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Arghadeh R, Alizadeh MH, Minoonejad H, Sheikhhoseini R, Asgari M, Jaitner T. 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. Front Sports Act Living 2024; 6:1385693. [PMID: 38840951 PMCID: PMC11150595 DOI: 10.3389/fspor.2024.1385693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/07/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Unstable surfaces are commonly utilized to enhance the flexibility of the musculoskeletal system for achieving training or rehabilitation goals. However, their effects on shoulder muscle activation during various push-up (PU) exercises have not been thoroughly investigated. Therefore, the purpose of this study was to synthesize electromyography (EMG) data of shoulder muscles in individuals without scapular dyskinesis performing different PU exercises on both stable and unstable surfaces. Methods A systematic online search was conducted in electronic databases, including Web of Science, PubMed, Scopus, and Google Scholar, up to January 16, 2024, using predefined sets of keywords. Out of the 1,971 titles and abstracts screened, 80 articles were reviewed in detail by two independent researchers to check the eligibility, of which 28 eligible studies were ultimately included. Following assessment of the quality and risk of bias, the studies were categorized based on exercises and muscle groups, and a meta-analysis using a random-effects model was performed to estimate the overall effect size. Results The use of unstable surfaces led to a decrease in anterior deltoid activity during PU [P = 0.032; I2 = 91.34%; SMD = -0.630 (95% CI -1.205, -0.055)], an increase in pectoralis major activity during PU [P = 0.006; I2 = 63.72%; SMD = 0.282 (95% CI 0.079, 0.484)], as well as during knee PU [P = 0.018; I2 = 32.29%; SMD = 0.309 (95% CI 0.052, 0.565)], and an increase in triceps brachii activity during PU [P = 0.000; I2 = 85.05%; SMD = 0.813 (95% CI 0.457, 1.168)], knee PU [P = 0.000; I2 = 0.00%; SMD = 0.589 (95% CI 0.288, 0.891)], as well as during push-up plus [P = 0.006; I2 = 13.16%; SMD = 0.563 (95% CI 0.161, 0.965)]. However, the use of unstable surfaces did not show a significant effect on the EMG activity of the pectoralis major during push-up plus [P = 0.312; I2 = 22.82%; SMD = 0.207 (95% CI -0.194, 0.609)]. Conclusions Unstable surfaces can modulate muscle activity in different PU exercises, while the effects on the targeted muscles depend on the type of exercise. The findings of this review provide a framework based on the level of activity of each shoulder muscle during different PU exercises, which can help coaches, trainers, and sports therapists select the most suitable type of PU for designing training or rehabilitation programs. Particularly, the most suitable exercise for increasing anterior deltoid activity is PU on a stable surface. To concurrently increase activity of the pectoralis major and triceps brachii, adding unstable surfaces under hands during knee PU and standard PU is recommended. Systematic Review Registration PROSPERO, identifier CRD42021268465.
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Affiliation(s)
- Ramin Arghadeh
- Department of Sports Injury and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
| | - Mohammad Hossein Alizadeh
- Department of Sports Injury and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
| | - Hooman Minoonejad
- Department of Sports Injury and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
| | - Rahman Sheikhhoseini
- Department of Corrective Exercises and Sports Injury, Faculty of Physical Education and Sport Sciences, Allameh Tabataba’i University, Tehran, Iran
| | - Mojtaba Asgari
- Institute for Sport and Sport Science, TU Dortmund University, Dortmund, Germany
| | - Thomas Jaitner
- Institute for Sport and Sport Science, TU Dortmund University, Dortmund, Germany
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Batista GDA, Beltrán SP, dos Passos MHP, Calixtre LB, Santos LRDH, de Araújo RC. Comparison of the Electromyography Activity during Exercises with Stable and Unstable Surfaces: A Systematic Review and Meta-Analysis. Sports (Basel) 2024; 12:111. [PMID: 38668579 PMCID: PMC11055131 DOI: 10.3390/sports12040111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/13/2024] [Accepted: 04/02/2024] [Indexed: 04/29/2024] Open
Abstract
The effect of electromyographic (EMG) activity on agonist muscles during exercises performed on stable and unstable surfaces remains uncertain. We aimed to review the literature regarding the comparison of the EMG activity of the agonist muscles of exercises performed on stable and unstable surfaces. Eighty-six studies that evaluated the EMG activity of 1783 individuals during exercises for the lower limbs, upper limbs, and core were included. The EMG activities of the pectoralis major (SMD = 0.28 [95% CI 0.09, 0.47]) and triceps brachii muscles (SMD = 0.45 [95% CI 0.25, 0.66]) were significantly increased when the unstable device was added to the exercise. Likewise, the EMG activity of all core muscles showed a significant increase with the unstable surface during the exercises, such as the rectus abdominis (SMD = 0.51 [95% CI 0.37, 0.66]), external oblique (SMD = 0.44 [95% CI 0.28, 0.61]), internal oblique (SMD = 1.04 [95% CI 0.02, 2.07]), erector spinae (SMD = 0.37 [95% CI 0.04, 0.71]), and lumbar multifidus (SMD = 0.35 [95% CI 0.08, 0.61]). However, the lower limb muscles did not show greater EMG activity during the exercise with unstable surfaces compared to the stable surface. In conclusion, unstable conditions increase the EMG activity of some upper limb and core muscles compared to a stable surface.
