Background: The Functional Assessment of Chronic Illness Therapy (FACIT) for Dyspnea was developed to assess multidimensional dyspnea using two subscales (experience of dyspnea and functional limitation) and a total score. Objects: This study aimed to assess the reliability and validity of the Korean version of the FACIT-dyspnea 10-item short form questionnaire (FACIT-dyspnea-K). Methods: Subjects were 163 patients with cancer. Dyspnea-related scales (modified Medical Research Council scale [mMRC], European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 [EORTC QLQ-C30], Hospital Anxiety and Depression [HAD], and WHO Performance Scale) were used to validate the FACIT-dyspnea-K. Results: Internal consistency was confirmed by Cronbach’s alpha values of 0.90 and 0.95 in factors 1 and 2, respectively. Convergence validity was determined by comparing the two factors and total score of the FACIT-dyspnea-K with conceptually related assessment tools measuring the physical and emotional effects of dyspnea, with which correlations ranged from 0.364 to 0.567. Criterion validity was established by significant differences in the FACITdyspnea- K score between groups when the patients were classified by performance status as assessed by the WHO performance scale. Furthermore, the FACIT-dyspnea-K showed notable correlations with other dyspnea scales (mMRC, EORTC QLQ-C30, and HAD) for cancer patients (r = 0.28 to 0.54). The test-retest reliability of the two factors and total score of the FACITdyspnea- K appeared to be excellent (Cronbach’s alpha = 0.96 to 0.97). Conclusion: This study supports FACIT-dyspnea-K as a valid and reliable instrument to assess the dyspnea experience of cancer patients in clinical settings.

Background: High-heeled shoes can change spinal alignment and feet movement, which leads to muscle fatigue and discomfort in lumbopelvic region, legs, and feet while walking. Objects: This study aimed to identify the effects of different shoe heel heights on the walking velocity and electromyographic (EMG) activities of the lower leg muscles during short- and long-distance walking in young females. Methods: Fifteen young females were recruited in this study. The experiments were performed with the following two different shoe heel heights: 0 ㎝ and 7 ㎝. All participants underwent an electromyographic procedure to measure the activities and fatigue levels of the tibialis anterior (TA), medial gastrocnemius (MG), rectus femoris (RF), and hamstring muscles with each heel height during both short- and long-distance walking. The walking velocities were measured using the short-distance (10-m walk) and long-distance (6-min walk) walking tests. Results: Significant interaction effects were found between heel height and walking distance conditions for the EMG activities and fatigue levels of TA and MG muscles, and walking velocity (p<.05). The walking velocity and activities of the TA, MG, and RF muscles appeared to be significantly different between the 0 ㎝ and 7 ㎝ heel heights during both short- and long-distance walking (p<.05). Significant difference in the fatigue level of the MG muscle were found between the 0 ㎝ and 7 ㎝ heel heights during long-distance walking. In addition, walking velocity and the fatigue level of the MG muscle at the 7 ㎝ heel height revealed significant differences in the comparison of short- and long-distance walking (p<.05). Conclusion: These findings indicate that higher shoe heel height leads to a decrease in the walking velocity and an increase in the activity and fatigue level of the lower leg muscles, particularly during long-distance walking.

Background: Hemispatial neglect is defined as the failure to attend, report, respond, or orient toward meaningful stimuli provided in the contralateral side of a brain lesion. Objects: This study was conducted to find out the effect of dynamic trunk equilibirum exercise for stroke patients with hemi-spatial neglect. Methods: This study included 21 stroke subjects, randomly assigned to either the experimental group or the control group. The exercise program consisted of 5 sessions of 20 minutes per week during 4 weeks. The line-bisection test, the Albert test, the balance function score, the Berg balance scale, the postural assessment scale for stroke and the modified Barthel index were measured before and after training. All data were analyzed using SPSS 12.0 for Windows. Between-group and within-group comparison was analyzed by using Independent t-test and Paired t-test respectively. Results: The results of study were as follows: There were significant differences between before and after intervention in both group (p<.05). There were significant differences in the line-bisection test, Albert test, balance function score, Berg balance scale, postural assessment scale for stroke and modified Barthel index between the experimental group and the control group (p<.05). Conclusion: Dynamic trunk equilibrium exercise had a positive effect on patients’ neglect, balance ability and activities of daily living. Further studies are required to generalize the results of this study.

