SUPERIOR TRAINING-SPECIFIC ADAPTATIONS WITH AN
8-WEEK YOAK PUSH-UP TRAINING PROGRAM
CAMILA LIMA, YIMENG LI, JONATHAN L. LOW, NEHARA HERAT,
School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador,
Canada
ABSTRACT
Lima, C, Li, Y, Low, JL, Herat, N, and Behm, DG. Superior
training-specific adaptations with an 8-week yoak push-up
training program. J Strength Cond Res 32(9): 2409–2418,
Downloaded from http://journals.lww.com/nsca-jscr by BhDMf5ePHKbH4TTImqenVOtRaxoTfzXq/0ik/c1nMvfoFYJsoWVPFDyTZcOOdvm8 on 08/29/2018
2018—There are few progressive metastability training pro-
grams in the literature. The purpose of this study was to inves-
tigate changes in strength, endurance, muscle activation, and
neuromuscular efficiency after an 8-week progressive, push-up
training program under stable and unstable conditions. Nine-
teen male and female recreationally trained participants per-
formed twice per week, an 8-week push-up training program,
using either a relatively unstable suspension system (Yoak) or
under stable conditions. Participants were tested in 2 separate
sessions before and after training for chest press maximal vol-
untary isometric contraction (MVIC) forces, and unstable and
stable push-up endurance. Participants were tested during all
testing measures for anterior deltoid, biceps brachii (BB), tri-
ceps brachii (TB), and serratus anterior (SA) electromyography
(EMG) activity. The training progression consisted of altering
the suspension configurations, push-up height, and increasing
the number of sets (1–3 sets). The stable group performed
153.3 and 33.8% less repetitions than the Yoak group when
performing push-ups on the Yoak device or stable floor,
respectively (p = 0.03). Training-induced MVIC forces were
9.2% (p = 0.03) greater for the Yoak vs. the stable group.
Regarding neuromuscular efficiency, the Yoak group
decreased (30.4%; p = 0.01) and stable group increased
(97.8%; p = 0.02) antagonist BB EMG activity from pre- to
post-training. Both groups decreased the TB fatigue index from
pre- to post-training. Nevertheless, Yoak group demonstrated
12.5% (p = 0.09) and 8.9% (p = 0.02) lower fatigue indexes
with TB and SA, respectively, than the stable group. These
findings suggest that Yoak training demonstrates superior im-
provements over stable training for push-up endurance, neuro-
muscular efficiency, MVIC, and fatigue index.
Address correspondence to Dr. David G. Behm, dbehm@mun.ca.
32(9)/2409–2418
Journal of Strength and Conditioning Research
Ó 2018 National Strength and Conditioning Association
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
AND DAVID G. BEHM
KEY WORDS metastability, instability, unstable, endurance,
strength
INTRODUCTION
T
he stability of individuals is often in a state of flux,
moving from relatively stable to unstable condi-
tions and vice versa (37). This transition, known as
metastability (37), is imperative for successful
movement and balance, whether the movement is initiated
by an elderly adult that fears falling or an elite athlete. Meta-
stable training can help to maintain musculoskeletal health
and rehabilitate musculoskeletal injuries (4,8,17,23,28) and
enhance work and athletic performance (8,9,17).
According to the principle of training specificity (14,15),
training must attempt to mimic the demands of the task.
Many metastability exercises involve standing on an unstable
surface (4,9,11,12,17). Metastable resistance exercises can
increase both core (trunk) and limb muscle activation
(2,3,30,34,41,42). Proponents of metastability training sug-
gest the relative instability may stress the neuromuscular
system to a greater extent than training with more stable
devices (19,20,25,31,49,51). However, actions performed on
unstable surfaces or using unstable devices can impair force
(7,8,10,11,13,43), power (29,38), velocity, and range of
motion (29). These force decrements may be attributed to
a transition from muscle mobilizing to stabilizing functions
(1). More research is necessary to investigate whether a pro-
gressive resistance training program, using an instability sus-
pension device with multiple degrees of freedom, can
provide training-induced improvements in force, neuromus-
cular efficiency (the extent of muscle activation needed to
perform a task), and endurance. It is possible that more
extreme levels of instability might not provide a conducive
environment (because of instability-induced decreased force,
power, velocity, and range of motion) to promote training
adaptations (2,7).
There are many unstable surfaces available for the lower
body such as inflatable balls, discs, wobble or balance boards,
foam tubes, high-density and low-density foam platforms, as
well as many other related devices (4,9–11,17). For the upper
VOLUME 32 | NUMBER 9 | SEPTEMBER 2018 | 2409
 Yoak Suspension Training
body, these aforementioned similar devices have been used
as well as suspended chains and ropes (18,22,40). Typically,
the ropes and chains for the upper body are suspended from
a stable support with the instability derived from their lateral
and anteroposterior degrees of freedom of movement. How-
ever, suspension devices that can provide unilateral move-
ment in a vertical direction have only been investigated in
one study (22). Athletes, such as rowers, boxers, and martial
artists, would need movement training expertise in all 3
planes (frontal, sagittal, and transverse). The efficacy of such
