Effects of Electro-Muscle Stimulation Exercise Combined with Mat Pilates on Pain, Anxiety, and Strength in Sedentary Females with Fibromyalgia: A Single-Blind Randomized Controlled Trial

BACKGROUND AND OBJECTIVES

Fibromyalgia syndrome (FM) is a chronic pain disorder that is ranked as one of the four most common rheumatological diseases in the world. This study aims to investigate the effects of an eight-week mat Pilates and electro-muscle stimulation (EMS) with combined mat Pilates exercises on pain, depression, anxiety, and strength in sedentary women.

METHODS

This study is a single-blind randomized controlled trial. A total of 30 sedentary female patients (Pilates (n = 15), EMS (n = 15)) diagnosed with FM were included in the study. The patients were subjected to Beck Depression (BDIs) and Anxiety Inventories (BAIs); a Fibromyalgia Impact Questionnaire (FIQ); five different Single-Leg Hop Tests (SLHTs); modified push-up (MPU), Handgrip Strength (HGS), Deep Squat (DSQ), V-Sit Flexor, bent-arm hang (BA), sit-up and Biering-Sørensen tests; and anthropometric tests before and after the 8-week exercise program.

RESULTS

The eight weeks of mat Pilates exercises combined with mat Pilates and EMS revealed significant results (p < 0.05) in anthropometric data (abdomen, lower abdomen, hips) (p < 0.05) except for the results of chest circumference measurements (p > 0.05). In addition, there were statistically significant positive results in BDIs, BAIs, FIQs, lower extremity (all SLHTs and DSQ), upper extremity (MPU, HGS, BA), and core (V-SIT, sit-up, Biering-Sørensen test) strength test findings (p < 0.05).

CONCLUSIONS

Combining the mat Pilates exercises with EMS is an effective and reliable method to improve the pain, anxiety, depression, and strength of female patients diagnosed with FM.

Reliability and Validity of the Star Excursion Balance Test for Evaluating Dynamic Balance of Upper Extremities

BACKGROUND

Upper extremity (UE) dynamic balance is a significant physical fitness ability, which includes high-level neuromuscular proprioception, joint mobility, force, and coordination. The evaluation methods of UE dynamic balance are insufficient and lack experimental support. The Star Excursion Balance Test (SEBT) is a reliable assessment of dynamic balance and injury risk of the lower extremity.

HYPOTHESIS

The UE-SEBT is a reliable and reproducible approach for evaluating dynamic balance of UEs.

STUDY DESIGN

Observational study.

LEVEL OF EVIDENCE

Level 4.

METHODS

This cross-sectional study recruited 65 healthy adults. All participants were required to complete UE-SEBT, UE Y-balance test (UE-YBT), maximal voluntary isometric contraction (MVIC) of UE, closed kinetic chain UE stability test (CKCUEST), trunk flexor endurance test (TFET), trunk extensor endurance test (TEET), and lateral trunk endurance test (LTET). Intra- and inter-rater reliability and the correlation of UE-SEBT with other outcomes were measured.

RESULTS

Among the participants, the intra- and interoperator reliability of UE-SEBT in all directions and composite score achieved a moderate-to-excellent (intraclass correlation coefficients [ICC], 0.729-0.946) reliability. For validity, the UE-SEBT had a moderate to very strong correlation with UE-YBT (r = 0.315-0.755, P < 0.01) and a strong correlation with CKCUEST (r = 0.4-0.67, P < 0.01). Furthermore, the UE-SEBT performance showed weak-to-strong correlations with MVIC (r = 0.26-0.43, P < 0.05). UE-SEBT was also correlated with LTET, TEET, and TFET to varying degrees.

CONCLUSION

UE-SEBT has good reliability and validity to assess UE dynamic balance compared with other tests.

CLINICAL RELEVANCE

UE-SEBT can be used as a clinical assessment method to evaluate UE dynamic balance and injury prevention.

Differences and Relationships Between Push-up and Sit-up Variations Among Male Law Enforcement Cadets

