| 21. |
- Fröberg, Åsa, et al.
(författare)
-
Altered patterns of displacement within the Achilles tendon following surgical repair
- 2017
-
Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 25:6, s. 1857-1865
-
Tidskriftsartikel (refereegranskat)abstract
- Ultrasound speckle tracking was used to compare tendon deformation patterns between uninjured and surgically repaired Achilles tendons at 14-27-month follow-up. The hypothesis was that the non-homogenous displacement pattern previously described in uninjured tendons, where displacement within deep layers of the tendons exceeds that of superficial layers, is altered following tendon rupture and subsequent surgical repair. In the first part of this study, an in-house-developed block-matching speckle tracking algorithm was evaluated for assessment of displacement on porcine flexor digitorum tendons. Displacement data from speckle tracking were compared to displacement data from manual tracking. In the second part of the study, eleven patients with previous unilateral surgically treated Achilles tendon rupture were investigated using ultrasound speckle tracking. The difference in superficial and deep tendon displacement was assessed. Displacement patterns in the surgically repaired and uninjured tendons were compared during passive motion (Thompson's squeeze test) and during active ankle dorsiflexion. The difference in peak displacement between superficial and deep layers was significantly (p < 0.01) larger in the uninjured tendons as compared to the surgically repaired tendons both during Thompson's test (-0.7 +/- 0.2 mm compared to -0.1 +/- 0.1 mm) and active dorsiflexion (3.3 +/- 1.1 mm compared to 0.3 +/- 0.2 mm). The evaluation of the speckle tracking algorithm showed correlations of r ae 0.89 between displacement data acquired from speckle tracking and the reference displacement acquired from manual tracking. Speckle tracking systematically underestimated the magnitude of displacement with coefficients of variation of less than 11.7%. Uninjured Achilles tendons display a non-uniform displacement pattern thought to reflect gliding between fascicles. This pattern was altered after a mean duration of 19 +/- 4 months following surgical repair of the tendon indicating that fascicle sliding is impaired. This may affect modulation of the action between different components of the triceps surae, which in turn may affect force transmission and tendon elasticity resulting in impaired function and risk of re-rupture.
|
|
| 22. |
- Gerdle, Björn, et al.
(författare)
-
Biochemical alterations in the trapezius muscle of patients with chronic whiplash associated disorders (WAD) - A microdialysis study
- 2008
-
Ingår i: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 12:1, s. 82-93
-
Tidskriftsartikel (refereegranskat)abstract
- The mechanisms behind the development of chronic trapezius myalgia in patients with whiplash associated disorders (WAD) appear to involve both peripheral and central components, but the specific contribution of alterations in muscle is not clear. Female patients with WAD and involvement of trapezius (N = 22) and female controls (N = 20; CON) were studied during an experiment compromised of rest (baseline), 20 min repetitive low.-force exercise and 120 min recovery. Their interstitial concentrations of serotonin (5-HT), glutamate, lactate, pyruvate, potassium, interleukin-6 (IL-6), and blood flow were determined in the trapezius muscle using a microdialysis technique. Pressure pain thresholds (PPT) over trapezius and tibialis anterior muscles were also assessed. In WAD, we found signs of generalized hypersensitivity according to PPT. The WAD group had significantly higher interstitial [IL-6] and [5-HT] in the trapezius than the CON. [Pyruvate] was overall significantly lower in WAD, and with lactate it showed another time-pattern throughout the test. In the multivariate regression analysis of pain intensity [5-HT] was the strongest regressor and positively correlated with pain intensity in WAD. In addition, blood flow, [pyruvate], and [potassium] influenced the pain intensity in a complex time dependent way. These findings may indicate that peripheral nociceptive processes are activated in WAD with generalized hypersensitivity for pressure and they are not identical with those reported in chronic work-related trapezius myalgia, which could indicate different pain mechanisms.
|
|
| 23. |
- Hyden, L. C., et al.