a device for training needs to be validated and more firmly
established.
Most push-up training studies that compare stable vs.
unstable training environments report increased lower back
(i.e., lumbar erector spinae) (18,22,44), abdominals (40), tri-
ceps brachii (TB) (22,40), biceps brachii (BB) (40), upper
trapezius (22,47), serratus anterior (SA) (18,45,50), and rec-
tus femoris (18,22) electromyographic (EMG) activity. By
contrast, Kalantari et al. (36) found greater trapezius, SA,
BB, teres major, and posterior deltoid EMG activity with
their stable push-ups. Another study used participants with
scapular dyskinesis and reported decreased SA EMG activity
with push-ups under unstable conditions (47). Because high-
er levels of instability can result in higher muscle activity but
lower force output (2,7,10), it is unknown whether a highly
unstable system with greater degrees of freedom would actu-
ally provide greater training benefits.
Training programs must be structured, so that athletes are
prepared for the wide variety of postures and external forces.
This is best accomplished through performance of exercises
that encompass all planes of movement. There is also a need
for progressive increases in resistance or complexity (insta-
bility). The unstable devices in most of the previous training
studies cannot incorporate progressive increases in instabil-
ity. A new device (Yoak) can be manipulated to suspend with
single or double suspension in concert with slings, which
allows for a progressive increase of instability. It is unknown
whether this progression can provide substantial training
improvements.
The objective of the study was to investigate possible
training-related changes in strength, endurance, and neuro-
muscular efficiency after an 8-week push-up training pro-
gram comparing push-ups preformed under stable and
unstable suspension systems. It was hypothesized that the
progressive instability (variety of degrees of freedom and
planes of movement) and suspension (Yoak) push-up
training program would provide greater training improve-
ments than a program performed on a stable floor involving
limited movement planes and axes.
METHODS
Experimental Approach to the Problem
The study involved an 8-week push-up training program
performed either with an unstable suspension system (Yoak)
or on a stable floor. Pre- and post-training measures included
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maximal voluntary isometric contraction (MVIC) force with
a chest press exercise, push-up endurance (number of
repetitions), neuromuscular efficiency (mean EMG
activity/muscle activation during the first 3 push-ups), and
the fatigue index (EMG activity of the last 3 repetitions vs.
first 3 push-up repetitions).
Subjects
Based on a statistical power analysis of related training articles
(14,21,48), approximately 10 participants would be needed in
each training group to achieve an alpha of 0.05 with a power
of 0.8. Hence, 22 participants were recruited and 19 partici-
pants completed the program (10 suspension subjects and 9
stable push-up subjects). Mean anthropometric characteristics
for the suspension and stable push-up groups were as follows
(all measurements mean 6 SD): Yoak suspension group (5
men; 23.6 6 3.04 years, 180.25 6 3.41 cm, 76.86 6 4.07 kg
and 5 women; 22.2 6 5.06 years, 161.04 6 7.72 cm, and 64.3
6 6.69 kg) and stable push-up group (3 men; 21.66 6 1.52
years, 177.5 6 4.33 cm, 78.63 6 1.06 kg and 6 women; 21.16 6
1.47 years, 164.86 6 7.55 cm, and 63.3 6 17.14 kg). All par-
ticipants reported being recreationally active, engaging in
resistance training or aerobic exercise at least twice per week.
Exclusion criteria included any history of neurological or mus-
culoskeletal injuries in the past year. Participants were in-
structed to refrain from vigorous physical activity and from
consuming alcoholic beverages 24 hours before testing. Caf-
feinated beverages and dietary supplements were not to be
consumed within 6 hours before testing. All participants were
verbally informed of the experimental protocol and gave writ-
ten informed consent. Ethical approval was obtained through
the Memorial University of Newfoundland Institutional Cen-
ter for Health Research ethics board (20180010-HK) and
adhered to the Declaration of Helsinki.
Procedures
Measures. Two pre-testing sessions (separated by at least 24
hours) were conducted the week before the 8-week training
program, whereas 2 post-testing sessions using the 2 training
devices (testing on Yoak suspension and stable floor for
training-specific testing) and the chest press MVIC were
conducted the week after the training program.
Push-up Endurance. Before and after training, push-ups were
performed to task failure (inability to raise the body to full-
elbow extension) on separate days using the Yoak suspension
system and on a stable floor. The pacing of the push-ups was
consistent and monitored with a metronome at 1 Hz. Proper
form (i.e., straight trunk) and consistent push-up depth (elbows
flex to 908) was ensured by visual inspection of the researchers.
The number of repetitions performed was recorded.
Electromyography. In accordance with previously published
reports from this laboratory (7,13,16) and SENIAM recom-
mendations (33), EMG electrodes were placed collar to col-
lar (2 cm) on the midbellies of the anterior deltoid (AD), BB,
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pared before and after training

