| 1. |
- Beischer, Susanne, et al.
(författare)
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Young Athletes Who Return to Sport Before 9 Months After Anterior Cruciate Ligament Reconstruction Have a Rate of New Injury 7 Times That of Those Who Delay Return
- 2020
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Ingår i: Journal of Orthopaedic & Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 50:2, s. 83-90
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the association between sustaining a second anterior cruciate ligament (ACL) injury and (1) time to return to sport, (2) symmetrical muscle function, and (3) symmetrical quadriceps strength at the time of return to sport in young athletes after primary ACL reconstruction. DESIGN: Prospective cohort study. METHODS: Patient demographics and results from 5 tests of muscle function (2 strength tests and 3 hop tests) were extracted from a rehabilitation registry. A questionnaire was sent to athletes (1530 years old) who were involved in knee-strenuous sport before the injury and had undergone primary ACL reconstruction to determine time of return to knee-strenuous sport (preinjury Tegner Activity Scale score of 6 or greater). We used the Cox proportional hazard regression model to analyze time to event. RESULTS: One hundred fifty-nine (32% of initial sample) athletes (mean +/- SD age, 21.5 +/- 4.4 years; 64% female) were included. Athletes with a higher preinjury Tegner Activity Scale score had a higher rate of second ACL injury (hazard ratio = 2.1; 95% confidence interval: 1.2, 3.6; P<.01). Athletes who returned to knee-strenuous sport before 9 months after reconstruction had a higher rate of second ACL injury (hazard ratio = 6.7; 95% confidence interval: 2.6,16.7; P<.001). There was no association between symmetrical muscle function or quadriceps strength and second ACL injury. CONCLUSION: Returning to knee-strenuous sport before 9 months after ACL reconstruction was associated with an approximately 7-fold increased rate of sustaining a second ACL injury. Achieving symmetrical muscle function or quadriceps strength was not associated with new ACL injury in young athletes.
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| 2. |
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| 3. |
- Bohgard, Mats, et al.
(författare)
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Nu krävs satsning på forskning för ett hållbart arbetsliv
- 2021
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Ingår i: Dagens Medicin. - 1104-7488.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Debatt: Vi vill att forskningsråden skapar tvärvetenskapliga regionala forskningscentrum för arbetslivsforskning, som är internationellt konkurrenskraftiga och ger nationellt och regionalt kunskapsstöd. Dessa centrum ska ge kunskaper för både befintliga och framtida utmaningar. Stora vinster kan fås om forskning om folkhälsa och yttre miljö samordnas i centrumen. Arbetslivet är grunden för hälsa, välstånd och ett välfungerande samhälle. För att säkra att framtidens arbetsliv bidrar till hälsa och välstånd behövs både kunskap om hur det ska utformas och en uthållig infrastruktur för forskning. Tyvärr saknas detta. Gammal kunskap faller i glömska.
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| 4. |
- Grävare Silbernagel, Karin, 1965, et al.
(författare)
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Evaluation of lower leg function in patients with Achilles tendinopathy
- 2006
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Ingår i: Knee Surg Sports Traumatol Arthrosc. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 14:11, s. 1207-17
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Tidskriftsartikel (refereegranskat)abstract
- Achilles tendinopathy is considered to be one of the most common overuse injuries in elite and recreational athletes. However, the effect that the Achilles tendinopathy has on patients' physical performance is still unclear. The purpose of this study was to evaluate if Achilles tendinopathy caused functional deficits on the injured side compared with the non-injured side in patients. A test battery comprised of tests for different aspects of muscle-tendon function of the gastrocnemius, soleus and Achilles tendon complex was developed to evaluate lower leg function. The test battery's test-retest reliability and sensitivity (the percent probability that the tests would demonstrate abnormal lower limb symmetry index in patients) were also evaluated. The test battery consisted of three jump tests, a counter movements jump (CMJ), a drop counter movement jump (drop CMJ) and hopping, and two strength tests, concentric toe-raises, eccentric-concentric toe-raises and toe-raises for endurance. The reliability was evaluated through a test-retest design on 15 healthy subjects. The test battery's sensitivity and possible functional deficits in patients with Achilles tendinopathy were evaluated on 42 patients (19 women and 23 men). An excellent reliability was found between test days 1-2 and 2-3 for all tests (ICC = 0.76-0.94) except for concentric toe-raise, test 2-3, which had fair reliability (ICC = 0.73). The methodological error ranged from 8 to 17%. There were significant differences (P = 0.001-0.049) between the non-injured (or least symptomatic) side and injured (most symptomatic) side for hopping, drop CMJ, concentric and eccentric-concentric toe-raises, and significant differences (P = 0.000-0.012) in the level of pain during CMJ, hopping, and drop CMJ. The sensitivity of the test battery at a 90% capacity was 88. Achilles tendinopathy causes not only pain and symptoms in patients but also apparent impairments in various aspects of lower leg muscle-tendon function as measured with the test battery. This test battery is reliable and able to detect differences in lower leg function between the injured or "most symptomatic" and non-injured or "least symptomatic" side in patients with Achilles tendinopathy. The test battery has higher demand on patients' function compared with each individual test.