Background:Active trigger points (TrPs) of the suboccipital muscles greatly contribute to the occurrence of chronic tension-type headache, with increased sensitivity of TrPs and facilitated referred pain.Objects:This study aimed to investigate whether the integration of high-frequency diathermy into suboccipital release is more beneficial than the use of suboccipital release alone.Methods:Thirty subjects were assigned to either experimental group-1 (EG-1) to undergo suboccipital release combined with high-frequency diathermy (frequency: 0.3 MHz, and electrode type: resistive electronic transfer), or EG-2 to undergo suboccipital release alone, or the control group (CG) with no intervention, with 10 subjects in each group. The assessment tools included the headache impact test 6 (HIT-6), perceived level of tenderness, neck disability index, and neck mobility. Intervention was performed for 10 minutes, twice per week, for 4 weeks, and measurements were performed before and after the interventions.Results:The between-group comparison of the post-test values and changes between pretest and post-test showed significant differences for all parameters at p<.05, except for the left-to-right lateral bending range. In the post hoc test, EG-1 showed significant differences for the parameters in comparison with the CG, while no significant differences in the perceived tenderness level, on both temporal regions, were found between EG-2 and CG. Furthermore, the HIT-6 score and perceived tenderness level, in the right temporal region, showed significant differences between EG-1 and EG-2. In the within-group comparison, EG-1 and EG-2 appeared to be significantly different between pretest and post-test (p<.05), except for the perceived tenderness level in the right temporal region, with significance for the EG-1 group only (p<.05).Conclusion:These findings suggest that the suboccipital release technique may be advantageous to improve headache, tenderness, and neck function and mobility, with more favorable effects with the incorporation of high-frequency diathermy.

Background:Research efforts to improve the pulmonary function of people with limited chest function have focused on the diaphragmatic ability to control breathing pattern. Real-time ultrasonography is appropriate to demonstrate diaphragmatic mechanism during breathing.Objective:The purpose of this study was to investigate the effects of diaphragmatic breathing training using real-time ultrasonographic imaging (RUSI) on the chest function of young females with limited chest mobility.Methods:Twenty-six subjects with limited chest mobility were randomly allocated to the experimental group (EG) and control group (CG) depending on the use of RUSI during diaphragmatic breathing training, with 13 subjects in each group. For both groups, diaphragmatic breathing training was performed for 30-min, including three 10-min sets with a 1-min rest interval. An extra option for the EG was the use of the RUSI during the training. Outcome measures comprised the diaphragmatic excursion range during quiet and deep breathing, pulmonary function (forced vital capacity; FVC, forced expiratory volume in 1-sec; FEV1, tidal volume; TV, and maximal voluntary ventilation; MVV), and chest circumferences at upper, middle, and lower levels.Results:The between-group comparison revealed that the diaphragmatic excursion range during deep breathing, FVC, and middle and lower chest circumferences were greater at post-test and that the changes between the pretest and post-test values were greater in the EG than in the CG (p<.05). In addition, the subjects in the EG showed increased post-test values for all the variables compared with the pretest values, except for TV and MVV (p<.05). In contrast, the subjects in the CG showed significant improvements for the diaphragmatic excursion range during quiet and deep breathings, FVC, FEV1, and middle and lower chest circumferences after the intervention (p<.05).Conclusion:These results indicate that using RUSI during diaphragmatic breathing training might be more beneficial for people with limited chest mobility than when diaphragmatic breathing training is used alone.

Background:Limitation of hamstring extensibility is often associated with various musculoskeletal problems such as alterations in posture and walking patterns. Thus, certain appropriate strategies need to be established for its management.Objects:The aim of this study was to compare the effects of the neural mobilization technique and static stretching exercises on popliteal angle and hamstring compliance in young women with short hamstring syndrome (SHS).Methods:Thirty-three women with SHS were randomly assigned to either group-1 (n1=17) that underwent the neural mobilization technique or group-2 (n2=16) that underwent the static stretching exercises. Outcome measures included the active popliteal angle (APA) and a hamstring’s electromyographic (EMG) activity at a maximum popliteal angle of the baseline. Intervention for each group was performed for a total time of 3-min (6 sets of a 30-sec application).Results:There were significant interactions between time and group in the APA [group-1 (pre-test to post-test): 69.70±8.14° to 74.14±8.07° and group-2: 68.66±7.42° to 70.52±7.92°] (F1,31=6.678, p=.015) and the EMG activity of the hamstring (group-1: 1.12±.30μV to .69±.31μV and group-2: 1.19±.49μV to 1.13±.47 μV)(F1,31=6.678, p=.015). Between-group comparison revealed that the EMG activity of the hamstring was significantly different at post-test between the groups (p<.05). Furthermore, in within-group comparison, group-1 appeared to be significantly different for both variables between pre- and post-test (p<.05); however, group-2 showed significant difference in only the APA between pre- and post-test (p<.05).Conclusion:These findings suggest that the neural mobilization technique and static stretching exercises may be advantageous to improve hamstring compliance in young women with SHS, resulting in a more favorable outcome in the neural mobilization technique.

