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  • Fältström, Anne, 1970- (författare)
  • One Anterior Cruciate Ligament injury is enough! : Focus on female football players
  • 2016
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Background: Anterior cruciate ligament (ACL) injury is a severe and common injury, and females have 2-4 times higher injury risk compared to men. Return to sport (RTS) is a common goal after an ACL reconstruction (ACLR), but only about two thirds of patients RTS. Young patients who RTS may have a 30-40 times increased risk of sustaining an additional ACL injury to the ipsi- or contralateral knee compared with an uninjured person.Aims: The overall aim of this thesis was to increase the knowledge about female football players with ACLR, and patients with bilateral ACL injuries, and to identify predictors for additional ipsi- and/or contralateral ACLR.Methods: This thesis comprises four studies. Study I and II were cross-sectional, including females who sustained a primary ACL rupture while playing football and underwent ACLR 6–36 months prior to study inclusion. In study I, 182 females were included at a median of 18 months (IQR 13) after ACLR. All players completed a battery of questionnaires. Ninety-four players (52%) returned to football and were playing at the time of completing the questionnaires, and 88 (48%) had not returned. In study II, 77 of the 94 active female football players (from study I) with an ACLR and 77 kneehealthy female football players were included. A battery of tests was used to assess postural control (the Star excursion balance test) and hop performance (the one-leg hop for distance, the five jump test and the side hop). Movement asymmetries in the lower limbs and trunk were assessed with the drop vertical jump and the tuck jump using two-dimensional analyses. Study III, was a cohort study including all patients with a primary ACLR (n=22,429) registered in the Swedish national ACL register between January 2005 and February 2013. Data extracted from the register to identify predictors for additional ACLR were: patient age at primary ACLR, sex, activity performed at the time of ACL injury, primary injury to the right- or left knee, time between injury and primary ACLR, presence of any concomitant injuries, graft type, Knee injury and Osteoarthritis Outcome Score and Euroqol Index Five Dimensions measured pre-operatively. Study IV was cross-sectional. In this study, patient-reported knee function, quality of life and activity level in 66 patients with bilateral ACL injuries was investigated and outcomes were compared with 182 patients with unilateral ACLR.Results: Factors associated with returning to football in females were; short time between injury and ACLR (0–3 months, OR 5.6; 3–12 months OR 4.7 vs. reference group >12 months) and high motivation (study I). In all functional tests, the reconstructed and uninvolved limbs did not differ, and players with ACLR and controls differed only minimally. Nine to 49% of the players with ACLR and controls had side-to-side differences and movement asymmetries and only one fifth had results that met the recommended guidelines for successful outcome on all the different tests (study II). Main predictors for revision and contralateral ACLR were younger age (fourfold increased rate for <16 vs. >35-year-old patients), having ACLR early after the primary injury (two to threefold increased rate for ACLR within 3 months vs. >12 months), and incurring the primary injury while playing football (study III). Patients with bilateral ACL injuries reported poorer knee function and quality of life compared to those who had undergone unilateral ACLR. They had a high activity level before their first and second ACL injuries but an impaired activity level at follow-up after their second injury (study IV).Conclusions: Female football players who returned to football after an ACLR had high motivation and had undergone ACLR within one year after injury. Players with ACLR had similar functional performance to healthy controls. Movement asymmetries, which in previous studies have been associated with increased risk for primary and secondary ACL injury, occurred to a high degree in both groups. The rate of additional ACLR seemed to be increased in a selected group of young patients who desire to return to strenuous sports like football quickly after primary ACLR. Sustaining a contralateral ACL injury led to impaired knee function and activity level.
