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- Gard, Gunvor
(författare)
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Physical and psychosocial occupational strain
- 1990
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This monography thesis is based on five empirical studies of physical and psychosocial occupational strain in working life. The first three studies concern the working environment of crane couplers. The first study, a questionnaire study, showed that monotonous postures and movements, heavy lifting and long walking distances were common reasons for regarding crane coupling as a physically strenuous work. The second study, a medical study, showed that clinical findings were more prevalent in the right neck- and shoulder region. The third study, an electromyographic study showed that the physical strain in crane coupling can be reduced by using wooden or other light weight spacers, to rearrange the layout so that slinging is always possible or by using slings mode of fibre or other light weight material. This study also indicated that crane coupling work may cause harmful effects to the shoulder- or neck region. The fourth study examined psychosocial strain and qualification in administrative computer work by using questionnaires, interviews and physiological measurements at repeated occasions. The results indicated a good agreement between level of qualification, psychosocial work load and job satisfaction. Computerisation lead to increased qualifications at work. This improved job satisfaction but at the same time resulted in an increased workload. The fifth study concerns how patients visiting primary health care perceive physical and psychosocial occupational strain. It could be shown that the patients perceived physical as well as psychosocial strain as important working environment problems
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| 2. |
- Gerdle, Björn, 1953-
(författare)
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Leisure and muscular performance in health and disease : a study of 40-64-year-old northern Swedes
- 1985
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Categories and frequencies of leisureactivities employed by 156 randomly selected males and females aged 40-44, 50-54, 60-64 were investigated by structured interviews and were related to leisuresatisfaction, to experienced health and socio-economic status. In equal numbers (15) of males and females from each group and in 24 males (60 +_6 years) with intermittent claudication (Cl) isokinetic plantar flexion performance was investigated with registrations of peak torque (PT), contractional work (CW), active range-of-motion (RoM) and integrated electromyograms from all threee triceps surae heads. Subjects performed a few maximum plantarflexions at different velocities of angular motion and also up to 200 consecutive plantar flexions at 60 °/s. The males aged 40-44 were re -investigated after two years additionally using electromyographic power frequency analyses.Leisure choice was mainly age and sex independent and extensively included outdoor activities. Leisure satisfaction was positively associated with relative frequency of activities. Symptoms of bodily discomfort, in particular backpain, were quite common and apparently caused relatively low level of mutual leisure activities. Thus, with in this age span, leisure activities appear rather rigid but often successfully, adhered to . Common ailments influence partnership mutuality negatively.Plantar flexion PT and CW are adequately p re dicta ble by sex, age and crural circumference. Uniformly a 3:2 male/female ratio characterizes mechanical output and iEMG. The latter is velocity independent. Output decreases with increasing age. Hence the output/excitation balance (CW/iEMG) is age, but not sex, dependent. CI-patients produce less PT and CW than do controls. Independently of this disease, of age and sex, PT and CW describe parallel negative exponential functions of velocity.During repeated manoeuvres plantar flexion output and iEMG initially drop, there after to maintain nearly steady-state levels. Throughout up to 200 contractions CW/iEMG was unaltered in the clinically healthy. Test/re-test with two years interval yielded nearly identical results. Leftshifts in mean power frequency in parallel with output-drop imply that the latter probably is due to FT-motor unit fatigue. For CW, but not for PT, the drop became slower and the (relative) steady-state level higher with increasing age, indicating significant increase in endurance with age. In the Cl-patients, output, but not excitation, decreased after a few repititions. Therefore, CW/iEMG fell dramatically, implying intramuscular fatigue. Taken together with findings of close associations between total cumulated work and measured/expected maximum walking tole rance it is suggested that measurements of CW and calculations of CW/iEMG are of clinical value.
