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. 2022 Jun 30;10:e13589. doi: 10.7717/peerj.13589

Table 1. Summary of the characteristics and results of the selected studies.

Author (year) Participants (Age; height; weight) Exercises Support surface (support device) Scapular muscles evaluated Results
Biscarini, Contemori & Grolla (2019) n = 18 (11 M, 7 F; 21-52 y; 159–187 cm; 51-86 kg) Plank Stable (Floor) MT, SA The use of unstable surfaces significantly increased the EMG activity of SA muscle
Unstable (Wobble board)
Borreani et al. (2015a); Borreani et al. (2015b) n = 29 M (23.5 ± 3.1 y; 178.2 ± 5.9 cm; 75.2 ± 8.5 kg) Push-up Stable (Floor) UT The use of unstable surfaces significantly increased the EMG activity of UT muscle
Half push-up Unstable (Suspension)
Borreani et al. (2015a); Borreani et al. (2015b) n = 30 M (23 ± 1.13 y; 178.87 ± 8.21 cm; 78.01 ± 8.5 kg) Push-up Stable (Floor) SA The use of unstable surfaces such as stability disc, fitness dome, and wobble board significantly increased the EMG activity of the SA.
Unstable (Stability Disc; Wobble Board; BOSU ball; Suspension equipment) Suspension only increased trunk EMG activity
Byrne et al. (2014) n = 21 (10 M, 11 F; 21.9 ± 2.4 y; 175.5 ± 10.13 cm; 74.2 ± 12.61 kg) Plank Stable (Floor) SA There were no statistically significant differences between stable and unstable surface.
Unstable (Suspension equipment) Post hoc analysis revealed that foot suspension generated greater SA EMG activation than arm suspension.
Calatayud et al. (2014a); Calatayud et al. (2014b) n = 29 M (22.6 ± 2.6 y; 176.0 ± 4.4 cm; 74.6 ± 6.7 kg) Push-up Stable (Floor) UT, SA There were no differences in UT EMG activity between stable and unstable surfaces.
Half Push-up Unstable (Suspension equipment) The use of unstable surfaces decreased the EMG activity of SA muscle
Calatayud et al. (2014a); Calatayud et al. (2014b) n = 29 M (23.5 ± 3.1 y; 178.2 ± 5.9 cm; 75.2 ± 8.5 kg) Push-up Stable (Floor) UT The use of unstable surfaces significantly increased the EMG activity of UT
Unstable (Suspension equipment)
De Araújo et al. (2011) n = 20 M (22 ± 3 y; 175 ± 5 cm; 68 ± 7 kg) One arm isometric Stable (Floor) UT, SA There were no statistically significant differences between the stable and unstable surface for any of the evaluated muscles
Unstable (Therapeutic Ball)
De Araújo et al. (2018) n = 18 M (21.50 ± 2.65 years; 173 ± 3 cm; 74.9 ± 2.69 kg) Push-up Stable (Floor) UT, LT, SA The use of unstable surfaces significantly increased the EMG activity of UT and SA muscles.
Unstable (Wobble board)
De Araújo et al. (2020) n = 23 M (21.74 ± 3 y; 175 ± 6 cm; 71.20 ± 7.79 kg) Push-up plus Stable (Floor) UT, LT, SA The use of unstable surfaces (BOSU ball) increased the EMG activity of SA. No significant differences were observed for the UT muscle.
Unstable (BOSU ball)
De Mey et al. (2014) n = 47 (26 M, 21 F; 22 ± 4.31 y; 176 ± 8.3 cm; 69 ± 8.57 kg) Push-up Stable (Bar) UT, LT, SA The use of unstable surfaces increased the EMG activity of UT in Push-up. No significant differences were observed for the SA muscle.
Scap protraction Unstable (Suspension equipment) The use of unstable surfaces decreased the EMG activity of SA in scap protraction.
De Faria et al. (2021) n = 14 M (24.57 ± 4.30 y; 176 ± 6 cm; 82.79 ± 9.04 kg) Push-up Stable (Floor) UT, LT, SA There were no statistically significant differences between the stable and unstable surface for any of the evaluated muscles.
Unstable (Wobble Board)
Gioftsos et al. (2016) n = 13 M (20.5 ± 1.0 y; 178.8 ± 7.2 cm; 79.2 ± 12.3 kg) Push-up Stable (Floor) UT, LT, SA There were no statistically significant differences between the stable and unstable surface for any of the evaluated muscles.
Scap protraction Unstable (Wobble Board)
Push-up plus
Herrington, Waterman & Smith (2015) n = 21 (10 M, 11 F; 22.8 ± 1.4 y) Plank Stable (Floor) SA The use of the foam surface decreased the EMG activity of SA during the one hand isometric exercise.
One arm isometric Unstable (Therapeutic Ball, Foam) No significant differences were observed in the EMG activity of the SA muscle on unstable surfaces during a plank exercise.
Horsak et al. (2017) n = 19 F (23 ± 3 y; 167 ± 6 cm; 60 ± 6 kg) Scap protraction Stable (Floor) UT, LT, SA There were no statistically significant differences in periscapular EMG activity when comparing between stable and unstable support surface
Push-up plus Unstable (Suspension equipment)
Karagiannakis, Athanasopoulos & Mandalidis (2018) n = 15 F (24.0 ± 5.2 y; 172.5 ± 5.5 cm; 65.6 ± 5.1) Push-up Stable (Floor) UT, SA No interaction was observed between group, dominance, or type of surface. Periscapular EMG activity was not influenced by unstable surfaces