  • Gustafsson, Monika, et al. (författare)
  • From shame to respect : musculoskeletal pain patients' experience of a rehabilitation programme, a qualitative study
  • 2004
  • Ingår i: Journal of Rehabilitation Medicine. - Oslo : Taylor & Francis. - 1650-1977 .- 1651-2081. ; 36:3, s. 97-103
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: This study aimed to describe and analyse how participants with fibromyalgia or chronic, widespread, musculoskeletal pain, 1 year after completion, experienced a rehabilitation programme; and what knowledge and strategies they had gained.Design, methods and subjects: Semi-structured interviews with 16 female patients were analysed using the grounded theory method of constant comparison.Results: One core category, from shame to respect, and 4 categories, developing body awareness/knowledge, setting limits, changing self-image and negative counterbalancing factors, and hopelessness and frustration over one's employment situation emerged from the data. The core category represents a process where the informants changed emotionally. Three categories were identified as important for starting and maintaining the process, one category affected the process negatively.Conclusion: The rehabilitation programme started the process of change, from shame to respect. The informants learned new strategies for handling their pain and other symptoms; they improved their self-image and communication in their social environment.
  • Högström, Gabriel, et al. (författare)
  • Body composition and performance : influence of sport and gender among adolescents
  • 2012
  • Ingår i: Journal of Strength and Conditioning Research. - : Lippincott Williams & Wilkins. - 1064-8011 .- 1533-4287. ; 26:7, s. 1799-1804
  • Tidskriftsartikel (refereegranskat)abstract
    • Body composition is well known to be associated with endurance performance amongst adult skiers, however the association among adolescent cross-country and alpine skiers is inadequately explored. The study sample was comprised of 145 male and female adolescent subjects (aged 15-17 years), including 48 cross-country skiers, 33 alpine skiers, and 68 control subjects. Body composition [%body fat, %lean mass, bone mineral density (g/cm2)] was measured with a dual-emission X-ray absorptiometer, and pulse and oxygen uptake were measured at three break points during incremental performance tests to determine physical fitness levels. Female cross-country and alpine skiers were found to have significantly higher %lean mass (mean difference = 7.7%, p < 0.001) and lower %body fat (mean difference = (8.1%, p < 0.001) than female control subjects. Male cross-country skiers were found to have lower %body fat (mean difference = 3.2%, p < 0.05) and higher %lean mass (mean difference = 3.3%, p < 0.01) than male alpine skiers and higher % lean mass (mean difference = 3.7%, p < 0.05) and % body fat (mean difference = 3.2%, p < 0.05) than controls. The present study found strong associations between %lean mass and the OBLA and VO2 max weight adjusted thresholds among both genders of the cross-country skiing cohort (r = 0.47-0.67, p < 0.05) and the female alpine skiing cohort (r = 0.77-0.79, p < 0.001 for all). The present study suggests that body composition is associated with physical performance already in adolescent athletes.
  • Johansson, Sverker, et al. (författare)
  • The Swedish occupational fatigue inventory in people with multiple sclerosis
  • 2008
  • Ingår i: Journal of Rehabilitation Medicine. - Oslo : Taylor & Francis. - 1650-1977 .- 1651-2081. ; 40:9, s. 737-743
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To investigate the applicability of the Swedish Occupational Fatigue Inventory and its ability to identify different dimensions of fatigue in people with multiple sclerosis with varying, degrees of disease severity, and the correlation of each of its 5 dimensions with the Fatigue Severity Scale.Design: An observational. prospective study.Subjects: Two hundred and nineteen outpatients: 59.5% had mild. 170%, moderate and 23.5% severe disease severity; 83%, received immunomodulatory treatment.Methods: Both questionnaires were administered at inclusion, and at 12 and 24 months. Analyses of internal consistency. item-total correlation, factor analysis and tests of correlations were performed.Results: The instrument was completed by 97% of subjects. Internal consistency was satisfactory in the dimensions Lack of energy, Lack of motivation and Sleepiness, but not in Physical exertion and Physical discomfort. Factor analysis revealed that all but 3 items (2 in Physical exertion, 1 in Physical discomfort) loaded satisfactorily in 5 dimensions. Correlations between the dimensions and the Fatigue Severity Scale were low, except for a moderate correlation found for Lack of energy.Conclusion: The dimensions Lack of energy, Lack of motivation and Sleepiness appear applicable for use in people with multiple sclerosis. Further development of the physical dimensions and studies on the instrument's capacity to measure changes are needed.
