Kinetic analysis of push-up exercises: a systematic review with practical recommendations

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

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.

Can different variations of suspension exercises provide adequate loads and muscle activations for upper body training?

The purpose of this study was to assess the differences in muscle activation (EMG) and body weight distribution (%BW) between suspension (TRX™ push-up and TRX™ inverted row) and conventional exercises (bench press and lying barbell row) using different contraction types (isometric and isotonic) and position variations (feet on the ground [FG] and feet on suspension device [FD]). It was also used to determine the intensity of the force applied to the straps of the suspension device corresponding to one repetition maximum (1-RM). Twelve male athletes (ages-24.5±4.2 years (mean±standard deviation [SD]); Height-181.0±6.8 cm; body mass-83.08±6.81 kg) participated in this study. Two suspension devices were used, one for the FD variation and one for the FG variation pectoralis major (PM) and triceps brachii (TRI) activations were assessed during the TRX™ push-up and bench press exercises. Transversus trapezius (TRA) and biceps brachii (BB) activations were assessed during the TRX™ inverted row and lying barbell row exercises. The results showed significant differences between exercises (FG and FD variations of TRX™ push-up and bench press) in PM activities (isometric and isotonic) (p≤0.05). However, these differences were only observed during isometric TRI activation (p≤0.05). In the FG and FD variations of the TRX™ inverted row and lying barbell row exercises, there were only differences in the isometric contractions of the TRA and BB (p≤0.05). In the suspension device of push-ups and inverted row for the FD variations, 70.5% and 72.64% of 1-RM intensity were obtained, respectively. Similar responses to training intensities and muscle activations can be obtained in suspension exercises and conventional exercises. FD variations of suspension exercises can be more effective in terms of muscle activations than FG variations, and isotonic suspension exercises increase exercise intensity more than isometric suspension exercises.

Network of muscle fibers activation facilitates inter-muscular coordination, adapts to fatigue and reflects muscle function

Fundamental movement patterns require continuous skeletal muscle coordination, where muscle fibers with different timing of activation synchronize their dynamics across muscles with distinct functions. It is unknown how muscle fibers integrate as a network to generate and fine tune movements. We investigate how distinct muscle fiber types synchronize across arm and chest muscles, and respond to fatigue during maximal push-up exercise. We uncover that a complex inter-muscular network of muscle fiber cross-frequency interactions underlies push-up movements. The network exhibits hierarchical organization (sub-networks/modules) with specific links strength stratification profile, reflecting distinct functions of muscles involved in push-up movements. We find network reorganization with fatigue where network modules follow distinct phase-space trajectories reflecting their functional role and adaptation to fatigue. Consistent with earlier observations for squat movements under same protocol, our findings point to general principles of inter-muscular coordination for fundamental movements, and open a new area of research, Network Physiology of Exercise.

Role of active joint position sense on the upper extremity functional performance tests in college volleyball players

Background

It has been well established that proprioception plays a decisive role in shoulder stability and sport performance. Notwithstanding, there is a lack of clear association between active joint position sense (AJPS) and the performance of upper-extremity functional performance tests. The aim of this study was to determine whether the AJPS of the shoulder complex is associated with the performance of college volleyball players with the following functional tests: Y-Balance Test-Upper Quarter (YBT-UQ), Closed Kinetic Chain Upper-Extremity Stability Test (CKCUEST), and Seated Medicine Ball Throw (SMBT). The secondary aim was to investigate whether the magnitude of the proprioception error through the AJPS had the ability to act as a predictor for functional test scores.

Methods

Cross-sectional study with a convenience sampling. Healthy college volleyball players (≥12 h of training/week), 30 males and 22 females, between 18 and 26 years of age were included. AJPS of the shoulder (90° of flexion (90°Flex), 90° of internal rotation at 90° of abduction (90°IR/ABD), 90° of external rotation at 90° of abduction (90°ER/ABD)) and three upper-extremity functional performance tests (YBT-UQ, CKCUEST and SMBT) were assessed. A Pearson's test and a stepwise multiple linear regression analysis were used to determine possible associations and relationships between outcome measures, respectively.