(författare)
-
Pain gestures : the orchestration of speech and body gestures
- 2002
-
Ingår i: Health. - : SAGE Publications. - 1363-4593 .- 1461-7196. ; 6:3, s. 325-345
-
Tidskriftsartikel (refereegranskat)abstract
- This article is about the use and function of gestures in pain communication. More specifically how we can communicate an internal bodily experience like pain with the help of gestures. This is of great importance both in everyday situations and in medical consultations of various types. Our focus in this article is on the issues of the gesture as a communicative resource, how verbal and nonverbal communicative resources are related to each other and in what way gestures contribute to the structure of different types of pain. Thirty-seven patients have been interviewed about their pain experiences and the main result is that several communicative modalities are interwoven in the pain accounts. Three different functions of gestures were identified: the pointing, iconic and symbolic functions. The clinical relevance of this approach to gestures in pain communication is to take note of the intricate interplay of different communicative resources used in the pain description, and to emphasize both verbal and nonverbal interaction in the clinical conversation as a resource in the care situation.
|
|
| 24. |
- Hydén, Lars-Christer, 1954-, et al.
(författare)
-
Pain Gestures : The Orchestration of Talk and Body Gestures
- 2002
-
Ingår i: Health. - : SAGE Publications. - 1363-4593 .- 1461-7196. ; 6:3, s. 325-345
-
Tidskriftsartikel (refereegranskat)abstract
- This article is about the use and function of gestures in pain communication. More specifically how we can communicate an internal bodily experience like pain with the help of gestures. This is of great importance both in everyday situations and in medical consultations of various types. Our focus in this article is on the issues of the gesture as a communicative resource, how verbal and nonverbal communicative resources are related to each other and in what way gestures contribute to the structure of different types of pain. Thirty-seven patients have been interviewed about their pain experiences and the main result is that several communicative modalities are interwoven in the pain accounts. Three different functions of gestures were identified: the pointing, iconic and symbolic functions. The clinical relevance of this approach to gestures in pain communication is to take note of the intricate interplay of different communicative resources used in the pain description, and to emphasize both verbal and nonverbal interaction in the clinical conversation as a resource in the care situation.
|
|
| 25. |
- Larsson, Matilda, et al.
(författare)
-
Wave intensity wall analysis: a novel noninvasive method to measure wave inntensity
- 2009
-
Ingår i: Heart and Vessels. - : Springer Science and Business Media LLC. - 0910-8327 .- 1615-2573. ; 24, s. 357-365
-
Tidskriftsartikel (refereegranskat)abstract
- Wave intensity analysis is a concept providing information about the interaction of the heart and the vascular system. Originally, the technique was invasive. Since then new noninvasive methods have been developed. A recently developed ultrasound technique to estimate tissue motion and deformation is speckle-tracking echocardiography. Speckle tracking-based techniques allow for accurate measurement of movement and deformation variables in the arterial wall in both the radial and the longitudinal direction. The aim of this study was to test if speckle tracking-derived deformation data could be used as input for wave intensity calculations. The new concept was to approximate changes of flow and pressure by deformation changes of the arterial wall in longitudinal and radial directions. Flow changes (dU/dt) were approximated by strain rate (sr, 1/s) of the arterial wall in the longitudinal direction, whereas pressure changes (dP/dt) were approximated by sign reversed strain rate (1/s) in the arterial wall in the radial direction. To validate the new concept, a comparison between the newly developed Wave Intensity Wall Analysis (WIWA) algorithm and a commonly used and validated wave intensity system (SSD-5500, Aloka, Tokyo, Japan) was performed. The studied population consisted of ten healthy individuals (three women, seven men) and ten patients (all men) with coronary artery disease. The present validation study indicates that the mechanical properties of the arterial wall, as measured by a speckle tracking-based technique are a possible input for wave intensity calculations. The study demonstrates good visual agreement between the two systems and the time interval between the two positive peaks (W1-W2) measured by the Aloka system and the WIWA system correlated for the total group (r = 0.595, P < 0.001). The correlation for the diseased subgroup was r = 0.797, P < 0.001 and for the healthy subgroup no significant correlation was found (P > 0.05). The results of the study indicate that the mechanical properties of the arterial wall could be used as input for wave intensity calculations. The WIWA concept is a promising new method that potentially provides several advantages over earlier wave intensity methods, but it still has limitations and needs further refinement and larger studies to find the optimal clinical use.
|
|
| 26. |
- Lo, Hiu Kwan, et al.
