Department of Mechanical Engineering, Technion Israel Institute of Technology, Haifa, Israel.
Department of Mechanical Engineering, Technion Israel Institute of Technology, School of Medicine, Haifa, Israel; Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
J Hand Ther. 2018 Jul-Sep;31(3):322-330. doi: 10.1016/j.jht.2017.04.005. Epub 2017 Jul 3.
Cross-sectional cohort.
Push-ups are used ubiquitously to evaluate and strengthen the upper body. They are usually performed in 1 of 2 main ways: with the wrist in hyperextension and with the wrist in a neutral position.
The purpose of our study was to compare the dynamic forces in the wrist during the 2 push-up styles.
Fourteen volunteers performed push-ups in 2 different patterns: on a hyperextended wrist and a neutral wrist (NW). Two force plates and a motion capture system were used to measure the ground reaction forces (GRFs) and the kinematics of the upper extremity during push-ups. Kinematic and kinetic analyses were performed using Matlab software (Mathworks, Natick, MA).
The GRF vector was distributed differently during the different types of push-ups. For both methods, the total GRF carried by the upper dominant extremity was larger than those of the nondominant extremity. In the NW configuration, the GRF vector was more uniform throughout the push-up in the vertical direction. The horizontal distance between the capitate bone location and the GRF origin was smaller in hyperextension. The forces traveled more dorsally over a wider area and more ulnarly in the hyperextended wrist.
Forces are transmitted differently through the wrist in the 2 methods. Push-ups on an NW are likely safer because ligaments may be preferentially loaded in hyperextension. Further study may delineate the differences in the anatomic location of force transmission and the long-term clinical effect on the wrist.
This study supports the performance of push-ups on a wrist in neutral flexion extension; both to enable patients after surgery or injury to strengthen the upper body and prevent injury and long-term wear in the wrist. The knowledge gained from this study may assist in outlining guidelines for push-up performance.
Diagnostic level 2a.
横断面队列研究。
俯卧撑被广泛用于评估和增强上半身。它们通常以以下 2 种主要方式之一进行：手腕过度伸展和手腕处于中立位置。
我们的研究目的是比较这 2 种俯卧撑方式下手腕的动态力。
14 名志愿者以 2 种不同的模式进行俯卧撑：手腕过度伸展和手腕中立位（NW）。使用 2 个测力板和运动捕捉系统来测量俯卧撑过程中的地面反作用力（GRF）和上肢运动学。运动学和动力学分析使用 Matlab 软件（Mathworks，Natick，MA）进行。
在不同类型的俯卧撑中，GRF 矢量的分布方式不同。对于这两种方法，上肢优势侧承受的总 GRF 都大于非优势侧。在 NW 配置中，GRF 矢量在整个俯卧撑过程中在垂直方向上更均匀。在过度伸展时，头状骨位置与 GRF 原点之间的水平距离更小。力在过度伸展的手腕中更向背侧传播，在更宽的区域内更向尺侧传播。
在这 2 种方法中，力通过手腕的传递方式不同。NW 上的俯卧撑可能更安全，因为韧带可能优先在过度伸展时承受负荷。进一步的研究可能会阐明力传递的解剖位置以及对腕关节的长期临床影响方面的差异。
本研究支持在手腕中立伸展/屈曲位进行俯卧撑；这既可以使术后或受伤的患者增强上半身力量，又可以防止手腕受伤和长期磨损。本研究获得的知识可能有助于制定俯卧撑操作指南。
诊断水平 2a。