Results

The analysis revealed that AJPS at 90°IR/ABD and 90°ER/ABD were the only proprioceptive variables with an association to the YBT-UQ and SMBT. Despite these relationships, only the AJPS at 90°IR/ABD was associated with the performance of the YBT-UQ in; superolateral direction (β = -0.7; 95% CI [-1.3 to 0.1]; p = 0.025); inferolateral direction (β = -1.5; 95% CI [-2.1 to -0.8]; p = 0.001); and composite score (β = -0.8; 95% CI [-1.3 to -0.3]; p = 0.002). From these, AJPS at 90°IR/ABD mainly explained the variability of YBT-UQ (inferolateral direction) performance (R² = 0.32; %R² = 0.32). Our findings allow for a possible expanded role for proprioception as a contributing factor in upper limb motor control during functional movements. Further research is required to explore and distinguish the associations between proprioception, motor control and sport performance involving the upper limbs.

The influence of speed and strength abilities on the overall endurance of children aged 13-14 years with different typologies

AIM: The aim of this study was to determine the effect of a set of speed-strength exercises on the development of general endurance in schoolchildren aged 13–14, taking into account the differentiated load. METHODS: The pedagogical experiment was conducted on the basis of secondary school 60 in Kirov, Russia. The study involved 40 schoolchildren from the 7th grade, who were differentiated into the control and experimental groups of 20 people in each class. Children from the control group (CG) were engaged in physical education according to the standard program, and children from the experimental group additionally performed exercises for the development of speed and strength abilities with different loads. The strength of the nervous system was determined by tapping test, speed-strength abilities were determined by tests – flexion and extension of the arms at the stop while lying on the floor, long jump from a place with a push with two legs, and lifting the torso from the supine position. Overall endurance was determined by the “3 km ski run” test. RESULTS: In the CG, there was an improvement of only 2–4%. In the experimental group, there were significant improvements of 11–16%. CONCLUSION: I f schoolchildren perform exercises for the development of speed and strength abilities at physical education classes at school every time, then not only the indicators of these abilities will improve, but also the indicators of the overall endurance of children aged 13–14 will improve. Our results allow us to supplement the standard physical education program at school and effectively develop the physical qualities of schoolchildren aged 13–14.

Comparison of ground reaction forces and joint kinematics between three different tempos during push-up exercise

Study aim

This study was aimed to analysis in detail how different tempos [2:0:2 (30 bpm), 1:0:1 (60 bpm), Explosive (EXP)] effect to ground reaction forces (vGRF) and joint kinematics of push-up exercise (PUP).

Material and methods

Twenty-four recreationally male athletes (age: 24.9 ± 3.6 years) participated in this study. Kinetic and kinematic data were obtained by load-cells and a motion analysis software. Data was analysed from a single repetition which is showed peak vGRF of dominant side during PUP. Joint velocities were calculated by taking the difference between the descent and ascent phases.

Results

There was significant difference between 2:0:2 (30 bpm) – EXP in terms of dominant side of shoulder (p ≤ 0.02) and between 1:0:1 (60 bpm) – EXP in the dominant elbow joint displacements (p ≤ 0.05). The velocity differences between the descent and ascent phases of shoulder and elbow joints were found statistically significant between tempos (p ≤ 0.05). In terms of range of motion (ROM) of right and left side, there was significant differences between tempos (p ≤ 0.001). No significant differences were found between all tempos in the ascent phase of right-left and left descent phase in terms of average vGRF (p > 0.05) except right descent average vGRF (p ≤ 0.02).

Conclusions

In conclusion, right-left sides of ROM was used most effectively in 2:0:2 (30 bpm) and 1:0:1 (60 bpm) tempos. Less displacement was also observed in EXP and when tempo increased percentage of peak vGRF (at elbow flexion phase for right-left sides) to total repetition decreased. Highest ascent and descent phase velocity differences (for right-left sides) and highest peak vGRF (elbow flexion phase) observed in EXP. This study shows that increasing tempo will result in more unsteady joint kinematics and more vGRF, so if the goal is controlled and safe PUP, tempo should be slow.

