Background: Individuals with scapular winging have a weak serratus anterior (SA) muscle, and to compensate, the pectoralis major (PM) and upper trapezius (UT) muscles excessively activate, which can cause upper extremity dysfunction. This study aimed to compare the effects of isometric horizontal abduction (IHA) on SA, PM, and UT muscle activity, as well as the SA/PM and SA/UT muscle activity ratios during knee push-up plus (KPP) at 90° and 120° of shoulder flexion.
Objects: This study aimed to compare the effects of IHA on SA, PM, and UT muscle activity, as well as the SA/PM and SA/UT muscle activity ratios during KPP at 90° and 120° of shoulder flexion.
Methods: This study, conducted at a university research laboratory, included 20 individuals with scapular winging. Participants performed KPP with and without IHA at 90° (KPP90) and 120° (KPP120) of shoulder flexion. SA, PM, and UT muscle activity were measured using surface electromyography.
Results: PM activity in KPP90 with IHA was significantly lower than KPP90 and in KPP120 was significantly lower than KPP90. UT activity was significantly greater with IHA than without IHA and at 120° than 90° of shoulder flexion. SA/PM muscle activity ratio was significantly higher in KPP90 with IHA than without IHA and in KPP120 than in KPP90. SA/UT muscle activity ratio was significantly lower with IHA than without IHA.
Conclusion: KPP90 with IHA and KPP120 are effective exercises to reduce PM activity and increase SA/PM muscle activity ratio. However, applying IHA in KPP90 also reduces SA/UT muscle activity ratio, implying that it would be preferable to apply KPP120 in individuals overusing their UT muscles.

INTRODUCTION
MATERIALS AND METHODS
    1. Participants
    2. Surface EMG Data Collection
    3. Procedures
    4. Statistical Analysis
RESULTS
DISCUSSION
CONCLUSIONS
FUNDING
ACKNOWLEDGEMENTS
CONFLICTS OF INTEREST
AUTHOR CONTRIBUTIONS
ORCID
REFERENCES

• Jung-Hoon Choi(Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Department of Rehabilitation Team, Yongin Severance Hospital)
• Heon-Seock Cynn(Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University)
• Seung-Min Baik(Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University)
• Seok-Hyun Kim(Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University) Corresponding author