Background: Chronic back pain shows a high correlation with lumbar disability, physical disability for daily activities, and psychosocial factors, such as depression. Object: The purpose of this study was to examine the correlation of the level of pain and disability with psychosocial factors, which are potential disturbance variables, in patients with chronic lumbar pain. Method: The sample included 258 patients, who had complained of chronic lumbar pain for more than three months. The Quadruple Visual Analogue Scale was used to measure the level of pain, and a Korean version of Oswestry Disability Index was used to measure the level of disability. Psychosocial factors were measured using the Tampa scale for Kinesiophobia-11, Fear Avoidance Beliefs Questionnaire, and Pain Self-Efficacy Questionnaire. The collected data was analyzed using PASW 18.0, and an independent samples t-test was used to examine frequency, percentage, mean, and standard deviation of sociodemographic characteristics and major variables. Pearson’s correlation coefficient was used to investigate the correlation between the level of pain and disability and psychosocial factors. Stepwise multiple regression analysis was done to determine the level of pain and psychosocial factors of functional disorder. The significance level was set at α=.05. Result: There is a strong correlation between the level of pain and functional disorder and psychosocial factors in patients with chronic lumbar pain. The study also revealed that as the levels of pain and fear avoidance increase, pain self-efficacy decreases. Conclusion: The results suggest that negative perceptions towards pain, limitations of physical movement, and severe fear avoidance directly affect the decrease in pain self-efficacy. Therefore, it is recommended to test pain self-efficacy when measuring the level of pain and disability in patients with chronic low back pain.

The objective of this study was to determine the duration of maintained calf muscle flexibility gained in young adults with calf muscle tightness, as measured by increases in ankle active and passive dorsiflexion range of motion (DFROM) after three stretching interventions. Twenty subjects (5 men and 15 women) with calf muscle tightness received the following three stretching interventions in one leg (assigned at random): static stretching (SS), eccentric training on stable surface (ETS), and eccentric training on unstable surfaces (ETU). The subjects received all three interventions to the same leg, applied in a random order. Each intervention had a break of at least 24 h in-between, in order to minimize any carryover effect. Each intervention used two types of stretching: with the calf muscle stretched and both knees straight, and with the knee slightly bent in order to maximize the activation of the soleus muscle. All three interventions were performed for 200 seconds. We measured the duration of maintained calf muscle flexibility through active and passive ankle DFROM before intervention, immediately after intervention (time 0), and then 3, 6, 9, 15, and 30 min after intervention. We found a difference in the duration of maintained calf muscle flexibility between the three interventions. In the ETS and ETU interventions, a significant improvement in calf muscle flexibility, both ankle active and passive dorsiflexion ranges of motion (ADFROM and PDFROM), was maintained for 30 min. In the SS intervention, however, ADFROM before 9 min and PDFROM before 6 min were statistically different from the baseline. Our results suggest that ETS and ETU may be more effective than SS for maintaining calfmuscle flexibility in young adults.

The aim of this study was to compare the duration of hamstring flexibility improvement after 3 stretching interventions in people with limited hamstring flexibility. Twenty-two subjects (12 men, 10 women) with limited hamstring flexibility of the dominant leg received 3 stretching interventions— modified dynamic stretching (MDS), hold-relax (HR), and static stretching (SS)—in a random order. All the subjects received all 3 interventions at intervals of at least 24 hours to minimize any carry-over effect. Modified dynamic stretching was applied as a closed kinetic chain exercise in the supine position by using the sling suspension system (Redcord Trainer®). The SS and HR interventions were individually performed in the straight leg raising (SLR) position, and all 3 interventions were performed for 3 minutes. Outcome measures included passive knee extension (PKE) measurements. Five post-test measurements were recorded for all subjects at 3, 6, 9, 15, and 30 minutes after the interventions. MDS was associated with a significant increase in knee extension range of motion even at 30 minutes post-treatment. In contrast, the HR and SS stretching methods showed increased hamstring flexibility for only 6 minutes post-treatment. Improvements in the range of motion of knee extension (indicating enhancement in hamstring flexibility) with MDS were maintained longer than those with the HR and SS interventions. Therefore, MDS may be more effective than the other interventions for maintaining hamstring flexibility.

