Causal Relationship Between the Risk Factors and Work-Related Musculoskeletal Disorders Among Professional Drivers: A Systematic Review.

OBJECTIVE: This review evaluates the evidence on the strength of causal relationship between categories of risk factors (RFs) and work-related musculoskeletal disorders (WRMSDs) among professional drivers. BACKGROUND: A compilation of evidence on the causal relationship between RFs and WRMSDs among professional drivers is lacking. METHODS: A systematic search of the literature was conducted in major electronic data bases that include Medline (1946 + via OvidSP), Embase (1974 + OvidSP), CINAHL (1982+), AMED, and Web of Science. The methodological quality of the studies was assessed and scored. A descriptive analysis on the categories of RFs associated with WRMSDs was conducted. The Bradford-Hill causation criteria and evidence interpretation tool were used to evaluate the causal relationship between RFs and WRMSDs in professional drivers. RESULTS: Among the 54 studies reviewed, a strong evidence suggests a causal relationship between RFs such as whole-body vibration, awkward postures, lifting tasks, manual material handling, job stress, job demand, and previous pain episodes with WRMSDs. Moderate evidence was observed on RFs such as uncomfortable seat and low job satisfaction. The evidence on causal relationship between RFs such as years of professional driving, driving duration, and individual characteristics such as age and body mass index was inconclusive. CONCLUSION: There is strong to moderate evidence on the causal relationship between the physical and psychosocial RFs and WRMSDs among professional drivers. APPLICATION: Potential application of this review highlights evidence to occupational health practitioners, policy makers, and stakeholders on the strength of causal relationship between RFs and WRMSDs among professional drivers.

An investigation of the prevalence of work-related musculoskeletal pain and related disability among poultry slaughterhouse workers: a cross-sectional study.

PURPOSE: The poultry slaughterhouse workers (PSW) are at substantial risk of developing work-related musculoskeletal pain (WMSP) at workplace due to their work. This study investigated the prevalence rate of WMSP and related disability among the PSW. METHODS: A cross-sectional descriptive study was conducted among 78 PSW (40 women and 38 men) in the region of northern Thailand. The prevalence rate of WMSP was evaluated using the Standardized Nordic Musculoskeletal Questionnaire (SNMQ). The disability related to the MSP was evaluated using a series of disability questionnaires. Descriptive statistics were used to evaluate the WMSP. Data on the disability were summarized in frequency, mean (M), standard deviation (SD) and percentage. RESULTS: The prevalence rate of WMSP in the past 7 days were higher in the shoulder region (61.5%, N = 48) followed by wrists/hands (60.3%, N = 47), and lower back region (35.9%, N = 28). The WMSP over the past 12 months was also high at the shoulder (61.5%, N = 48), wrists/hands (60.3%, N = 47), and neck region (37.1%, N = 29), respectively. The overall disability related to WMSP among PSW was found to be mild to moderate across different body regions. CONCLUSIONS: PSW had a high prevalence rate of WMSP in the shoulders, wrists/hands, lower back, and neck regions. However, the PSW with WMSP reported only mild to moderate disability in the work.

A Clinical Evaluation of Scapular Dyskinesis Among Professional Bus Drivers With Unilateral Upper Quadrant Musculoskeletal Pain.

BACKGROUND: Professional bus drivers report a high prevalence of upper quadrant musculoskeletal pain which could be associated with scapular dyskinesis (SD). However, the evidence for valid and reliable screening methods for this condition is limited as SD among bus drivers is an emerging area of research. Therefore, the main aim of the study was to investigate the reliability of dynamic scapular motion test (DSMT) using video analysis as an accurate method to evaluate SD and to identify patterns of SD among bus drivers. METHODS: In total, 32 bus drivers from a private bus company with unilateral upper quadrant musculoskeletal pain participated in the study. The DSMT was conducted and the SD was captured in the video during shoulder flexion-abduction movements. Two investigators analyzed the video recordings and identified the patterns of SD. The intra- and interrater reliability were determined using the percentage of agreement and weighted Kappa coefficients (Kw). Descriptive analysis was used to examine the patterns of SD. FINDINGS: The intra- and interrater reliability of DSMT using video analysis were excellent (Kw coefficient: 0.762-0.878 and 0.87-1.00, respectively). About 56.2% and 53.1% of bus drivers presented SD with the shoulder flexion and abduction movements during DSMT. Medial border prominence (Type II pattern of SD) was identified as the common pattern of SD. CONCLUSION/APPLICATION TO PRACTICE: The DSMT using video analysis showed excellent intra- and interrater reliability to evaluate SD. Occupational health practitioners can consider DSMT using video analysis to identify SD among people with upper quadrant musculoskeletal pain at the workplace.

