| 1. |
- Aagaard, Knut E., et al.
(författare)
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Factors associated with healing failure after early repair of acute, trauma-related rotator cuff tears
- 2023
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Ingår i: Journal of Shoulder and Elbow Surgery. - : MOSBY-ELSEVIER. - 1058-2746 .- 1532-6500. ; 32:10, s. 2074-2081
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Tidskriftsartikel (refereegranskat)abstract
- Background: Healing failure after rotator cuff repair is a challenging problem. Acute, trauma-related tears are considered a separate entity and are often treated surgically. The aim of this study was to identify factors associated with healing failure in previously asymptomatic patients with trauma-related rotator cuff tears treated with early arthroscopic repair. Methods: This study included 62 consecutively recruited patients (23% women; median age, 61 years; age range, 42-75 years) with acute symptoms in a previously asymptomatic shoulder and a magnetic resonance imaging–verified full-thickness rotator cuff tear after shoulder trauma. All patients were offered, and underwent, early arthroscopic repair, during which a biopsy specimen was harvested from the supraspinatus tendon and analyzed for signs of degeneration. Of the patients, 57 (92%) completed 1-year follow-up and underwent assessment of repair integrity on magnetic resonance images according to the Sugaya classification. Risk factors for healing failure were investigated using a causal-relation diagram where age, body mass index, tendon degeneration (Bonar score), diabetes mellitus, fatty infiltration (FI), sex, smoking, tear location regarding integrity of the rotator cable, and tear size (number of ruptured tendons and tendon retraction) were included and analyzed. Results: Healing failure at 1 year was identified in 37% of patients (n = 21). A high degree of FI of the supraspinatus muscle (P = .01), a tear location including disruption of rotator cable integrity (P = .01), and old age (P = .03) were associated with healing failure. Tendon degeneration as determined by histopathology was not associated with healing failure at 1-year follow-up (P = .63). Conclusion: Older age, increased FI of the supraspinatus muscle, and a tear including disruption of the rotator cable increased the risk of healing failure after early arthroscopic repair in patients with trauma-related full-thickness rotator cuff tears.
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| 2. |
- Adolfsson, Lars, 1955-, et al.
(författare)
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The Adolfsson-Björnsson Activity Scale (ABAS) Improves Description of Patient Characteristics
- 2022
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Ingår i: Archives of Clinical and Biomedical Research. - : Fortune Journals. - 2572-5017. ; 06:02, s. 408-417
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: Age and gender have been regarded important for surgical decision making and used as inclusion criteria for clinical trials. Individual demands and level of activity have been less considered. A self-administered scale, defining subjectively assessed level of activity involving the upper extremities was therefore developed. The primary purpose of this study was to present the scale. Secondarily to investigate its reliability and correlation with age and gender.Patients and Methods: A scale with 8 categories ranging from extremely demanding to non-demanding activities, separated according to hand dominance, was constructed. Reliability testing was performed on 103 healthy individuals of both genders with a wide age range (20-86). 241 patients, median age 58 years (range 18-97), with different upper extremity injuries completed the scale. Participants were instructed to mark activities representative for their normal activity level. Correlation with age and gender was then investigated using Spearman Correlation Coefficient (SCC).Results: The level of activity ranged from 1, corresponding tominimal use of the arm, to 8 defined as elite sports. For test-retest Intraclass Correlation Coefficient (ICC) was 0.89 for the dominant and 0.90 for the non-dominant arm. Correlations between gender, age and level of activity were weak.Interpretation: The scale was found reliable and feasible to use. Age and gender were weakly correlated with level of activity and patients with low and high activities found in all ages and both genders. The activity scale allows improved description of patients included in clinical trials and can aid in treatment decision making but is primarily not intended for measurement of treatment outcome.
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| 3. |
- Adolfsson, Lars, et al.
(författare)
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Union of Scaphoid Waist Fractures in Adults Despite No or Minimal Immobilization : a Report of Five Cases
- 2020
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Ingår i: SN Comprehensive Clinical Medicine. - : Springer. - 2523-8973. ; 2:4, s. 491-495
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Tidskriftsartikel (refereegranskat)abstract
- Traditionally scaphoid waist fractures have been treated with a long period, 10–12 weeks, of immobilization in a plaster cast until radiological union. The long period of immobilization sometimes infers great discomfort for the patients. To avoid this, surgical treatment with screw fixation has for the last decade been advocated as an option also for undisplaced fractures. In this report, we present five cases with undisplaced scaphoid waist fractures that have healed both radiologically and clinically without any immobilization at all or after a very short period of protection in a cast. These observations challenge the current treatment guidelines.