ABSTRACT

Lopes dos Santos, M, Thompson, M, Dinyer-McNeely, T, Torrence, T, Lockie, RG, Orr, RM, and Dawes, JJ. Differences and relationships between push-up and sit-up variations among male law enforcement cadets. J Strength Cond Res 37(9): 1865-1869, 2023-The purpose of this study was to explore variation-dependent differences in push-up and sit-up tests, as well as to identify the relationships between push-up and sit-up variations commonly performed among tactical personnel. Data from 41 (age = 21.1 ± 1.8 years, body mass = 89.5 ± 15.5 kg) male police cadets from one US-based training academy who performed the standard push-up (PU Standard ), hand-release push-up (PU Hand-release ), standard sit-up (SU Standard ), and hands behind the head sit-up (SU BehindHead ) were examined. The maximum number of repetitions completed for each exercise was used for analyses with paired-samples t tests used to identify significant differences between outcome measures and effect sizes (ES) to determine change in magnitude. A significant difference, with a large ES, was found in the number of repetitions completed between the push-up variations ( p < 0.001, ES = 0.75) and sit-up variations ( p < 0.001, ES = 1.02). Performance in PU Standard was only able to explain 39% of the variation in PU Hand-release ( r = 0.62, r2 = 0.39, p < 0.001), and performance in the SU Standard was only able to explain 29% of the variation in SU BehindHead ( r = 0.54, r2 = 0.29, p < 0.001). The current study suggests differences in performance capabilities may be dependent on the push-up and sit-up variations chosen for testing. Although it is still unclear whether one variation would be a better predictor of police work performance, agencies must give special attention to the overall construct validity of fitness tests for entry and retention of law enforcement officers.

Male-Female Differences in Push-up Test Performance at Various Cadences

ABSTRACT

Rozenek, R, Byrne, JJ, Crussemeyer, J, and Garhammer, J. Male-Female Differences in Push-up Test Performance at Various Cadences. J Strength Cond Res 36(12): 3324-3329, 2022-Push-up (PU) testing is widely used to assess upper-extremity muscular endurance. However, little information exists regarding the influence of cadence on PU performance. Forty-four healthy men and women (age range = 21-36 years) completed 4 PU test sessions on separate days in a randomized order using standard PUs. Cadences of 30, 45, and 60 PU·min -1 were used for 3 tests, whereas a fourth test was performed at a self-selected (SS) cadence. The total number of PUs completed, vertical ground reaction forces (vGRFs) acting on each hand and the feet, and the sum of the vGRFs were determined for each test. Results showed men performed more PU than women at any cadence ( p ≤ 0.05) and had a faster mean SS cadence (49.9 ± 11.4 PU·min -1 vs 42.8 ± 8.4 PU·min -1 ) ( p ≤ 0.05). The maximum number of PU were performed when using either the SS cadence or 60 PU·min -1 , with little difference observed between them ( p ≤ 0.05). The sum of vGRFs was greatest at 60 PU·min -1 and when scaled to body mass (BM) represented 1.58 ± 0.14x and 1.33 ± 0.08x BM for men and women, respectively. As cadence increased, men shifted more weight to the hand contact points compared with women ( p ≤ 0.05). Distinct differences in SS cadence and distribution of forces were observed between the sexes suggesting different strategies while performing the PU test. These differences should be considered when selecting a protocol for PU testing.

Upper body push to pull ratios in law enforcement officer recruits

BACKGROUND: Law enforcement recruits (LER) often encounter shoulder injuries, which may cause attrition from academies. Investigating required upper body muscular fitness may inform of muscular balance around shoulder joints through anterior and posterior ratios in LER. OBJECTIVE: To investigate push to pull ratios (P2P) and factors related with P2P in LER. METHODS: LER (95 males; 12 females) completed testing during a single session in the academy’s first week: body mass, one-repetition maximum (1RM) bench press, push-up repetitions (reps) to failure, and pull-up reps to failure. Calculations were: estimated pull-up 1-RM=body mass+0.033*(body mass x pull-ups); endurance P2P (eP2P)=push-ups / pull-ups; strength P2P (sP2P)=bench press 1RM / estimated pull-up 1-RM. Pearson correlation coefficients assessed relationships among tests and P2P (p <  0.05). RESULTS: The sP2P was positively correlated with bench press 1-RM and push-ups. The eP2P was negatively associated with pull-up reps and 1-RM. Females had similar eP2P, but lower sP2P than male recruits (p <  0.05). CONCLUSION: Practitioners may benefit from examining eP2P and sP2P as they should not be used interchangeably. Future research should examine whether the P2P ratios are associated with injury and subsequent inability to successfully complete law enforcement training academies.

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 analysis of the closed kinetic chain upper extremity stability test in healthy young adults

OBJECTIVES

To compare kinematic and ground reaction force (GRF) patterns between the dominant and non-dominant limbs in males and females conducting the closed kinetic chain upper extremity stability test (CKCUEST).

DESIGN

Descriptive.

SETTING

Biomechanics laboratory.

PARTICIPANTS

Sixteen male and sixteen female healthy and physically active young adults.

MAIN OUTCOME MEASURES

Hand contact and flight times, peak and average vertical (vGRF) and medial-lateral (mlGRF) ground reaction forces, medial-lateral (ML) distance and ML velocity per repetition, three-dimensional (3D) distance and 3D velocity per repetition, and average number of touches per trial during the CKCUEST.