(författare)
-
Factors associated with work ability following exercise interventions for people with chronic whiplash-associated disorders : Secondary analysis of a randomized controlled trial
- 2018
-
Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 50:9, s. 828-836
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the efficacy of exercise interventions and factors associated with changes in work ability for people with chronic whiplash-associated disorders. Design: Secondary analysis of a single-blind, randomized multi-centre controlled trial. Setting: Interventions were conducted in Swedish primary care settings. Patients: A total of 165 individuals with chronic whiplash-associated disorders grade II-III. Methods: Participants were randomly allocated to neck-specific exercise, neck-specific exercise with a behavioural approach, or prescribed physical activity interventions. Work ability was evaluated with the Work Ability Index at baseline, 3, 6 and 12 months. Results: The neck-specific exercise with a behavioural approach intervention significantly improved work ability compared with the prescribed physical activity intervention (3 months, p = 0.03; 6 months, p = 0.01; 12 months, p = 0.01), and neck-specific exercise at 12 months (p = 0.01). Neck-specific exercise was better than the prescribed physical activity intervention at 6 months (p = 0.05). An increase in work ability from baseline to one year for the neck-specific exercise with a behavioural approach group (p < 0.01) was the only significant within-group difference. Higher self-rated physical demands at work, greater disability, greater depression and poorer financial situation were associated with poorer work ability (p < 0.01). Conclusion: This study found that neck-specific exercise with a behavioural approach intervention was better at improving self-reported work ability than neck-specific exercise or prescribed physical activity. Improvement in work ability is associated with a variety of factors.
|
|
| 27. |
- Löfstedt, Tommy, et al.
(författare)
-
Dynamic ultrasound imaging : a multivariate approach for the analysis and comparison of time-dependent musculoskeletal movements
- 2012
-
Ingår i: BMC Medical Imaging. - : Springer Science and Business Media LLC. - 1471-2342. ; 12:1, s. 29-
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Muscle functions are generally assumed to affect a wide variety of conditions and activities, including pain, ischemic and neurological disorders, exercise and injury. It is therefore very desirable to obtain more information on musculoskeletal contributions to and activity during clinical processes such as the treatment of muscle injuries, post-surgery evaluations, and the monitoring of progressive degeneration in neuromuscular disorders.The spatial image resolution achievable with ultrasound systems has improved tremendously in the last few years and it is nowadays possible to study skeletal muscles in real-time during activity. However, ultrasound imaging has an inherent problem that makes it difficult to compare different measurement series or image sequences from two or more subjects. Due to physiological differences between different subjects, the ultrasound sequences will be visually different -- partly because of variation in probe placement and partly because of the difficulty of perfectly reproducing any given movement. METHODS: Ultrasound images of the biceps and calf of a single subject were transformed to achieve congruence and then efficiently compressed and stacked to facilitate analysis using a multivariate method known as O2PLS. O2PLS identifies related and unrelated variation in and between two sets of data such that different phases of the studied movements can be analysed. The methodology was used to study the dynamics of the Achilles tendon and the calf and also the Biceps brachii and upper arm. The movements of these parts of the body are both of interest in clinical orthopaedic research. RESULTS: This study extends the novel method of multivariate analysis of congruent images (MACI) to facilitate comparisons between two series of ultrasound images. This increases its potential range of medical applications and its utility for detecting, visualising and quantifying the dynamics and functions of skeletal muscle. CONCLUSIONS: The most important results of this study are that MACI with O2PLS is able to consistently extract meaningful variability from pairs of ultrasound sequences. The MACI method with O2PLS is a powerful tool with great potential for visualising and comparing dynamics between movements. It has many potential clinical applications in the study of muscle injuries, post-surgery evaluations and evaluations of rehabilitation, and the assessment of athletic training interventions.