(mean average of last 3
repetitions/first 3 repetitions).

Chest Press Maximal Voluntary

Isometric Contraction Peak Force.
Participants performed an
MVIC chest press while lying
supine on a bench. With each
hand, participants grasped hand-
grips attached to rope-like slings
that were chained to a Wheat-
stone bridge configuration strain
gauge (Omega Engineering, Inc.,
Don Mills, Ontario, Canada),
which was connected to a metal
plate on the floor. Differential
voltage from the strain gauge
was amplified (Biopac Systems,
Inc., DA 100), A/D converted
(AcqKnowledge BioPac
MP100WSW; Holliston, MA,
USA) and monitored on a com-
puter at a sampling rate of 2,000
Hz. Verbal encouragement was
given during the 4-seconds trial
to ensure maximal force produc-
tion. Two trials were separated
by a 1-minute rest. The slings
were arranged to ensure that the
subjects’ brachium (upper arm)
was parallel to the floor with
the elbows at 908. Participants
Figure 1. Yoak suspension push-up progressions from height of 1 m (A), 0.7 m (B), and 0.4 m (C) from floor. were requested to contract as fast
and as hard as possible.

TB, and SA on the right side of the body. A ground electrode
was placed on the head of the radius. Skin preparation for
the electrodes included shaving, light abrading, followed by
alcohol swabbing. Electromyography was collected using
a Biopac (Biopac Systems, Inc., Holliston, MA, USA) data
acquisition system at a sample rate of 2,000 Hz (amplifica-
tion: 1,000, impedance = 2 MV, common mode-rejection
ratio .110 dB$min (50/60 Hz), noise .5 mV). A band-
pass filter (10–500 Hz) was applied before digital conversion.
The mean amplitude of the root mean square (RMS) EMG
was calculated and used for analysis. For the MVIC chest
press, EMG was analyzed over a 1-second duration that
included 500 ms before and after the peak force output.
For the neuromuscular efficiency measures, the average
RMS EMG of both the concentric and eccentric phases of
the push-up was normalized to the chest press MVIC EMG.
For the fatigue index, the first and last 3 repetitions of the
number of repetitions used in the pre-training test were com-
Training Program. The 2 groups (Yoak suspension vs. stable
push-ups) performed a series of push-ups 2 times per week
over an 8-week period. The training program progressed
from 1 set of push-ups to task failure in the first week, to 2
and 3 sets of each exercise in the second and subsequent
weeks, respectively. Participants performed each set to
failure to ensure that an overload stress was placed on the
musculature with the goal to promote an overcompensatory
training adaptation (5). The number of repetitions performed
by each participant was recorded for every set and training
session. Rest intervals consisted of 5 minutes between sets.
Push-up training exercises were performed either with the
suspension Yoak device or against an Olympic bar or on
a stable floor using body mass as resistance. The Yoak device
is a bowed, 1.2-m (4 feet) long, flat wooden cross-piece
manufactured with an aluminum core, and multiple holes
spanning its breadth for ease of grasping and hanging
weights. When anchored overhead with slings, it can be