Prevalence of musculoskeletal pain and associated disability among professional bus drivers: a cross-sectional study.

PURPOSE: Professional bus drivers risk developing musculoskeletal pain (MSP) and disability due to their working condition. The current study investigates the prevalence rate of MSP and disability among professional bus drivers. METHODS: A cross-sectional study was conducted among 83 professional bus drivers. The prevalence rate of MSP was evaluated using a standardized Nordic musculoskeletal questionnaire. The disabilities due to the MSP were evaluated using neck disability index (NDI), Oswestry disability index (ODI) and shoulder pain and disability index (SPADI) tools. Prevalence of MSP was presented with 95% of confidence interval (CI) at an alpha level of 0.05. The 12 months and 7 days prevalence of MSP were tabulated for analysing the trend of MSP between the upper and lower body regions. RESULTS: The drivers had a mean driving experience of 10.07 ± 7.26 years. The mean driving hours/week were 50.25 ± 12.82 h. Neck and back were the most affected regions with a prevalence rate of 81.9% (N = 68) and 80.7% (N = 67) at 12 months. Back region recorded the highest 7 days prevalence rate for MSP with 53% (N = 44). Approximately one fourth of the bus drivers population (23.9%, N = 16) had moderate disability in back region. More than half with MSP in the neck region presented mild disability (54.4%, N = 37). CONCLUSION: The bus drivers reported a high prevalence rate of MSP in the neck, back and shoulder regions with mild to moderate disabilities. Appropriate health care and rehabilitation programs are necessary for the prevention and management of MSP among the bus drivers.

Are patient expectations associated with treatment outcomes in individuals with chronic low back pain? A systematic review of randomised controlled trials.

AIM: The importance of patient expectations (PEs) on treatment outcomes is poorly understood in clinical practice. The aim of this review is to investigate the evidence behind association between pre-treatment PEs and treatment outcomes such as pain intensity (PI), level of function (LF) and health-related quality of life (HRQoL) among individuals with chronic low back pain (CLBP). METHODS: A systematic search was conducted for randomised controlled trials published between 1946 and May 2019 across major databases using the key MeSH terminologies. The association between PEs and PI, LF and HRQoL were extracted and categorised into positive, negative or no association for analysing the data. A descriptive synthesis was conducted and the association between PEs and PI, LF and HRQoL were reported. RESULTS: Among the total of seven trials, two trials demonstrated a positive association between PEs and PI in short (≤6 weeks) and long term (>6 months), while another two trials demonstrated no association at medium term (>6 weeks-≤6 months). About four trials demonstrated a positive significant association between PEs and LF, 2 at medium and 2 at long terms. The only available trial demonstrated no association between PEs and HRQoL at medium term. CONCLUSION: PEs is associated with PI at short and long terms. Also, evidence suggests association between PEs and LF at medium and long terms. Currently, there is no evidence of association between PEs and HRQoL. Further studies with valid tools to measure PE are warranted among individuals with CLBP.

Prevalence of musculoskeletal pain among professional drivers: A systematic review.

OBJECTIVES: Professional drivers are at high risk of developing musculoskeletal pain (MSP) due to risk factors such as prolonged sitting, whole body vibration, awkward posture, and repetitive actions. This review investigates the reported prevalence of MSP among professional drivers. METHODS: An electronic search of Medline (1946 + via OvidSP), Embase (1974 + OvidSP), CINAHL (1982+), AMED, PubMed, and Web of Science from 1990 to July 2019 was performed. Methodological quality of studies was assessed using three quality assessment tools for cross-sectional, case-control, and prospective cohort studies. The prevalence of MSP was reported using descriptive analysis. RESULTS: A total of 56 studies conducted in 23 different countries across a total of 14 types of occupational transport were reviewed. Data of a total pooled population of 18 882 professional drivers were analyzed for MSP. The prevalence of MSP ranged between 43.1% and 93%. The low back was the most frequently reported body region for MSP with a meta-prevalence rate of 53% (N = 9998). Neck, shoulder, and upper back were the other common regions with high prevalence. CONCLUSION: There is a high prevalence of MSP in professional drivers and low back was the most frequently reported body region, followed by neck, upper back, shoulder, knee, hip/thigh, wrist, ankle, and elbow. MSP is complicated in nature and therefore in-depth exploration of causal relationships between MSP and risk factors is necessary so that appropriate healthcare programs can be initiated to prevent and treat MSP effectively.