  • Jong, Mats, 1968-, et al. (författare)
  • Experiences of injuries and injury reporting among Swedish skydivers
  • 2014
  • Ingår i: Journal of sports medicine (Hindawi Publishing Corporation). - New York : Hindawi Publishing Corporation. - 2356-7651 .- 2314-6176. ; 2014, s. 102645-
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective of the present study was to illuminate the experience of injuries and the process of injury reporting within the Swedish skydiving culture.The study had a qualitative approach where data was collected in narrative interviews that were subsequently analyzed with content analysis. Seventeen respondents between the ages of 22 and 44 were recruited at three skydiving drop zones in Sweden.Injury events related to the full phase of a skydive were described. Risk of injury is individually viewed as an integrated element of the recreational activity counterbalanced by its recreational value. The human factor of inadequate judgment such as miscalculation and distraction dominate the descriptions as causes of injuries. Organization and leadership act as facilitators or constrainers for reporting incidents and injuries.On the basis of this study it is interpreted that safety work and incident reporting in Swedish skydiving may be influenced more by local drop zone culture than by the national association policy. Formal and informal hierarchical structures among skydivers seem to decide how skydiving is practiced, rule enforcement, and injury reporting. We suggest that initial training and continuing education need to be change from the current top-down, to a bottom-up perspective, where the individual skydiver learns to see the positive implications of safety work and injury reporting.
  • Karlsson, Linn, 1974- (författare)
  • Chronic Pain and Exercise : Studies on pain intensity, biochemistry, adherence and attitudes
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Chronic pain is common in western countries and entails considerable consequences for the afflicted individuals as well as for the society. Furthermore, chronic pain is complex including an advanced interplay between biological-, psychological- and social aspects. Treatment of chronic pain attempts to decrease pain intensity and increase physical-, psychological- and social functioning. However, the treatment of chronic pain is still not optimized. Different types of physical activity and exercise (PA&E) are commonly applied as non-pharmacological treatment strategies for chronic pain, but the most efficient type and dose of PA&E are unclear. In addition, adherence to prescribed PA&E is often troublesome, which further complicates the application of PA&E as treatment for chronic pain.The aim of this thesis is to increase the knowledge about PA&E as treatment for chronic pain regarding pain intensity, biochemical substances, adherence and attitudes.The findings of this thesis were that a long-term, home-based PA&E intervention comprising strength exercises as well as stretch exercises decreased pain intensity and increased function in women with chronic neck- and shoulder pain. Using microdialysis technique, differences in pain modulatory biochemical substances were found, before the intervention, in painful trapezius muscle compared to pain-free trapezius muscle. In addition, alterations in pain modulatory substances in painful trapezius muscle after the intervention were found, which possibly could imply peripheral physiological effects of PA&E. Furthermore, psychological factors could be associated to the effects of and adherence to the PA&E intervention. An intention to be physically active were expressed by patients with chronic pain, but a discordance between the intention and PA&E-behaviour were evident, even though the PA&E were experienced as valuable.In conclusion, this thesis strengthens the importance of PA&E as treatment for chronic pain. Especially, this thesis increases the knowledge about; possible peripheral pain inhibitory effects after long-term exercise; how psychological factors might affect the results of PA&E; and also about important behavioural aspects that might affect adherence to prescribed PA&E. This thesis highlights the need of more research on physiological pain inhibitory effects of long-term PA&E in chronic pain. Furthermore, improved methods for ensured adherence to prescribed PA&E are necessary in order to optimize the effect of PA&E as treatment for chronic pain.