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Affiliation(s)
- Gabriel de Amorim Batista
- Associated Graduate Program in Physical Education UPE/UFPB, University of Pernambuco, Recife 50100-130, Brazil; (S.P.B.); (M.H.P.d.P.)
| | - Sol Patricia Beltrán
- Associated Graduate Program in Physical Education UPE/UFPB, University of Pernambuco, Recife 50100-130, Brazil; (S.P.B.); (M.H.P.d.P.)
| | - Muana Hiandra Pereira dos Passos
- Associated Graduate Program in Physical Education UPE/UFPB, University of Pernambuco, Recife 50100-130, Brazil; (S.P.B.); (M.H.P.d.P.)
| | - Letícia Bojikian Calixtre
- Graduate Program in Rehabilitation and Functional Performance (PPGRDF), University of Pernambuco (UPE–Campus Petrolina), Petrolina 56328-900, Brazil; (L.B.C.); (L.R.d.H.S.); (R.C.d.A.)
| | - Laís Regina de Holanda Santos
- Graduate Program in Rehabilitation and Functional Performance (PPGRDF), University of Pernambuco (UPE–Campus Petrolina), Petrolina 56328-900, Brazil; (L.B.C.); (L.R.d.H.S.); (R.C.d.A.)
| | - Rodrigo Cappato de Araújo
- Graduate Program in Rehabilitation and Functional Performance (PPGRDF), University of Pernambuco (UPE–Campus Petrolina), Petrolina 56328-900, Brazil; (L.B.C.); (L.R.d.H.S.); (R.C.d.A.)
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Owens LP, Khaiyat O, Coyles G. Muscle Activations of the Upper Extremity and Core during Elevation and Rotational Movements in Overhead Throwing Athletes. Int J Sports Phys Ther 2024; 19:466-476. [PMID: 38576830 PMCID: PMC10987313 DOI: 10.26603/001c.94604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/07/2024] [Indexed: 04/06/2024] Open
Abstract
Background A strong body of literature has been published outlining muscle activity differences during sports performance in groups of overhead athletes. However, there are limited studies that have directly compared the muscle activity in overhead athletes with and without history of shoulder injury during functional everyday tasks. Purpose This study aimed to identify muscle activities across fourteen upper extremity and core muscles during three functional everyday movements in athletes with and without history of shoulder injury. Study Design Cross-Sectional Study. Methods Thirty-two male overhead throwing athletes (fifteen healthy and seventeen injured) were recruited and completed three everyday functional movements of high elevation, low elevation, and rotation, using their dominant arm to move an object between two fixed positions. Electromyography (EMG) was recorded for fourteen muscles including: biceps brachii, deltoids (anterior, medial, and posterior), trapezius (upper and lower), pectoralis major, latissimus dorsi, serratus anterior, infraspinatus, external obliques, and gluteus maximus (all surface electrodes) and supraspinatus (fine wire electrode). Mixed model repeated measures ANOVA and post-hoc analysis assessed mean muscle activity (%MVC) between groups and each movement phase. Results Upper trapezius elicited higher mean activity in healthy athletes during both phases of the arm rotation task (p \< 0.05). No differences between groups were evident for arm elevation tasks. Qualitative analysis of muscle patterns during functional tasks reflected a temporal shift in muscle activation timings and magnitudes between athlete groups, suggesting potential compensatory mechanisms in injured athletes. Conclusion Injured overhead athletes appear to utilize other upper limb and shoulder girdle muscles to compensate for lower upper trapezius activity during functional everyday tasks. Level of Evidence 3.