Outcome measures used in the smartphone applications for the management of low back pain: a systematic scoping review.

PURPOSE: Smartphone applications (SPApps) have become a key tool for the self-management of low back pain (LBP). However, the scientific evidence behind the outcome measures used in SPApps for LBP is never investigated before. Therefore, this systematic review firstly assess the quality of the free SPApps for LBP, secondly examines the outcome measures used and thirdly evaluates the outcome measures against the International Classification of Functioning, Disability and Health (ICF) core set classifications for LBP. METHODS: A systematic scoping review was conducted in the iTunes and Google Play™ on-line stores for LBP SPApps which are free to download. These searches were conducted using keywords suggested by the Cochrane Back and Neck Group. SPApps were screened and downloaded to assess the quality using the Mobile App Rating Scale (MARS). SPApps using outcome measures were reviewed separately to evaluate whether their outcome measures represented any of the ICF components for LBP. RESULTS: The overall quality of the apps has a mean MARS score of 2.5/5. Out of 74 apps reviewed, only four apps had outcome measures that could be linked to ICF components for LBP. Two of the four categories comprising the LBP core set were well represented. CONCLUSION: The overall quality of the SPApps for LBP is low. Only very few SPApps offer outcome measures to monitor their effectiveness in the management of LBP. There is very limited evidence to show that the outcome measures used in the apps represents all the four core sets of LBP criteria set by ICF.

Effects of Massage as a Combination Therapy with Lumbopelvic Stability Exercises as Compared to Standard Massage Therapy in Low Back Pain: a Randomized Cross-Over Study.

BACKGROUND: Little is known about the effects of providing massage as a combination therapy (CT) with lumbopelvic stability training (LPST) in management of chronic nonspecific low back pain (CLBP) among elite female weight lifters. It is unclear whether massage therapy (MT) together with LPST has any additional clinical benefits for individuals with CLBP. PURPOSE: The current study compares the therapeutic effects of CT against MT as a stand-alone intervention on pain intensity (PI), pain pressure threshold (PPT), tissue blood flow (TBF), and lumbopelvic stability (LPS) among elite weight lifters with CLBP. SETTING: The study was conducted at the campus for National Olympic weight lifting training camp. PARTICIPANTS: A total of 16 professional female elite weight lifting athletes who were training for Olympic weight lifting competition participated in the study. RESEARCH DESIGN: A within-subject, repeated measures, crossover, single-blinded, randomized allocation study. INTERVENTION: The athletes were randomized into three sessions of CT and MT with a time interval of 24 hrs within sessions and a wash out period of four weeks between the sessions. MAIN OUTCOME MEASURES: The PI, PPT, TBF, and LPS were measured before and after each session repeatedly in both groups of intervention. The changes in the PI, PPT, TBF, and LPS were analyzed using repeated measures analysis of variance (ANOVA). RESULTS: The results showed that the CT significantly demonstrated greater effects in reducing pain perception (45%-51%), improving pain pressure threshold (15% up to 25%), and increasing tissue blood flow (131%-152%) than MT (p < .001). CONCLUSION: The combination therapy of massage therapy and LPST is likely to provide more clinical benefits in terms of PI, PPT, and TBF when compared to massage as a stand-alone therapy among individuals with chronic nonspecific low back pain.

Immediate Effects of Core Stabilization Exercise on ß-Endorphin and Cortisol Levels Among Patients With Chronic Nonspecific Low Back Pain: A Randomized Crossover Design.

