PNF and Movement 2021; 19(2): 269-278
Effective Cueing Method That Increases Selective Muscle Activation of the Serratus Anterior in Healthy Adults
Jong-Jae Choi, P.T., M.Sc.⋅Chang-Ho Song, P.T., Ph.D.
Department of Physical Therapy, Sahmyook University
Correspondence to: Chang-Ho Song (
Received: August 5, 2021; Revised: August 13, 2021; Accepted: August 13, 2021; Published online: August 31, 2021.
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Purpose: This study aimed to investigate effective cueing methods for selective muscle activation of the serratus anterior.
Methods: Based on the inclusion criteria, 26 healthy adults, both males and females, were recruited for the measurement of muscle activation of the upper trapezius and serratus anterior muscles while performing basic movements in knee push-up plus (KPP) and dynamic hug (DH) positions using five different cueing methods. An electromyogram was used to measure muscle activation, and both muscle activation and muscle ratio (serratus anterior/upper trapezius) were compared during the basic movements and different cueing methods. The cueing methods were trapezius verbal cueing, trapezius verbal cueing + trapezius tactile cueing, emphasis verbal cueing, serratus anterior tactile cueing, and trapezius verbal cueing + trapezius tactile cueing + serratus anterior tactile cueing.
Results: The results of the study showed that there was a significant difference in the muscles for the two exercises (p < 0.05). There was also a significant difference between the cueing methods (p < 0.05). The correlative effect between the muscles and cueing methods was also significant (p < 0.05). The muscle ratio in trapezius verbal cueing + trapezius tactile cueing + serratus anterior tactile cueing during KPP and DH was higher than in basic movements and other cueing methods. This confirms that trapezius verbal cueing + trapezius tactile cueing + serratus anterior tactile cueing is an effective cueing method for selective activation of the serratus anterior during KPP and DH. This study also demonstrated that cueing by a therapist may both increase and decrease selective muscle activation.
Conclusion: Through this study, an effective cueing method to selectively activate the serratus anterior may be suggested, and the results of this study may provide basic information regarding future studies and clinical practice.
Keywords: Electromyography, Serratus anterior, Exercise, Cueing, Muscle activity

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