| 1. |
- Andersson, Maria L.E. 1968-, et al.
(author)
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Metabolic factors associated to clinical hand osteoarthritis in individuals with knee pain
- 2020
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In: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 79:Suppl. 1, s. 1734-1734
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Journal article (peer-reviewed)abstract
- Background: There is some evidence supporting associations between metabolic factors, clinical hand osteoarthritis (OA) and radiographic knee OA. However, more studies are needed regarding early knee OA.Objectives: The aim was to study associations between metabolic factors and clinical hand OA at baseline in a cohort of individuals with knee pain, with and without radiographic knee OA.Methods: In an ongoing five-year longitudinal study of knee pain, hand OA was assessed by clinical examinations in 296 of the included individuals at baseline [1]. BMI, waist circumference (WC) and blood pressure was measured. Body composition was assessed with Inbody 770. Fasting plasma glucose, triglycerides, cholesterol, HDL-and LDL-cholesterol and HbA1c was analysed. Metabolic syndrome (MetS)was present if central obesity (WC ≥94 cm in men and ≥80cm in women) plus any two of the following factors: raised blood pressure (systolic blood pressure ≥ 130 or diastolic blood pressure ≥ 85 mm Hg or treatment of hypertension), raised triglycerides (≥ 1.7 mmol/L or specific treatment), reduced HDL-cholesterol (men < 1.03 mmol/L and women < 1.29 mmol/L or specific treatment), raised glucose (glucose ≥ 5.6 mmol/L, or type 2 diabetes). Hand strength and self-reported disability of the arm, shoulder and hand (quickDASH) was assessed.The individuals were divided according to having clinical hand OA or not, according to Altman [1]. The associations between background factors and clinical hand OA were calculated by crude logistic regression analyses, adjusting for age and sex.Results: Fifty-five percent of the individuals in the study was overweight or obese, 40% had MetS and 23% had radiographic knee OA. In total 34% of the individuals had clinical hand OA. The group with hand OA were older, had higher proportion of body fat, fasting plasma glucose, HbA1C, worse quickDASH score and lower hand strength, table 1. Clinical hand OA was significantly associated to higher age (OR 1.04, 95%CI 1.01-1.07), higher fasting plasma glucose (1.56, 1.05-2.30), worse quickDASH (1.04, 1.02-1.06) and lower hand strength (0.99, 0.99 -0.998), but not to proportion of body fat and HbA1c.Conclusion: In this cross-sectional study, the only metabolic factor associated with clinical hand OA was fasting plasma glucose. Contrary to other studies, there were no gender differences found. The association between development of clinical hand OA and metabolic factors in individuals with knee pain need to be further assessed in longitudinal studies.
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| 2. |
- Andersson, Maria L.E. 1968-, et al.