Bilateral Radial Head Fracture Secondary to Weighted Push-Up Exercise: Case Report and Review of Literature of a Rare Injury

A 33-year-old male presented with bilateral radial head fractures after weighted prone push-up exercise. The patient had Mason type I and II on right and left sides, respectively. He was managed conservatively with limited immobilisation and early range of motion exercises. The fracture healed and patient had no complaints at the last follow-up of 13 months. Bilateral radial head fracture is rare with push-up exercise, and can be successfully treated conservatively with immobilisation and early rehabilitation. Although push-up exercises are an excellent workout with known benefits, unusual modifications of standard techniques should be avoided.

The validity of using one force platform to quantify whole-body forces, velocities, and power during a plyometric push-up

Background

Previous studies have typically measured velocity and power parameters during the push-up, either using one or two force platforms. The purpose of the study was to compare the force, velocity, and power parameters between the one-force-platform method and the two-force-platform method during plyometric push-ups.

Methods

Thirty-four physically active young adults participated in the study to perform the plyometric push-up. For the two-force-platform calculation method, the forces applied to the feet and hands were both measured. For the one-force-platform calculation method, the forces applied to the feet were assumed to be constant, while the forces applied to hands were measured by one force platform. Whole-body linear velocities were calculated based on the impulse and momentum theorem. Whole-body power was calculated as the product of the whole-body forces and velocities.

Results

The one-force-platform method overestimated the whole-body velocities and power compared with the two-force-platform method (1.39 ± 0.37 m/s vs. 0.90 ± 0.23 m/s, Cohen’s d = 1.59, p < 0.05; 1.63 ± 0.47 W/body weight vs. 1.03 ± 0.29 W/body weight, Cohen’s d = 1.49, p < 0.05). These differences were caused by the decreased forces applied to the feet compared to the initial value throughout most of the push-up phase. Large to perfect correlations (r = 0.55 – 0.99) were found for most variables between the two-force-platform and one-force-platform methods. Previous findings of push-up velocities and power using the two-force-platform and one-force-platform methods should be compared with caution. While the two-force-platform method is recommended, linear regression equations may be used to predict velocities and power parameters obtained from one force platform.

Conclusions

For those professionals who need to accurately quantify kinetic variables during the plyometric push-up, the two-force-platform method should be considered.

Biomechanical stability of simple coronal shear fracture fixation of the capitellum

BACKGROUND

Coronal shear fractures of the capitellum are rare, and their surgical management is challenging, without a defined gold standard. The purpose of this study was to compare the biomechanical stability of 3 different internal fixation techniques for simple coronal shear fractures of the capitellum without posterior comminution.

METHODS

Dubberley type IA fractures of the capitellum were created in 18 cadaveric elbows, which were age and sex matched to the following 3 internal fixation groups: (1) two anteroposterior cannulated headless compression screws (HCSs), (2) two anteroposterior HCSs with an additional anterior antiglide plate (antiGP), and (3) a posterolateral distal humeral locking plate (LP). All fixation techniques were cyclically loaded with 75 N over 2000 cycles and ultimately until construct failure. Data were analyzed for displacement, construct stiffness, and ultimate load to failure.

RESULTS

Fragment displacement under cyclic loading with 2000 cycles did not show a significant difference (P = .886) between the 3 groups. The HCS group showed the highest stiffness compared with the HCS-antiGP and LP groups (602 N/mm vs. 540 N/mm vs. 462 N/mm, P = .417), without reaching a statistically significant difference. Ultimate load to failure was also not significantly different on comparison of all 3 groups (P = .297).

CONCLUSIONS

Simple coronal shear fractures of the capitellum are biomechanically equally stabilized by HCSs compared with HCSs with an additional antiGP or a posterolateral distal humeral LP. In view of the advantages of less (invasive) metalware, the clinical use of 2 isolated anteroposterior HCSs appears reasonable.