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Affiliation(s)
- Liam P Owens
- School of Health and Sport Sciences Liverpool Hope University
| | - Omid Khaiyat
- School of Health and Sport Sciences Liverpool Hope University
| | - Ginny Coyles
- School of Health and Sport Sciences Liverpool Hope University
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Can EN, Harput G, Turgut E. Shoulder and Scapular Muscle Activity During Low and High Plank Variations With Different Body-Weight-Bearing Statuses. J Strength Cond Res 2024; 38:245-252. [PMID: 37815235 DOI: 10.1519/jsc.0000000000004622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
ABSTRACT Can, EN, Harput, G, and Turgut, E. Shoulder and scapular muscle activity during low and high plank variations with different body-weight-bearing statuses. J Strength Cond Res 38(2): 245-252, 2024-This study investigated the activation levels and activation ratios of shoulder and scapular muscles during low plank (LP) and high plank (HP) variations, with varying levels of body-mass support, including 4-point, 3-pod, and 2-point body-weight-bearing (BWB) statuses. The study was conducted with 21 healthy men (mean ± SD , 26 ± 6.5 years of age and 24.4 ± 2.4 kg·m -2 BMI). Ten different plank exercises were performed in a mixed order by changing elbow joint positions (LP and HP) and BWB statuses (2-point, 3-pod, and 4-point). Activation levels of the lower trapezius (LT), middle trapezius (MT), upper trapezius (UT), biceps brachii, triceps brachii, infraspinatus, and serratus anterior (SA) muscles were assessed with a surface electromyography device. Results of this study showed that elbow position changes resulted in higher LT ( p = 0.01) and TB ( p = 0.001) activation in HP exercises. In general, it was observed that an increase in BWB status was effective in increasing activation for the scapula and shoulder girdle muscles. The ratios of the UT muscle to the SA, LT, and MT muscles were less than 1 during side plank, bird dog, front reach, shoulder taps, and plank with shoulder external rotation exercises. High plank with toe touch exercise resulted in a marked increase in the UT activation. Therefore, it was concluded plank variations alter activation levels and activation ratios of shoulder and scapular muscles. Plank exercises may be used in shoulder rehabilitation and the progression in plank variations can be achieved by changing elbow position and BWB status based on individual requirements.
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Affiliation(s)
- Ezgi Nur Can
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
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Adeel M, Lin BS, Chaudhary MA, Chen HC, Peng CW. Effects of Strengthening Exercises on Human Kinetic Chains Based on a Systematic Review. J Funct Morphol Kinesiol 2024; 9:22. [PMID: 38249099 PMCID: PMC10801545 DOI: 10.3390/jfmk9010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 01/08/2024] [Indexed: 01/23/2024] Open
Abstract
Kinetic chains (KCs) are primarily affected by the load of different activities that recruit muscles from different regions. We explored the effects of strengthening exercises on KCs through muscle activation. Four databases were searched from 1990 to 2019. The muscles of each KC, their surface electromyography (sEMG), and the exercises conducted were reported. We found 36 studies that presented muscle activation using the percent (%) maximal voluntary isometric contraction (MVIC) or average sEMG for nine KCs in different regions. The % MVIC is presented as the following four categories: low (≤20%), moderate (21~40%), high (41~60%), and very high (>60%). Only four studies mentioned muscle activation in more than three KCs, while the remaining studies reported inconsistent sEMG processing, lacked normalization, and muscle activation in one or two KCs. The roles of stabilizers and the base of support in overhead throwing mobility using balance exercises were examined, and the concentric phase of chin-up and lat pull-down activated the entire KC by recruiting multiple muscles. Also, deep-water running was shown to prevent the risk of falls and enhance balance and stability. In addition, low-load trunk rotations improved the muscles of the back and external oblique activation. Based on this study's findings, closed-chain exercises activate more groups of muscles in a kinetic chain than open-chain exercises. However, no closed or open chain exercise can activate optimal KCs.