(author)
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Metabolic Factors Associated to Radiographic Knee Osteoarthritis in Individuals with Knee Pain
- 2020
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In: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 79:Suppl. 1, s. 793-793
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Journal article (peer-reviewed)abstract
- Metabolic factors have been shown to be associated to radiographic knee osteoarthritis (OA) [1]. More knowledge about associations between metabolic factors and early clinical knee OA is needed.Objectives:The aim was to study associations between metabolic factors and radiographic knee OA in individuals with knee painMethods:In total 272 individuals with radiographs at baseline, from an ongoing longitudinal study of knee pain (without cruciate ligament injury), were included in the present cross-sectional study. At baseline BMI, waist circumference (WC) and visceral fat area (VFA) were assessed. Fasting plasma glucose, triglycerides, cholesterol, HDL-and LDL-cholesterol were analysed. Metabolic syndrome (MetS) was present if central obesity (WC ≥94 cm in men and ≥80cm in women) plus any two of the following factors: raised blood pressure (systolic blood pressure ≥ 130 or diastolic blood pressure ≥ 85 mm Hg or treatment of hypertension), raised triglycerides (≥ 1.7 mmol/L or specific treatment), reduced HDL-cholesterol (men < 1.03 mmol/L and women < 1.29 mmol/L or specific treatment), raised glucose (glucose ≥ 5.6 mmol/L, or type 2 diabetes).The individuals were divided in two groups according to Ahlbäck [2], one group, who had grade I or more in at least one knee (radiographic knee OA, ROA) n=62 and the other group, not fulfilling Ahlbäck criteria (no radiograhic knee OA, No OA) n=211. The associations between metabolic factors and knee OA were calculated by crude logistic regression analyses, adjusting for age and sex.Results:The group with radiographic knee OA were older, had higher BMI, higher amount of visceral fat and more had central obesity, table 1. Ninety- four percent of the group with ROA had central obesity compared to 76%, p=0.002 in the no OA group. There was no difference between the groups regarding MetS, 44% in the ROA group vs. 39%, p=0.5. The group with ROA had increased cholesterol, triglycerides and LDL-cholesterol. There were no differences in fasting glucose between the groups, though both groups had a mean glucose value in the upper range of normal value, table 1. Factors associated to having radiographic knee OA were age (OR 1.11, 95% CI 1.06-1.17), BMI (1.07, 1.003-1.13), central obesity (3.91, 1.32-11.61) and raised triglycerides (2.35, 1.03-5.38).Table 1.Baseline descriptivesNo OAMean (sd)ROAMean(sd)p-valueN21162Age50 (9)56 (4)<0.001Sex, women, %66710.454BMI25.9 (4.7)27.7 (4.7)0.007VFA (cm2)109 (53)126 (52)0.026WC, cm94 (13)99 (13)0.006Raised Blood pressure, %66530.063Cholesterol (mmol/L)5.2 (1.0)5.5 (1.1)0.033Triglycerides (mmol/L)1.0 (0.6)1.2 (0.7)0.035Raised triglycerides, %9210.008LDL-cholesterol (mmol/L)3.4 (1.0)3.7 (1.1)0.027HDL-cholesterol (mmol/L)1.7 (0.4)1.7 (0.5)0.547Reduced HDL11150.460Glucose (mmol/L)5.5 (0.9)5.5 (0.5)0.858Conclusion:There were associations between some metabolic factors and radiographic knee OA in individuals with knee pain. Fasting glucose was increased in both groups. The associations between metabolic risk factors and the development of knee OA needs to be assessed in longitudinal studies.References:[1]Sellam J, Bone Spine 2013;80:568-73.[2]Ahlback S,. Acta Radiol Diagn (Stockh) 1968Suppl 277:7-72.Disclosure of Interests:None declared
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| 3. |
- Landgren, Ellen, et al.
(author)
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“Mastering a New Life Situation” – Patients’ Preferences of Treatment Outcomes in Early Rheumatoid Arthritis – A Longitudinal Qualitative Study
- 2020
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In: Patient Preference and Adherence. - : Dove Medical Press Ltd.. - 1177-889X. ; 14, s. 1421-1433
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Journal article (peer-reviewed)abstract
- Purpose: To explore patients’ preferred treatment outcomes during their first two years with rheumatoid arthritis (RA). Patients and Methods: A qualitative, longitudinal, multicenter study with interviews at two time points was performed in Sweden. Individual interviews were conducted at time point 1 with 31 patients with RA, defined as disease duration of ≤1 year and treatment for 3–7 months. Seven focus group interviews and five individual interviews were conducted at time point 2 with 22 patients 12–20 months after treatment initiation. The interviews were analyzed using the Qualitative Analysis Guide of Leuven. A core category with four related concepts emerged. Results: The core finding of patient-preferred treatment outcomes was “mastering a new life situation”. Patients preferred to experience control of the disease by controlling the symptoms and by experiencing absence of disease. To experience autonomy by regaining former activity level, experiencing independence, and being empowered was another preferred outcome. Patients preferred to regain identity through being able to participate, experience well-being, and regain former self-image. To experience joy in everyday life through vitality and believing in the future was another preferred outcome. Patients’ preferences developed over time from the acute phase of controlling the symptoms and wanting to return to the life they lived prior to diagnosis, to a more preventive way of self-management and empower-ment to master the new life situation. Conclusion: The patients’ preferred treatment outcomes during the first two years with RA were to master their new life situation and changed from a preference to return to a life lived prior disease onset, to a preference of living with quality of life, despite RA. This study increases the understanding of patients’ preferred treatment outcomes in the early disease course and can be a foundation for tailoring interventions to be more person-centered and to improve long-term treatment outcomes. © 2020 Landgren et al.