Core Endurance Relationships With Athletic and Functional Performance in Inactive People

Research regarding the relationship between core muscle endurance and performance is limited. The purpose of this study was to analyze the association between core/trunk endurance and athletic performance. Seventy-four healthy participants between 18 and 45 years old participated in this study (Age: 26.0 ± 6.5 years; Mass: 74.6 ± 12.8 kg; Height: 1.74 ± 0.08 m; BMI: 19.0 ± 6.8 kg/m²). The core endurance was measured using the McGill protocol, consisting of the following tests: trunk flexion, back extension, and side-bridge. Functional performance was evaluated with push-ups, sit to stand, T-run test, countermovement jump (CMJ), Yo-Yo test, maximum dynamic strength-one repetition maximum (1RM) and muscle power on the bench press, pull row, and leg press. The regression results between the McGill protocol (proxy for core/trunk endurance) and the dependent variables were: 1RM pull row: r² = 0.109 with p = 0.046; RM bench press: r² = 0.149 with p = 0.012; RM leg press: r² = 0.144 with p = 0.013 and power pull row: r² = 0.151 with p = 0.016; power bench press: r² = 0.136 with p = 0.026; power leg press: r² = 0.122 with p = 0.013), push-ups: r² = 0.157 with p < 0.001, sit to stand: r² = 0.198 with p < 0,001), functional movement score: r² = 0.209 with p < 0.001). Nevertheless, core endurance scores were not able to predict jump ability (r² = 0.014, p = 0.807) or agility (T-test: 0.036 with p = 0.497). In conclusion, core endurance exerted no significant influence the agility and jump performance but influenced the ability to run intermittently, exert maximum power and strength in different actions (push, pull, and lift exercises) related to the better quality of movement (FMS).

Validity and Reliability of a New Specific Parkour Test: Physiological and Performance Responses

Main aim of this study was examining validity and reliability of using a new specific Parkour repeated sprint ability test (SPRSA) for assessing repeated sprint ability while facing obstacles and establishing between-day reliability and sensitivity of SPRSA related to its physiological and performance responses. Thirteen high-level traceurs (three females) performed in random order and twice eight tests for assessing a total of 23 variables: SPRSA (a typical maximal-speed shuttle run interspersed with four Parkour competition-common fundamentals) and seven established fitness tests, core stability, hand-grip, vertical-jump, long-jump, pull-up, 300-m shuttle run (as a field test for anaerobic capacity), and Leger test. Except for muscular elasticity index of vertical jump test (intra-class Correlation Coefficient model 3,1 [ICC₃,₁] = 0.54 [fair]), fitness tests’ ICC₃,₁s resulted excellent (ICC₃,₁: 0.93–1.00). SPRSA total time and time of its fastest sprint (SPRSA peak time) were significantly correlated with the majority of core stability (r: −0.79 to 0.59; P < 0.01–0.05), jumping (r: −0.78 to 0.67; P < 0.01–0.05), pull-up tests (r: −0.86; P < 0.01), 300-m shuttle run test total time (r: 0.77–0.82; P < 0.01), and Leger test-estimated VO₂ max (r: −0.78; P < 0.01). Principal component analysis (PCA) of the 23 variables led to extraction of four significant components (each due to different variables’ combinations), which explained 90.2% of 23 variables’ total variance. SPRSA (i.e., total and peak time) showed high reliability (ICC₃,₁: 0.991–0.998 and standard-error-of-measurement %: 0.07–0.32). Finally, SPRSA showed high sensitivity (smallest-worthwhile-change %: 0.29–0.68). Considering its excellent logical and strong ecological validity, SPRSA may serve as a valid specific field test for Parkour sport. In addition, thanks to its high reliability and sensitivity, this test is suitable for monitoring, evaluating, and programming training processes for Parkour practitioners in repeated sprint ability involving crossing obstacles.