Background: Many studies regarding task-oriented training have recently demonstrated functional improvement in patients with post-stroke hemiparesis. The task-oriented approach is very diverse, and chronic stroke patients must have access to a sustained systematic treatment program to enhance their walking ability. Objectives: This study aimed to compare the effects of the task-oriented circuit training and treadmill training on walking function and quality of life in patients with chronic stroke. Methods: Fourteen patients with chronic stroke volunteered for this study. The subjects were randomly divided into a task-oriented circuit training group and a treadmill training group with 7 patients in each. Each training regimen was performed for 30 min a day and 3 days a week for 4 weeks. Assessment tools included the Timed Up-and-Go Test (TUGT), 10-m Walk Test, 6-min Walk Test (6MWT), and the Stroke Impact Scale (SIS). Results: The change in results of the TUGT, 6MWT, and SIS measured prior to and following the training regimens appeared to be significantly different between the two groups (p<.05). In addition, after the intervention, significant differences were found for all parameters in the task-oriented circuit training group and for the TUGT, 6MWT, and SIS in the treadmill training group (p<.05). Conclusion: The findings suggest that task-related circuit training and treadmill training may be helpful to improve walking function and quality of life of patients with post-stroke hemiparesis. Additionally, a task-related circuit training program may achieve more favorable outcomes than a treadmill program.

The purpose of this study was to evaluate the effect of dual-task training with cognitive effort on the walking and balance functions of chronic stroke patients. The study included 14 chronic stroke patients, who were randomly divided into the experimental group (EG) and control group (CG), each with 7 patients. The EG performed the dual-task training with cognitive effort 3 times a week, 30 minutes for 4 weeks, where as the CG performed single-task training three times a week, for 30 minutes for 4 weeks. Outcome assessments were made with 10 m walk test, timed up and go test, 6 minutes walk test, and Berg balance scale. In within-group comparison, subjects from the EG showed significant differences in all variables (p<.05), while subjects from the CG showed only significant differences in 6 minutes walk test, and Berg balance scale (p<.05). Further, there was significant difference in the improvement rate of 10 m walk test. The findings suggest that the dual-task with cognitive effort may be beneficial for improving walking and balance functions of patients with chronic stroke.

The purpose of this study was to evaluate the differences in electromyographic (EMG) activities of upper limb muscles between cross- and parallel-aligned taping and to compare the effects of these 2 taping methods in healthy adults. Thirty subjects, who volunteered for this study, were tested under 3 taping conditions in random order: (1) no taping, (2) cross-aligned taping, and (3) parallel-aligned taping. EMG activities of the biceps brachii, triceps brachii, flexor carpi ulnaris, and extensor carpi radialis muscles were measured. All muscles showed significant differences in EMG activity among the 3 conditions (p<.05). In the post hoc test, biceps brachii and triceps brachii muscles showed significant differences in EMG activity between the no taping and the cross-aligned taping conditions and between the no taping and the parallel-aligned taping conditions. Additionally, the EMG activities of the flexor carpi radialis and extensor carpi radialis muscles appeared to be significantly different between the no taping and parallel-aligned taping conditions. These findings demonstrate that taping may be helpful for decreasing muscle activity, regardless of the direction of tape application. This study provides useful information to future researchers regarding the effects of taping on muscle activity.

This study aimed to investigate the influence of shoe heel height and muscle fatigue on static and dynamic balance in young women. Thirty women who were used to wearing high heels volunteered to participate in this study. The shoe heel heights were 0 ㎝ and 7 ㎝. And ankle plantar flexor fatigue was experimentally induced. Static and dynamic balance were measured using the one leg standing test (OLST) and the star excursion balance test (SEBT) in anterior, posteromedial, and posterolateral directions, respectively. Values in the OLST (shoe heel height 0 ㎝, 28.83±3.24 sec to 26.12±6.13 sec; and 7 ㎝, 24.75±7.09 sec to 16.86±9.32 sec) and the SEBT in anterior (shoe heel height 0 ㎝, 71.02±4.57% to 69.50±3.66%; and 7 ㎝, 64.17±3.53% to 59.61±4.06%) and posteromedial (shoe heel height 0 ㎝, 92.01±5.61% to 90.38±7.10%; and 7 ㎝, 83.09±7.29% to 76.83±9.28%) directions were significantly reduced when fatigue-inducing exercise was performed (p<.05). Furthermore, within these parameters, there were significant interaction effects between shoe heel height and fatigue condition (p<.05). These findings suggest that shoe heel height and muscle fatigue contribute to some changes in static and dynamic balance in young women, probably leading to negative effects on physical function during a variety of activities of daily living.

