| 1. |
- Bleakley, C., et al.
(författare)
-
Does mechanical loading restore ligament biomechanics after injury? A systematic review of studies using animal models
- 2023
-
Ingår i: BMC Musculoskeletal Disorders. - : Springer Nature. - 1471-2474. ; 24:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundMechanical loading is purported to restore ligament biomechanics post-injury. But this is difficult to corroborate in clinical research when key ligament tissue properties (e.g. strength, stiffness), cannot be accurately measured. We reviewed experimental animal models, to evaluate if post-injury loading restores tissue biomechanics more favourably than immobilisation or unloading. Our second objective was to explore if outcomes are moderated by loading parameters (e.g. nature, magnitude, duration, frequency of loading).MethodsElectronic and supplemental searches were performed in April 2021 and updated in May 2023. We included controlled trials using injured animal ligament models, where at least one group was subjected to a mechanical loading intervention postinjury. There were no restrictions on the dose, time of initiation, intensity, or nature of the load. Animals with concomitant fractures or tendon injuries were excluded. Prespecified primary and secondary outcomes were force/stress at ligament failure, stiffness, laxity/deformation. The Systematic Review Center for Laboratory animal Experimentation tool was used to assess the risk of bias.ResultsThere were seven eligible studies; all had a high risk of bias. All studies used surgically induced injury to the medial collateral ligament of the rat or rabbit knee. Three studies recorded large effects in favour of ad libitum loading postinjury (vs. unloading), for force at failure and stiffness at 12-week follow up. However, loaded ligaments had greater laxity at initial recruitment (vs. unloaded) at 6 and 12 weeks postinjury. There were trends from two studies that adding structured exercise intervention (short bouts of daily swimming) to ad libitum activity further enhances ligament behaviour under high loads (force at failure, stiffness). Only one study compared different loading parameters (e.g. type, frequency); reporting that an increase in loading duration (from 5 to 15 min/day) had minimal effect on biomechanical outcomes.ConclusionThere is preliminary evidence that post-injury loading results in stronger, stiffer ligament tissue, but has a negative effect on low load extensibility. Findings are preliminary due to high risk of bias in animal models, and the optimal loading dose for healing ligaments remains unclear.
|
|
| 2. |
- Knutsson, Björn, et al.
(författare)
-
Waiting for lumbar spinal stenosis surgery : suffering and a possibility to discover coping abilities
- 2022
-
Ingår i: Orthopedic Reviews. - : Open Medical Publishing. - 2035-8237 .- 2035-8164. ; 14:1, s. 1-7
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The objective of this study was to describe aspects of suffering related to being a person with LSS and how suffering is managed before LSS surgery.Methods/design/setting: A Swedish county hospital. Interviews with 18 consecutive patients on the waiting list for LSS surgery. The themes that emerged from content analysis were further interpreted using Antonovsky salutogenic model as a sensitizing concept.Results: The suffering from LSS before surgery included the main theme of experiencing an impaired physical and social life and struggling to be believed and taken seriously. This had coping strategies to manage symptoms before surgery: a good physician-patient relationship alleviates the burden of long waiting times; ways to manage pain and disability; ambiguous expectations and hope for recovery, and; ways to handle concerns before surgery).Conclusion: Being a person with LSS includes suffering and a possibility to discover coping abilities or having support structures for doing so. Our study emphasizes the importance of a supportive dialogue, where physicians and patients make the suffering from LSS and care before LSS surgery more comprehensible and manageable.
|
|
| 3. |
- Essner, Ann, et al.