The purpose of this study was to determine the effect of the pelvic compression belt (PCB) on the electromyography (EMG) activities of trunk muscles during sit-to-stand (SitTS), and stand-to-sit (StandTS) tasks. Twenty healthy subjects (7 men and 13 women) were recruited for this study. The subjects performed SitTS, and StandTS tasks, with and without a PCB. Surface EMG was used to record activity of the internal oblique (IO), external oblique (EO), rectus abdominis (RA), erector spinae (ES), and multifidus (MF) of the dominant limb. EMG activity significantly decreased in the RA (without the PCB, %maximal voluntary isometric contraction [%MVIC]; with the PCB, %MVIC), EO (without the PCB, %MVIC; with the PCB, %MVIC), MF (without the PCB, %MVIC; with the PCB, %MVIC), and ES (without the PCB, %MVIC; with the PCB, %MVIC) during the SitTS task and in the IO (without the PCB, %MVIC; with the PCB, %MVIlC), RA (without the PCB, %MVIC; with the PCB, %MVIC), EO (without the PCB, %MVIC; with the PCB, %MVIC), MF (without the PCB, %MVIC; with the PCB, %MVIC), and ES (without the PCB, %MVIC; with the PCB, %MVIC) during the StandTS task when a PCB was used (p<.05). In men the EMG activity of the MF significantly decreased during the SitTS task when a PCB was used (p<.05): in women, the EMG activity of the RA, EO, MF, and ES during the SitTS task and that of the EO, MF, and ES during the SitTS task significantly decreased when a PCB was used (p<.05). In addition, the rates of change in the EMG activity of each muscle differed significantly during the SitTS and StandTS tasks before and after the use of the PCB. However, the EMG activity did not significantly differ between the male and female subjects. These findings suggest that the PCB may contribute to the modification of activation patterns of the trunk muscles during SitTS, and StandTS tasks.

This study aimed to determine the usefulness of classifying patients with neck pain on the basis of the results of passive scapular elevation test. We classified 21 patients with neck pain into positive (n=12) and negative (n=9) groups on the basis of passive scapular elevation test; the 2 groups then equally performed scapular stabilization exercise program for 30 min, 3 times a week, for 4 weeks. Visual analogue scale (VAS), neck disability index (NDI), and range of motion (ROM) were recorded both before and after the intervention for both groups. Paired t-test was used to determine that there were significant changes between before and after the intervention, and independent t-test was used for analyzing changes between two groups of dependent variables. After 4 weeks of training, we observed significant decrease in pain and disability (p<.05) and a significant increase in rotation, flexion, extension, and side-bending ROM (p<.05) in both groups. Further, between pre- and post-intervention evaluations, we observed a significant decrease in pain and disability and a significant increase in rotation and flexion ROM in the positive group than in the negative group (p<.05). These results indicate that passive scapular elevation test may be used to identify mechanical disorders of the cervicoscapular muscle in patients with neck pain. Therefore, we recommend the use of passive scapular elevation test to determine appropriate treatment intervention when treating patients with neck pain.

The lower trapezius muscle is an important stabilizer and primary mover of the scapula. The potential use of ultrasound imaging to evaluate scapular muscle function warrants investigation. The purpose of this study is to use ultrasound imaging for determining the effectiveness of 4 different isometric exercises for maximally activating the lower trapezius muscles in healthy subjects. Twenty-eight (14 men and 14 women) volunteers were recruited for this study. Thickness measurements of the lower trapezius muscles were recorded during 4 exercises: latissimus pulldown (LP), prone V-raise (PV), prone row (PR), and modified prone cobra (MP). Lower trapezius muscle thickness was measured 3 times by 2 investigators at a point 3 cm lateral to the lateral edge of the T8 spinous process. The order of 4 exercise execution was randomized for each participant. To identify statistical significance, one-way ANOVA with repeated measures was used with the significance level of .05. Intraclass correlation coefficient (ICC) for intra-reliability was .86~.98 and inter-rater reliability .83~.96 for the lower trapezius, respectively (p<.01). Thickness changes in the lower trapezius muscles between the relaxed and contracted states in men were as follows: LP (, 182%), MP (, 167%), PV (, 149%), and PR (, 133%). In women the values were as follows: LP (, 163%), MP (, 131%), PV (, 129%), and PR ( mm, 100%). Thickness of the lower trapezius muscles significantly differed between exercises in both the gender (p<.01). The LP was the most effective exercise for increasing the activation of the lower trapezius muscle in both the gender. We recommend performing the LP exercise for strengthening the lower trapezius muscles.

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.