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Batbayar Y1, Uga D2, Saito R3, Nakazawa R1, Sakamoto M1, Oidov B4
1Graduate School of Health Sciences, Gunma University, Maebashi, Japan, 2Jobu Hospital for Respiratory Diseases, Maebashi, Japan, 3Gunma Chuo Hospital, Maebashi, Japan, 4Third State Central Hospital of Mongolia, Ulaanbaatar, Mongolia
Background: Clinicians use the push-up plus (PUP) exercise various posture to improve an imbalance activation of scapular and shoulder muscles for patients by rehabilitation progression. The PUP training is performed by hands and feet. Thus, the required activation of the muscle is changed during PUP exercise, depending on the changes of supporting hand position. There is a lack of literature that analyzed muscles activity of scapular stabilizer and other shoulder muscles involved PUP by posture and supporting hand position.
Purpose: The purpose of our study was to investigate the muscle activity in each posture of modified PUP exercise and their effect of hand width changes on activation of scapular and shoulder muscles.
Methods: 10 healthy men (age 23.9±2.0 years old, height 174.0±6.0 cm, weight 65.3±5.0 kg, and shoulder width 40.2±1.0 cm) participated in this study. The subjects did knee PUP (KPUP), elbow PUP (EPUP) and standard PUP (SPUP) exercises in two different hand position widths at random as follows: shoulder width (SW) and 30% narrower than SW (30%NSW). The subjects held posture for 5 sec and repeated 3 times during the PUP exercise in each posture and hand position. Surface electromyography was used to measure the muscle activities and muscle activity ratio. Target muscles were serratus anterior (SA), group of trapezius muscles, pectoralis major (PM), anterior deltoid (AD), latissimus dorsi and triceps on the dominant side. In analysis, we compared the muscle activity and muscle activity ratio within the posture and hand positions.
Results: The SA muscle activity was higher in EPUP (83.3±29.1) compared with SPUP (73.6±14.8) and KPUP postures (49.3±21.8). Meanwhile, PM/SA muscle activity ratio (0.27±0.1) was significantly increased than SPUP (0.18±0.2) posture. In the SPUP, SA muscle activity was greater than KPUP, and PM muscle activity was smaller than EPUP posture. On the other hand, AD muscle activation was greater than KPUP posture. The KPUP posture illustrated smaller SA muscle activation than other 2 postures. However, AD muscle activity was significantly decreased in KPUP (24.2±10.2) than SPUP (50.2±28.9) and EPUP (45.0±15.7) postures. Hand positions comparison were: the SA muscle activity was significantly increased in SW (83.3±29.1) than 30%NSW (64.9±18.3) hand position during EPUP. Further, the PM/SA muscle activity ratio was significantly smaller in SW (0.18±0.2) than 30%NSW (0.29±0.3) hand position during SPUP.
Conclusion(s): Findings of this study suggest that PUP exercise begins with KPUP posture and progress into the SPUP, finally the EPUP posture with SW hand position. This progression may assist the particular activation of SA muscle without compensatory activation of PM muscle for patients with shoulder disorder in rehabilitation gradually.
Implications: We think that our findings could be useful for physiotherapy, depending on the muscle of interest clinicians should consider the posture and hand position when incorporating the PUP exercise into rehabilitation.
Keywords: Push-up plus, hand position, modified push-up
Funding acknowledgements: None
Purpose: The purpose of our study was to investigate the muscle activity in each posture of modified PUP exercise and their effect of hand width changes on activation of scapular and shoulder muscles.
Methods: 10 healthy men (age 23.9±2.0 years old, height 174.0±6.0 cm, weight 65.3±5.0 kg, and shoulder width 40.2±1.0 cm) participated in this study. The subjects did knee PUP (KPUP), elbow PUP (EPUP) and standard PUP (SPUP) exercises in two different hand position widths at random as follows: shoulder width (SW) and 30% narrower than SW (30%NSW). The subjects held posture for 5 sec and repeated 3 times during the PUP exercise in each posture and hand position. Surface electromyography was used to measure the muscle activities and muscle activity ratio. Target muscles were serratus anterior (SA), group of trapezius muscles, pectoralis major (PM), anterior deltoid (AD), latissimus dorsi and triceps on the dominant side. In analysis, we compared the muscle activity and muscle activity ratio within the posture and hand positions.
Results: The SA muscle activity was higher in EPUP (83.3±29.1) compared with SPUP (73.6±14.8) and KPUP postures (49.3±21.8). Meanwhile, PM/SA muscle activity ratio (0.27±0.1) was significantly increased than SPUP (0.18±0.2) posture. In the SPUP, SA muscle activity was greater than KPUP, and PM muscle activity was smaller than EPUP posture. On the other hand, AD muscle activation was greater than KPUP posture. The KPUP posture illustrated smaller SA muscle activation than other 2 postures. However, AD muscle activity was significantly decreased in KPUP (24.2±10.2) than SPUP (50.2±28.9) and EPUP (45.0±15.7) postures. Hand positions comparison were: the SA muscle activity was significantly increased in SW (83.3±29.1) than 30%NSW (64.9±18.3) hand position during EPUP. Further, the PM/SA muscle activity ratio was significantly smaller in SW (0.18±0.2) than 30%NSW (0.29±0.3) hand position during SPUP.
Conclusion(s): Findings of this study suggest that PUP exercise begins with KPUP posture and progress into the SPUP, finally the EPUP posture with SW hand position. This progression may assist the particular activation of SA muscle without compensatory activation of PM muscle for patients with shoulder disorder in rehabilitation gradually.
Implications: We think that our findings could be useful for physiotherapy, depending on the muscle of interest clinicians should consider the posture and hand position when incorporating the PUP exercise into rehabilitation.
Keywords: Push-up plus, hand position, modified push-up
Funding acknowledgements: None
Topic: Musculoskeletal: upper limb; Musculoskeletal: upper limb
Ethics approval required: Yes
Institution: Gunma University
Ethics committee: Ethics Committee
Ethics number: 2017-139
All authors, affiliations and abstracts have been published as submitted.