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 Yoak Suspension Training
Figure 2. Stable group push-up progressions from height of 1 m (A), 0.7 m (B) from floor, and the floor (C). maintained, hands were placed
manipulated to single or double suspension in concert with
slings, which allow for a progressive increase of instability
(Figure 1). The Yoak push-up strap height was altered
dependent on the push-up capability of the participant to
provide a progressive upper-body, metastable push-up train-
ing program. The first strap progression had the handles 1
meter above the floor placing the body in an approximate
458 angle to the floor. Once a participant could perform 15
or more repetitions at this height, they were progressed to
the next strap height at 70 cm from the floor. Once again, if
the individual could perform 15 or more push-ups, then they
were progressed to a strap height of 40 cm from the floor
(Figure 1). Henceforth, the participants would continue
focusing on increasing the number of push-ups with no fur-
ther strap height progressions. Similarly, with the stable
push-up group, if 15 push-ups could not be accomplished,
the participant would begin by performing push-ups against
an olympic bar placed in a squat rack 1 meter above the floor
(Figure 2). Once 15 or more push-ups were achieved, then
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2412 Journal of Strength and Conditioning Research
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they were similarly progressed
to 40 cm from the floor and
then to the floor. The unstable
suspension system provided
a greater challenge for execut-
ing the prescribed push-up
movement. Thus, the third or
final level for the unstable
push-up training was per-
formed at 40 cm from the floor,
which provided a similar level
of exertion as performing a sta-
ble push-up from the floor.
With the Yoak suspension
device, the strap(s) suspended
from the ceiling securing the
Yoak could also be altered to
provide a more stable configu-
ration (2 suspension straps) or
a relatively more unstable con-
figuration (1 suspension strap)
(Figure 3). Yoak suspension
push-up training progressed
from a double strap to combi-
nations of double and single
strap(s) (i.e., 2 sets with double
suspension and 1 set with sin-
gle suspension followed in the
next week by 1 set with double
suspension and 2 sets with sin-
gle suspension). Researchers
monitored participant form to
ensure that a straight back was
immediately outside the width
of the shoulders, and the pac-
ing was consistent as monitored with a metronome (1 Hz: 1
second up and 1 second down). (Table 1 for training pro-
gram details). Subjects were monitored to ensure that the
push-up action descended until the elbows were at a right
angle and ascended to a fully extended arm position.
Statistical Analyses
The normality and homogeneity of variances within the data
were confirmed with the Shapiro–Wilk and Levene tests,
respectively. The chest press MVIC force was analyzed with
a 2-way analysis of variance (ANOVA) (2 training groups 3
2 times). The push-up endurance (number of repetitions),
neuromuscular efficiency, and fatigue index were analyzed
with a 3-way ANOVA (2 training groups 3 2 testing con-
ditions 3 2 times). Training conditions included the Yoak
suspension vs. the stable push-ups, testing conditions
involved testing on the Yoak suspension vs. stable floor, with
time conditions including pre- and post-training. Significant
main effects were detected with a Bonferroni post hoc
TM
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Figure 3. Photograph of Yoak suspension device with 2 suspension straps (A) and 1 suspension strap (B).

analysis, whereas interactions were identified with Student’s calculations involved dividing the change score by the mean
paired t-test. The level of significance was set at p # 0.05. SD of the raw data to arrive at a standard ES (26). Cohen’s
Effect sizes (ESs) were calculated and reported. Effect size d values equal to or greater than 0.2, 0.5, and 0.8 were used to

TABLE 1. Push-up training program: frequency 2 3 week for 8 weeks.*

Yoak suspension program

Week Sets Repetitions Yoak suspension configuration (from the ceiling)

1 1 To fatigue 2 suspension straps for both sessions

2 2 To fatigue 2 suspension straps for both sessions
3 3 To fatigue 2 sets with 2 straps—1 set with 1 strap for both sessions
4 3 To fatigue Session 1: 1 set with 1 strap—2 sets with 2 straps
4 3 To fatigue Session 2: 2 sets with 1 strap—1 set with 2 straps
5 3 To fatigue Both sessions: 1 set with 1 strap—2 sets with 2 straps
6 3 To fatigue Both sessions: 2 sets with 1 strap—1 set with 2 straps
7 3 To fatigue Session 1: 2 sets with 1 strap—1 set with 2 straps
7 3 To fatigue Session 2: 1 set with 1 strap—2 sets with 2 straps
8 3 To fatigue Both sessions: 2 sets with 1 strap—1 set with 2 straps

Stable (floor) program

Week Sets Repetitions

1 1 To fatigue
2 2 To fatigue
3 3 To fatigue
4 3 To fatigue
5 3 To fatigue
6 3 To fatigue
7 3 To fatigue
8 3 To fatigue

*The height of the push-up straps (Yoak) or the olympic bar to floor (stable) was progressed on an individual basis dependent on
whether the individual could perform 15 or more push-ups.

