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Background Prone hip extension is used to clinically assess movement control in patients with nonspecific low back pain (LBP). Excessive lumbopelvic movements and altered muscle activation patterns are common in patients with nonspecific LBP. However, no evidence exists regarding lumbar multifidus and lumbar erector spinae muscle synergy patterns in patients with nonspecific LBP during this clinical test. Objective To determine the difference in lumbopelvic motion and change in muscle synergy between patients with nonspecific LBP and healthy individuals. Design A cross-sectional study design. Setting University physical therapy clinic and laboratory. Participants Seven patients with nonspecific LBP (age [mean ± SD] 29 ± 5 years, 43% female, body mass index [BMI] of 25 ± 2 kg/m2 , Numeric Pain Rating Scale 6 ± 2; Oswestry Disability Index 20% ± 8%) and seven age-, sex-, and BMI-matched healthy individuals (mean age 28 ± 5 years, 43% female, BMI of 22 ± 2 kg/m2 ) were recruited. Methods Each participant performed six repetitions of prone hip extension on each side; kinematic and electromyographic data were collected simultaneously. Main outcome measurements Kinematic data were used to represent lumbopelvic motion, whereas electromyography (EMG) data were used to represent muscle activity. A paired t-test was used to determine the difference in lumbopelvic motion. Principal component analysis and two-way repeated-measures analysis of variance were used to extract muscle synergies and identify differences in muscle synergy patterns between and within groups. Results Results demonstrated no significant group difference (P > .05) in amount of lumbopelvic motion. However, healthy individuals synergistically activate lumbar multifidus and lumbar erector spinae with 81.0% variance accounted for (VAF). Patients with nonspecific LBP had an altered synergy with independent activation of lumbar multifidus on the painful side with 32.0% VAF and the lumbar multifidus on the nonpainful side, and both lumbar erector spinae with 52.2% VAF synergistically activated. Conclusions These findings suggest that clinicians should focus on muscle activation patterns rather than the amount of lumbopelvic motion during clinical observation of prone hip extension. Level of evidence Level III.

Although prolonged sitting appears as a novel risk factor related to health outcomes for all ages, its association needs to be replicated in occupational conditions. This study explored the associations between sedentary behavior and four noncommunicable diseases (NCDs) as well as two cardiometabolic risk factors (CMRFs) among workers in a petroleum company, Thailand. All workers were invited to complete the online self-report questionnaire. Sedentary behavior was measured as the amount of time sitting at work, during recreation, and while commuting. Out of 3365 workers contacted, 1133 (34%) participated. Prevalence of NCDs and CMRFs was 36% and was positively associated with sedentary behavior. After adjusting for age, BMI, and exercise, the risk of NCDs and CMRFs for sedentary office work was 40% greater compared with more active field work. Those who took a break without sitting more than twice a day and commuted by walking or cycling had less risk of NCDs and CMRFs. The total duration of sedentary behavior was 10 h/day, and two-thirds of that total was workplace sitting. This was significantly associated with NCDs and CMRFs (p < 0.001). Day-and-night rotating shiftwork was negatively associated with NCDs and CMRFs (p < 0.001). Sedentary behavior should be considered a health risk among workers. Hence, to promote a healthy lifestyle and safe workplace, organizations should encourage standing activities during break and physically active commutes, and have workers avoid prolonged sitting.

The purposes of this study were to (1) quantify trunk endurance times according to subjects' age and sex; and (2) identify factors affecting the endurance times.Endurance times ofsedentary workers aged 20-49 years were determined by an extensor endurance, aflexor endurance, and right and left side bridge (trunk lateral flexor) tests. Each test was performed once in random order with a resting period of 10 minutes between tests.Of 137 workers, Two-way analysis ofvariance indicated that age had no effect on these 4 isometric trunk endurance tests. Sex had an effect on the extensor endurance test, and right and left side bridge tests. Females had longer endurance times than males for the trunk extensor muscle, whereas males had longer endurance times thanfemales for right and left lateral flexor trunk muscles. Low negative but significant Pearson ' correlations (r = -0.233 to -0.377, p = 0.047 to 0.001) were found between extensor endurance times vs. body weight and abdominal skinfold thickness in both sexes. Only in males, both right and left side bridge endurance times correlated with abdominal skinfold thickness (r = -0.296 and r = -0.382, respectively, p0.05 both).Sex, weight and abdominal skinfold thickness factors should be considered when trunk muscle endurance is evaluated.