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Affiliation(s)
- Muhammad Adeel
- Department of Computer Science and Information Engineering, National Taipei University, New Taipei City 23741, Taiwan; (M.A.); (B.-S.L.)
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan
| | - Bor-Shing Lin
- Department of Computer Science and Information Engineering, National Taipei University, New Taipei City 23741, Taiwan; (M.A.); (B.-S.L.)
| | | | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan;
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Chih-Wei Peng
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
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Arghadeh R, Alizadeh MH, Minoonejad H, Sheikhhoseini R, Asgari M, Jaitner T. Electromyography of scapular stabilizers in people without scapular dyskinesis during push-ups: a systematic review and meta-analysis. Front Physiol 2023; 14:1296279. [PMID: 38116582 PMCID: PMC10728295 DOI: 10.3389/fphys.2023.1296279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023] Open
Abstract
Background: Push-up (PU) is widely considered an effective exercise to stabilize the scapular, especially if performed on unstable surfaces. However, available studies cover a wide range of exercise variations and differ according to exercise prescription, muscle selection and study design. Therefore, findings are contradictory, and conclusions for a proper application of the PU are difficult to draw. Objective: To synthesize the available literature on the changes in the activity of the periscapular muscles in individuals without scapular dyskinesis while performing different types of PU on unstable surfaces. Search procedure: Four online databases were searched from the earliest publications to 9 August 2023, using predefined keywords. Out of the 2,850 potential references identified in the primary search, 92 studies were reviewed in detail, of which 38 met the inclusion criteria and were included. Methodological quality was evaluated using a standardized form based on the Newcastle‒Ottawa scale for observational studies. Data combination was performed using CMA (v3), and the random-effects model was used to calculate the standardized mean difference (SMD) with a 95% confidence interval (CI). Results: The use of unstable surfaces in people without scapular dyskinesis led to increased activity of the upper trapezius during the PU (p = 0.017; I2 = 84.95%; SMD = 0.425 [95% CI 0.077, 0.773]) and knee PU (p = 0.023; I2 = 70.23%; SMD = 0.474 [95% CI 0.066, 0.882]) exercises and increased activity of the middle trapezius (MT) (p = 0.003; I2 = 64.50%; SMD = 0.672 [95% CI 0.225, 1.119]) and serratus anterior (SA) (p = 0.039; I2 = 4.25%; SMD = 0.216 [95% CI 0.011, 0.420]) muscles during the push-up plus (PUP) exercise. Conclusion: Using an unstable support base during PU does not necessarily increase the activity of all scapular stabilizers. The amount of muscle activity depends on the type of PU other than the type of support base. If an unstable surface is used, PUP exercise appears to be the most effective modality to increase the quality of training, improve performance, and prevent the occurrence of scapular dyskinesis due to the increase in the activity of the MT and SA muscles. Systematic Review Registration: http://www.crd.york.ac.uk/PROSPERO, CRD42021268465.