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 Yoak Suspension Training

Figure 4. Figure illustrates pre- to post-training mean and SD of the maximal number of repetitions changes with Yoak and stable trained groups when tested
on the Yoak device (2 straps) and on the stable floor. *Detail the significant pre- to post-training increases in number of push-up repetitions.

determine whether the effect sizes (magnitude of change)
were small, medium, or large, respectively.
RESULTS
Push-up Endurance (Number of Repetitions)
A training condition 3 test condition interaction (p = 0.02)
demonstrated that the Yoak suspension–trained group per-
formed significantly more Yoak push-up repetitions (67.7%)
compared with the stable group. There was a near significant
training condition x time (p = 0.08) interaction with the Yoak
suspension group demonstrating a greater training response
than the stable group. The number of push-ups increased by
81.6 and 30.6% for the Yoak suspension and stable groups,
respectively. A 3-way interaction (p = 0.03) illustrated that
the stable trained group when performing push-ups on the
Yoak suspension system performed 153.3, and 33.8% less
repetitions than the Yoak suspension–trained group per-
forming push-ups on the Yoak or on the stable floor, respec-
tively, as well, the stable trained group performed 46.4%
more push-ups on the stable floor compared with the Yoak
testing condition (Figure 4).
A main effect for time (p , 0.0001) indicated that there
were 56% more repetitions performed post-test compared
with pre-test. The Yoak suspension–trained group executed

Figure 5. Figure illustrates mean and SD of the maximal voluntary isometric contraction (MVIC) chest press force changes pre- to post-training for the Yoak and
stable training groups. *Indicate that the Yoak-trained post-training values were significantly greater than all other measures.

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a near significant 21.3% greater number of repetitions than

the stable group (main effect for training condition: p =

0.59 6 0.38,

1.05 6 0.45,

0.61 6 0.31,

0.79 6 0.55,
0.1). A greater number of repetitions were performed

ES = 0.12

ES = 0.01

ES = 0.15

ES = 0.48
Post-test
(27.7%) when tested on the stable floor vs. on the Yoak
Stable test condition suspension system (main effect for testing condition:
p = 0.04).

Chest Press Maximal Voluntary Isometric Contraction Force

0.64 6 0.41

1.04 6 0.85

0.65 6 0.22

1.1 6 0.73
There was a significant training condition x time interaction
Pre-test

(p = 0.03), whereby the Yoak suspension–trained group

increased their chest press MVIC force by 9.2% compared
with a 0.5% increase with the stable trained group (Figure 5).
A main effect for time showed a significant (p , 0.05) 4.8%
Stable trained

†Italics represent significant pre- to post-training changes in normalized EMG of the first 3 push-up repetitions (neuromuscular efficiency).
0.92 6 0.45, ES = 1.30

0.54 6 0.32, ES = 1.14

0.81 6 0.37, ES = 0.30

0.45 6 0.21, ES = 0.23

increase in chest press MVIC force.

Neuromuscular Efficiency
Post-test

Significant training condition 3 time interactions showed

Yoak test condition

that the BB of the Yoak suspension–trained group ex-

hibited a 30.4% (p = 0.013) decrease in EMG activity
(improved neuromuscular efficiency with the first 3 rep-
etitions), whereas the stable trained group demonstrated
a 97.8% (p = 0.02) increase in EMG activity (diminished
*BB = biceps brachii; ES = effect size; TB = triceps brachii; AD = anterior deltoid; SA = serratus anterior.

