• Journal of Korean Physical Therapy Science
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• v.15 no.3
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• pp.31-41
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• 2008

Purpose : The purpose of this study is to examine the muscle activity of shoulder stabilization according to change of supporting base interval between push-up bend and push-up plus position and is to prevent or treat a shoulder injury by the most effective exercise for rehabilitation. Methods : This study analyzed the muscle activity according to change of supporting base interval between push-up bend and push-up plus movement. The participants without neuromuscular disease were 25 students - 12 males and 13 females - all twenty or over and the surface electrode of EMG attached on pectoralis major, triceps long head, middle trapezius, lower trapezius, serratus anterior and latissimus dorsi. The process has practiced 3 sessions of supporting base interval - narrowing interval, two shoulder interval, broad interval - by push-up bend and push-up plus movement. Result : 1. The muscle activity of pectoralis major was significantly increased according to narrow interval of supporting base on push-up plus movement and was significant difference(p<.05). 2. The muscle activity of biceps was significantly increased according to narrow interval of supporting base on push-up bend movement(p<.05). 3. The muscle activity of middle or lower trapezius was a difference according to change of supporting base on push-up bend and push-up plus movement but was not significant difference. 4. The muscle activity of serratus anterior was significantly increased according to broad interval of supporting base on push-up bend movement(p<.05). 5. The muscle activity of latissimus dorsi was significantly increased according to broad interval of supporting base on push-up bend movement(p<.05). Conclusion : These results lead us to the conclusion that push-up bend exercise have the effect of muscle strength of biceps on narrowing interval, of serratus anterior or latissimus dorsi on broad interval and push-up plus exercise have the effect of muscle strength of pectoralis major on narrowing interval of support base.

• Journal of International Academy of Physical Therapy Research
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• v.6 no.1
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• pp.815-823
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• 2015

This study aimed to examine the most effective exercise method for shoulder joint rehabilitation by comparatively observing activity of shoulder stabilizer muscles during push up and push up plus exercises under diverse stable conditions. The subjects were 20 healthy adults students who went to M university. While the subjects conducted push up and push up plus exercises under diverse stable conditions(a stable surface, a support of 25cm height, a support of 30 cm height and a balance pad), activities of the upper trapezius muscle, pectoralis major muscle, serratus anterior muscle, and triceps brachii muscle were recorded. During push up and push up plus exercises, activities of the stabilizer muscles were higher when the stable condition was changed rather than on the stable surface. In particular, when the support of 30cm height and balance pads were applied, activity of the shoulder stabilizer was highest. There were significant differences in the upper trapezius muscle and triceps brachii muscle during the push up exercise(p<.05) and in the serratus anterior muscle during the push up plus exercise(p<.05). Activities of the shoulder stabilizers were higher when the upper and lower limbs' surface stable conditions were changed than the stable surface. Therefore, when programs for rehabilitation of shoulder joints are applied, provision of diverse stable conditions according to patients' conditions will be effective methods.

• PNF and Movement
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• v.10 no.3
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• pp.1-6
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• 2012

Purpose : The purpose of this study was to examine activities of the scapular stabilizers during push-up plus and PNF backward rocking exercises. Methods : 9 subjects performed randomly push-up plus and PNF backward rocking exercises in four point kneeling. The activities of 4 scapular stabilizing muscles were compared between push-up plus and PNF backward rocking exercises. Results : PNF backward rocking exercise showed significantly higher lower trapezius and lower serratus anterior activations compared to push-up plus exercise. Push-up plus exercise showed significantly higher middle serratus anterior activation than PNF backward rocking exercise. Conclusion : PNF backward rocking exercise facilitates the lower trapezius and serratus anterior activations compared to push-up plus exercise.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.18 no.1
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• pp.31-37
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• 2012

