Browse > Article

Selective Activation of Serratus Anterior Using Electromyography Biofeedback During Push-Up Plus  

Jeon, Yong-Jin (Dept. of Rehabilitation Therapy, The Graduate School, Yonsei University)
Choung, Sung-Dae (Dept. of Rehabilitation Therapy, The Graduate School, Yonsei University)
Kim, Si-Hyun (Dept. of Rehabilitation Therapy, The Graduate School, Yonsei University)
Cynn, Heon-Seock (Dept. of Physical Therapy, College of Health Science, Yonsei University, Dept. of Ergonomic Therapy, The Graduate School of Health and Environment, Yonsei University)
Publication Information
Physical Therapy Korea / v.18, no.1, 2011 , pp. 1-8 More about this Journal
Push-up plus has been advocated for increasing the activity of the serratus anterior muscle, the most critical scapular stabilizer. However, no previous study has reported the possibility of compensatory motion on the part of the pectoralis major, which could substitute for the action of the serratus anterior during push-up plus. The aim of the current study was to investigate the immediate effect of electromyography (EMG) biofeedback of the pectoralis major muscle on the pectoralis major, upper trapezius, and serratus anterior muscles during push-up plus. Fourteen healthy young subjects voluntarily participated in this study; each subject performed push-up plus from the quadruped position, in two conditions (i.e., with or without visual and auditory biofeedback). Surface EMG was used to measure pectoralis major, serratus anterior, and upper trapezius activity. A paired t-test was used to determine any statistically significant difference between the two conditions. Additionally, effect size was calculated to quantify the magnitude of EMG biofeedback in each muscle. Visual and auditory feedback reduced pectoralis major muscle activity significantly (p=.000) and increased the serratus anterior muscle activity significantly (p=.002), but did not induce a significant difference in upper trapezius muscle activity (p=.881). Thus, it is concluded that the visual and auditory feedback of pectoralis major muscle activity can be used to facilitate serratus anterior muscle activity during push-up plus.
Biofeedback; Push-Up plus; Surface electromyography;
Citations & Related Records
연도 인용수 순위
  • Reference
1 이충휘. 물리치료사와 작업치료사를 위한 연구방법론. 3판. 서울, 계축문화사, 2008.
2 Basmajian JV. Biofeedback in rehabilitation: A review of principles and practices. Arch Phys Med Rehabil. 1981;62(10):469-475.
3 Cools AM, Dewitte V, Lanszweert F, et al. Rehabilitation of scapular muscle balance: Which exercises to prescribe? Am J Sports Med. 2007;35(10):1744-1751.   DOI   ScienceOn
4 Cram JR, Kasman GS, Holtz J. Introduction to Surface Electromyography. Gaithersburg. Aspen Pub, 1998.
5 Decker MJ, Hintermeister RA, Faber KJ, et al. Serratus anterior muscle activity during selected rehabilitation exercises. Am J Sports Med. 1999;27(6):784-791.   DOI
6 Dursun N, Dursun E, Kilic Z. Electromyographic biofeedback-controlled exercise versus conservative care for patellofemoral pain syndrome. Arch Phys Med Rehabil. 2001;82(12):1692-1695.   DOI   ScienceOn
7 Ekstrom RA, Bifulco KM, Lopau CJ, et al. Comparing the function of the upper and lower parts of the serratus anterior muscle using surface electromyography. J Orthop Sports Phys Ther. 2004;34(5):235-243.   DOI
8 Ekstrom RA, Soderberg GL, Donatelli RA. Normalization procedures using maximum voluntary isometric contractions for the serratus anterior and trapezius muscles during surface EMG analysis. J Electromyogr Kinesiol 2005;15(4):418-428.   DOI   ScienceOn
9 Ellenbecker TS, Davies GJ. Closed Kinematic Chain Exercise: A comprehensive guide to multiple joint exercise. Champaign, IL. Human Kinetics Publishers, 2001: 53-58.
10 Glousman R, Jobe F, Tibone J, et al. Dynanic electromyo graphic analysis of the throwing shoulder with glenohumeral instability. J Bone Joint Surg Am 1998;70(2):220-226.
11 Hardwick DH, Beebe JA, McDonnell MK, et al. A comparison of serratus anterior muscle activation during a wall slide anterior and other traditional exercises. J Orthop Sports Phys Ther. 2006;36(12):903-910.   DOI   ScienceOn
12 Hancock RE, Hawkins RJ. Applications of electromyography in the throwing shoulder. Clin Orthop Relat Res. 1996;(330):84-97.
13 Holtermann A, Mork PJ, Andersen LL, et al. The usc of EMG biofeedback for learning of selective activation of intra-muscular parts within the serratus anterior muscle: A novel approach for rehabilitation of scapular muscle imbalance. J Electromyogr Kinesiol. 2010;20(2):359-365.   DOI   ScienceOn
14 Lear LJ, Gross MT. An electromyographical analysis of the scapular stabilizing synergists during a push-up progression. J Orthop Sports Phys Ther. 1998;28(3):146-157.   DOI
15 Holtermann A, Roeleveld K, Mork PJ, et al. Selective activation of neuromuscular compartments within the human trapezius muscle. J Electromyogr Kinesiol. 2009;19(5):896-902.   DOI   ScienceOn
16 Ingersoll CD, Knight KL. Patellar location changes following EMG biofeedback or progressive resistive exercises. Med Sci Sports Exerc. 1991;23(10):1122-1127.
17 Kendall FP, McCreay EK. Muscles Testing and Function. 3rd ed. Baltimore, Williams & Wilkins, 1983.
18 Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. 2000;80(3):276-291.
19 Ludewig PM, Hoff MS, Osowski EE, et al. Relative balance of serratus anterior and upper trapezius muscle activity during push-up exercises. Am J Sports Med. 2004;32(2):484-493.   DOI   ScienceOn
20 Magee DJ. Instability and Stabilization: Theory and treatment 2nd ed. Seminar Workbook, 1999.
21 Martins J, Tucci HT, Andrade R, et al. Electromyographic amplitude ratio of serratus anterior and upper trapezius muscles during modified push-ups and bench press exercises. J Strength Cond Res. 2008;22(2):477-484.   DOI   ScienceOn
22 McClure PW, Bialker J, Neff N, et. al. Shoulder function and 3-dimensional kinematics in people with shoulder impingement syndrome before and after a 6-week exercise program. Phys Ther. 2004;84(7):832-848.
23 Moseley JB Jr, Jobe FW, Pink M, et al. EMG analysis of the scapular muscles during a shoulder rehabilitation program. Am J Sports Med. 1992;20(2):128-134.   DOI   ScienceOn
24 Mottram SL. Dynamic stability of the scapula. Man Ther. 1997;2(3):123-131.   DOI   ScienceOn
25 Ng GY, Zhang AQ, Li CK. Biofeedback exercise improved the EMG activity ratio of the medial and lateral vasti muscles in subjects with patellofe-moral pain syndrome. J Electromyogr Kinesiol. 2008;18(1):128-133.   DOI   ScienceOn
26 Scovazzo ML, Browne A, Pink M, et al. The painful shoulder during freestyle swimming: An electromyographic cinematographic analysis of twelve muscles. Am J Sports Med. 1991;19(6);577-582.   DOI   ScienceOn
27 Sahrmann S. Diagnosis and Treatment of Movement Impairment Syndrome. St. Louis, Mosby, 2001.