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Affiliation(s)
- Ramin Arghadeh
- Department of Sports Injury and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
| | - Mohammad Hossein Alizadeh
- Department of Sports Injury and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
| | - Hooman Minoonejad
- Department of Sports Injury and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
| | - Rahman Sheikhhoseini
- Department of Corrective Exercises and Sports Injury, Faculty of Physical Education and Sport Sciences, Allameh Tabataba’i University, Tehran, Iran
| | - Mojtaba Asgari
- Institute for Sport and Sport Science, TU Dortmund University, Dortmund, Germany
| | - Thomas Jaitner
- Institute for Sport and Sport Science, TU Dortmund University, Dortmund, Germany
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Parel I, Candoli V, Filippi MV, Padolino A, Merolla G, Sanniti S, Galassi R, Paladini P, Cutti AG. Shoulder Rehabilitation Exercises With Kinematic Biofeedback After Arthroscopic Rotator Cuff Repair: Protocol for a New Integrated Rehabilitation Program. JMIR Res Protoc 2023; 12:e35757. [PMID: 36947146 PMCID: PMC10131889 DOI: 10.2196/35757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 07/28/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The recovery of scapular and humeral physiological kinematic parameters, as well as the sensorimotor control of movement, plays a primary role in the rehabilitation process after arthroscopic rotator cuff repair. A highly customized rehabilitation approach is required to achieve this aim. Biofeedback can be a useful tool, but there is poor evidence of its application in the rehabilitation after arthroscopic rotator cuff tear repair. OBJECTIVE The aim of this paper is to outline an innovative exercise-based rehabilitation program exploiting visual biofeedback for the recovery of patients arthroscopically treated for rotator cuff repair. METHODS For establishment of the innovative program, a multidisciplinary team involving experts in shoulder surgery, rehabilitation medicine, physical therapy, and biomedical and clinical engineering was formed. Starting from a conventional rehabilitation program, the team selected a set of exercises to be integrated with a biofeedback tool, named the INAIL (National Institute for Insurance against Accidents at Work) Shoulder and Elbow Outpatient program (ISEO program). ISEO is a motion analysis system based on inertial wearable sensors positioned over the thorax, scapula, humerus, and forearm. ISEO can return a visual biofeedback of humerus and scapula angles over time or of the scapula-humeral coordination, with possible overlap of patient-specific or asymptomatic reference values. A set of 12 progressive exercises was defined, divided into four groups based on humerus and scapula movements. Each group comprises 2-4 of the 12 exercises with an increasing level of complexity. Exercises can require the use of a ball, stick, rubber band, and/or towel. For each exercise, we present the starting position of the patient, the modality of execution, and the target position, together with notes about the critical factors to observe. The type of visual biofeedback to adopt is specified, such as the coordination between angles or the variation of a single angle over time. To guide the therapist in customizing the patient's rehabilitation program, a list of operative guidelines is provided. RESULTS We describe various applications of the ISEO exercise program in terms of frequency and intensity. CONCLUSIONS An innovative rehabilitation program to restore scapular and humeral kinematics after rotator cuff repair based on kinematic biofeedback is presented. Biofeedback is expected to increase patient awareness and self-correction under therapist supervision. Randomized controlled trials are needed to investigate the potential effect of the exercise-based biofeedback in comparison with conventional rehabilitation programs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/35757.
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Affiliation(s)
- Ilaria Parel
- Laboratory of Biomechanics, Azienda Unità Sanitaria Locale della Romagna, Cattolica, Italy
- Department of Clinical Engineering, Azienda Unità Sanitaria Locale della Romagna, Cesena, Italy
| | - Valeria Candoli
- Department of Rehabilitation Medicine, Azienda Unità Sanitaria Locale della Romagna, Riccione, Italy
| | - Maria Vittoria Filippi
- Department of Rehabilitation Medicine, Azienda Unità Sanitaria Locale della Romagna, Riccione, Italy
| | - Antonio Padolino
- Laboratory of Biomechanics, Azienda Unità Sanitaria Locale della Romagna, Cattolica, Italy
- Shoulder and Elbow Surgical Unit, Azienda Unità Sanitaria Locale della Romagna, Cattolica, Italy
| | - Giovanni Merolla
- Laboratory of Biomechanics, Azienda Unità Sanitaria Locale della Romagna, Cattolica, Italy
- Shoulder and Elbow Surgical Unit, Azienda Unità Sanitaria Locale della Romagna, Cattolica, Italy
| | - Stefano Sanniti
- Department of Clinical Engineering, Azienda Unità Sanitaria Locale della Romagna, Cesena, Italy
| | - Riccardo Galassi
- Department of Rehabilitation Medicine, Azienda Unità Sanitaria Locale della Romagna, Riccione, Italy
| | - Paolo Paladini
- Laboratory of Biomechanics, Azienda Unità Sanitaria Locale della Romagna, Cattolica, Italy
- Shoulder and Elbow Surgical Unit, Azienda Unità Sanitaria Locale della Romagna, Cattolica, Italy