OBJECTIVE: The main objective of the study was to measure the levels of plasma ß-endorphin (PB) and plasma cortisol (PC) under lumbar core stabilization exercise (LCSE), placebo and control conditions in patients with chronic nonspecific low back pain. METHODS: Twenty-four participants with chronic nonspecific low back pain participated in a randomized, placebo-controlled, crossover design study. There were 3 experimental exercise conditions: control condition (positioning in crook lying and rest), placebo condition (passive cycling in crook lying using automatic cycler), and LCSE on a Pilates device tested with a 48-hour interval between sessions by concealed randomization. A blood sample was collected before and after the exercise conditions. Plasma ß-endorphin and PC were measured through enzyme-linked immunosorbent assay and electrochemiluminescence in a Cobas E411 auto analyzer. RESULTS: A significant difference in PB level was identified before and after the LCSE condition (P < .05), whereas no significant differences were noted in control and placebo exercise conditions. Also, the trend of elevation of PB under the LCSE was significantly different compared with the placebo and control conditions (P < .01). In contrast, the PC level remained unchanged in all 3 conditions. CONCLUSION: The findings of this study indicate that LCSE could possibly influence PB but not PC level among patients with chronic nonspecific low back pain. The mechanism of action of the pain-relieving effect of LCSE might be related to an endogenous opioid mechanism as part of its effects and might not be involved with a stress-induced analgesia mechanism.

Lumbopelvic Core Stabilization Exercise and Pain Modulation Among Individuals with Chronic Nonspecific Low Back Pain.

BACKGROUND: Lumbopelvic stabilization training (LPST) may provide therapeutic benefits on pain modulation in chronic nonspecific low back pain conditions. This study aimed to examine the effects of LPST on pain threshold and pain intensity in comparison with the passive automated cycling intervention and control intervention among patients with chronic nonspecific low back pain. METHODS: A within-subject, repeated-measures, crossover randomized controlled design was conducted among 25 participants (7 males and 18 females) with chronic nonspecific low back pain. All the participants received 3 different types of experimental interventions, which included LPST, the passive automated cycling intervention, and the control intervention randomly, with 48 hours between the sessions. The pressure pain threshold (PPT), hot-cold pain threshold, and pain intensity were estimated before and after the interventions. RESULTS: Repeated-measures analysis of variance showed that LPST provided therapeutic effects as it improved the PPT beyond the placebo and control interventions (P < 0.01). The pain intensity under the LPST condition was significantly better than that under the passive automated cycling intervention and controlled intervention (P < 0.001). Heat pain threshold under the LPST condition also showed a significant trend of improvement beyond the control (P < 0.05), but no significant effects on cold pain threshold were evident. CONCLUSIONS: Lumbopelvic stabilization training may provide therapeutic effects by inducing pain modulation through an improvement in the pain threshold and reduction in pain intensity. LPST may be considered as part of the management programs for treatment of chronic low back pain.

Improvements in tissue blood flow and lumbopelvic stability after lumbopelvic core stabilization training in patients with chronic non-specific low back pain.

[Purpose] This study investigated the effects of lumbopelvic stabilization training on tissue blood flow changes in the lumbopelvic region and lumbopelvic stability compared to placebo treatment and controlled intervention among patients with chronic non-specific low back pain. [Subjects and Methods] A total of 25 participants (7 males, 18 females; mean age, 33.3 ± 14.4 years) participated in this within-subject, repeated-measures, double-blind, placebo-controlled comparison trial. The participants randomly underwent three types of interventions that included lumbopelvic stabilization training, placebo treatment, and controlled intervention with 48 hours between sessions. Lumbopelvic stability and tissue blood flow were measured using a pressure biofeedback device and a laser Doppler flow meter before and after the interventions. [Results] The repeated-measures analysis of variance results demonstrated a significant increase in tissue blood flow over the lumbopelvic region tissues for post- versus pre-lumbopelvic stabilization training and compared to placebo and control interventions. A significant increase in lumbopelvic stability before and after lumbopelvic stabilization training was noted, as well as upon comparison to placebo and control interventions. [Conclusion] The current study supports an increase in tissue blood flow in the lumbopelvic region and improved lumbopelvic stability after core training among patients with chronic non-specific low back pain.

Prophylactic Effects of Sauna on Delayed-Onset Muscle Soreness of the Wrist Extensors.