neuromuscular efficiency) when performing Yoak sus-

0.69 6 0.42

0.47 6 0.24

0.51 6 0.31

1.2 6 0.83

pension push-ups when comparing pre- to post-training

Pre-test

results. Both the AD and SA EMG activity indicated sig-

nificant and near significant 3-way interactions. With the
AD, the Yoak suspension–trained group had near signifi-
cant 32.8% (p = 0.07) and 20.6% (p = 0.1) decreases in
0.68 6 0.39, ES = 0.22

1.11 6 1.05, ES = 0.57

0.61 6 0.29, ES = 0.50

0.85 6 0.42, ES = 0.49

EMG activity with the first 3 Yoak suspension and stable

floor push-up repetitions, respectively, after training. The
Yoak suspension–trained group had significant 51.9% (p =
Post-test
Stable test condition

0.02) and 41.8% (p = 0.1) decreases in SA EMG activity

with the first 3 Yoak suspension and stable floor push-up
repetitions, respectively, after training. Furthermore, the
stable trained group exhibited 62.2% (p = 0.04) less SA
EMG activity after training when performing the first 3
push-up repetitions on the Yoak suspension system
0.61 6 0.23

0.74 6 0.23

0.75 6 0.27

1.1 6 0.59

(Table 2). Main effects for training group were evident

Pre-test
Yoak trained

with improved neuromuscular efficiency for the BB

(64.1%, p = 0.04) with the Yoak vs. stable training
groups. A main effect for time for SA (p , 0.05) indicated
51.9% improved neuromuscular efficiency pre- to post-
TABLE 2. Neuromuscular efficiency.*†

0.68 6 0.47,

0.39 6 0.14,

0.31 6 0.15,

0.31 6 0.19,

training.
ES = 0.58

ES = 0.57

ES = 1.2
ES = 0.7
Post-test
Yoak test condition

Fatigue Index
There were significant main effects for training condition,
test condition, and time but no significant interactions for the
TB. A near-significant (p = 0.09) main effect for training
0.98 6 0.55

0.49 6 0.21

0.45 6 0.25

0.63 6 0.35

condition indicated that, for the TB, the Yoak suspension–

Pre-test

trained group had a 12.5% lower fatigue index than the

stable trained group. Post-training results showed a 23.1%
decrease in the TB fatigue index (main effect for time; p =
0.03). With the AD, a main effect for test condition (p =
BB

AD

SA
TB

0.026) showed an 8.9% lower fatigue index with the Yoak

suspension system. There were no significant results for the
BB or the SA.