RESULTS

Only peak and average mlGRF were statistically different between limbs. Males and females were statistically different across every measured variable. ML and 3D velocities were the only variables strongly correlated to the number of touches achieved.

CONCLUSIONS

Both sexes were symmetrical between limbs in all but mlGRF; however, there were distinct differences in both kinematics and GRF patterns between sexes that may be attributed to differences in the testing position between males and females.

Push-Ups are Able to Predict the Bench Press 1-RM and Constitute an Alternative for Measuring Maximum Upper Body Strength Based on Load-Velocity Relationships

The aims of this study were firstly to compare the similarity in upper-body muscle activation between the bench press and push-up at similar loads, and secondly to establish a 1-RM prediction equation between the two exercises based upon the load-velocity relationship. Twenty resistance-trained male athletes (age 22.5 ± 5.24 years, body mass 83.7 ± 10.7 kg, body height 1.80 ± 0.06 m) performed push-ups and bench presses with four different loads. Push-ups were performed without a weight vest and with a 10-20-30 kg weight vest. Bench presses were performed at 50-80% of athletes' assumed 1 repetition max (1-RM) in 10 kg steps, while a linear encoder measured performance during the exercises. A load-velocity relationship was established as a product of the load and velocity for the push-up and bench press per participant and the equation was used to establish a predicted 1-RM. Mean muscle activation of eight upper body muscles was recorded for each exercise and each load. The main findings of this study demonstrate an extremely large association between the predicted 1-RM loads performed with the push-up and bench press (r = 0.93) in experienced resistance trained men. Furthermore, most muscles showed similar activations between the two exercises with the different loads except the deltoid and biceps brachii muscles. It may be concluded that it is possible to predict a cross-over 1-RM between the two exercises based upon the load-velocity relationship in each exercise, and that training push-ups largely targets the same muscles as the bench press except the deltoid and biceps muscles. For coaches and athletes, the use of this method is a low cost and time-effective alternative for standard 1-RM bench press testing to predict maximal upper body strength.

Association Between Performance in Muscle Fitness Field Tests and Skeletal Muscle Mass in Soldiers

INTRODUCTION

Muscle strength and muscle endurance are important fitness components related to safe and efficient execution of physically demanding military work. In soldiers, these components are traditionally measured from simple field tests like push-ups, sit-ups, and pull-ups. However, the validity of such muscle fitness field tests is questioned due to reports of low association between test performance and the ability to conduct strength demanding military work (eg, lift and carry tasks). It is therefore necessary to study, develop, and implement more valid field tests, which are still feasible for mass testing in the military. Skeletal muscle mass (SMM) is an important physiological component related to maximal muscle force generation (strength). Thus, an alternative way of validating muscle fitness field tests is by comparisons against SMM. The purpose of the present study was to investigate the association between SMM and performance in five muscle fitness field tests.

MATERIALS AND METHODS

A total of 275 military cadets (including 27 women) participated in this method comparison study. The field tests included push-ups, sit-ups, pull-ups (vertical for men, horizontal for women), standing medicine ball throw, and Sargent jump (peak power and jump height). SMM was estimated from bioelectrical impedance analysis and expressed in absolute values (kg) or relative to body mass. Pearson correlation coefficients (r) were calculated to investigate associations between SMM and performance in the five field tests. The study was submitted to the Regional Committee for Medical and Health Research Ethics prior to startup, and the Committee considered the study to be exempted from notification. The study was reviewed and approved by the Norwegian Social Science Data Services.

RESULTS

In men, the highest correlation against absolute SMM was found for the Sargent jump (peak power) and the medicine ball throw (r = 0.71 and 0.54, respectively). The same trend was evident for women (r = 0.85 and 0.61, respectively) and for the two genders combined (r = 0.85 and 0.79, respectively). All these r-values were significant (P < 0.001). In men, the highest r against relative SMM was found for pull-ups (r = 0.50, P < 0.001). The same pattern was found in women, but the association was not significant (r = 0.36, P = 0.07). The sit-ups test demonstrated low or nonsignificant associations with both absolute and relative SMM.

CONCLUSIONS

Among the five muscle fitness field tests investigated, the Sargent jump (peak power) and the medicine ball throw demonstrated the strongest correlation coefficients against absolute SMM. Thus, these two tests should be better alternatives for assessing relevant upper and lower body strength and power in soldiers compared with push-ups, pull-ups, and sit-ups. Pull-ups generally demonstrated the strongest correlation against relative SMM. Sit-ups demonstrated low or nonsignificant associations with both absolute and relative SMM. Consequently, the test should be considered for removal from military fitness test batteries or replaced by alternative abdominal tests that are more valid.