  • Kristén, Lars, 1956-, et al. (författare)
  • Conceptions of Children and Adolescents with Physical Disabilities about Their Participation in a Sports Programme
  • 2002
  • Ingår i: European Physical Education Review. - London : Sage Publications. - 1356-336X .- 1741-2749. ; 8:2, s. 139-156
  • Tidskriftsartikel (refereegranskat)abstract
    • Sport and leisure can be of significant importance for the well-being and social support of children and adolescents with physical disabilities. However, it has been established that organized sport sometimes has a social construction, in that those without disabilities are favoured at the expense of others. The aim of this study was, therefore, to describe conceptions of children and adolescents with physical disabilities about their participation in a sports programme. Using questions based on a holistic view of the human being, 20 children and adolescents were interviewed. The method of analysis used was inspired by phenomenography. Six categories emerged: Getting new friends, learning, strengthening one’s physique, becoming someone, experiencing nature and having a good time. The findings show the great diversity of sports participation. Further, the conceptions mirror the difficulty of dividing people into groups and of delimiting important areas. The findings highlight the importance of programmes where actors from different sections of society cooperate. Even if the findings cannot be generalized, they nevertheless demonstrate that physical activity involves many positive factors both at the individual and at the society level. © 2002, North West Counties Physical Education Association and SAGE Publications. All rights reserved.
  • Larsson, Anders, et al. (författare)
  • Life style intervention in moderately overweight individuals is associated with decreased levels of cathepsins L and S in plasma
  • 2014
  • Ingår i: Annals of Clinical and Laboratory Science. - : The Association of Clinical Scientists. - 0091-7370 .- 1550-8080. ; 44:3, s. 283-285
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Adipose tissue cells produce cathepsins L and S, which have proatherogenic effects. Obesity is strongly linked to atherogenesis, cardiovascular morbidity, and mortality. OBJECTIVE: The aim of the present study was to see if life style interventions/weight reduction could decrease cathepsin L and S levels in blood plasma. METHOD: Study subjects (n=31) were recruited to a life style intervention program aiming at increased physical activity, more healthy eating habits, and weight reduction for most of the participants. Blood samples were collected at inclusion and after 4 and 8 weeks. RESULTS: Cathepsin L was significantly reduced at 4 weeks (p<0.0001) and 8 weeks (p=0.0004). A similar reduction was also seen for cathepsin S at 4 weeks (p=0.03) and 8 weeks (p=0.008). No significant change in fractalkine values was observed at 4 weeks (p=0.58), but a significant increase was apparent at 8 weeks (p=0.0002). CONCLUSION: The intervention program resulted in significant reductions of cathepsin L and S levels in plasma after 4 and 8 weeks of intervention.
  • Lindberg, Ann-Sofie, 1972-, et al. (författare)
  • Self-rated physical loads of work tasks among firefighters
  • 2014
  • Ingår i: International Journal of Occupational Safety and Ergonomics. - Abingdon : Taylor & Francis. - 1080-3548 .- 2376-9130. ; 20:2, s. 309-321
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The present study sought to identify firefighters' rated physical demands for the most frequently occuring work tasks and to determine if the ratings differed between full-time and part-time firefighters to help create a basis for the development of physical employment tests for firefighters.Methods: An extensive questionnaire was completed by 125 and 68 firefighters in 2000 and 2010, respectively. The data were analysed with the Mann-Whitney U test and binominal test and ranked on the basis of the responses in each category.Results: Significant differences were seen between the full-time and part-time firefighters. The work tasks rated as the most physically strenous in terms of aerobic fitness, muscle strength, work posture and body control by most responders were smoke diving upstairs (carrying a hose), victim rescue in different ways, carrying a stretcher over terrain and pulling a hose.Conclusions: Physically strenous work tasks should be included in the end-point performance variables used to select physical performance tests for firefighters. The part-time firefighters with no experience in several of the work tasks suggests that work-related exercises are important if both groups of firefighters are expected to do similar work.
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