BACKGROUND: High-intensity of exercise or unaccustomed eccentric exercise can cause the phenomenon of Exercise-Induced Muscle Damage (EIMD) which usually results in cramps, muscle strain, impaired muscle function and delayed-onset muscle soreness. OBJECTIVES: This study investigated the prophylactic effects of sauna towards the symptoms associated with muscle damage from eccentric exercises of wrist extensor muscle group. PATIENTS AND METHODS: A total of twenty-eight subjects (mean age 20.9 years old, SD = 1.6) were randomly divided into the sauna group (n = 14) and the control group (n = 14). In the sauna group, subjects received sauna before eccentric exercise of the wrist extensor. The eccentric exercises were conducted on the non-dominant arm by using an isokinetic dynamometer. Pain Intensity (PI), Pressure Pain Threshold (PPT) and passive range of motion of wrist flexion (PF-ROM) and extension (PE-ROM) were measured as pain variables. Grip Strength (GS) and Wrist Extension Strength (WES) were measured as variables of wrist extensor muscle function. All the measurements were performed at baseline, immediately after and from 1st to 8th days after the exercise-induced muscle damage. RESULTS: The sauna group significantly demonstrated a lower deficit in ROM (passive flexion and passive extension), GS and WES following exercise than that of the control group (P < 0.05). CONCLUSIONS: Sauna application prior to the exercise-induced muscle damage demonstrated effectiveness in reduction of sensory impairment (PF-ROM and PE-ROM) and improvement of muscle functions (GS, and WES) in wrist extensor muscle group.

Effect of Therapeutic Sequence of Hot Pack and Ultrasound on Physiological Response Over Trigger Point of Upper Trapezius.

BACKGROUND: Musculoskeletal pain is a common problem among athletes. Apart from sport injuries, the myofascial pain syndrome is another important problem that affects performance of the athlete. OBJECTIVES: The aim of this study was to evaluate the effects of therapeutic sequences of the hot pack in combination with ultrasound on the physiological responses over the latent myofascial trigger point (LMTrP) of upper trapezius muscle. MATERIALS AND METHODS: Thirty subjects with a latent myofascial trigger point (LMTrP) in both sides of the upper trapezius muscle participated in the study (age 27.33 ± 4.34 years, weight 58.11 ± 7.47 kg, height 161.50 ± 5.82 cm, pressure pain threshold 2.28 ± 0.24 kg/cm(2), pain intensity 7.17 ± 2.25 VAS). All subjects received both treatments (hot pack followed by ultrasound: HP + US; and ultrasound followed by hot pack: US + HP) by randomization with a 24 to 48-hour interval between sessions. Outcome measures, including the tissue blood flow (TBF), pressure pain threshold (PPT), supra-thermal threshold (STT) and visual analog scale (VAS) were evaluated at baseline, immediately, after 30 minutes and after 60 minutes. RESULTS: The TBF and PPT significantly increased from baseline in both treatment conditions (i.e. HP + US and US + HP), while the HP + US condition showed a trend toward significant difference in VAS and STT in 45°C. CONCLUSIONS: The application of HP and US treatment induces physiological responses (especially, TBF and PPT) on the LMTrP. This finding provides the direction toward the management of MTrPs condition.

Clinical evaluation of the anterior translation of glenohumeral joint using ultrasonography: an intra- and inter-rater reliability study.

OBJECTIVE: The aim of this study was to investigate the intra- and inter-rater reliability of ultrasonography (US) to measure anterior translation of the humeral head (ATHH) among healthy subjects and patients with sacroiliac joint dysfunction. METHODS: The study included a total of 22 shoulder joints from 11 subjects. Six subjects were healthy and 5 had sacroiliac joint dysfunction. Anterior translation of the humeral head was measured twice using US by two different investigators. Intraclass correlation coefficient (ICC3,1), standard error of measurements (SEMs), coefficient of variations (CVs) and Bland-Altman plot were used as analytical tests to investigate intra- and inter-rater reliability, amount of error and agreeability of the measurements between investigators. RESULTS: Intraclass correlation coefficient was 0.94, showing a high level of intra-rater reliability of the first investigator with SEMs (0.01 cm) and CV (5.1%) in measuring ATHH. Intra-rater reliability of the second investigator was 0.84 with SEMs (0.03 cms) and CV (9.6%), indicating a high level of reliability. Inter-rater reliability was high, with an ICC value of 0.92 with SEMs (0.02 cms) and CV (5.9%). CONCLUSION: The use of US as a measurement of ATHH has good levels of intra- and inter-rater reliability in clinical practice.

Intrarater reliability of pain intensity, tissue blood flow, thermal pain threshold, pressure pain threshold and lumbo-pelvic stability tests in subjects with low back pain.