| | - Andrea Giovanni Cutti
- Laboratory of Motion Analysis, National Institute for Insurance against Accidents at Work Prosthetic Center, Vigorso di Budrio, Italy
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Mendez-Rebolledo G, Orozco-Chavez I, Morales-Verdugo J, Ramirez-Campillo R, Cools AM. 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. PeerJ 2022; 10:e13589. [PMID: 35791364 PMCID: PMC9250763 DOI: 10.7717/peerj.13589] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/24/2022] [Indexed: 01/17/2023] Open
Abstract
Background Multiple investigations have compared the electromyographic (EMG) activity of the scapular muscles between stable and unstable support surfaces during the execution of closed kinetic chain exercises. However, these comparative analyses have grouped different unstable surfaces (wobble board, BOSU, therapeutic ball, and suspension equipment) into a single data pool, without considering the possible differences in neuromuscular demand induced by each unstable support surface. This study aimed to analyze the individual effect of different unstable support surfaces compared to a stable support surface on scapular muscles EMG activity during the execution of closed kinetic chain exercises. Methodology A literature search was conducted of the Pubmed Central, ScienceDirect and SPORTDiscus databases. Studies which investigated scapular muscles EMG during push-ups and compared at least two support surfaces were included. The risk of bias of included articles was assessed using a standardized quality assessment form for descriptive, observational and EMG studies, and the certainty of the evidence was measured with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. A random-effects model was used to calculate effect sizes (ES, Hedge's g). Results Thirty studies were selected in the systematic review. Of these, twenty-three low-to-high quality studies (498 participants) were included in the meta-analysis. The main analyzes revealed, in decreasing order, greater UT EMG activity during push-ups performed on suspension equipment (ES = 2.92; p = 0.004), therapeutic ball (ES = 1.03; p < 0.001) and wobble board (ES = 0.33; p = 0.003); without effect on the BOSU ball. In addition, no effect was observed for SA on any unstable device. The certainty of the evidence ranged from low to very low due to the inclusion of descriptive studies, as well as high imprecision, inconsistency, and risk of publication bias. Conclusion These findings could be applied in scapular muscles strengthening in healthy individuals. The use of suspension equipment achieves higher UT activation levels. Conversely, the use of any type of unstable devices to increase the activation levels of the SA in shoulder musculoskeletal dysfunctions is not recommended. These conclusions should be interpreted with caution as the available evidence showed a low to very low certainty of evidence, downgraded mostly by inconsistency and imprecision.
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Affiliation(s)
| | - Ignacio Orozco-Chavez
- Departamento de Ciencias del Movimiento Humano, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Juan Morales-Verdugo
- Departamento de Ciencias Preclínicas, Facultad de Medicina, Universidad Católica del Maule, Talca, Chile
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Ann M.J. Cools
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Cappato de Araújo R, Andrade da Silva H, Pereira Dos Passos MH, Alves de Oliveira VM, Rodarti Pitangui AC. Use of unstable exercises in periscapular muscle activity: A systematic review and meta-analysis of electromyographic studies. J Bodyw Mov Ther 2020; 26:318-328. [PMID: 33992265 DOI: 10.1016/j.jbmt.2020.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/12/2020] [Accepted: 12/05/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The use of unstable surfaces has been proposed to increase the neuromuscular demand. This strategy has been adopted to generate an increase in the activity of periscapular muscles due to its role in the stabilization of the scapula. However, the influence of this instability on the EMG activity remains uncertain. The aim of this study was to analyze the effects of using unstable surfaces on the EMG activity of the periscapular muscles. METHODS A comprehensive search in the PubMed, EMBASE, SCIELO, Web of Science, SCOPUS, Cochrane and LILACS databases was undertaken from their year of inception up to December 2019. Studies which directly investigated the EMG activity of periscapular muscles in healthy individuals while performing exercises for the upper limbs in stable and unstable conditions. RESULTS A total of 33 studies which evaluated a total of 678 healthy individuals were found according to the eligibility criteria. A meta-analysis identified that the EMG activity of the upper trapezius showed a trivial increase with the insertion of the unstable surface (P = 0.04; SMD = 0.14 [95%CI 0.00, 0.27]). No significant effects were observed on the middle trapezius (P = 0.10) and lower trapezius (P = 0.25). A decrease of the anterior serratus EMG activity with a small effect size was observed by implementing an unstable surface (P = 0.01; SMD = -0.21 [95%CI -0.36, -0.05]). CONCLUSION The use of unstable surfaces generated a trivial increase in the upper trapezius activity, and a slight decrease in the anterior serratus activity. No effect was observed on the middle and lower trapezius.