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| 4. |
- Ahnström, Johan, et al.
(författare)
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Farmers and nature conservation: What is known about attitudes, context factors and actions affecting conservation?
- 2009
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Ingår i: Renewable Agriculture and Food Systems. - 1742-1705 .- 1742-1713. ; 24, s. 38-47
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Tidskriftsartikel (refereegranskat)abstract
- Farmers' attitudes towards viability of specific conservation practices or actions strongly impact their decisions on adoption and change. This review of 'attitude' information reveals a wide range of perceptions about what conservation means and what the impacts of adoption will mean in economic and environmental terms. Farmers operate in a tight financial situation, and in parts of the world they are highly dependent on government subsidies, and cannot afford to risk losing that support. Use of conservation practices is most effective when these are understood in the context of the individual farm, and decisions are rooted in land and resource stewardship and long-term concerns about health of the farm and the soil. The attitudes of farmers entering agri-environmental schemes decide the quality of the result. A model is developed to show how attitudes of the farmer, the farming context and agri-environmental schemes interact and thus influence how the farming community affects nature and biodiversity. As new agri-environmental schemes are planned, agricultural development specialists need to recognize the complexity of farmer attitudes, the importance of location and individual farmer circumstances, and the multiple factors that influence decisions. We provide these insights and the model to conservation biologists conducting research in farming areas, decision makers who develop future agri-environmental schemes, educators training tomorrow's extension officers and nature conservationists, and researchers dealing with nature conservation issues through a combination of scientific disciplines.
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| 5. |
- Arnell, Malin
(författare)
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Avhandling / Av_handling (Dissertation / Through_action)
- 2016
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Konstnärligt arbete (övrigt vetenskapligt/konstnärligt)abstract
- If we are being-of-the-world, how can we ever avoid participation? From this question Avhandling / Av_handling (Dissertation / Through_ action) unfolds. It invites to engage in an ongoing continuum of entanglements, where the moment of connection is unavoidable. This invitation demands that we are attentive to our mutual co-constitutiveness, that we take responsibility for what gets excluded as well as what comes to matter.Avhandling / Av_handling (Dissertation / Through_action) introduces, purposes and explores a specific format, the live dissertation, an academic instance that demands performative responses during the public defense. It is a dissertation in choreography written through space-time-language-matter with and for human and more-than-human bodies, and other discursive-material becomings. By this Avhandling / Av_handling (Dissertation / Through_action) recognizes the force of what Karen Barad conceptualized as ethico-onto-epistemologocial engtanglements through intra-action. It engages a posthumanist and agential-realist reworking of the notion of performativity, in which all bodies (not only human bodies) come to matter through the world’s performativity—its iterative intra-activity. In this framework, knowledge is made as a direct material engagement, a cutting together-apart—a process by which cuts enact violence but also open up and rework agential conditions of possibility.During Avhandling / Av_handling (Dissertation / Through_ action) diffractive choreographic methods and techniques, which had been developed through diverse intra-active studies—actions, collaborations, and works that span throughout 2010-2016, were re-activated, applied, manifested, and experienced. These practices were made present through specific agential forces that enacted them—such as breath, text, touch, voice, vegetation, spatial proximity, motion, distance, asphalt, material walls and material voids (the reactor hole), pain, and disgust. These practices also enacted processes of queering causality, agency and relationality, and dislocating authority, while (my / the / our) human and more-than-human body / bodies pursued embodied affinities, and a state of becoming-with. Through these re-activated intra-active studies Avhandling / Av_handling (Dissertation / Through_action) examines and articulates choreography and performance as ever-present negotiations of vulnerability, intimacy, force, and power as enactments that are of-the-world.As part of the choreographic practice Sugar Rush Productions | Maria Åkesson together with Tsomak Oga, Sooz Romero, and Debora Vega were video documenting Avhandling / Av_handling (Dissertation / Through_action). This documentation together with other remains (as a non-representative residue) will be made available after the defense here: dissertationthroughaction.space
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| 6. |
- Bergeå, Hanna, et al.
