP) has been used to emphasize serratus anterior activation. Alterations in body posture have been suggested for targeted activation of muscles surrounding the shoulder and rotator cuff, but little data exists to inform these changes. The purpose of this research was to examine upper extremity muscle activity changes when varying aspects of the PUP. Healthy male participants (n = 20) performed PUP trials using combinations of hand contact area (knuckles/palms), humeral rotation (neutral/60° internal/60° external) and hand location (shoulder height/±30% arm length superior/inferior) at a fixed cadence. Electromyographic (EMG) activation from 14 muscles of the right upper extremity during each trial were examined, as well as ratios of activation for 7 muscle pairs. Palm contact and a superior hand location increased serratus activation, but absolute EMG changes between these effects were marginal (standard error = 3.8). Each independent variable altered mean EMG for most muscles as a main effect, with the largest changes in infraspinatus, upper and lower trapezius, and anterior deltoid. Altering the standard PUP does not seem to enhance serratus activation, but diverse responses in other muscles have training implications. These changes in muscle strategies can tailor the use of modified PUP exercises to target individual muscles or groups.
... Lee et al. 5) stated that holding a push-up bar when performing PUPE is more effective than performing it on a flat surface. Yoon et al. 6) and Lee et al. 7) reported that the three positions of the forearm, neutral, internal rotation, and external rotation, have different effects on the stability of the scapulothoracic joint. The PUPE with the forearm in external rotation is more effective at strengthening the SA. ...
... Yoon et al. 6) stated that external rotation of the forearm was associated with the highest muscle activities in push-up exercises, and Lee et al. 7) also noted that on both unstable and stable surfaces, external rotation of the forearm resulted in the highest muscle activity. Lee et al. 5) stated that holding a push-up bar while performing PUPE was more effective than performing on a flat surface. ...
... Lee et al. 5) stated that holding a push-up bar while performing PUPE was more effective than performing on a flat surface. Yoon et al. 6) and Lee et al. 7) reported that the three positions of the forearm, neutral, internal rotation, and external rotation, had different effects on the stability of the scapulothoracic joint, and PUPE with the forearm in the external rotation position was the most effective at strengthening the SA. Moon 14) conducted an experiment in which PUPE was carried out on a stable surface with the forearm in the neutral position, at shoulder angles of 110°, 90°, or 70°. ...
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... Yoon et al. 13) reported that on stable surfaces, the electromyographic activity of SA was the highest in ERP and the lowest in NP. Lee et al. 14) reported that, when only NP and IRP were compared, higher electromyographic activity was shown in NP than in IRP. In the present study, the electromyographic activity of SA was the highest in ERP, similar to the results reported by Yoon et al. 13) This is because we used sling devices which are unstable surfaces. ...
... Yoon et al. 13) reported that on stable surfaces, the electromyographic activity of SA was the highest in ERP and the lowest in NP. Lee et al. 14) reported that, when only NP and IRP were compared, higher electromyographic activity was shown in NP than in IRP. In the present study, the electromyographic activity of SA was the highest in ERP, similar to the results reported by Yoon et al. 13) This is because we used sling devices which are unstable surfaces. On unstable surface, BB and TB support the upper and lower side of the shoulder joints, while UT, LT and PM support the front and back sides to suppress movements of the shoulders, thereby providing stability. ...
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[Purpose] The purpose of the present study was to examine the effects of changes in hand position on the electromyographic activities of the shoulder stabilizer muscles during push-up plus exercises (PUPE) on unstable surfaces. [Subjects] The subjects of the present study were normal adults in their 20s (n=15). PUPEs were performed with the hands in the neutral positions (NP), internal rotation positions (IRP), and external rotation positions (ERP) using a sling device for the unstable surface. [Methods] We measured the electromyographic activities of the wrist flexor (WF), the wrist extensor (WE), the biceps brachii (BB), the triceps brachii (TB), the upper trapezius (UT), the lower trapezius (LT), the serratus anterior (SA), and the pectoralis major (PM). The muscle activites were compared and analyzed using electromyography. [Results] When hand position changed, WF activity in NP, and SA activity in ERP, were significantly different from their respective activities in the other positions. [Conclusion] To selectively enhance the electromyographic activity of the SA during PUPE using a sling device as an unstable surface, we consider performance of PUPE in ERP is an effective intervention.
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Context: Selective strengthening of scapular stabilizers is one of the emphases of the recent literature. Closed kinetic chain (CKC) exercises are used extensively in shoulder rehabilitation. However, a limited number of studies have reported scapular muscle ratios during CKC exercises. Objectives: To determine the CKC exercises producing the optimal ratios of the scapular stabilizer muscles in healthy shoulders. Evidence acquisition: A systematic search within PubMed, Embase, CINAHL Plus, and SPORTDiscus with Full Text and ULAKBIM National Medical Database was performed up to January 2018. Studies were selected according to the predetermined criteria. If the pooled mean ratios (upper trapezius [UT]/middle trapezius [MT], UT/lower trapezius [LT], and UT/serratus anterior [SA]), which were calculated from the percentage of maximum voluntary contractions of muscles, were <0.60, these exercises were considered as ideal for higher activation of the MT, LT, and SA than the UT. Evidence synthesis: The search identified 1284 studies, and 29 observational studies were included for review. Seventy-nine CKC exercises were determined. Four exercises for the MT, 9 for the LT, and 59 for the SA were identified from the articles as being optimal exercises to activate the specified muscle more than the UT. Conclusions: This review identified optimal CKC exercises that provide good ratios between the MT, LT, and SA with the UT. Most exercises have optimal UT/SA ratios, but some exercises performed on unstable surfaces may lead to excessive activation of the UT relative to the SA. For the UT/MT, the isometric low row, inferior glide, and half supine pull-up with slings are the ideal exercises. Isometric one-hand knee push-up variations seem to be the best choice for the UT/LT. The results suggest that many CKC exercises may be utilized to enhance scapular muscle balance when rehabilitating shoulder pathology.
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[Purpose] The purpose of this study was to determine the effect of hand position changes on electromyographic activity of shoulder stabilizers during push-up plus exercise (PUPE) performed on both stable and unstable surfaces. [Subjects] This study was performed on a cohort of 20 normal adults divided into an unstable surface group (USG) (n=10) and a stable surface group (SSG) (n=10). [Methods] A sling device was used to provide an unstable surface, and a push-up bar was used to provide a stable surface. PUPEs were performed with hands in various positions: the neutral position (NP), the internal rotation position (IRP), or the external rotation position (ERP). Electromyography was used to determine and analyze the electromyographic activity of the upper trapezius muscle (UT), the lower trapezius muscle (LT), the serratus anterior muscle (SA), and the pectoralis major muscle (PM). [Results] Comparison of the results within the USG and SSG showed significant differences depending on the hand position used during the exercise. Comparison between the USG and SSG showed that the ERP hand posture resulted in significant differences in electromyographic activity of the SA in the USG. [Conclusion] The electromyographic activity of the SA indicated that performing PUPEs using the ERP on an unstable surface provided more effective intervention for shoulder stabilization than ERP on a stable surface.