Patients in medical treatment for attention deficit/hyperactivity disorder (ADHD): Are they at risk in drug screening?

The use of medicines to treat attention deficit/hyperactivity disorder (ADHD) has increased worldwide, including the use of amphetamine-based medicines or prodrugs that metabolise to amphetamine in vivo. At the same time, drugs-of-abuse testing by non-specific, point-of-care immunoassay methods ('quick tests') has increased. This article discusses the risk of 'false positive' results or post-analytical misinterpretations of results when immunoassays are used to analyse biological samples from ADHD patients. A rapid evidence review was conducted to identify studies that have focused on the risk of 'false positive' test results in immunoassay testing of patients treated with atomoxetine, bupropion, clonidine, guanfacine, methylphenidate, and modafinil. There is only evidence to suggest that bupropion should cause 'false positive' immunoassay results. However, there is a lack of systematic, updated evaluations and validations of cross-reactivity patterns for immunoassays in the literature. Advanced laboratory methods can distinguish the use of medicines from illicit amphetamine by stereospecific analysis of dextro- and levoamphetamine; however, these analytical services are not commonly available for routine drug testing. The present situation calls for more awareness, proper education and information on these critical ethical issues in drug testing, both for clinicians, other healthcare professionals involved in drug testing and for patients in medical treatment for ADHD. The pitfalls of immunoassays due to cross-reactivity and insufficient specificity/sensitivity can have serious negative consequences for patients safety with regard to incorrect laboratory drug-testing results. Consequently, confirmatory laboratory analysis should always be performed for 'presumptive' positive immunoassay screening results.

Muscle Activity Patterns do not Differ Between Push-Up and Bench Press Exercises

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.

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

Push-ups represent one of the simplest and most popular strengthening exercise. The aim of this study was to systematically review and critically appraise the literature on the kinetics-related characteristics of different types of push-ups, with the objective of optimising training prescription and exercise-related load. A systematic search was conducted in the electronic databases PubMed, Google Scholar and Science Direct up to April 2018. Studies that reported kinetic data (e.g. initial and peak-force supported by the upper-limbs, impact-force, peak-flexion-moment of the elbow-joint, rate of propulsive- and impact-, and vertebral-joint compressive-forces) related to push-ups and included trained, recreational and untrained participants, were considered. The risk of bias in the included studies was assessed using the Critical Appraisal Skills Programme scale. From 5290 articles retrieved in the initial search, only 26 studies were included in this review. Kinetic data for 46 push-up variants were assessed. A limitation of the current review is that the relationship between our findings and actual clinical or practical consequences is not statistically proven but can only be inferred from our critical descriptive approach. Overall, this review provides detailed data on specific characteristics and intensities of push-up variations, in order to optimise exercise prescription for training and rehabilitation purposes.

Comparison Between Bench Press Throw and Ballistic Push-up Tests to Assess Upper-Body Power in Trained Individuals

Bartolomei, S, Nigro, F, Ruggeri, S, Malagoli Lanzoni, I, Ciacci, S, Merni, F, Sadres, E, Hoffman, JR, and Semprini, G. Comparison between bench press throw and ballistic push-up tests to assess upper-body power in trained individuals. J Strength Cond Res 32(6): 1503-1510, 2018-The purpose of this study was to validate the ballistic push-up (BPU) test performed with hands on a force plate as a method to measure upper-body power. Twenty-eight experienced resistance-trained men (age = 25.4 ± 5.2 years; body mass = 78.5 ± 9.0 kg; body height = 179.6 ± 7.8 cm) performed, 2 days apart, a bench press 1 repetition maximum (1RM) test and upper-body power tests. Mean power (MP) and peak power (PP) were assessed using the bench press throw (BT) test and the BPU test performed in randomized order. The area under the force/power curve (AUC) obtained at BT was also calculated. Power expressed at BPU was estimated using a time-based prediction equation. Mean force and the participant's body weight were used to predict the bench press 1RM. Pearson product-moment correlations were used to examine relationships between the power assessment methods and between the predicted 1RM bench and the actual value. Large correlations (0.79; p < 0.001) were found between AUC and MP expressed at BPU. Large correlations were also detected between MP and PP expressed at BT and BPU (0.75; p < 0.001 and 0.74; p < 0.001, respectively). Very large correlations (0.87; p < 0.001) were found between the 1RM bench and the 1RM predicted by the BPU. Results of this study indicate that BPU represents a valid and reliable method to estimate the upper-body power in resistance-trained individuals.