(författare)
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Dialogprocessen om allemansrätten : underlag för utveckling av dialogmetodik och dialogkompetens
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Under 2012 och 2013 har avdelningen för Miljökommunikation vid SLU fungerat som rådgivare till Naturvårdsverket i planeringen och genomförandet av en dialogprocess om allemansrätten och dess tillämpning. Denna rapport har tillkommit som ett avslutande led i detta uppdrag. Syftet med rapporten är att stödja utveckling av dialogmetodik och dialogkompetens inom naturresurshanteringen genom att redogöra för och kritiskt diskutera de erfarenheter som vi gjort av att arbeta med en omtvistad och komplex samhällsfråga genom dialog. I rapporten redogör vi för de tankar och teorier som har väglett planeringen av dialogprocessen och diskuterar vad vi, så här i efterhand, anser att vi kunde ha gjort annorlunda. Syftet med rapporten är alltså inte att diskutera dialogprocessens innehåll och/eller hur olika aktörer och intressen ser på frågor som rör allemansrätten. Rapporten ska ses som ett underlag för hur den som ansvarar för en dialogprocess bör planera, genomföra och förhålla sig till deltagarna och det som sker. Rapporten består av följande fem delar: 1. Viktiga förutsättningar och ramar för upplägg och planering av dialogprocessen 2. Händelseutvecklingen i de fem möten som processen bestod av 3. Deltagarnas åsikter om processen, vad de tycker att de lärt sig 4. Deltagarnas rapportering av lärdomar från dialogprocessen till sina hemorganisationer 5. Diskussioner och rekommendationer
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| 7. |
- Björnsson Hallgren, Hanna, 1976-, et al.
(författare)
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A specific exercise strategy for patients with subacromial pain significantly reduced the need for surgery : one-year results of a randomised controlled study
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: A specific exercise strategy focusing on eccentric exercises, for treating sbacromial pain has in a previous study been found effective at three-month followup.The aim of the present study was to investigate if the positive short-term results were maintained after one year. A further aim was to examine if baseline clinical score, rotator cuff status and radiological findings influenced the choice of surgery.Methods: 97 patients on the waiting-list for arthroscopic subacromial decompression were in the first study randomized to a three-month specific exercise strategy or unspecific exercises (controls). Patients were examined with radiology, ultrasound and assessed with clinical scores: primary Constant-Murley score. After three months of exercises the patients were asked if they still wanted surgery and this option was available until the one-year follow-up. All patients were re-assessed with clinical scores one year after inclusion or one year after surgical intervention and the number of patients that had chosen surgery in each group was compared. The baseline Constant-Murley score and the status of subacromial structures were analyzed in relation to patient's choice of surgery.Results: The positive short-term effect (improved shoulder function and pain) of the specific exercises was maintained after one-year. Compared to the three-month followup all patients had improved significantly (p < 0.0001) in Constant-Murley score. The number of patients that had chosen surgery in the control exercise group (63%) was significantly larger (p < 0.0001) than in the specific exercise group (24%). Patients that had chosen surgery had a significantly lower baseline Constant-Murley score and significantly more often a full-thickness tear. Patients with partial-thickness tears did not differ from those with intact cuff tendons.Conclusions: The positive short-term outcomes after specific exercises were maintained after one year and reduced the need of surgery significantly more than the unspecific control exercises. Patients with low baseline clinical score and/or a full-thickness tear significantly more often chose surgery.Level of evidence: I, Randomized controlled trail according to Consort statement.
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| 8. |
- Björnsson Hallgren, Hanna, et al.