The purpose of this study was to determine the effects of warm-up and cool-down exercises on pain and muscle activation of delayed onset muscle soreness after intense exercise. Delayed onset muscle soreness was caused by the eccentric exercise in the elbow flexor muscle of the non-dominant upper limb. Forty-four subjects volunteered to participate in this study and were randomly assigned to one of the following groups: warm-up and cool-down group, only warm-up group, only cool-down group, or control group with no intervention. The level of perceived pain using the visual analogue scale and electromyographic activation change in maximal voluntary isometric contraction were measured 4 times at the following times: 10 min, 24 hr, 48 hr, and 72 hr after the exercise. The results revealed the main effect between the groups and interaction effect between the group and measurement session (p<.05). The warm-up and cool-down group showed most favorable results with respect to reduced perceived pain level and increased muscle strength in most measurement sessions, and the only warm-up group showed significantly more decreased pain level than the control group at 24 hr and 48 hr and more increased muscle activation than the cool-down group at 48 hr (p<.05). However, there were no significant differences in pain level and muscle activation between the only cool-down group and control group at all measurement sessions (p>.05). The findings suggest that the warm-up exercise performed before an intense exercise had beneficial effects on the symptoms of delayed onset muscle soreness, whereas cool-down exercise performed after the intense exercise did not.

This study aimed to investigate whether isometric lower limb exercise can activate contralateral trunk muscles and whether the magnitude of muscle activation is related to lower limb movement in sitting. This study included 25 healthy young subjects (20 males and 5 females). The magnitude of trunk muscle activation was measured using surface electromyography (EMG) during hip flexion, extension, adduction, and abduction, and a significant difference was observed in the activation levels of trunk muscles among the tests (p<.01). The EMG activity of the multifidus (MF) and erector spinae (ES) muscles on the contralateral side were significantly greater during hip extension. However, the activation levels of the contralateral internal oblique (IO) and rectus abdominis (RA) muscles were greatest during hip flexion. The MF : ES EMG ratio was significantly greater during hip isometric during hip isometric flexion and abduction compared to hip extension and adduction. There was no significantly difference in the IO : RA ratio during the isometric contractions toward different directions. These findings indicate that isometric lower limb exercise can elicit trunk muscle contraction on the contralateral side and may therefore be helped for developing contralateral trunk muscle strength in individuals undergoing rehabilitation.

This study aimed to identify the asymmetry observed in the electromyography (EMG) activity patterns of selected trunk and thigh muscles between the affected and unaffected sides during the sit-to-stand movement in ambulatory patients with post-stroke hemiparesis. This study included 20 patients with post-stroke hemiparesis. The differences between stroke fast walkers (, 11 subjects) and stroke slow walkers (<8 m/s, 9 subjects) were compared. The activation magnitude and onset time of the multifidus, lumbar erector spinae, hamstrings, and quadriceps during the sit-to-stand movement were recorded through surface EMG. Moreover, the EMG activation magnitude and onset time ratios of each bilateral corresponding muscle from the trunk and leg were measured by dividing the relevant values of the unaffected side by those of the affected side. In all the subjects, the activation magnitudes of the multifidus, hamstring, and quadriceps on the affected side significantly decreased compared to those on the unaffected side (p<.05). The onset time of muscle activity in the affected side was markedly delayed for the multifidus and quadriceps during the task (p<.05). The activation magnitude ratios of the quadriceps were markedly decreased in the stroke slow walkers as compared to those in the stroke fast walkers. These findings indicate that the asymmetry in the multifidus, hamstring, and quadriceps muscle activation patterns in patients with post-stroke hemiparesis may be due to the excessive muscle activation in the unaffected side to compensate for the weakened muscle activity in the affected side. Our findings may provide researchers and clinicians with information that can be useful in rehabilitation therapy.