(författare)
-
Comparison of Polar® RS800CX heart rate monitor and electrocardiogram for measuring inter-beat intervals in healthy dogs
- 2015
-
Ingår i: Physiology and Behavior. - : Elsevier. - 0031-9384 .- 1873-507X. ; 138:January, s. 247-253
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to assess the criterion validity, relative reliability and level of agreement ofPolar® RS800CX heart rate monitor measuring inter-beat intervals (IBIs), compared to simultaneously recordedelectrocardiogram (ECG) in dogs.Methods: Five continuous minutes of simultaneously recorded IBIs from Polar® RS800CX and Cardiostore ECG in11 adult healthy dogs maintaining standing position were analyzed. Polar® data was statistically compared toECG data to assess for systematic differences between the methods. Three different methods for handling missingIBI data were used. Criterion validities were calculated by intraclass correlation coefficients (ICCs) and corresponding95% confidence intervals (CIs). Relative reliabilities and levels of agreement were calculated by ICCsand the Bland and Altman analysis for repeated measurements per subject.Results: Correlation coefficients between IBI data from ECG and Polar® RS800CX varied between 0.73 and 0.84depending on how missing values were handled. Polar® was over- and underestimating IBI data compared toECG. The mean difference in log transformed (base10) IBI data was 0.8%, and 93.2% of the values were withinthe limits of agreement. Internally excluding three subjects presenting IBI series containing more than 5% erroneousIBIs resulted in ICCs between 0.97 and 0.99. Bland and Altman analysis (n = 8) showed mean differencewas 1.8 ms, and 98.5% of the IBI values were plotted inside limits of agreement.Conclusion: This study showed that Polar® systematically biased recorded IBI series and that it was fundamentalto detect measurement errors. For Polar® RS800CX heart rate monitor to be used interchangeably to ECG, byshowing excellent criterion validity and reliable IBI measures in group and individual samples, only less than5% of artifacts could be accepted.
|
|
| 4. |
- Jedenmalm, Anneli, et al.
(författare)
-
Validation of a 3D CT method for measurement of linear wear of acetabular cups : A hip simulator study
- 2011
-
Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 82:1, s. 35-41
-
Tidskriftsartikel (refereegranskat)abstract
- Material and methods Ultra-high molecular weight polyethylene cups with a titanium mesh molded on the outside were subjected to wear using a hip simulator. Before and after wear, they were (1) imaged with a CT scanner using a phantom model device, (2) measured using a coordinate measurement machine (CMM), and (3) weighed. CMM was used as the reference method for measurement of femoral head penetration into the cup and for comparison with CT, and gravimetric measurements were used as a reference for both CT and CMM. Femoral head penetration and wear vector angle were studied. The head diameters were also measured with both CMM and CT. The repeatability of the method proposed was evaluated with two repeated measurements using different positions of the phantom in the CT scanner. Results The accuracy of the 3D CT method for evaluation of linear wear was 0.51 mm and the repeatability was 0.39 mm. Repeatability for wear vector angle was 17 degrees A degrees. Interpretation This study of metal-meshed hip-simulated acetabular cups shows that CT has the capacity for reliable measurement of linear wear of acetabular cups at a clinically relevant level of accuracy.
|
|
| 5. |
- Kanis, J A, et al.
(författare)
-
Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX.
- 2023
-
Ingår i: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. - : Springer Nature. - 1433-2965 .- 0937-941X. ; 34:12, s. 2027-2045
-
Tidskriftsartikel (refereegranskat)abstract
- A large international meta-analysis using primary data from 64 cohorts has quantified the increased risk of fracture associated with a previous history of fracture for future use in FRAX.The aim of this study was to quantify the fracture risk associated with a prior fracture on an international basis and to explore the relationship of this risk with age, sex, time since baseline and bone mineral density (BMD).We studied 665,971 men and 1,438,535 women from 64 cohorts in 32 countries followed for a total of 19.5 million person-years. The effect of a prior history of fracture on the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture, and hip fracture alone was examined using an extended Poisson model in each cohort. Covariates examined were age, sex, BMD, and duration of follow-up. The results of the different studies were merged by using the weighted β-coefficients.A previous fracture history, compared with individuals without a prior fracture, was associated with a significantly increased risk of any clinical fracture (hazard ratio, HR = 1.88; 95% CI = 1.72-2.07). The risk ratio was similar for the outcome of osteoporotic fracture (HR = 1.87; 95% CI = 1.69-2.07), major osteoporotic fracture (HR = 1.83; 95% CI = 1.63-2.06), or for hip fracture (HR = 1.82; 95% CI = 1.62-2.06). There was no significant difference in risk ratio between men and women. Subsequent fracture risk was marginally downward adjusted when account was taken of BMD. Low BMD explained a minority of the risk for any clinical fracture (14%), osteoporotic fracture (17%), and for hip fracture (33%). The risk ratio for all fracture outcomes related to prior fracture decreased significantly with adjustment for age and time since baseline examination.A previous history of fracture confers an increased risk of fracture of substantial importance beyond that explained by BMD. The effect is similar in men and women. Its quantitation on an international basis permits the more accurate use of this risk factor in case finding strategies.
|
|
| 6. |
- Vandenput, Liesbeth, et al.