Acute Effect of Upper and Lower Body Postactivation Exercises on Shot Put Performance

Kontou, EI, Berberidou, FT, Pilianidis, TC, Mantzouranis, NI, and Methenitis, SK. Acute effect of upper and lower body postactivation exercises on shot put performance. J Strength Cond Res 32(4): 970-982, 2018-The purpose of this study was to investigate the effect of different types of upper and lower' extremities exercises on acute increase of shot put performance, in moderate experienced throwers. Eight (n = 8) males and 9 (n = 9) female throwers participated in this study. Their bench press and squat maximum strength were measured while their shot put performance from power position was evaluated before and after 4 interventions: (a) plyometric push-ups (Plyo), (b) 6 s isometric push-ups (Iso), (c) 3 countermovement jumps (CMJs) and (d) 10 reps. of skipping (Skip). Interventions were performed in counterbalanced order with a 48-hour interval. Significant increase (p < 0.05) of shot put performances was observed after Plyo, Iso, and CMJ (range: 2.30 ± 1.82%-5.72 ± 4.32%). In addition, Iso induced the highest increase while Skip did not induce any improvement of throwing performance. The highest increases were recorded in men's performance after CMJ (5.72 ± 4.32%) while in women's performance after Iso (3.59 ± 2.7%). Javelin and discus throwers increase higher their performance after CMJs while shot putters after Iso. Significant correlations were found between training experience, maximum/relative strength, shot put performance and increase of throwing performance (%) after the interventions (r: 0.519-0.991, p < 0.05). Percentage increase of performance between Iso and Plyo have negative correlations (r: -0.569, p < 0.05) in contrast of those between Skip and CMJ (r: 0.710, p < 0.05). These results suggest that upper or lower body postactivation interventions may acutely increase the throwing performance. However, experience and strength are significant determinant of this increase.

Effects of Different Relative Loads on Power Performance During the Ballistic Push-up

Wang, R, Hoffman, JR, Sadres, E, Bartolomei, S, Muddle, TWD, Fukuda, DH, and Stout, JR. Effects of different relative loads on power performance during the ballistic push-up. J Strength Cond Res 31(12): 3411-3416, 2017-The purpose of this investigation was to examine the effect of load on force and power performance during a ballistic push-up. Sixty (24.5 ± 4.3 years, 1.75 ± 0.07 m, and 80.8 ± 13.5 kg) recreationally active men who participated in this investigation completed all testing and were included in the data analysis. All participants were required to perform a 1 repetition maximum bench press, and ballistic push-ups without external load (T1), with 10% (T2) and 20% (T3) of their body mass. Ballistic push-ups during T2 and T3 were performed using a weight loaded vest. Peak and mean force, power, as well as net impulse and flight time were determined for each ballistic push-up. Peak and mean force were both significantly greater (p < 0.01) during T3 (1,062 ± 202 and 901 ± 154 N, respectively), than both T2 (1,017 ± 202 and 842 ± 151 N, respectively) and T1 (960 ± 188 and 792 ± 140 N, respectively). Peak and mean power were significantly greater (p < 0.01) during T1 (950 ± 257 and 521 ± 148 W, respectively), than both T2 (872 ± 246 and 485 ± 143 W, respectively) and T3 (814 ± 275 and 485 ± 162 W, respectively). Peak and mean power were greatest during T1, regardless of participants' strength levels. Significant (p < 0.01) greater net impulse and smaller peak velocity and flight time were also noted from T1 to T3. Results of this investigation indicated that maximal power outputs were achieved without the use of an external load when performing the ballistic push-up, regardless of the participants' level of strength.

Upper-Body Strength Measures and Pop-Up Performance of Stronger and Weaker Surfers