This study aimed to evaluate factors related to the ability of ambulatory patients with cerebral palsy (CP) to walk over vertical and horizontal obstacles. Twenty patients with spastic CP who were able to walk independently for at least 10 m with or without walking devices were recruited for the study. Participants were required to walk over small obstacles (1, 4, and 8 cm in height or width; total of 6 conditions). A 'fail' was recorded when either the lower limbs or the walking device contacted the obstacle. Linear regression analyses were used to determine the effects of age, sex, walking devices, eyeglasses, subtype (hemiplegia or diplegia), ankle foot orthoses, functional level, and score of body mass index on the ability of obstacle crossing. Fifteen participants (75%) failed to adequately clear the foot or walking device over obstacles in at least 1 condition. The chance of failure in crossing vertical obstacle was affected by the use of ankle foot orthoses, eyeglasses, gender, and CP subtype (p<.05). The failure rate crossing horizontal obstacle was affected by CP subtype. These findings suggest that rehabilitation procedures should (1) consider the clinical characteristics of patients in order to prepare them to be more independent while performing daily activities, and (2) incorporate environmental conditions that patients encounter at home and in the community.

The purpose of this study was to investigate intra-rater reliability and determine the validity of electromyography (EMG) measurements to represent muscle activity and ultrasonography (US) to represent muscle thickness during manual muscle testing (MMT) to external abdominal oblique (EO) and lumbar multifidus (MF). Twenty healthy subjects were recruited for this study and asked to perform MMT at differing levels. The subjects' muscle activity using EMG was measured by a ratio to maximum voluntary contraction (MVC) and root mean square (RMS) methods. The subjects' muscle thickness using US was measured by raw muscle thickness and change ratio of thickness to maximum (MVC) or resting condition. In three trials, measurements were performed on each subject by one examiner. The intra-rater reliability of measurements of EMG and US to EO and MF was calculated using intra-class coefficients. The intra-rater reliability of all measurements was excellent (ICC=.75~.98) in EMG and US. The conduct validity was calculated by one-way ANOVA with repeated measurements to compare whether the EMG and US measurements were different between MMT at different levels. There was only a significant difference between all grades at %MVC thickness measurement of US. These results suggest that a %MVC thickness measurement of US was a more sensitive and discriminate in all manual muscle testing grades. This information will be useful for the selection of US measurement and analysis methods in clinics.

The purpose of this study was to determine the effect of sciatic nerve mobilization technique on perceived pain, straight leg raise test (SLR), and strength of knee extensor, location of symptoms (LOS) in patients with chronic low back pain. 22 patients with chronic low back pain were recruited for this study. The subjects were randomly assigned to either the experimental group (EG) or the control group (CG), with 11 patients in each group. All patients received a routine physical therapy (hot pack and transcutaneous electrical nerve stimulation). The mobilization technique of the sciatic nerve was performed for 10 min in the case of the EG subjects. Outcome measurements included the level of the perceived pain, SLR, and strength of the knee extensor, LOS. The measurements were recorded 3 times: before the intervention, after the intervention, and at 1 hour of follow up. The two groups did not significantly differ with regard to the level of perceived pain, SLR, and strength of the knee extensor, LOS before the test (p>.05). In the case of the EG subjects, all the variables measured after the intervention significantly differed from those measured before the intervention (p<.05). However, in the case of the CG subjects, a significant difference was noted only with regard to the level of perceived pain (p<.05). The findings indicate that sciatic nerve mobilization technique exerts a positive effect on the control of subjective symptoms and knee strength in patients with chronic low back pain. Further studies are required to generalize the result of this study.

To develop effective training methods for strengthening a weakened quadriceps femoris muscle in hemiplegic patients, we examined the effects of maximal isometric contraction of the nonparalyzed knee joint on the electromyographic activities of the paralytic muscle. An electromyogram (EMG) was used to record the electromyographic activities of the paralytic quadriceps femoris muscle in 27 hemiplegic patients. The maximal isometric contraction was measured for each subject to normalize the electromyographic activities. The maximal isometric extension and flexion exercises were randomly conducted when the knee joint angles of the nonparalyzed knees were 0˚, 45˚, and 90˚. The patients were encouraged to maintain maximal isometric contractions in both knee joints during each measurement, and three measurements were taken. A one-minute rest interval was given between each measurement to minimize the effects of muscle fatigue. An average from the three values was taken as being the root mean square of the EMG and was recorded as being the maximal isometric contraction. The electromyographic activity obtained for each measurement was expressed as a percentage of the reference voluntary contraction, which was determined using the values obtained during the maximal isometric contraction. The results of this study are summarized as follows: First, when the knee joint angle of the nonparalyzed knee was 0˚, the electromyographic activities of the paralytic medial aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). Second, when the knee joint angle of the nonparalyzed knee was 90˚, the electromyographic activities of the paralytic lateral aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). The results show that myoelectrical activities of paralytic quardriceps were not related to measurement angles and exercise directions of the nonparalized knee joint. Studies on various indirect intervention to improve muscular strength of patients with nervous system disorders of the weakened muscle should be constantly conducted.

