| 1. |
- Björklund, Martin, et al.
(författare)
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Sensory adaptation after a 2-week stretching regimen of the rectus femoris muscle
- 2001
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier BV. - 0003-9993 .- 1532-821X. ; 82:9, s. 1245-1250
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the effects of a muscle stretching regimen for the rectus femoris muscle on subjective stretch sensation and range of motion (ROM). DESIGN: A 2 x 2 crossover design comprising 2 treatments and 2 intervention periods. SETTING: A military base in Sweden. PARTICIPANTS: A volunteer sample of 29 male military conscripts divided into 2 groups, with each group subjected to both experimental and control treatments at different time periods. INTERVENTION: Two weeks of supervised stretching (4 times/wk) of the rectus femoris muscle (experimental treatment) and the calf muscles (control treatment). MAIN OUTCOME MEASURES: Subjective rating of the stretch sensation for the anterior aspect of the thigh determined on a category ratio scale. Passive knee flexion ROM determined on each test with the same applied torque, specific for each subject. RESULTS: An additive analysis of variance revealed that the stretch sensation after the experimental treatment was decreased, compared with the control treatment (p <.01). The knee flexion, however, remained the same regardless of the treatment. CONCLUSION: Sensory adaptation seems to be an important mechanistic factor in the effect stretching has on ROM changes. The lack of change in knee flexion suggests that the stretching, as performed in this study, did not influence stiffness of the rectus femoris muscle. Sensory adaptation may also be an underlying mechanism in the alleviating effect of stretching when applied to tired, tender, and painful muscles.
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| 2. |
- Björklund, Martin, et al.
(författare)
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The assessment of symptoms and functional limitations in low back pain patients : validity and reliability of a new questionnaire
- 2007
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Ingår i: European spine journal. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 16:11, s. 1799-1811
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Tidskriftsartikel (refereegranskat)abstract
- Many of the existing low back pain (LBP) questionnaires of function and symptoms have a content of different domains of disability presented as a single sum score, making it difficult to derive changes within a specific domain. The present study describes the development of a clinically derived back-specific questionnaire incorporating both a functional limitation and a symptom scale, with a further subdivision of the symptom scale in separate indices for severity and temporal aspects. The aims of the study were to assess the overall reliability and validity of the new questionnaire, named the Profile Fitness Mapping questionnaire (PFM). A total of 193 chronic LBP patients answered the PFM together with five validated criterion questionnaires. For the internal consistency of the questionnaires, the three indices of the PFM had the highest Cronbach's alpha (0.90-0.95) and all items had item-total correlations above 0.2. The correlation coefficients between the PFM and the back-specific criterion questionnaires ranged between 0.61 and 0.83, indicating good concurrent criterion validity. The best discriminative ability between patients with different pain severities was demonstrated by the functional limitation scale of the PFM. Well centered score distribution with no patient's score at the floor or the ceiling level indicates that the PFM has the potential to detect the improvement or worsening of symptoms and functional limitations in chronic LBP patients. Classification according to the International Classification of Functioning, Disability and health (ICF) of WHO revealed a high degree of homogeneous item content of the symptom scale to the domain of impairments, and of the functional limitation scale to the domain of activity limitations. The present study suggests that the PFM has a high internal consistency and is a valid indicator of symptoms and functional limitations of LBP patients. It offers the combination of a composite total score and the possibility of evaluations within specific domains of disability. Complementary evaluation of test-retest reliability and responsiveness to change is warranted.
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| 3. |
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| 4. |
- Björklund, Martin, et al.
(författare)
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The profile fitness mapping scales, validity of a new back-specific questionnaire
- 2009
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Konferensbidrag (refereegranskat)abstract
- Background: Disability questionnaires for LBP-patients mostlyemanate from health professionals and have a content of differentdomains of disability presented as a single sum score, makingit difficult to derive changes within a specific domain. Thisstudy introduces a new back-specific questionnaire, the ProfileFitness Mapping questionnaire (PFM), which was based on patient’sself-reported characteristics of the LBP. The PFM incorporatesboth a functional limitation and a symptom scale, with furthersubdivision of the symptom scale in separate indices for severityand temporal aspects. The aim of the study was to assess theoverall validity of the PFM.Methods and Results: Chronic LBP-patients (n=193) answered thePFM and four validated back-specific criterion questionnaires.The correlation coefficients between the PFM and the criterionquestionnaires showed good concurrent criterion validity (0.61– 0.83). The best discriminative ability between patientswith different pain severity was demonstrated by the functionallimitation scale of the PFM. Classification according to theICF revealed a high degree of homogeneous item content of thesymptom scale to the domain of impairments, and of the functionallimitation scale to the domain of activity limitations. Wellcentered score distribution indicates that the PFM has the potentialto detect improvement or worsening of symptoms and functionallimitations in chronic LBP-patients.Conclusion: The results of the study signify that the PFM isa valid indicator of symptoms and functional limitations ofLBP-patients. It provides the combination of a composite totalscore and the possibility of evaluations within specific domainsof disability.