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Affiliation(s)
- Rodrigo Cappato de Araújo
- Postgraduate Program in Physical Education, University of Pernambuco (UPE), Brazil, Br 203 Km2 S/N, Cidade Universitária, Petrolina, PE, 56328-903, Brazil; Postgraduate Program in Rehabilitation and Functional Performance, University of Pernambuco (UPE), Brazil, Br 203 Km2 S/N, Cidade Universitária, Petrolina, PE, 56328-903, Brazil.
| | - Hítalo Andrade da Silva
- Postgraduate Program in Physical Education, University of Pernambuco (UPE), Brazil, Br 203 Km2 S/N, Cidade Universitária, Petrolina, PE, 56328-903, Brazil
| | - Muana Hiandra Pereira Dos Passos
- Postgraduate Program in Physical Education, University of Pernambuco (UPE), Brazil, Br 203 Km2 S/N, Cidade Universitária, Petrolina, PE, 56328-903, Brazil
| | - Valéria Mayaly Alves de Oliveira
- Postgraduate Program in Physical Education, University of Pernambuco (UPE), Brazil, Br 203 Km2 S/N, Cidade Universitária, Petrolina, PE, 56328-903, Brazil
| | - Ana Carolina Rodarti Pitangui
- Postgraduate Program in Physical Education, University of Pernambuco (UPE), Brazil, Br 203 Km2 S/N, Cidade Universitária, Petrolina, PE, 56328-903, Brazil; Postgraduate Program in Rehabilitation and Functional Performance, University of Pernambuco (UPE), Brazil, Br 203 Km2 S/N, Cidade Universitária, Petrolina, PE, 56328-903, Brazil
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Di Giminiani R, Giovannelli A, Capuano L, Izzicupo P, Di Blasio A, Masedu F. Neuromuscular Strategies in Stretch-Shortening Exercises with Increasing Drop Heights: The Role of Muscle Coactivation in Leg Stiffness and Power Propulsion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228647. [PMID: 33233323 PMCID: PMC7700220 DOI: 10.3390/ijerph17228647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/11/2020] [Accepted: 11/19/2020] [Indexed: 05/24/2023]
Abstract
When applying drop jump exercises, knowing the magnitude of the stimulus is fundamental to stabilize the leg joints and to generate movements with the highest power. The effects of different drop heights on leg muscles coactivation, leg stiffness and power propulsion were investigated in fifteen sport science students. Drop jumps from heights of 20, 30, 40, 50, and 60 cm in a random order were performed on a force platform. During each drop jump, the ground reaction force, knee angle displacement, and synchronized surface-electromyography root-mean-square (sEMGRMS) activity (vastus lateralis, VL; vastus medialis, VM; rectus femoris, RF; biceps femoris, BF; tibialis anterior, TA and lateral gastrocnemius, LG) were recorded. The coactivation in the pre-contact phase, between VL and BF, VM and BF as well as RF and BF, was dependent on the drop height (p < 0.01; effect size (ES) ranged from 0.45 to 0.90). Leg stiffness was dependent on the drop height (p < 0.001; ES = 0.27-0.28) and was modulated by the coactivation of VM-BF (p = 0.034) and RF-BF (p = 0.046) during the braking phase. Power propulsion was also dependent on the drop height (p < 0.001; ES = 0.34); however, it was primarily modulated by the coactivation of LG-TA during the braking phase (p = 0.002). The coactivation of thigh muscles explains leg stiffness adjustments at different drop heights. On the contrary, the coactivation of shank muscles is mostly responsible for the power propulsion.
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Affiliation(s)
- Riccardo Di Giminiani
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.G.); (L.C.); (F.M.)
| | - Aldo Giovannelli
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.G.); (L.C.); (F.M.)
| | - Lorenzo Capuano
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.G.); (L.C.); (F.M.)
| | - Pascal Izzicupo
- Department of Medicine and Aging Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (P.I.); (A.D.B.)
| | - Andrea Di Blasio
- Department of Medicine and Aging Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (P.I.); (A.D.B.)
| | - Francesco Masedu
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.G.); (L.C.); (F.M.)
