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

Overview

Journal J Athl Train

Specialty Orthopedics

Date 2019 Oct 5

PMID 31584855

Citations 5

Authors

Fu-Jie Kang

Hsiang-Ling Ou

Kun-Ying Lin

Jiu-Jenq Lin

Affiliations

Soon will be listed here.

Abstract

Context: Whereas the serratus anterior (SA) and the upper trapezius (UT) work as a force couple for scapular motion, weakness of the SA and overactivation of the UT are often present in overhead athletes with shoulder dysfunction. Therefore, researchers addressing an intramuscular imbalance between the SA and UT have focused on finding exercises that target the weak SA and minimally activate the UT.

Objective: To compare the effectiveness of push-up plus (PUP) exercise variants based on the electromyographic (EMG) activity of the SA and UT.

Data Sources: A systematic search of PubMed and Scopus between January 1, 2000, and March 31, 2008.

Study Selection: Studies of PUP exercises that involved EMG analysis.

Data Extraction: We assessed study quality using the Critical Appraisal Skills Program. For the systematic analysis, the following data were extracted: (1) author, year, and study design; (2) participant characteristics; (3) type of PUP intervention; (4) EMG outcome measures; and (5) main results. For the meta-analysis, the EMG data of the SA and UT were calculated using the mean difference of EMG activity with a 95% confidence interval.

Data Synthesis: Based on 19 studies with 356 participants, different hand positions (the distance between the hands, shoulder-flexion angle, and elbow-flexion angle) and different lower extremity positions variably affected the activation of the SA and UT during the PUP exercise. Also, when participants performed the PUP on an unstable surface compared with a stable surface, UT activity increased 2.74% (95% confidence interval = 0.07%, 5.41%).

Conclusions: The standard PUP exercise elicited high EMG activity of the SA. Participants generated higher SA and lower UT EMG activity when they performed the PUP exercise on a stable surface in full elbow extension, with the hands placed shoulder-width apart, shoulder-flexion angles of 110° or 120°, and the ipsilateral lower extremity lifted.

Citing Articles

Exercise into Pain in Chronic Rotator Cuff-Related Shoulder Pain: A Randomized Controlled Trial with 6-Month Follow-Up.

Cavaggion C, Luque-Suarez A, Voogt L, Juul-Kristensen B, Wollants G, Beke L Open Access J Sports Med. 2024; 15:181-196.

PMID: 39635498 PMC: 11616428. DOI: 10.2147/OAJSM.S483272.

Effects of Using a Special Weighted Vest on Muscle Activity around the Scapula during Knee Push-Up Plus in Healthy Subjects.

Liu L, Liu Y, Yuk Y, Lim H Healthcare (Basel). 2024; 12(17).

PMID: 39273802 PMC: 11394717. DOI: 10.3390/healthcare12171778.

Electromyography of shoulder muscles in individuals without scapular dyskinesis during closed kinetic chain exercises on stable and unstable surfaces: a systematic review and meta-analysis.

Arghadeh R, Alizadeh M, Minoonejad H, Sheikhhoseini R, Asgari M, Jaitner T Front Sports Act Living. 2024; 6:1385693.

PMID: 38840951 PMC: 11150595. DOI: 10.3389/fspor.2024.1385693.

Electromyography of scapular stabilizers in people without scapular dyskinesis during push-ups: a systematic review and meta-analysis.

Arghadeh R, Alizadeh M, Minoonejad H, Sheikhhoseini R, Asgari M, Jaitner T Front Physiol. 2023; 14:1296279.

PMID: 38116582 PMC: 10728295. DOI: 10.3389/fphys.2023.1296279.

Electromyographic analysis of the serratus anterior and upper trapezius in closed kinetic chain exercises performed on different unstable support surfaces: a systematic review and meta-analysis.

Mendez-Rebolledo G, Orozco-Chavez I, Morales-Verdugo J, Ramirez-Campillo R, Cools A PeerJ. 2022; 10:e13589.

PMID: 35791364 PMC: 9250763. DOI: 10.7717/peerj.13589.

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