to determine the effects ofback belt use on trunk muscle performance and the association between those performance outcomes with Work-Related Musculoskeletal Disorders (WMSDs).All manual lifting workers in one grocery distribution, warehouse center were interviewed about the history of illness, back injury, WMSDs, lifting manner and experience of back belt use. They were assessedfor trunk muscles performance including the flexion (F), the extension (E) and the right and left side bridge (RSB and LSB) endurance test and Exercise Level of Lumbar Stabilization test (ELLS). Pearson s correlation and Spearman's rank correlation statistics were used to determine the association.One hundred and seven males, aged 18 to 42 years participated in the study. Most participants had ELLS at levels 2 (31.1%) and 3 (30.2%). The mean F, E, RSB and LSB endurance times were 62.33, 88.62, 77.17 and 77.33 seconds, respectively. The greatest area of WMSDs was the lower back (53.33%). Significant correlations were found between the ELLS and RSB (r = 0.244, p = 0.012) and between the ELLS and LSB (r = 0.199, p = 0.041). Significant correlations were found between pain scale of backpain and ELLS (r = -0.299, p = 0.016). Significant correlations were found between the number of WMSD areas and trunkflexion endurance (r = -0.263, p = 0.007), right trunk endurance (r,= -0.195, p = 0.044), left trunk endurance (r = -0.325, p = 0.001) and endurance ratio of RSB/LSB (r(s) = 0.224, p = 0.022). Furthermore, most participants (84.1%) had imbalanced endurance of RSB/LSB. Duration andfrequency ofback belt use did not correlate with any trunk muscle performance. This may have been because few participants did not wear belts (10.1%) or wore belts sometimes (26.6%).Low correlation was found between back belt use and WMSDs. To prevent back injury, the lifting workers should be trained to balance their trunk muscles endurance, especially right and left trunk muscles and to stabilize their lower back while lifting.

This study aimed to investigate the electromyography (EMG) activity amongfive abdominal and back muscles at six starting positions in untrained individuals.Twenty-five healthy individuals aged 20.9 +/- 3.9 years, who were inexperienced with lumbar stabilization exercise, were recruited. They were asked to perform maximum voluntary isometric contraction (MVIC), and then six starting positions in random order EMG data ofeach starting position were normalized as a percentage of MVIC. Friedman two-way analysis of variance (ANOVA) and Wilcoxon signed-ranks tests were used for data analysis.Significant differences in EMG activity of five abdominal and back muscles were found in all six starting positions (p0.001). The highest EMG activity ofthe transversus abdominis/internal abdominal oblique (TrA/IO) was found in crook lying, with right leg lifted (CLR), and of multifidus (MF) in four-point kneeling with straight right leg lifted horizontally (4p-SRL).The results suggested that CLR and sitting on a gym ball (SG) were able tofacilitate TrA/IO activity with minimal activity from the rectus abdominis (RA), while CL, 4p-SRL, andSG were able tofacilitate MF activity with minimal activity from erector spinae (ES).

To investigate the correlation between Short Form-36 (SF-36) and exercise capacity including: (1) metabolic equivalents measured by an exercise stress test (METs of EST), (2) peak oxygen consumption (VO2 peak), and (3) walking distances measured by a six-minute walk test (6MWT).SF-36, EST and 6MWT were estimated at the sixth week after coronary artery bypass graft (n=17) and percutaneous coronary intervention (n=13) patients. Pearson product-moment correlation was used to evaluate the relationship ofparameters.Physicalfunctioning scale ofSF-36showed moderate correlation with METs (r = 0.55, p0.01),fair correlation with VO2 peak of 6MWT (r = 0.46, p0.05) and walking distance (r = 0.43, p0.05). Bodily pain showed fair correlation with METs (r = 0.40, p0.05) and walking distance (r = 0.45, p0.05). Socialfunctioningshowedfair correlation with METs (r = 0.38, p0.05). Report-health transition showed fair correlation with METs (r = 0.38, p0.05) and walking distance (r = 0.41, p0.05).The physical domain ofSF-36 that comprised physicalfunction, role-physical, bodily pain and general health correlated with physical capacity ofthese post-operation groups (r = 0.49, p0.001). Therefore, clinicians can use the SF-36 and 6MWTto evaluate functional capacity in addition to ESTand indirect calorimetry conveniently.