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Grant MJ, Hawkes DH, McMahon J, Horsley I, Khaiyat OA. Vibration as an adjunct to exercise: its impact on shoulder muscle activation. Eur J Appl Physiol 2019; 119:1789-1798. [PMID: 31152231 DOI: 10.1007/s00421-019-04168-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 05/28/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE There is an interest within elite sport in understanding the impact of a vibrating platform as an adjunct to exercise in the training and rehabilitation of throwing athletes. However, there has been no comprehensive evaluation of its impact on the rotator cuff muscles or its effect on the timing of shoulder muscle recruitment more globally. METHODS Twenty healthy participants were recruited with EMG recorded from 15 shoulder girdle muscles. Isometric shoulder flexion at 25% maximal voluntary contraction was performed in three testing scenarios [no vibration; whole body vibration (WBV); and arm vibration (AV)]. A press up and triceps dips with and without vibration were also performed. Muscular recruitment was assessed pre- and post-vibration exposure as participants initiated forward flexion. RESULTS Activation of the anterior deltoid (p = 0.002), serratus anterior (p = 0.004), and rotator cuff muscles (p = 0.004-0.022) occurred significantly earlier following exposure to vibration. Significantly greater activation was seen in the anterior, middle and posterior deltoid, upper, middle and lower trapezius, serratus anterior, teres major, latissimus dorsi, supraspinatus, and infraspinatus when the isometric contraction was performed with either WBV and/or AV (p = < 0.001-0.040). Similarly, increased activation was also demonstrated during the press up and triceps dips when performed with vibration. CONCLUSION The use of vibration as an adjunct to exercise provokes a near global increase in shoulder muscle activation level. Furthermore, exposure to vibration alters muscular recruitment improving readiness for movement. This has potential implications within elite sport for both training and game preparation; however, further longitudinal work is required.
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Affiliation(s)
- Michael J Grant
- Trauma and Orthopaedic Surgery, North West (Mersey) Deanery, Liverpool, UK
| | - David H Hawkes
- Trauma and Orthopaedic Surgery, North West (Mersey) Deanery, Liverpool, UK
- School of Health Sciences, Liverpool Hope University, Liverpool, UK
| | - Jessica McMahon
- School of Health Sciences, Liverpool Hope University, Liverpool, UK
| | - Ian Horsley
- England Institute for Sport, Sports City, Manchester, UK
| | - Omid A Khaiyat
- School of Health Sciences, Liverpool Hope University, Liverpool, UK.
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Gottschall JS, Hastings B, Becker Z. Muscle Activity Patterns do not Differ Between Push-Up and Bench Press Exercises. J Appl Biomech 2018; 34:442-447. [PMID: 29809073 DOI: 10.1123/jab.2017-0063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 03/31/2018] [Accepted: 04/24/2018] [Indexed: 11/18/2022]
Abstract
Popular topics for upper-body resistance training involve the differences between hand positions, open versus closed chain exercises, and movement variations for the novice to the advanced. It was hypothesized that there will be no difference between closed (push-up) versus open (bench press) chain exercises for the primary muscle group activity nor would there be a difference between push-ups on the toes versus knees with respect to the percent contribution of each muscle. Surface muscle activity was measured for 8 upper-body and core muscles during a sequence of push-up and bench press variations with a normalized weight for 12 active men. Each participant completed push-ups and bench press exercises at each of 3 hand positions. The results demonstrated that there were few differences between closed versus open chain exercises for the primary muscle groups with the exception of core activation. In addition, in general, narrow hand positions yielded greater activation, and there were no significant differences between push-ups on the toes versus knees with respect to the percent contribution for the primary muscle groups. In conclusion, closed chain exercises may be preferred for functional training, and knee push-ups may be ideal as a novice push-up variation.
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Horsak B, Kiener M, Pötzelsberger A, Siragy T. Serratus anterior and trapezius muscle activity during knee push-up plus and knee-plus exercises performed on a stable, an unstable surface and during sling-suspension. Phys Ther Sport 2017; 23:86-92. [DOI: 10.1016/j.ptsp.2016.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/14/2016] [Accepted: 08/04/2016] [Indexed: 11/17/2022]
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Limitation of motion and shoulder disabilities in patients with cardiac implantable electronic devices. Int J Rehabil Res 2015; 38:287-93. [DOI: 10.1097/mrr.0000000000000122] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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