Background: The purpose of this study was conducted to investigate the effects of Push-up plus exercise with kinesio taping on the pain and shoulder motor function in patient with shoulder myofacial pain syndrome. Methods: The patients with myofacial pain syndrome were randomly divided 2 groups. kinesio taping group (n=20) was taken physical therapy program and kinesio taping. Push-up plus exercise with taping group (n=22) was taken physical therapy and kinesio taping with Push-up plus exercise. The kinesio taping applied on upper trapezius and levator scapulae. The Push-up plus exercise performed in standing position and qudripad position during 10 seconds on 15 time, 3 set per each positions. We mearsured the pain degree using PPT, VAS, MPSSI and shoulder motor function using CSA before and after experiment. The significant test of PPT, VAS, MPSSI, CSA according to applying the kinesio taping and Push-up plus exercise between groups used ANCOVA. Results: In the result following analysis, there was significance on PPT (F=7.378, p=.016), VAS (F=13.071, p=.031), CSA (F=5.302, p=.026) between kinesio taping group and Push-up plus exercise with tapping group. Then, Push-up plus exercise with kinesio taping group has significance on the PPT, VAS, CSA in patients with myofacial pain syndrome. Conclusions: It may suggest that kinesio taping combined with Push-up plus exercise will be helpful of the pain and shoulder function improvement in the patients with myofacial pain syndrome.

• Physical Therapy Korea
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• v.24 no.1
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• pp.86-96
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• 2017

Background: Scapular dyskinesis is characterized by altered scapular position and motion. Specifically, excess activation of the Upper trapezius (UT) combined with decreased Lower trapezius (LT) and Serratus anterior (SA) have been observed. The Standard push-up plus exercise (SPP) is considered as a therapeutic exercise for increasing SA activity and maintaining the scapular kinematics. In addition, Using the Sling surface can lead to higher muscle activity. However, the advantage of an unstable surface has been uncertatin. Objects: To compare the activation of the UT, LT, and lower serratus anterior (LSA) muscles during various push-up plus exercises with and without sling in subjects with scapular dyskinesis. Methods: Total 18 male subjects with scapular dyskinesis were recruited. The UT, LT, and LSA electromyographic activities and the UT/LSA and UT/LT EMG activity ratios were measured during three push-up plus exercises with and without sling. Two-way repeated of analysis of variance was used to determine the statistical significance. Results: The UT activity was significantly lower in all postures without sling than that with sling. In addition, the LSA activity was significantly greater without than with sling, and significantly large in SPP, Low back supported push-up plus (LSPP), and Quadruped push-up plus. Additionally, the UT/LSA and UT/LT activity ratios were lower in SPP and LSPP without sling than with the other four push-up plus exercises. Conclusion: The push-up plus without sling were considered to decrease UT and increase LSA activity compared with exercises with sling. Furthermore, SPP without sling seems to be a more effective exercise for increasing LSA activity and lowering the UT/LSA and UT/LT activity ratios in scapular dyskinesis subjects.

• The Journal of Korean Physical Therapy
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• v.32 no.1
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• pp.58-63
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• 2020

Purpose: This study examined the effects of the right or left knee lift during push up plus in the quadruped position on the serratus anterior (SA) muscle activity. Methods: Twenty-one subjects (male 11, female 10) performed the quadruped position on push up plus. The muscle activities of the lower trapezius (LT), SA, and upper trapezius (UT) were measured by surface electromyography. Repeated measurements of one-way ANOVA were performed for statistical analysis of the data, and the criterion for statistical significance was set to p<0.05 and comparative analysis of the UT and SA ratio using a Paired t-test. Results: The right SA increased the muscle activity of the right knee lift during quadruped position push up plus (p<0.05). In particular, the right SA muscle activity was higher than the left. In addition, comparative analysis of the UT and SA ratio to the right knee lift during quadruped position push up plus was performed (p<0.05). The right was found to be a significant statistic compared to the left, but the left SA increased the muscle activity of the left knee lift during quadruped position push up plus (p<0.05). The left SA muscle activity was higher than right. In addition, comparative analysis of UT and SA ratio to the left knee lift during quadruped position push up plus was performed (p<0.05). The left was found to be a significance statistic than the right. In addition, the interaction effect between the groups showed significant differences (p<0.05). Conclusion: Knee lift during push up plus is recommended for the selective activation of a research exercise protocol of one side of the serratus anterior.