This study aimed to compare 2 protocols recommended to patients with chronic cervical cord injury: each protocol included breathing exercises (inhalation-oriented or exhalation-oriented) and facilitation maneuver for the accessory respiratory muscles. Seventeen patients with chronic cervical cord injury volunteered to participate in this study, and we randomized these patients into 2 groups: the inhalation-oriented breathing exercise group (IOBEG) and exhalation-oriented breathing exercise group (EOBEG), consisting of 8 and 9 patients, respectively. Patients in the IOBEG performed inspiratory exercises using intermittent positive pressure breathing devices, while those in the EOBEG performed expiratory exercises using incentive spirometry. All exercises were performed by the subjects twice a day for 4 weeks, with each session lasting an average of 20 min. The outcomes were assessed on the basis of the pre- and post-treatment values of vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC. In the IOBEG, no significant differences were observed between the pre- and post-treatment values of any of the measured variables (p>.05); however, in the EOBEG, significant improvement was noted in the VC, FVC, FEV1 measured (p<.05) after the treatment. In addition, the rates of change in the values of VC, FVC, and FEV1 differed significantly between the 2 groups (p<.05). These findings suggest that the EOBEs can enhance respiratory function and are clinically feasible in patients with chronic cervical cord injury. Further studies will be undertaken to evaluate the clinical application of these findings.

This study aimed to investigate the effect of differing heel heights on the electromyographic (EMG) activity in vastus medialis (VM) and vastus lateralis (VL) during stair ascending and descending activities. A total of 26 healthy women volunteered to perform stair-ascending and stair-descending tasks with 3 heel heights: barefoot, 3 cm, and 7 cm. The EMG activities of the VM and VL were recorded during the tasks. During the stair ascending and descending tasks, the EMG activities of both VM and VL significantly changed with differing the heel heights (p<.05). Moreover, the EMG activities of VM and VL during the stair ascending task were significantly higher than the corresponding values during the stair-descending task (p<.05). However, there were no significant differences between the VM:VL EMG ratios for the 3 heel heights (p>.05). The VM:VL EMG ratios between the 2 tasks differed significantly in the 7 cm high heel condition (p<.05). Despite an increase in the EMG activities in both VM and VL during stair ascending and descending tasks, there was no change in the relative EMG intensities of VM and VL, which was measured by calculating the VM:VL ratio this result indicates that no VM:VL imbalances were elicited. The relative EMG intensities of VM and VL during stair descent were lower than the corresponding values during the ascent, suggesting that VM and VL may show an imbalance in the eccentric activation during the weight-acceptance phase. This study provides useful information that will facilitate future research on how heel height affects muscle activity around the knee joint.

The objectives of this study were to investigate the relationship between fear-avoidance beliefs and functional status in individuals suffering from low back pain, and to identify factors that influence on fear-avoidance beliefs, functional status and pain. A cross-sectional study included 214 individuals with low back pain. Each of subjects completed a fear-avoidance beliefs questionnaire (FABQ) which divided into two subscales, FABQ for physical activity (FABQ-PA) and FABQ for work(FABQ-W), Oswestry disability index (ODI) and numeric pain rating scale (NPRS). Individuals with radiating pain were significantly higher in FABQ-PA, FABQ-total, and ODI scores than with no radiation pain (p<.05). Individuals who had received surgery were significantly higher in FABQ-PA, FABQ-total, ODI and NPRS scores when compared with individuals who had not received it (p<.05). And individuals with taking medication were significantly higher in all variables (FABQ-PA, FABQ-W, FABQ-total ODI and NPRS) than individuals not taking medication (p<.05). In correlation analysis. age appeared to be significantly correlated with FABQ-PA, FABQ-total and ODI scores (p<.05), and all variables was significantly correlated with each other (p<.01). These findings indicate that individuals suffering from low back pain have psychosocial problems such as fear-avoidance beliefs as well as functional status and pain. Fear-avoidance beliefs may contribute to aggravate physical symptoms, and therefore it should be carefully considered for the management of individuals with low back pain.