To compare lipid and carbohydrate use during and after a high-intensity endurance exercise bout between lean and obese subjects.Lean and obese healthy male subjects with energetic physical activity and stable body weight were recruited to participate in the present study. The respiratory exchange ratio (RER), lipid and carbohydrate oxidation, and lipid and carbohydrate energy expenditure during resting condition, high-intensity exercise and 180 min after exercise were determined by indirect calorimetryTen lean and ten obese healthy male subjects, aged 26+/-4 years, completed a 300-kcal high-intensity exercise session. Resting energy expenditure and lipid energy expenditure in the obese group were significantly higher than those of the lean group. The RER, lipid oxidation, and carbohydrate oxidation were not significantly different between groups throughout the exercise period. The total energy expenditure and total lipid and carbohydrate energy expenditure were also not significantly different between lean and obese groups. During the 180-minute post exercise period, both lean and obese subjects showed a declination in RER and carbohydrate oxidation and an increase in lipid oxidation.Substrate use during and after high-intensity exercise between healthy lean and obese subjects was not significantly different. Both groups used carbohydrates and lipids as the main substrate sources during and after high-intensity exercise, respectively.

Neck pain is associated with certain breathingpatterns and may lead to altered respiratory function. Moreover the altered breathing patterns may cause neck pain symptoms. This study has determined the effects of respiratory muscle reeducation on neck pain symptoms and respiratory function.Subjects with chronic neck pain (n = 36) were re-educated with three breathing patterns for 30 min. The pain intensity at rest and at the end-of-range of each neck movement, the cervical range of motion (CROM) measured from photographic images and the chest expansion during full inhalation and exhalation recorded using videography were evaluated before and after breathing re-education. Upper trapezius, anterior scalene, and sternocleidomastoid activity were evaluated during normal and deep breathing using surface electromyography, and the respiratory function measured by a spirometer was also evaluated during the same period.The pain intensity and the muscle activity were significantly decreased after re-education. The CROM and chest expansion at lower rib cage were significantly increased after re-education.Breathing re-education can change breathing patterns and increase chest expansion. This change leads to an improvement in CROM Positive consequences may result from the improvement in diaphragm contraction or reduced activity of accessory muscles.

To develop an online, self-report questionnaire on computer work-related exposure (OSCWE) and to determine the internal consistency, face and content validity of the questionnaire.The online, self-report questionnaire was developed to determine the risk factors related to musculoskeletal disorders in computer users. It comprised five domains: personal, work-related, work environment, physical health and psychosocial factors. The questionnaire's content was validated by an occupational medical doctor and three physical therapy lecturers involved in ergonomic teaching. Twenty-five lay people examined the feasibility of computer-administered and the user-friendly language. The item correlation in each domain was analyzed by the internal consistency (Cronbach's alpha; alpha).The content of the questionnaire was considered congruent with the testing purposes. Eight hundred and thirty-five computer users at the PTT Exploration and Production Public Company Limited registered to the online self-report questionnaire. The internal consistency of the five domains was: personal (alpha = 0.58), work-related (alpha = 0.348), work environment (alpha = 0.72), physical health (alpha = 0.68) and psychosocial factor (alpha = 0.93).The findings suggested that the OSCWE had acceptable internal consistency for work environment and psychosocial factors. The OSCWE is available to use in population-based survey research among computer office workers.

Investigate the effect of lower extremity exercise on maximum lower extremity muscle strength and physical capacity in COPD patients.Twenty moderate to very severe COPD patients were allocated into trained and control groups. The trained group received eight weeks of lower extremity functional exercise including forward step up, lateral step up, heel raise, and lunge at home. Maximum muscle strength and Six Minute Walk Distance (6MWD) assessments were performed at pre-training, week 4, and week 8 in hospital settings.There was no significant difference between trained and control groups in maximum muscle strength and 6MWD at the beginning of the program. However, there was a significant improvement in 6MWD after eight weeks of training, whereas there were no significant differences in the control group.Functional exercise may improve physical capacity in moderate to very severe COPD patients. It is beneficial and easy to perform at home.