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 Yoak Suspension Training
DISCUSSION
The most important findings in this study were that the Yoak
suspension training group showed training-specific
responses with superior improvements for push-up endur-
ance, and neuromuscular efficiency vs. the stable trained
group. There was also evidence for some nontraining-
specific, Yoak suspension training advantages with chest
press MVIC force and near-significant improvements with
the neuromuscular efficiency of the AD and SA and the TB
fatigue index. Unlike a number of other stable and unstable
resistance training systems, the Yoak suspension system can
provide additional instability training progressions by
advancing from a double suspension (2 bands) to a single
suspension system. With the unencumbered exercise straps,
resisted movement occurs over multiple planes and axes
progressing from a bilateral emphasis (double suspension) to
greater unilateral demands (single suspension).
The Yoak suspension group exhibited substantially higher
(81.6%) training-induced increases in the number of push-up
repetitions performed on the Yoak suspension system than
the stable group (30.6%). This result follows the concept of
training specificity (5,15), whereby training in an environ-
ment similar to the testing environment provides greater
gains than a dissimilar testing environment. The Yoak sus-
pension system, especially when suspended with a single
sling, forces the individual to use each arm independently
to ensure that balance is maintained. Stable push-ups permit
an over-reliance on a dominant arm, for example, without
the possibility of losing balance. This improved unilateral
independent control of upper limbs with the Yoak system
would be an important asset for sports that involve the coor-
dinated control of both arms such as combat sports (boxing
and martial arts), rowing, and other sports.
The Yoak suspension–trained group had significantly
superior post-training force increases with the chest press
MVIC. Although this action was performed while supine
on a stable bench, it might also be ascribed to training spec-
ificity. The isometric bench press MVC was performed with
2 separate unilateral straps. Thus, the action was similar to
the Yoak suspension push-up that was performed with 2
straps suspended from the Yoak. The Yoak-trained individ-
uals would have become more proficient at coordinating 2
unilateral straps, which must have transferred more effi-
ciently to this testing situation. If a single bar had been used
rather than 2 independent straps, the bar would have
emphasized a more bilateral action and might have provided
a more similar action to the stable training push-up group. It
could be speculated that the Yoak suspension training advan-
tage might have been nullified with a single bar.
Although isometric force is typically reduced under
unstable conditions (4,7,8,11,17), studies using dynamic
unstable chest press exercises (similar muscle groups as the
dynamic push-ups in this study) report either preserved iso-
kinetic bench press strength (performed on a physioball)
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(27,32) or small force and power decrements (6–10%) (39)
that might not compromise the training effect. Hence, the
dynamic Yoak suspension push-ups during training may not
have induced as substantial force impairments compared
with previous isometric studies (4,7,8,11,17).
Similar training specificity was evident with the signifi-
cantly improved neuromuscular efficiency of the BB (30.4%)
with the Yoak suspension–trained group compared with the
stable trained group, which demonstrated a 97.8% impair-
ment in neuromuscular efficiency when performing Yoak
suspension push-ups. Previous training studies have reported
post-training lower antagonist EMG levels during lifting
activities (24,46). If the BB works as an antagonist in the
push-up exercise, why would there be an improved neuro-
muscular efficiency? The role of the antagonist with the
push-ups would be to control arm and shoulder position.
The short and long heads of the biceps can both contribute
as stabilizers of the glenohumeral joint and their roles in
stabilization increases as joint stability decreases (35). Unsta-
ble suspension training in this study may have improved the
efficiency of the BB in its role for stabilization and motor
control. Similarly, there were near significant improvements
with the neuromuscular efficiency of the AD and SA. During
push-ups, both muscles can provide stabilization for the
shoulder and scapula, respectively, and thus tended to
become more efficient after the Yoak suspension training
program. The improved neuromuscular efficiency of these
muscles (BB, AD, and SA) would decrease the extent of
activation needed to perform the task (i.e., less motor unit
recruitment and firing frequency) (6), decreasing the energy
output needed for each push-up, and thus contributing to
the increased number of repetitions performed.
The significant main effects for decreased fatigue indexes
of the TB and AD also indicate that, for a similar number of
push-ups after training and before training, the EMG
increase due to fatiguing contractions was lower. With
submaximal fatiguing contractions, there is an increased
recruitment and rate coding of motor units to compensate
for the initially fatigued motor units resulting in an increased
EMG signal (6). Similar to the neuromuscular efficiency ex-
hibited with the first 3 contractions, the lower degree of
muscle activation and associated lower energy output would
reduce the amplitude of the RMS EMG signal illustrating an
improved efficiency not only with nonfatigued but also
under more fatiguing conditions.
A limitation of the study was the unequal sex ratio in each
group (Yoak: 5/5 vs. Stable 3/6). However, although the
ratio did not precisely match the general population (50%/
50%), there was representation from both sexes. Because
most studies suffer from inadequate female representation,
this study actually had slightly greater female numbers.
In conclusion, the progressive metastable Yoak suspension
training program provided greater training-specific improve-
ments for push-up endurance (number of repetitions per-
formed), chest press MVIC force (using 2 independent

unilateral straps), as well as increased neuromuscular effi-
ciency and lower fatigue indexes. It is suggested that the
challenges of the metastable environment of the Yoak
suspension system evoked greater training adaptations than
stable push-ups by enabling improved stabilization and
motor control. Although the greater chest press MVIC
would suggest greater strength increases with the Yoak
suspension system, it is also possible that the aforementioned
possible improvements in stabilization and coordination
could have made substantial contributions to the MVIC
force increases.
PRACTICAL APPLICATIONS
It is recommended that training devices such as the Yoak
suspension system, which enable varying degrees of insta-
bility, can provide superior strength and endurance training
results especially when tested under similar metastable
conditions. Although all individuals could benefit from such
training, athletes who use unilateral arm movements such as
combat athletes (i.e., boxers, wrestlers, and martial arts),
rowers, racquet athletes (i.e., tennis, squash), and others
could especially benefit from the training-specific effects.
Individuals can use this system to progress from stable
bilateral exercises to unstable exercises beginning with
a double suspension system to a single suspension system.
Hence, the concept of progressive resistance training can be
incorporated even after switching to an unstable device such
as the Yoak.
ACKNOWLEDGMENTS
The authors declare no conflicts of interest with the contents
of the article.
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