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| 4. |
- Larsson, Jonas, 1968-, et al.
(author)
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Development and application of a questionnaire to self-rate physical work demands for ground combat soldiers
- 2020
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In: Applied Ergonomics. - Oxford : Elsevier. - 0003-6870 .- 1872-9126. ; 83
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Journal article (peer-reviewed)abstract
- Purpose: The aim of the present study was to identify the most physically demanding work tasks for Swedish ground combat soldiers through the development and application of a questionnaire survey. This is the first in a series of studies aiming to describe the development process and validation of physical selection standards in the Swedish armed forces.Methods: Based on procedural documentation, combat manuals and job analyses, a questionnaire was developed that defined and rated the perceived physical strain of 30 work tasks for ground combat soldiers. To assess validity, an expert focus group was used and psychometric analysis performed. The questionnaire was then distributed to 231 ground combat soldiers, of whom 165 responded (71%).Results: The questionnaire was validated in three steps to achieve face and content validity, and internal consistency was acceptable (Chronbach's alpha ≥0.95). Of the 30 work tasks included in the survey, transport of wounded was rated as the most demanding task for both aerobic capacity and strength. Other highly demanding tasks for aerobic capacity included combat movement (low/high crawl), dismounted attack in close country, urban and rough terrain and carrying heavy loads. There were no gender differences for either aerobic or strength demands in the top five most challenging tasks based on proportions.Conclusions: This study identified the most physically demanding tasks performed in the Swedish ground combat forces. Almost all the physically demanding tasks found in the present study contain elements of lifting and carrying, which require muscular strength and muscular endurance, with no gender differences. © 2019 Elsevier Ltd. All rights reserved.
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| 5. |
- Lindholm, Annelie, 1975-, et al.
(author)
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Nutrition- and feeding practice-related risk factors for rapid weight gain during the first year of life: a population-based birth cohort study
- 2020
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In: BMC Pediatrics. - London : Springer Science and Business Media LLC. - 1471-2431. ; 20:1
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Journal article (peer-reviewed)abstract
- Background Rapid weight gain (RWG) during infancy increases the risk of excess weight later in life. Nutrition- and feeding practices associated with RWG need to be further examined. The present study aimed to examine nutrition- and feeding practice-related risk factors for RWG during the first year of life. Methods A population-based longitudinal birth cohort study of 1780 infants, classified as having RWG or non-RWG during 0-3-4, 0-6 and 6-12 months. RWG was defined as a change > 0.67 in weight standard deviation scores. Associations between nutrition- and feeding practice-related factors and RWG were examined with logistic regression models. Results Of the participating infants, 47% had RWG during 0-3-4 months, 46% during 0-6 months and 8% during 6-12 months. In the fully adjusted models, bottle-feeding at birth and at 3-4 months and nighttime meals containing formula milk were positively associated with RWG during 0-3-4 months (p < 0.05 for all). Breastfeeding at 3-4 months and nighttime meals containing breast milk were negatively associated with RWG during this period (p < 0.001). Bottle-feeding at birth, 3-4 and 6 months and nighttime meals containing formula milk at 3-4 months were positively associated with RWG during 0-6 months (p < 0.01 for all). Breastfeeding at 3-4 and 6 months was negatively associated with RWG (p < 0.01). During 6-12 months, only bottle-feeding at 3-4 months was positively associated with RWG (p < 0.05). Conclusions RWG was more common during the first 6 months of life and bottle-feeding and formula milk given at night were risk factors for RWG during this period.