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| 4. |
- Bergman, Birgitta
(författare)
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Being a physiotherapist : professional role, utilization of time an d vocational strategies
- 1989
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In a research series carried out between 1984 and 1988 in the county of Västerbotten in northern Sweden, various aspects of the professional role and work of physiotherapists were studied. A variety of research methods were used: questionnaires (n = 163), a time budget study (n = 149), and a qualitative interview (n = 24). Physiotherapy was considered varied and creative, but not well defined or very specific in its objectives. Physiotherapy is still a predominantly female profession, though the proportion of male physiotherapists was increasing. The proportion entering full-time employment in physiotherapy increased due both to the greater number of male graduates and the increasing number of women working full-time. A partial internal division of work between the sexes has arisen. More women than men are employed in in-patient care, while proportionately more men worked outside institutions. Most respondents were firmly in control of their treatment methods, but were somewhat restricted in their freedom to decide whom to treat, and when to terminate treatment. Few had carried out any research concerning treatment and results. The time budget study showed that the treatment of patients took up on average 33% of the physiotherapists’ gross working hours and was the largest single task. Continuing education accounted for 5%, development work for 1% and the remaining occupational tasks for 38%. Occupational area was the most important factor in explaining the distribution of working hours, when other factors were kept constant. Neither sex nor gender markedly affects the carrying out of tasks other than treatment. Nor does professional post particularly affect time utilization other than for administrative tasks. This profession has a double objective: care and service more generally and to provide physiotherapy in particular—both equally important. In order to improve the quality of physiotherapy, and at the same time to extend their own specific, theoretical body of knowledge, a number of physiotherapists have reappraised and extended their concept of the profession to include management and research in their everyday work.Conclusion: The fact that occupational area exercises such a profound influence on the work of physiotherapists, taken together with the slight influence that professional post has, reveals that the individual physiotherapist must be prepared to play a broadly defined professional role. There seems to be a wealth of skill and expertise available within the profession, which could, however, be more efficiently used if the management and organization of physiotherapy service were better adapted to serve its objectives, and if these were better delineated and communicated.
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| 5. |
- Eklund, Michael, 1953-
(författare)
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On vocational rehabilitation in northern Sweden : with focus on life satisfaction and outcome prediction
- 1991
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A consecutive series of 149 subjects with complete or partial vocational disability due to somatic ill-health were investigated at admission for vocational rehabilitation and two years later. Subjects filled in checklists which encompassed 5 socio-demographic, 5 psycho-social and 9 life satisfaction items. Moreover, 5 dimensions of "handicap" were assessed.At admission subjects were physically examined. In this diagnostically mixed sample 80 of them had non-specific locomotor dysfunction with pain ("algia"). In this sub-sample 23 symptoms (yes/no alternatives) and 24 signs (present/not present) were registered.At the two-year follow-up actual source and level of income were registered and 126 subjects reported their levels of life satisfaction. A reference population including 163 employed subjects was used for comparisons of levels of life satisfaction.At admission satisfaction with life as a whole (level of happiness) and with 6/8 domain specific life satisfaction items were significantly lower for the vocational rehabilitation clients than for the references. Psycho-socio-demographic items formed 5 factors, two were socio-demographic and three psycho-social characteristics. Only few were "handicapped" concerning orientation, mobility and self-care, while the majority were financially and/or occupationally "handicapped".At the two-year follow-up 91% of the partly and 67% of those who at admission were completely vocationally disabled were undergoing education or were gainfully employed, giving a success rate of 77%. Moreover, return to work from unemployment resulted in significantly increased income. Successful rehabilitation resulted in normalization of the majority of life satisfaction domains. This was particularly true for overall vocational satisfaction. Level of happiness was increased but not up to the level of the references. At follow-up the level of or change in (admission/follow-up computations) vocational satisfaction were major predictors for level of or change in happiness. Hence, successful vocational rehabilitation led to increased social well-being.For the total sample major predictors of outcome were: Level of experienced health and belief in vocational return. It is suggested that these two variables arc useful instruments for vocational rehabilitation decision making. In the algic sub-sample signs and symptoms were - statistically - combined into 8 meaningful entities, characterizing regional, postural and relational syndromes. Whereas these may not necessarily be generalizable they may be of clinical descriptory value. However, only one of them contributed to outcome prediction; the major predictors for those algic subjects being belief in vocational return and sex.