(författare)
-
A meta-analysis of previous falls and subsequent fracture risk in cohort studies
- 2024
-
Ingår i: Osteoporosis International. - : Springer. - 0937-941X .- 1433-2965. ; 35:3, s. 469-494
-
Tidskriftsartikel (refereegranskat)abstract
- SummaryThe relationship between self-reported falls and fracture risk was estimated in an international meta-analysis of individual-level data from 46 prospective cohorts. Previous falls were associated with an increased fracture risk in women and men and should be considered as an additional risk factor in the FRAX® algorithm.IntroductionPrevious falls are a well-documented risk factor for subsequent fracture but have not yet been incorporated into the FRAX algorithm. The aim of this study was to evaluate, in an international meta-analysis, the association between previous falls and subsequent fracture risk and its relation to sex, age, duration of follow-up, and bone mineral density (BMD).MethodsThe resource comprised 906,359 women and men (66.9% female) from 46 prospective cohorts. Previous falls were uniformly defined as any fall occurring during the previous year in 43 cohorts; the remaining three cohorts had a different question construct. The association between previous falls and fracture risk (any clinical fracture, osteoporotic fracture, major osteoporotic fracture, and hip fracture) was examined using an extension of the Poisson regression model in each cohort and each sex, followed by random-effects meta-analyses of the weighted beta coefficients.ResultsFalls in the past year were reported in 21.4% of individuals. During a follow-up of 9,102,207 person-years, 87,352 fractures occurred of which 19,509 were hip fractures. A previous fall was associated with a significantly increased risk of any clinical fracture both in women (hazard ratio (HR) 1.42, 95% confidence interval (CI) 1.33–1.51) and men (HR 1.53, 95% CI 1.41–1.67). The HRs were of similar magnitude for osteoporotic, major osteoporotic fracture, and hip fracture. Sex significantly modified the association between previous fall and fracture risk, with predictive values being higher in men than in women (e.g., for major osteoporotic fracture, HR 1.53 (95% CI 1.27–1.84) in men vs. HR 1.32 (95% CI 1.20–1.45) in women, P for interaction = 0.013). The HRs associated with previous falls decreased with age in women and with duration of follow-up in men and women for most fracture outcomes. There was no evidence of an interaction between falls and BMD for fracture risk. Subsequent risk for a major osteoporotic fracture increased with each additional previous fall in women and men.ConclusionsA previous self-reported fall confers an increased risk of fracture that is largely independent of BMD. Previous falls should be considered as an additional risk factor in future iterations of FRAX to improve fracture risk prediction.
|
|
| 7. |
- Bagehorn, T., et al.
(författare)
-
Effect of increased shoe longitudinal bending stiffness on ankle and foot biomechanics in jump-cut movements of low and high degrees
- 2024
-
Ingår i: Footwear Science. - : Informa UK Limited. - 1942-4280 .- 1942-4299. ; 16:2, s. 135-146
-
Tidskriftsartikel (refereegranskat)abstract
- Lateral ankle sprains are the most common injuries in indoor and court sports, with ankle inversion being a primary injury driver. Stabilising the ankle during multidirectional changes is crucial for injury prevention. Conversely, increased shoe stiffness has been hypothesised to influence the magnitude of ankle inversion and may raise the risk for ankle injuries. Therefore, the purpose of this study was to investigate the influence of shoe longitudinal bending stiffness on ankle biomechanics during indoor and court sport-specific cutting movements. Biomechanical data from 19 participants were collected using a motion capture system and force plate. A jump-cut protocol with two different cutting directions after landing was performed in indoor shoes with and without carbon plate inserts of varying stiffness. Ankle kinematics and kinetics were analysed with statistical parametric mapping and repeated measures analysis of variance. A significant increase in ankle inversion during the 180° cut and a reduction in forefoot inversion (foot torsion) for stiffer footwear conditions during both the 45° and 180° cut were observed. While dorsiflexion moments differed during the last 10% of ground contact, ankle inversion moments did not significantly diverge between shoe conditions. Furthermore, a noteworthy correlation between footwear longitudinal bending stiffness and torsional stiffness was identified. In conclusion, increased bending stiffness significantly affected ankle and foot kinematics. The ankle compensated for restricted mobility and higher demands during high-degree jump-cuts, while foot torsion played a more prominent role in low-degree cuts. The heightened ankle inversion during high-degree cuts may induce an elevated risk for lateral ankle sprains. Further longitudinal studies are necessary to comprehensively understand injury incidence and the role of shoe stiffness in injury prevention.