Parsonage, J, Secomb, JL, Sheppard, JM, Ferrier, BK, Dowse, RA, and Nimphius, S. Upper-body strength measures and pop-up performance of stronger and weaker surfers. J Strength Cond Res 34(10): 2982-2989, 2020-The primary purpose of this study was to investigate the reliability of the isometric push-up (IPU), dynamic push-up (DPU), and force plate pop-up (FP POP) as measures of upper-body isometric and dynamic strength qualities in surfing athletes. Furthermore, the study aimed to compare pop-up performance between stronger and weaker surfers. Eighteen female (n = 9) and male (n = 9) surfers (age = 28.1 ± 6.4 years, mass = 69.6 ± 10.4 kg, and height = 172.5 ± 6.7 cm) completed a battery of upper-body strength assessments, of which exhibited high between-day reliability: IPU, (coefficient of variation [CV%] = 4.7, intraclass correlation coefficient [ICC] = 0.96), DPU (CV% = 5.0, ICC = 0.90), and FP POP (CV% = 4.4, ICC = 0.90). Participants were subsequently split into stronger (n = 9) and weaker (n = 9) surfers based on normalized peak force (PF) attained in the IPU. Pop-up performance was measured both in the water and during the FP POP and was referred to as time to pop-up (TTP). Significant between-group differences were observed for normalized PF during IPU (d = 1.59, p < 0.01) and DPU (d = 0.94 p = 0.04). Although not significant, there was a large magnitude difference in FP POP (d = 0.80, p = 0.08) and FP TTP (d = 0.85, p = 0.07). Significant correlations were identified between normalized IPU PF and normalized DPU FP (r = 0.69, p = 0.03) and FP TTP (r = 0.73, p = 0.02) in the stronger group. The weaker group exhibited a significant inverse correlation between normalized IPU PF and in-water TTP (r = -0.77, p < 0.01). The results suggest improvements in pop-up performance may be elicited by improving dynamic strength for stronger surfers, whereas pop-up performance in weaker surfers may be elicited by improving maximum strength. The upper-body strength assessments provided a novel insight into strength qualities that are associated with in-water performance of surfers (TTP).

Reliability and Sensitivity of the Power Push-up Test for Upper-Body Strength and Power in 6-15-Year-Old Male Athletes

Gillen, ZM, Miramonti, AA, McKay, BD, Jenkins, NDM, Leutzinger, TJ, and Cramer, JT. Reliability and sensitivity of the power push-up test for upper-body strength and power in 6-15-year-old male athletes. J Strength Cond Res 32(1): 83-96, 2018-The power push-up (PPU) test is an explosive upper-body test performed on a force plate and is currently being used in high school football combines throughout the United States. The purpose of this study was to quantify the reliability of the PPU test based on age and starting position (knees vs. toes) in young athletes. Sixty-eight boys (mean ± SD; age = 10.8 ± 2.0 years) were tested twice over 5 days. Boys were separated by age as 6-9 years (n = 16), 10-11 years (n = 26), and 12-15 years (n = 26). The PPU test was performed on a force plate while rotating from the knees vs. the toes. Measurements were peak force (PF, N), peak rate of force development (pRFD, N·s), average power (AP, W), and peak power (PP, W). Intraclass correlation coefficients (ICC2,1), SEMs, coefficients of variation (CVs), and minimum detectable changes (MDCs) were calculated to quantify reliability and sensitivity. Peak force from the knees in 10-15-year-olds, PF from the toes in 12-15-year-olds, and pRFD from the knees and toes in 12-15-year-olds were comparably reliable (ICC ≥ 0.84). Neither power measurements (AP or PP) for any age group, nor any measurements (PF, pRFD, AP, or PP) for the 6-9-year-olds were comparably reliable (ICC ≤ 0.74). When considering the reliable variables, PF was greater in the 12-15-year-olds than in 10-11-year-olds (p ≤ 0.05). In addition, in 12-15-year-olds, PF and pRFD were greater from the knees than from the toes (p ≤ 0.05). For reasons largely attributable to growth and development, the PPU test may be a reliable (ICC ≥ 0.80) and sensitive (CV ≤ 19%) measure of upper-body strength (PF), whereas pRFD was also reliable (ICC ≥ 0.80), but less sensitive (CV = 30-38%) in 10-15-year-old male athletes.

Low-load bench press and push-up induce similar muscle hypertrophy and strength gain

Aim

To investigate the effect of push-up training with a similar load of to 40% of 1- repetition maximumal (1RM) bench press on muscle hypertrophy and strength gain in men.

Methods

Eighteen male participants (age, 20.2 ± 0.73 years, range: 19-22 years, height: 169.8 ± 4.4 cm, weight: 64.5 ± 4.7 kg) were randomly assigned to one of two experimental groups: bench press at 40%1RM (bench-press group, n = 9) or push-ups with position adjusted (e.g. kneeling) to the same load of bench-press 40%1RM (push-up group, n = 9), performed twice per week for 8 weeks. Muscle thickness at three sites (biceps, triceps, and pectoralis major), bench-press 1RM, maximum repetition at 40%1RM, and power output (medicine ball throw) were measured before and after the training period.

Results

Significant increases in 1RM and muscle thickness (triceps and pectoralis major) were observed in bench-press group (1RM, from 60.0 ± 12.1 kg to 65.0 ± 12.1 kg, p < 0.01; triceps, from 26.3 ± 3.7 mm to 27.8 ± 3.8 mm, p < 0.01; pectoralis major, from 17.0 ± 2.8 mm to 20.8 ± 4.8 mm, p < 0.01) and in the push-up group (1RM, from 61.1 ± 12.2 kg to 64.2 ± 12.5 kg, p < 0.01; triceps, 27.7 ± 5.7 mm to 30.4 ± 6.6 mm, p < 0.01; pectoralis major, from 17.0 ± 2.8 mm to 20.8 ± 4.8 mm, p < 0.01). Biceps thickness significantly increased only in the bench-press group (28.4 ± 3.3 mm to 31.5 ± 3.7 mm, p < 0.01). Neither power output performance nor muscle endurance capacity changed in either group.