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| 6. |
- Malmborg, Julia, 1988-, et al.
(author)
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Risk Factors for Persistence and Development of Frequent Musculoskeletal Pain in Adolescent Athletes
- 2020
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In: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 79:Suppl 1, s. 206-206
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Journal article (peer-reviewed)abstract
- Physical activity has a positive impact on health, but adolescent athletes often report musculoskeletal pain (MP) which is negative in the aspect of sustaining physical activity over time. There is a lack of longitudinal assessments of MP and potential risk factors, such as timing of physical maturation, in adolescent athletes.Objectives:To identify risk factors associated with the persistence or development of frequent MP at a 2-year follow-up in adolescent sport school students.Methods:Fourteen-year-old sport school students (n=233) were invited to participate in this 2-year longitudinal study. Self-reports of MP was assessed as frequency, distribution, and intensity, and health status by EQ-5D. Physical maturation was calculated by the Mirwald equation (height, weight, and sitting height) (1), and categorized as early (>1 year), average (±1 year), or late (<–1 year). Students were grouped at baseline and follow-up into infrequent (never to monthly) or frequent (weekly to daily) MP groups. Logistic regression analysis was used to study associations between frequent MP at follow-up and baseline variables.Results:131 students (79 boys and 52 girls) were included in the study. Development or persistence of frequent MP at follow-up (n=61) was associated with being a girl, late physical maturation (only boys were categorized as late), non-contact sports participation, frequent MP at baseline, and reporting ≥2 MP sites at baseline. Students with a better health status at baseline were less likely to belong to the frequent MP group at follow-up (Table).Conclusion:Frequent MP is common in sport school students. MP in young athletes may become a future health problem and there is a need for recognition and interventions by coaches and health services to prevent MP from becoming persistent.References:[1]Mirwald, R. L., Baxter-Jones, A. D., Bailey, D. A., & Beunen, G. P. (2002). An assessment of maturity from anthropometric measurements.Med Sci Sports Exerc, 34(4), 689-694.Table.Associations between background variables at baseline and frequent MP at follow-up based on crude logistic regression analysis controlling each variable for sex.Baseline variablesModelInfrequent MP vs. Frequent MPOR(95% CI; p-value)SexBoys1.00Girls2.76(1.34–5.68; p<0.01)Physical maturationAverage (±1 year)1.00Early (>1 year)0.41(0.05–3.65; p=0.42)Late (<–1 year)3.83(1.13–12.95; p=0.03)Sport categoriesContact1.00Non-contact5.16(2.07–12.88; p<0.001)MP groupsInfrequent1.00Frequent2.74(1.31–5.72; p<0.01)MP intensity last week (NRS 0–10, best to worst)1.15(0.98–1.35; p=0.10)Number of MP sites01.0012.32(0.71–7.58; p=0.16)≥22.87(1.32–6.25; p<0.01)EQ-5D (0.00–1.00, worst to best)0.03(0.001–0.58; p=0.02)Disclosure of Interests:None declared
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| 7. |
- Söderström Malmborg, Julia, 1988-
(author)
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Pain and health in adolescents and young adults – pieces of a puzzle
- 2020
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Doctoral thesis (other academic/artistic)abstract
- Background: Musculoskeletal pain is a burden for the individual and for society, and it has a negative impact on overall health. The biological, psychological, and social factors that govern pain and health form a complex puzzle to put together. Musculoskeletal pain conditions may be alleviated by physical activity, but a too high level of physical activity may also increase the risk of pain. Youth athletes may be especially vulnerable to developing pain due to factors related to training load and physical maturity. Being physically active and maintaining a healthy diet is associated with better health, but if carried out to excess these health behaviours may become unhealthy. Our understanding of musculoskeletal pain and health in adolescents and young adults needs to be developed, both in individuals involved in sports and exercise and in the general population.Aim: The overall aim was to study musculoskeletal pain and its relationship to various health-related factors in adolescents and young