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| 5. |
- Björklund, Martin, et al.
(författare)
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The profile fitness mapping scales, validity of a new back-specific questionnaire
- 2007
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Ingår i: The 2007 Society for Back Pain Research Meeting.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUND: Disability questionnaires for LBP-patients mostly emanate from health professionals and have a content of different domains of disability presented as a single sum score, making it difficult to derive changes within a specific domain. This study introduces a new back-specific questionnaire, the Profile Fitness Mapping questionnaire (PFM), which was based on patient’s self-reported characteristics of the LBP. The PFM incorporates both a functional limitation and a symptom scale, with further subdivision of the symptom scale in separate indices for severity and temporal aspects. The aim of the study was to assess the overall validity of the PFM. METHODS AND RESULTS: Chronic LBP-patients (n=193) answered the PFM and four validated back-specific criterion questionnaires. The correlation coefficients between the PFM and the criterion questionnaires showed good concurrent criterion validity (0.61 – 0.83). The best discriminative ability between patients with different pain severity was demonstrated by the functional limitation scale of the PFM. Classification according to the ICF revealed a high degree of homogeneous item content of the symptom scale to the domain of impairments, and of the functional limitation scale to the domain of activity limitations. Well centered score distribution indicates that the PFM has the potential to detect improvement or worsening of symptoms and functional limitations in chronic LBP-patients. CONCLUSION: The results of the study signify that the PFM is a valid indicator of symptoms and functional limitations of LBP-patients. It provides the combination of a composite total score and the possibility of evaluations within specific domains of disability.
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| 6. |
- Björklund, Martin, et al.
(författare)
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The ProFitMap-neck - reliability and validity of a questionnaire for measuring symptoms and functional limitations in neck pain
- 2012
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Ingår i: Disability and Rehabilitation. - London : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 34:13, s. 1096-1107
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To assess overall reliability and validity of a neck-specific questionnaire, the Profile Fitness Mapping neck questionnaire (ProFitMap-neck), on three chronic neck pain groups. Method: Participating groups were as follows: whiplash associated disorders, inpatient care (IP-WAD, n = 127); nonspecific neck pain, inpatient care (IP-NS, n = 83) and nonspecific neck pain subjects (non-IP-NS, n = 104). All groups answered the ProFitMap-neck and the SF-36, whereas non-IP-NS also answered the Neck Disability Index (NDI) and the Functional Self-Efficacy Scale (SES). Internal consistency, test-retest reliability and components of convergent construct, face and content validity were determined for the ProFitMap-neck. Results: The ProFitMap-neck showed good internal consistency in all three groups, and ICC test-retest reliability (0.80-0.91). Good correlation (0.66-0.78) and highest agreement was reached with NDI. According to the International Classification of Functioning, Disability and Health, the symptom scale of the ProFitMap-neck was mainly classified to the domain of impairments-body functions, and the functional limitation scale to the activity limitation domain. Conclusion: The results indicate that the ProFitMap-neck is valid for measuring symptoms and functional limitations in people with chronic neck pain. The combination of a composite total score of symptoms and function as well as separate scores of each domain makes ProFitMap-neck suitable for research as well as in clinical practice.
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| 7. |
- Hamberg, Jern, et al.
(författare)
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Stretchability of the rectus femoris muscle: investigation of validity and intratester reliability of two methods including x-ray analysis of pelvic tilt.
- 1993
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Ingår i: Archives of Physical Medicine and Rehabilitation. - 0003-9993 .- 1532-821X. ; 74:3, s. 263-270
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Tidskriftsartikel (refereegranskat)abstract
- Validity and intratester reliability of two test methods designed to identify stretchability of the rectus femoris muscle (RFM) was investigated, combined with x-ray analysis of pelvic tilt in the sagittal plane. The first method is commonly used in clinical practice. The second is a new technique supposed to tilt the pelvis posteriorly and thus further separate the origin and insertion of the muscle. Investigation of validity and intratester reliability of the two methods was made by testing and retesting a random sample of 71 persons. The tests were performed with an equipment that automatically recorded the angle of knee flexion from a previously determined applied torque, indicating the end point of motion for that particular subject. Angle of knee flexion and subjective estimation of pain sensation due to stretch were recorded at each measurement. The pelvic tilt-analysis consisted of test-retest reliability of x-ray measurements, comparison between the methods in both starting and final position, and x-ray and electronic goniometer measurements. All applied torques were measured with a strain gauge. Two out of three criteria of validity favored the new method and the third pointed out the two methods as equal. The two methods as well as the x-ray measurements showed high reliability, and the hypothesis of a more posterior tilted pelvis in the new method was confirmed. The electronic goniometer was less sensitive than x-ray, but proposed to analyse pelvic tilt clinically. Methodology procedures for joint angle measurements are discussed.