(författare)
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A specific exercise strategy reduced the need for surgery in subacromial pain patients
- 2014
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 48:19, s. 1431-1436
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose A programme based on eccentric exercises for treating subacromial pain was in a previous study found effective at 3-month follow-up. The purposes of the present study were to investigate whether the results were maintained after 1 year and whether the baseline Constant-Murley score, rotator cuff status and radiological findings influenced the outcome. Patients and methods 97 patients on the waiting list for arthroscopic subacromial decompression had been randomised to a specific exercise programme or unspecific exercises (controls). After 3 months of exercises, the patients were asked whether they still wanted surgery and this option was available until a 1-year follow-up. 1 year after inclusion or 1 year after surgery, the number of patients who decided to have surgery in each group was compared. The choice of surgery was related to the baseline Constant-Murley score, ultrasound and radiographs taken at inclusion. Results All patients had improved significantly (pless than0.0001) in the Constant-Murley score at the 1-year follow-up. Significantly more patients in the control group decided to have surgery (63%) than those in the specific exercise group (24%; pless than0.0001). Patients who decided to have surgery had a significantly lower baseline Constant-Murley score and more often a full-thickness tear. Patients with partial tears did not differ from those with intact tendons. Interpretation The positive short-term results of specific exercises were maintained after 1 year, and this exercise strategy reduces the need for surgery. Full-thickness tear and a low baseline Constant-Murley score appear to be a predictive marker for a less good outcome.
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| 9. |
- Björnsson Hallgren, Hanna Cecilia, 1976-, et al.
(författare)
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Elevated plasma levels of TIMP-1 in patients with rotator cuff tear
- 2012
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 83:5, s. 523-528
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose:Extracellular matrix remodelling is altered in rotator cuff tears,16partly due to altered expression of matrix metalloproteinases (MMPs) and their inhibitors. It is unclear if this altered expression can be traced as changes in plasma protein levels.The purposes were to measure the plasma level of MMPs and their tissue inhibitors (TIMPs) inpatients with rotator cuff tears and to relate changes in the pattern of MMP and TIMP levels with the extent of the rotator cuff tear.Methods: Blood samples were collected from 17 patients, median 61 (range 39-77) years, with sonographically verified rotator cuff tears (partial- or full-thickness). These were compared with 16 gender and age matched control persons with sonographically intact rotator cuffs. Plasma levels of MMPs and TIMPs were measured simultaneously using Luminex technology and ELISA.Results: The plasma level of TIMP-1 was elevated in patients with rotator cuff tears, especially in those with full-thickness tears. The levels of TIMP-1, TIMP-3 and MMP-9 were higher in patients with full-thickness tears compared to those with partial-thickness tears, but only TIMP-1 was different from controls.Interpretation: The observed elevation of TIMP-1 in plasma might reflect local pathological processes in or around the rotator cuff, or a genetic predisposition in these patients. That levels of TIMP-1 and certain MMP´s was found to differ between partial and full thickness tears may reflect the extent of the lesion or different aetiology and pathomechanisms.
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| 10. |
- Björnsson Hallgren, Hanna C, et al.
(författare)
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Specific exercises for subacromial pain : Good results maintained for 5 years
- 2017
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Ingår i: Acta Orthopaedica. - : Taylor & Francis. - 1745-3674 .- 1745-3682. ; 88:6, s. 600-605
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose — We have previously shown that specific exercises reduced the need for surgery in subacromial painpatients at 1-year follow-up. We have now investigated whetherthis result was maintained after 5 years and compared the outcomesof surgery and non-surgical treatment.Patients and methods — 97 patients were included in the previouslyreported randomized study of patients on a waiting list forsurgery. These patients were randomized to specifi c or unspecifi cexercises. After 3 months of exercises the patients were asked ifthey still wanted surgery and this was also assessed at the present5-year follow-up. The 1-year assessment included Constant–Murley score, DASH, VAS at night, rest and activity, EQ-5D, andEQ-VAS. All these outcome assessments were repeated after 5years in 91 of the patients.Results — At the 5-year follow-up more patients in the specifi cexercise group had declined surgery, 33 of 47 as compared with16 of 44 (p = 0.001) in the unspecifi c exercise group. The meanConstant–Murley score continued to improve between the 1- and5-year follow-ups in both surgically and non-surgically treatedgroups. On a group level there was no clinically relevant changebetween 1 and 5 years in any of the other outcome measuresregardless of treatment.Interpretation — This 5-year follow-up of a previously publishedrandomized controlled trial found that specifi c exercisesreduced the need for surgery in patients with subacromial pain.Patients not responding to specifi c exercises may achieve similargood results with surgery. These fi ndings emphasize that a specifi cexercise program may serve as a selection tool for surgery.
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