Conclusions

Push-up exercise with similar load to 40%1RM bench press is comparably effective for muscle hypertrophy and strength gain over an 8-week training period.

Mind-muscle connection training principle: influence of muscle strength and training experience during a pushing movement

PURPOSE

To investigate the effect of different attentional focus conditions on muscle activity during the push-up exercise and to assess the possible influence of muscle strength and training experience.

METHODS

Eighteen resistance-trained men performed 1RM bench press testing and were familiarized with the procedure during the first session. In the second session, three different conditions were randomly performed: regular push-up and push-up focusing on using the pectoralis major and triceps brachii muscles, respectively. Surface electromyography (EMG) was recorded and analyzed (EMG normalized to max; nEMG) for the triceps brachii and pectoralis major muscles.

RESULTS

Participants had on average 8 (SD 6) years of training experience and 1RM of 1.25 (SD 0.28) kg per kg bodyweight. Focusing on using pectoralis major increased activity in this muscle by 9% nEMG (95% CI 5-13; Cohen's d 0.60) compared with the regular condition. Triceps activity was not significantly influenced by triceps focus although borderline significant, with a mean difference of 5% nEMG (95% CI 0-10; Cohen's d 0.30). However, years of training experience was positively associated with the ability to selectively activate the triceps (β = 0.41, P = 0.04), but not the pectoralis. Bench press 1RM was not significantly associated with the ability to selectively activate the muscles.

CONCLUSION

Pectoralis activity can be increased when focusing on using this muscle during push-ups, whereas the ability to do this for the triceps is dependent on years of training experience. Maximal muscle strength does not appear to be a decisive factor for the ability to selectively activate these muscles.

Selective Activation of Shoulder, Trunk, and Arm Muscles: A Comparative Analysis of Different Push-Up Variants

CONTEXT

The push-up is a widely used exercise for upper limb strengthening that can be performed with many variants. A comprehensive analysis of muscle activation during the ascendant phase (AP) and descendant phase (DP) in different variants could be useful for trainers and rehabilitators.

OBJECTIVE

To obtain information on the effect of different push-up variants on the electromyography (EMG) of a large sample of upper limb muscles and to investigate the role of the trunk and abdomen muscles during the AP and DP.

DESIGN

Cross-sectional study.

SETTING

University laboratory.

PATIENTS OR OTHER PARTICIPANTS

Eight healthy, young volunteers without a history of upper extremity or spine injury.

INTERVENTION(S)

Participants performed a set of 10 repetitions for each push-up variant: standard, wide, narrow, forward (FP), and backward (BP). Surface EMG of 12 selected muscles and kinematics data were synchronously recorded to describe the AP and DP.

MAIN OUTCOME MEASURE(S)

Mean EMG activity of the following muscles was analyzed: serratus anterior, deltoideus anterior, erector spinae, latissimus dorsi, rectus abdominis, triceps brachii caput longus, triceps brachii caput lateralis, obliquus externus abdominis, pectoralis major sternal head, pectoralis major clavicular head, trapezius transversalis, and biceps brachii.

RESULTS

The triceps brachii and pectoralis major exhibited greater activation during the narrow-base variant. The highest activation of abdomen and back muscles was recorded for the FP and BP variants. The DP demonstrated the least electrical activity across all muscles, with less marked differences for the abdominal and erector spinae muscles because of their role as stabilizers.

CONCLUSIONS

Based on these findings, we suggest the narrow-base variant to emphasize triceps and pectoralis activity and the BP variant for total upper body strength conditioning. The FP and BP variants should be implemented carefully in participants with low back pain because of the greater activation of abdominal and back muscles.

The effects of exercise type and elbow angle on vertical ground reaction force and muscle activity during a push-up plus exercise

Background

Proper alignment of the scapula during upper extremity motion is important in maintaining shoulder joint function and health. Push-up plus exercise is considered as one of the best exercise to strengthen the muscles that stabilize the scapula. The purpose of the study is to examine the effects of push-up plus variants and elbow position on vertical ground reaction force and electromyographical activity of four shoulder muscles during concentric contraction.