adults enrolled in sport or general education programmes.Methods: Study I was a cross-sectional study on university students (aged 19–29) from an exercise science programme (n = 118) and a business programme (n = 89), assessing health status, physical activity, and orthorexia nervosa (an exaggerated fixation on healthy food). Study II was a cross-sectional study (n = 178), and Study III a 2-year longitudinal (n = 131) study on sport school students (aged 14 at baseline), assessing musculoskeletal pain, health status, physical maturity, and sports performance. Study IV was a 3-year longitudinal study on students from a general upper secondary school (n = 256, aged 16 at baseline), assessing chronic musculoskeletal pain, health status, physical activity, sleep, stress, anxiety, and depression.Results: In Study I, compared to business students, exercise science students reported more pain, but better general health. A high level of physical activity in combination with orthorexia nervosa was most prevalent in men from the exercise science programme. In Studies II and III, pain was common in sport school students. At baseline, boys with constant pain were not as physically mature as boys with infrequent pain. Students with constant pain reported a worse health status than students with infrequent pain. At follow-up, frequent pain, frequent pain in two or more body regions, and a worse health status at baseline were identified as risk factors for having frequent pain at follow-up in girls. For boys, late physical maturation at baseline was a risk factor. Involvement in non-contact sports was also an identified risk factor over time in both sexes. Pain was associated with a worse sports performance in boys at both baseline and follow-up. In Study IV, chronic musculoskeletal pain was common in students from a general upper secondary school. A worse health status, severe sleeping problems, anxiety, and chronic musculoskeletal pain at baseline were associated with reporting chronic musculoskeletal pain at follow-up.Conclusions: Pain was prevalent, and also persistent, in adolescents and young adults, irrespective of attending sport or general education programmes. Pain is a biopsychosocial phenomenon and must be treated as such. Pain should be frequently monitored, and treatment should be introduced early on to prevent pain from becoming persistent.
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| 8. |
- Van der Elst, Kristien, et al.
(author)
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What do patients prefer? A multinational, longitudinal, qualitative study on patient-preferred treatment outcomes in early rheumatoid arthritis
- 2020
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In: RMD Open. - London : BMJ Publishing Group Ltd. - 2056-5933. ; 6:2
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To explore treatment outcomes preferred by patients with early rheumatoid arthritis (RA) and how these change throughout the early disease stage across three European countries.METHODS: A longitudinal, qualitative, multicentre study was conducted in Belgium, the Netherlands and Sweden. 80 patients with early RA were individually interviewed 3-9 months after treatment initiation and 51 of them participated again in either a focus group or an individual interview 12-21 months after treatment initiation. Data were first analysed by country, following the Qualitative Analysis Guide of Leuven (QUAGOL). Thereafter, a meta-synthesis, inspired by the principles of meta-ethnography and the QUAGOL, was performed, involving the local research teams.RESULTS: The meta-synthesis revealed 11 subthemes from which four main themes were identified: disease control, physical performance, self-accomplishment and well-being. 'A normal life despite RA' was an overarching patient-preferred outcome across countries. Belgian, Dutch and Swedish patients showed many similarities in terms of which outcomes they preferred throughout the early stage of RA. Some outcome preferences (eg, relief of fatigue and no side effects) developed differently over time across countries.CONCLUSIONS: This study on patient-preferred outcomes in early RA revealed that patients essentially want to live a normal life despite RA. Our findings help to understand what really matters to patients and provide specific insights into the early stage of RA, which should be addressed by clinicians of different disciplines from the start of treatment onwards. © Author(s) (or their employer(s)) 2020.
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