PURPOSE: This preliminary study aimed to determine the intrarater reliability of the quantitative tests for the study of non-specific low back pain. METHODS: Test-retest reliability of the measurements of ratio data was determined by an intraclass correlation coefficient (ICC), standard error of measurements (SEMs), coefficient of variation (CV), and one-way repeated measures ANOVA using the values collected from 13 young individuals (25.8 ± 6.2 years) with chronic non-specific low back pain on two occasions separated by 2 days. Percent agreement of the ordinal data was also determined by Cohen's Kappa statistics (kappa). The measures consisted of tissue blood flow (BF), average pain visual analog scales (VAS), pressure pain threshold (PPT), cold pain threshold (CPT), heat pain threshold (HPT) and lumbo-pelvic stability test (LPST). An acceptable reliability was determined as the ICC values of greater than 0.85, SEMs less than 5%, CV less than 15%, the kappa scores of greater than 80% and no evidence of systematic error (ANOVA, P>0.05). RESULTS: ICC of all measures in the lumbo-sacral area were greater than 0.87. The kappa was also greater than 83%. Most measures demonstrated a minimal error of measurements and less potential of systemic error in nature. Only the SEMs and the CV of the CPT exceeded the acceptable level. CONCLUSIONS: It is concluded that most of the quantitative measurements are reliable for the study of non-specific low back pain, however the CPT should be applied with care as it has a great variation among individuals and potential of measurement error.

Multifidus muscle size and symmetry among elite weightlifters.

OBJECTIVES: To examine muscle cross-sectional areas (CSA) and symmetry of lumbar multifidus (LM) muscles in elite weightlifters. DESIGN: Cross-sectional observational study SETTING: Neuromuscular and Pain Research Unit. PARTICIPANTS: Thirty-one elite weightlifters (15 males) participated in the study, representing the population of Thai weightlifters eligible for national selection. MAIN OUTCOME MEASURES: Resting CSA of the LM muscle were assessed bilaterally at 4 lumbar vertebral levels using ultrasound imaging. The between side differences (relative to the side of the preferred hand) were used to determine the asymmetry. RESULTS: The between side differences (relative to the preferred hand) of the LM muscle CSA were less than 3% for all vertebral levels and suggested symmetry between sides (p > .05). No difference was found between weightlifters with unilateral or bilateral pain symptoms. CONCLUSION: This study provides new information on resting CSA for the LM muscle in elite weightlifters. Future studies could investigate other aspects of neuromotor control of the LM muscle to determine if there are impairments which could be addressed in an attempt to decrease the high prevalence of LBP in this population.

Comparison of lateral abdominal muscle thickness between weightlifters and matched controls.

OBJECTIVE: To compare lateral abdominal muscle thickness between weightlifters and matched controls. DESIGN: A case control study design. SETTING: University laboratory. SUBJECTS: 16 female Thai national weightlifters and 16 matched controls participated in this study. MAIN OUTCOME MEASURES: Ultrasound imaging with a 12-MHz linear array was used to measure the resting thickness of transversus abdominis (TrA), internal oblique (IO) and total thickness (Total) of lateral abdominal muscle (LAM) on the right side of abdominal wall. The absolute muscle thickness and the relative contribution of each muscle to the total thickness were determined. RESULTS: Weightlifters had significantly thicker absolute TrA and IO muscles than matched controls (p < 0.01). Further, the relative thickness of the IO was significantly greater in weightlifters than matched controls (p < 0.05). CONCLUSIONS: The findings of this study suggest that routine Olympic style weight training among female weightlifters appears to result in preferential hypertrophy or adaptation of the IO muscle.

A prophylactic effect of proprioceptive neuromuscular facilitation (PNF) stretching on symptoms of muscle damage induced by eccentric exercise of the wrist extensors.

Stretching with proprioceptive neuromuscular facilitation (PNF) is frequently used before exercise. The prophylactic effect of PNF on symptoms of muscle damage induced by eccentric exercise of the wrist extensors was examined in this study. Twenty-eight healthy males were randomly divided into the PNF group (n = 14) and the control group (n = 14). PNF was used before eccentric exercise induction in the wrist extensors. All subjects were tested to examine muscle damage characteristics including sensory-motor functions at baseline, immediately, and from 1st to 8th days after the exercise-induced muscle damage (EIMD). The results demonstrated that the PNF group showed a lesser deficit in some sensory-motor functions (p < 0.05) than the control group. The prior PNF stretching application could be useful for attenuating the signs and symptoms of muscle damage after eccentric exercise.