Methods

A total of 22 healthy subjects volunteered for the study. Each of the subjects performed both modified and traditional push-up plus. Modified push-up plus was performed with both knees and hands touching the ground while the traditional push-up plus was executed with hands and feet contacting the ground. Electromyography (EMG) of the upper trapezius (UT), lower trapezius (LT), infraspinatus (INFRA), and serratus anterior (SA), and vertical ground reaction forces (vGRF) were collected.

Results

The traditional push-up plus exhibited higher EMG activity in all muscles tested (P < .05) and vertical ground reaction force (P < .001) compared to modified push-up plus. The highest difference in EMG activity between the two exercises was observed with the Serratus Anterior muscle (22%). Additionally, the traditional push-up plus presented a higher vGRF compared to the modified push-up plus (P < .001) by 17%. The SA had the greatest EMG activity compared to the other muscles tested during the concentric phase of the traditional push-up plus, and this did not occur during the plus phase of the exercise.

Conclusion

The highest activity of the serratus anterior occurred at 55° of elbow extension during the concentric phase of the traditional PUP and not at the plus phase of the exercise. This suggests that when prescribing an exercise to target the serratus anterior, a traditional push-up is adequate and the plus-phase is not necessary. However, for patients that cannot perform a traditional push-up, the modified push-up plus would be a great alternative to strengthen their serratus anterior.

Muscle activity levels in upper-body push exercises with different loads and stability conditions

BACKGROUND

Exercises that aim to stimulate muscular hypertrophy and increase neural drive to the muscle fibers should be used during rehabilitation. Thus, it is of interest to identify optimal exercises that efficiently achieve high muscle activation levels.

OBJECTIVE

The purpose of this study was to compare the muscle activation levels during push-up variations (ie, suspended push-ups with/without visual input on different suspension systems, and push-ups on the floor with/without additional elastic resistance) with the bench press exercise and the standing cable press exercise both performed at 50%, 70%, and 85% of the 1-repetition maximum.

METHODS

Young fit male university students (N = 29) performed 3 repetitions in all conditions under the same standardized procedures. Average amplitude of the electromyogram (EMG) root mean square for the rectus abdominis, external oblique, sternocostal head of the pectoralis major, anterior deltoid, long head of the triceps brachii, upper trapezius, anterior serratus, and posterior deltoid was recorded. The EMG signals were normalized to the maximum voluntary isometric contraction. The EMG data were analyzed with repeated-measures analysis of variance with a Bonferroni post hoc.

RESULTS AND CONCLUSIONS

Elastic-resisted push-ups induce similar EMG stimulus in the prime movers as the bench press at high loads while also providing a greater core challenge. Suspended push-ups are a highly effective way to stimulate abdominal muscles. Pectoralis major, anterior deltoid, and anterior serratus are highly elicited during more stable pushing conditions, whereas abdominal muscles, triceps brachii, posterior deltoid, and upper trapezius are affected in the opposite manner.

Scapular kinematics and shoulder elevation in a traditional push-up

CONTEXT

Proper scapulothoracic motion is critical for the health and function of the shoulder and represents a principal focus in the rehabilitation setting. Variants of the traditional push-up are used frequently to help restore proper scapular kinematics. To date, substantial research has focused on muscle activation levels of rotator cuff and scapular-stabilizing musculature, whereas a dearth of literature exists regarding scapular kinematics during push-up variants.

OBJECTIVE

To examine the effect of shoulder position on scapular kinematics across the range of motion (ROM) of a traditional push-up.

DESIGN

Cross-sectional study.

SETTING

University laboratory.

PATIENTS OR OTHER PARTICIPANTS

Sixteen healthy participants without a history of upper extremity or spine injury requiring rehabilitation or surgery.

INTERVENTION(S)

Participants performed a traditional push-up while kinematic measurements were acquired from multiple upper extremity segments. The 3 shoulder position conditions were (1) self-selected position, (2) shoulder adducted upon ascent (at side), and (3) shoulder elevated to approximately 90°.

MAIN OUTCOME MEASURE(S)

Scapular posterior tilt, upward rotation, and external rotation were examined across elbow-extension ROM and compared across conditions.

RESULTS

Posterior tilt was greater in the self-selected and at-side conditions than in the elevated condition and increased linearly with elbow extension. External rotation was greater in the self-selected and at-side conditions compared with that in the elevated condition. In the at-side condition, upward rotation began lower than in the other conditions at the start of the concentric phase but increased above the others soon after the elbow started to extend.

CONCLUSIONS

Performing a traditional push-up with the shoulders elevated may place the scapula in a position of impingement. Clinicians should be cognizant of shoulder elevation when prescribing and monitoring exercise progression. The results of this study will provide further direction for clinicians in prescribing rehabilitation exercises for the upper extremity, especially closed chain exercises for shoulder conditions.