• Journal of the Korean Applied Science and Technology
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• v.37 no.1
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• pp.1-6
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• 2020

The purpose of this study was to investigate the effects of sling and vibrator application of knee push-up plus motion on trunk muscle activities. Ten healthy adult males(age, 23.00±0.45 years; height, 176.60±1.64 cm; body mass, 67.50±1.22 kg; and BMI, 21.65±0.34 kg/㎡) were participated in this study as subjects. Three types' knee push-up plus motions were performed(basic knee push-up plus motion, BKPP; knee push-up plus motion with sling, KPPS; knee push-up plus motion with vibration, KPPV). We measured the right side's trunk muscle activities of the upper trapezius(UT), pectoralis major(PM), serratus anterior(SA), rectus abdominis(RA), and external oblique(EO). The research findings were as follows. UT, PM, SA, RA, and EO muscle activities were greatest during KPPV(p<.001). These results are expected to serve as reference materials for knee push-up plus motion applications in training programs for trunk muscle strengthening.

• Physical Therapy Korea
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• v.17 no.4
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• pp.8-15
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• 2010

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, $90^{\circ}$ internally rotated, and $90^{\circ}$ externally rotated hand positions), during which the activities of the serratus anterior, pectoralis major, and upper trapezius muscles were recorded using surface electromyography. The statistical significance at three different hand positions was tested by repeated one-way ANOVA. The mean activities of the serratus anterior increased and the mean activities of the pectoralis major decreased in the order of neutral hand position, internally rotated hand position, and externally rotated hand position. There was a significant difference during push-up plus between neutral and externally rotated hand positions as well as in the serratus anterior/pectoralis major activity ratio (p<.0.5). However, no significant differences were found in the activity of the upper trapezius muscle or the serratus anterior/upper trapezius activity ratio. We suggest that the push-up plus exercise performed in the externally rotated hand position could a beneficial strategy for selective strengthening of the serratus anterior muscle, while minimizing the activity of the pectoralis major muscle.

• Physical Therapy Korea
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• v.18 no.1
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• pp.1-8
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• 2011

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.

• Physical Therapy Korea
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• v.26 no.4
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• pp.29-34
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• 2019

Background: The serratus anterior is one of the most important muscle for maintaining good scapular alignment in the shoulder joint. The pectoralis major and upper trapezius may also compensate for weak serratus anterior muscles. The push-up plus exercise has been identified as the optimal exercise for maximum activation of the serratus anterior. Objects: The purpose of this study was to examine differences in surface electromyography (EMG) activity of upper trapezius, pectoralis major, and serratus anterior muscles during push-up plus exercises on variously angled surfaces in subjects with winged scapula. Methods: Sixteen subjects with winged scapula (male=5, female=11) volunteered for this study. The subjects performed push-up plus exercise on four different tilt angles, namely $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$. EMG activities in the serratus anterior, upper trapezius, and pectoralis major muscles during performance of push-up plus exercise were measured in all subjects. Data were processed from repeated measures one-way analysis of variance. Results: There was significant difference in the muscle activity of the serratus anterior on the different surface angles (p<.05). The results of the post-hoc analysis showed significantly greater serratus anterior muscle activity on a surface at a $0^{\circ}$ angle than at others tilt angles (p<.05). There was also significant difference in the ratio of serratus anterior to upper trapezius and serratus anterior to pectoralis major across the four surfaces (p<.05), and post-hoc analysis showed significantly greater values on the $0^{\circ}$ surface than on other tilts (p<.05). Conclusion: This study found that performing push-up plus exercises on a flat surface with $0^{\circ}$ and $30^{\circ}$ tilt angle achieves high activation of the serratus anterior muscle for selective strengthening. It can also take into account the sequential application, which is first performed at a $30^{\circ}$ and at a $0^{\circ}$ tilt angle for and effective but not excessive muscle activation.