|
|
| 8. |
- Cronskär, Marie, et al.
(författare)
-
Patient-Specific Clavicle Reconstruction Using Digital Design and Additive Manufacturing
- 2015
-
Ingår i: Journal of mechanical design (1990). - : ASME Press. - 1050-0472 .- 1528-9001. ; 137:11
-
Tidskriftsartikel (refereegranskat)abstract
- There is a trend toward operative treatment for certain types of clavicle fractures and these are usually treated with plate osteosynthesis. The subcutaneous location of the clavicle makes the plate fit important, but the clavicle has a complex shape, which varies greatly between individuals and hence standard plates often have a poor fit. Using computed tomography (CT) based design, the plate contour and screw positioning can be optimized to the actual case. A method for patient-specific plating using design based on CT-data, additive manufacturing (AM), and postprocessing was initially evaluated through three case studies, and the plate fit on the reduced fracture was tested during surgery (then replaced by commercial plates). In all three cases, the plates had an adequate fit on the reduced fracture. The time span from CT scan of the fracture to final implant was two days. An approach to achieve functional design and screw-hole positioning was initiated. These initial trials of patient-specific clavicle plating using AM indicate the potential for a smoother plate with optimized screw positioning. Further, the approach facilitates the surgeon's work and operating time can be saved.
|
|
| 9. |
- Koptyug, Andrey, 1956-, et al.
(författare)
-
Tin Man- Making Spare Parts for Human Body
- 2012
-
Ingår i: Science First Hand. - Novosibirsk, Russia : Publishing House INFOLIO. - 1810-3960. ; 44:2, s. 45-57
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- In this paper we would like to illustrate the present and future of additive manufacturing technologies in medicine, in particular when helping the humanity to acquire some needed "spare parts", using some examples provided by the Sports Technology (SportsTech) Group at the Department of Engineering and Sustainable Development of the Mid Sweden University.
|
|
| 10. |
- Larsson, Agneta, et al.
(författare)
-
Effects of work ability and health promoting interventions for women with musculoskeletal symptoms : A 9-month prospective study
- 2008
-
Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 9, s. 105-
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Women working in the public human service sector in 'overstrained' situations run the risk of musculoskeletal symptoms and long-term sick leave. In order to maintain the level of health and work ability and strengthen the potential resources for health, it is important that employees gain greater control over decisions and actions affecting their health - a process associated with the concept of self-efficacy. The aim of this study was to describe the effects of a self-efficacy intervention and an ergonomic education intervention for women with musculoskeletal symptoms, employed in the public sector.Methods: The design of the study was a 9-month prospective study describing the effects of two interventions, a comprehensive self-efficacy intervention (n = 21) and an ergonomic education intervention ( n = 21). Data were obtained by a self-report questionnaire on health-and work ability-related factors at baseline, and at ten weeks and nine months follow-up. Within-group differences over time were analysed.Results: Over the time period studied there were small magnitudes of improvements within each group. Within the self-efficacy intervention group positive effects in perceived work ability were shown. The ergonomic education group showed increased positive beliefs about future work ability and a more frequent use of pain coping strategies.Conclusion: Both interventions showed positive effects on women with musculoskeletal symptoms, but in different ways. Future research in this area should tailor interventions to participants' motivation and readiness to change.
|
|