|
|
| 28. |
- Löfstedt, Tommy, 1982-
(författare)
-
OnPLS : Orthogonal projections to latent structures in multiblock and path model data analysis
- 2012
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The amounts of data collected from each sample of e.g. chemical or biological materials have increased by orders of magnitude since the beginning of the 20th century. Furthermore, the number of ways to collect data from observations is also increasing. Such configurations with several massive data sets increase the demands on the methods used to analyse them. Methods that handle such data are called multiblock methods and they are the topic of this thesis. Data collected from advanced analytical instruments often contain variation from diverse mutually independent sources, which may confound observed patterns and hinder interpretation of latent variable models. For this reason, new methods have been developed that decompose the data matrices, placing variation from different sources of variation into separate parts. Such procedures are no longer merely pre-processing filters, as they initially were, but have become integral elements of model building and interpretation. One strain of such methods, called OPLS, has been particularly successful since it is easy to use, understand and interpret. This thesis describes the development of a new multiblock data analysis method called OnPLS, which extends the OPLS framework to the analysis of multiblock and path models with very general relationships between blocks in both rows and columns. OnPLS utilises OPLS to decompose sets of matrices, dividing each matrix into a globally joint part (a part shared with all the matrices it is connected to), several locally joint parts (parts shared with some, but not all, of the connected matrices) and a unique part that no other matrix shares. The OnPLS method was applied to several synthetic data sets and data sets of “real” measurements. For the synthetic data sets, where the results could be compared to known, true parameters, the method generated global multiblock (and path) models that were more similar to the true underlying structures compared to models without such decompositions. I.e. the globally joint, locally joint and unique models more closely resembled the corresponding true data. When applied to the real data sets, the OnPLS models revealed chemically or biologically relevant information in all kinds of variation, effectively increasing the interpretability since different kinds of variation are distinguished and separately analysed. OnPLS thus improves the quality of the models and facilitates better understanding of the data since it separates and separately analyses different kinds of variation. Each kind of variation is purer and less tainted by other kinds. OnPLS is therefore highly recommended to anyone engaged in multiblock or path model data analysis.
|
|
| 29. |
- Peolsson, Michael, et al.
(författare)
-
A pilot study using Tissue Velocity Ultrasound Imaging (TVI) to assess muscle activity pattern in patients with chronic trapezius myalgia
- 2008
-
Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 9
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Different research techniques indicate alterations in muscle tissue and in neuromuscular control of aching muscles in patients with chronic localized pain. Ultrasound can be used for analysis of muscle tissue dynamics in clinical practice. Aim: This study introduces a new muscle tissue sensitive ultrasound technique in order to provide a new methodology for providing a description of local muscle changes. This method is applied to investigate trapezius muscle tissue response especially with respect to specific regional deformation and deformation rates - during concentric shoulder elevation in patients with chronic trapezius myalgia and healthy controls before and after pain provocation. Methods: Patients with trapezius myalgia and healthy controls were analyzed using an ultrasound system equipped with tissue velocity imaging (TVI). The patients performed a standardized 3-cm concentric shoulder elevation before and after pain provocation/exercise at a standardized elevation tempo (30 bpm). A standardized region of interest (ROI), an ellipsis with a size that captures the upper and lower fascia of the trapezius muscle (4 cm width) at rest, was placed in the first frame of the loop registration of the elevation. The ROI was re-anchored frame by frame following the same anatomical landmark in the basal fascia during all frames of the concentric phase. In cardiac measurement, tissue velocities are measured in the axial projection towards and against the probe where red colour represents shortening and red lengthening. In the case of measuring the trapezius muscle, tissue deformation measurements are made orthogonally, thus, indirectly. Based on the assumption of muscle volume incompressibility, blue represents tissue contraction and red relaxation. Within the ROI, two variables were calculated as a function of time: deformation and deformation rate. Hereafter, max, mean, and quadratic mean values (RMS) of each variable were calculated and compared before and after pain provocation/exercise. Results: This new methodology seems valuable when looking at local muscle changes and studying the mechanism behind chronic muscle pain. The univariate analyses indicate that patients with chronic trapezius myalgia after pain provocation due to exercise at group level showed decreased strain and unchanged strain rate while healthy controls had unchanged strain and increased strain rate. However, the multivariate analysis indicates that most patients showed lower levels according to both strain and strain rate after exercise compared to most controls. Conclusion: Tissue velocity imaging can help describe musculoskeletal tissue activity and dynamics in patients with chronic pain conditions. An altered muscle tissue dynamic after pain provocation/exercise among the majority of trapezius myalgia patients compared with the healthy controls was found.
|
|
| 30. |
- Peolsson, Michael
(författare)
-
Att beskriva kronisk smärta : en lärprocess
- 2000
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Sammanfattningsvis syftar denna uppsats till att studera hur patienter beskriver sin smärta samt på vilka sätt de beskriver hur de utforskar sin smärta i vardagen. Jag vill med dessa beskrivningar som bakgrund lyfta fram patienters egen lärprocess om sin smärta. Avhandlingen syftar vidare till att diskutera hur vårdgivare kan lära sig av patienters smärtbeskrivningar. I detta sammanhang vill jag lyfta fram några begrepp som kan belysa hur patienterna i mina studier delger vad jag tolkar som smärtupplevelser.
|
|