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| 6. |
- Elmqvist, Lars-Gunnar, 1944-
(författare)
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Chronic anterior cruciate ligament tear : knee function and knee extensor muscle size, morphology and function before and after surgical reconstruction
- 1988
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Knee function was evaluated by knee score, activity level, clinical findings and performance tests, muscle size by computerized tomography (CT), morphology by light (LM) and electron microscopy (EM), muscle function by electromyography (EMG) and isokinetic performance in 29 patients with chronic anterior cruciate ligament (ACL) tear. Preoperatively CT disclosed a significant mean atrophy of the quadriceps and nonsignificant changes of the other muscle areas of the injured leg. Morphology of m vastus lateralis of the injured leg was normal in more than half of the biopsies preoperatively, the rest showed signs of nonoptimal activation. Significant decreases in all isokinetic parameters were noticed together with significantly decreased EMG of the quadriceps muscle of the injured leg.Âfter surgical reconstruction the knees were immobilized in a cast for 6 weeks at either 30° or 70° of knee flexion. After cast removal CT showed significant decreases of all areas which also remained after training. The 30° group showed larger fibres (intracellular oedema) and more frequent morphological abnormalities than the 70° group. Fourteen weeks postoperatively the patients were allocated to either a combination of isometric and progressive resistance training or isokinetic training for 6 weeks. CT showed slightly larger areas at 20 weeks postoperatively than at 6 weeks. Morphological abnormalities were still prominent at 20 weeks postoperatively. Maximum isokinetic knee extensor mechanical output and endurance were markedly decreased at 14 weeks postoperatively but both improved progressively during the one year rehabilitation, mostly during the intensive 6 week training period but irrespective of training programme used. Fatiguability/endurance level improved over the preoperative level. Muscular work/integrated EMG was stable while EMG/t increased indicating neuromuscular relearning.The clinical result at 28 months foliowup was excellent or good in 93% of the patients and clinical stability improved in 66%. Independent upon primary knee immobilization angle or training programmes no differences could be demonstrated with respect to stability, range of motion, function or isokinetic mechanical output. Isokinetic performance was still significantly lower in the injured compared to the noninjured leg and not significantly different from the preoperative values. Morphology, only 6 cases, showed abnormalities similar to preoperative findings.In conclusion, the reason for the decreased maximum and total knee extensor performance in these patients with ACL tears is suggested to be nonoptimal activation of normal functioning muscle fibres depending on changes in knee joint receptor afferent inflow. No differences concerning the markedly improved postoperative clinical result could be seen between the different treatment modalities used. A nonoptimal muscular activation might explain the still decreased isokinetic performance present at followup.
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| 7. |
- Johansson, Christer, 1953-
(författare)
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Elite sprinters, ice hockey players, orienteers and marathon runners : isokinetic leg muscle performance in relation to muscle structure and training
- 1987
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In male athletes from different sports, isokinetic knee extensor, and in orienteers also plantar flexor peak torque (PT), contractional work (CW) and integrated surface electromyograms (iEMG) were analysed.Single contraction PT, CW and iEMG in sprinters and marathon runners were significantly correlated to the cross-sectional area (CSA) of m. quadriceps, and to the Type II fibre area of m. vastus lateralis. When correcting PT, CW and iEMG for CSA of m. quadriceps, such correlations were found only for Type IIA fibre area at 180° s~1. Elec- tromyographically, m. vastus lateralis (biopsied muscle) was representative for m. quadriceps. Calculated optimal mean power (CW s~1) and electrical efficacy (CW/iEMG) approximated for sprinters 450° s-1 and for marathon runners 270° s~1, i.e. velocities at or above the upper limit of the dynamometers. In orienteers, plantar flexor PT increased during winter training, but decreased during competitive season. Knee extensor PT increased over the whole year. At 30 and 60° s~1 only knee extensor PT was negatively associated with the running velocity at onset of blood lactate accumulation (VOBLA)- Changes in VOBLA during winter period were negatively associated with changes in knee extensor PT at 180° s~1. During competitive season, changes in Vobla were negatively associated with the ratio quality : quantity running. In ice hockey players PT varied non-systematically with training and games.The biopsy specimens of marathon runners showed irregular fibre shapes, an increased amount of connective tissue and central fibre nuclei, indicating an early strain disease or functional adaptation to extreme demands.During repetitive contractions in sprinters and marathon runners, fatigue, i.e. slope of decline in CW, was significantly associated with the Type II fibre area of m. vastus lateralis. For knee extensors of sprinters, ice hockey players and orienteers, a steep decrease in CW/iEMG was observed. In contrast, knee extensors of marathon runners and plantar flexors of orienteers showed an almost unaltered CW/iEMG throughout the test. The knee extensor endurance level (CW/iEMG) was significantly correlated to the maximal oxygen uptake. In orienteers, an increase in endurance level of both tested muscle groups during winter training parallelled an increase in VOBLA and V02obla- In hockey players, fatigue and endurance pattern (CW and CW/iEMG) changed non-systematically with training and games.In conclusion, isokinetic measurements and iEMG reflect the structural properties of the knee extensor muscles in sprinters and marathon runners. The demonstrated characteristics and changes in leg muscle function in different groups of athletes apparently reflect varying demands from different sports activities.
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