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| 8. |
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| 9. |
- Sandlund, Jonas, et al.
(författare)
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Predictive and discriminative value of shoulder proprioception tests for patients with whiplash-associated disorders
- 2006
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 38:1, s. 44-49
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whether patients suffering from whiplash-associated disorders have impaired shoulder proprioception and whether the acuity of shoulder proprioception is reflected in the patients' symptoms and self-rated function. DESIGN: A comparative group design, including a correlation design for the patient group. SUBJECTS: Patients with chronic whiplash-associated disorders (n=37) and healthy subjects (n=41). The groups were matched for age and gender. METHODS: All subjects underwent a shoulder proprioception test involving active ipsilateral arm position-matching. Group difference was evaluated by multiple analysis of variance and analysis of variance. The patient group completed questionnaires addressing functioning and health and performed pain ratings. Associations between proprioceptive acuity and self-rated functioning and symptoms were studied by correlation and regression analyses. RESULTS: The patient group showed significantly lower acuity of shoulder proprioception. Moderate correlations were found between proprioceptive acuity and questionnaire scores representing physical functioning, so that low proprioceptive acuity was associated with low self-rated physical functioning. Scores representing pain-intensity did not correlate with proprioceptive acuity. CONCLUSION: The results show that, at the group level, patients with whiplash-associated disorders have impaired shoulder proprioception. The clinical relevance of this finding is strongly supported by the association between shoulder proprioceptive acuity and self-rated functioning in the patient group.
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| 10. |
- Sandlund, Jonas, et al.
(författare)
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Reduced shoulder proprioception in patients with whiplash associated disorders (WAD)
- 2004
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Ingår i: 8th International Federation of Orthopaedic Manipulative Therapists' Conference, Cape Town, South Africa.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- INTRODUCTION: Chronic whiplash associated disorders (WAD) are frequent in medical practice and are presented as a complex picture of neck -and shoulder pain along with numerous other symptoms. However, objective findings at physical examination are usually weak and thus the diagnosis of WAD is mostly based on the medical history and interpretation of personal information. Lately attention has focused on proprioceptive disturbances. Reasonably, vertigo, dizziness and fumbling often reported for WAD patients may be associated with alterations in proprioception. Our lab showed that experimentally induced pain directly impacts muscle spindle activity (MSA) in the muscles primarily affected, as well as in contralateral muscles. Since proprioception is mostly dependent upon MSA, pain originating from the neck region could potentially impair proprioception throughout the upper limbs. To validate proprioceptive testing as a diagnostic tool, the aims of the present study were to investigate: (1) shoulder proprioception, in the ability to reproduce a target position, in WAD patients compared to healthy controls; and (2) possible correlations between the degree of position matching error and subjective rating of health status, disability, self-efficacy and pain. METHODS: Participants were 38 WAD patients and 41 healthy subjects. From a start position of 50 degrees to the sagittal plane, shoulder horizontal-adduction movements of the right glenohumural joint to target positions of 18 and 30 degrees were conducted. The variable error (VE) of the position matching was used to assess the outcome. The patients also completed reports of their general health status (SF-36), disability due to pain (Pain disability index), pain-ratings (VAS) and self-efficacy beliefs (Self efficacy scale). RESULTS: The results showed a significantly higher VE in the WAD-group compared to the controls (p .< 0.001). VE and scores of the self-reports was found to correlate for all the questionnaires used. However, this was true only for the shorter (18 deg) target position. Put together in a step-wise multiple regression model the questionnaires could explain 46 percent of the position matching variance (p < 0.001), but again only when short target positions were focused. DISCUSSION AND CONCLUSION: A reduced ability to reproduce shoulder positions after active displacement implies a disturbance of the sensory motor function of patients with chronic WAD. According to our hypothesis, reduced proprioceptive function of muscle spindles could be responsible for this negative effect on precision and quality of movements. The correlation between position- matching errors and self-reports suggests that this in turn could be reflected in the person's everyday life. Correlations only for shorter target positions indicate that the control of different movement extents may depend on partly different mechanisms. The results may stimulate further research and the possibility of using proprioceptive tests to confirm symptoms and subjective disability in various musculo-skeletal disorders.
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