Unstable (BOSU ball)
Kim et al. (2014) n = 15 M (23.27 ± 1.28 y; 174.27 ± 3.51 cm; 67.33 ± 4.76 kg) Knee Push-up plus Stable (Floor) SA There were no statistically significant differences in SA EMG activity between stable and unstable surface.
Unstable (BOSU ball)
Kim & Yoo (2019) n = 11 M (22 ± 1.9 y; 174.57 ± 4.32 cm; 62.2 ± 4.7 kg) Push-up Stable (Floor) LT There were no statistically significant differences in LT EMG activity between stable and unstable surface.
Scap protraction Unstable (Wobble Board)
Lee, Lee & Park (2013) Unstable group:n = 10 M (23.7 ± 1.21 y; 175.16 ± 4.42 cm, 73.01 ± 8.67 kg) Push-up plus Stable (Floor) UT, LT, SA The use of unstable surfaces increased the EMG activity of the SA muscle.
Stable group:n = 10 M (23.3 ± 1.45 y, 174.27 ± 3.29 cm, 74.41 ± 7.49 kg) Unstable (Suspension equipment) There were no statistically significant differences in EMG activity of UT and LT between stable and unstable surface.
Lehman, Gilas & Patel (2008) n = 10 M (26.3 ± 1.1 y; 83.3 ± 10.9; 174.7 ± 12.9 cm) Push-up Stable (Floor) UT, LT, SA There were no statistically significant differences between stable and unstable support surface for any of the scapular muscles evaluated during push-up and scap protraction exercises
Scap protraction Unstable (Therapeutic ball)
Maenhout et al. (2010) n = 32 (16 M, 16 F; 22,88 ± 2,43 y; 173 ± 9 cm; 65,59 ± 8,14 kg) Knee Push-up plus Stable (Floor) UT, LT, SA The use of unstable surface (wobble board) decreased the EMG activity of SA.
Unstable (Wobble board)
Martins et al. (2008) n = 12 M (175 ± 54 cm; 22.8 ± 3.1 y; 68.7 ± 7.9 kg) One arm isometric Stable (Floor) UT, SA No significant differences were observed in the EMG activity of UT or SA when using unstable support surfaces.
Unstable (Therapeutic ball)
Park & Yoo (2013) n = 16 M (26 y; 176.1 ± 5.4 cm; 64.6 ± 4.9 kg) Push-up Stable (Floor) UT, LT, SA There was an increase in muscle activity of all scapular muscles when using the unstable support surface.
Unstable (Wobble Board)
Park & Yoo (2013) n = 14 M (22 ± 2 y; 174.6 ± 57 cm; 62.2 ± 4.8 kg) Push-up Stable (Floor) UT, SA The use of unstable surface (wobble board) increased the EMG activity of UT and SA.
Unstable (Wobble board)
Patselas et al. (2021) n = 13 M (21.1 ± 1.8 y; 180 ± 4 cm; 79 ± 12kg) Push-up Stable (Floor) UT, SA There were no statistically significant differences between stable and unstable support surface for any of the scapular muscles evaluated.
Push-up plus Unstable (Wobble board)
Sandhu, Mahajan & Shenoy (2008) n = 35 M (20-30 y; 173.65 ± 256 cm; 69.9 ± 0.2 kg) Push-up Stable (Floor) UT, SA There were no statistically significant differences between stable and unstable support surface for any of the scapular muscles evaluated.
Knee Push-up Unstable (Therapeutic ball)
Plank
Seo et al. (2013) n = 10 M (24.6 y; 176.2 ± 3.67 cm; 75.7 ± 5.16 kg) Half Push-up Stable (Chair) UT, MT, LT, SA The use of unstable surface (therapeutic ball) increased the EMG activity of UT, MT, LT and SA during half and knee push-up performance.
Knee Push-up Unstable (Therapeutic ball)
Pirauá et al. (2014) n = 30 M (21.7 ± 2.5 y; 70.5 ± 9 kg; 173 ± 1 cm) Push-up Stable (Floor) UT, LT, SA The use of unstable surface (wobble board) increased the EMG activity of UT and LT and decreases the EMG activity of SA.
Unstable (Wobble board)
Tucker et al. (2010) Healthy Group: n = 15 (11 M, 4 F; 21.0 ± 2.5 y; 176.0 ± 7.8 cm; 76.1 ± 13.4 15 kg) Push-up Stable (Floor) UT, MT, LT, SA The use of BOSU ball increased the EMG activity of UT, MT and LT muscles and decreased the EMG activity of SA.
Impingement Group: n = 15 (11 M-4 F; 20.4 ± 3.8 y; 174.1 ± 9.7 cm; 73.3 ± 11.7 kg) Unstable (BOSU ball, Cufflink) The use of cufflink decreased the EMG activity of the UT, MT, LT muscle and increased the EMG activity of SA.
Youdas et al. (2020a); Youdas et al. (2020b) n = 22 M (24.6 ± 3.2 y, 180 ± 10 cm; 87.9 ± 9.3 kg) Push-up Stable (Floor) SA SA recruitment decreased during a push-up with performance on suspension equipment and dual instability devices compared to the standard push-up.
n = 10 F (23.6 ± 1.4 y; 160 ± 10 cm; 60 ± 4.2 kg) Unstable (BOSU ball, Suspension equipment)
Youdas et al. (2018) n = 13 M (25.4 ± 5.7 y; 190 ± 10 cm; 89.6 ± 6 kg) Plank Stable (Floor) SA A high activation of SA was observed during the prone plank on floor and on therapeutic ball. There were no statistically significant differences between both conditions.
n = 13 F (25 ± 3.8 y; 170 ± 10 cm; 63.5 ± 7.3 kg) Unstable (Therapeutic ball)

Notes.

M
male
F
female
y
years
UT
upper trapezius muscle
MT
middle trapezius muscle
LT
lower trapezius muscle
SA
serratus anterior muscle