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| 5. |
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| 6. |
- Gustavsson, Alexander, et al.
(författare)
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A test battery for evaluating hop performance in patients with an ACL injury and patients who have undergone ACL reconstruction
- 2006
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Ingår i: Knee Surg Sports Traumatol Arthrosc. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 14:8, s. 778-88
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to develop a test battery of hop tests with high ability to discriminate (i.e. high test-retest reliability, sensitivity, specificity and accuracy) between the hop performance of the injured and the uninjured side in patients with an ACL injury and in patients who have undergone ACL reconstruction. Five hop tests were analysed: three maximum single hop tests and two hop tests while developing fatigue. Fifteen healthy subjects performed the five hop tests on three separate occasions in a test-retest design. Thirty patients, mean 11 months after an ACL injury and 35 patients, mean 6 months after ACL reconstruction were tested. ICC values ranged from 0.85 to 0.97 for the five hop tests, indicating that all the tests had high test-retest reliability. Sixty-seven percent to 100% of the healthy subjects had normal symmetry (i.e. <10% side-to-side difference) in the five hop tests. Abnormal symmetry in the five hop tests ranged from 43 to 77% for patients with an ACL injury and from 51 to 86% for patients who had undergone ACL reconstruction respectively. The three tests with the highest ability to discriminate hop performance were chosen for the test battery; they were the vertical jump, the hop for distance and the side hop. The test battery revealed a high level of sensitivity and accuracy in patients with an ACL injury (87 and 84%) and in patients who had undergone ACL reconstruction (91 and 88%), when at least one of the three tests was classified as abnormal. To summarise, the test battery consisting of both maximum single hop performances: the vertical jump and the hop for distance and hop performance while developing fatigue: the side hop, produced high test-retest reliability, sensitivity and accuracy. Further, the test battery produced higher values compared with any of the three hop tests individually revealing that only one out of ten patients had restored hop performance 11 months after an ACL injury and 6 months after ACL reconstruction. It is concluded that this test battery showed a high ability to discriminate between the hop performance of the injured and the uninjured side both in patients with an ACL injury and in patients who have undergone ACL reconstruction.
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| 7. |
- Gustavsson, Anders, et al.
(författare)
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Corrigendum to “Cost of disorders of the brain in Europe 2010” [Eur. Neuropsychopharmacol. 21 (2011) 718–779]
- 2012
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Ingår i: European Neuropsychopharmacology. - : Elsevier BV. - 0924-977X .- 1873-7862. ; 22:3, s. 237-238
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Tidskriftsartikel (refereegranskat)abstract
- The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people.
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| 8. |
- Gustavsson, Anders, et al.
(författare)
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Cost of disorders of the brain in Europe 2010.
- 2011
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Ingår i: European Neuropsychopharmacology. - Amsterdam : Elsevier BV. - 0924-977X .- 1873-7862. ; 21:10, s. 718-79
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people.AIMS: To estimate the number of persons with defined disorders of the brain in Europe in 2010, the total cost per person related to each disease in terms of direct and indirect costs, and an estimate of the total cost per disorder and country.METHODS: The best available estimates of the prevalence and cost per person for 19 groups of disorders of the brain (covering well over 100 specific disorders) were identified via a systematic review of the published literature. Together with the twelve disorders included in 2004, the following range of mental and neurologic groups of disorders is covered: addictive disorders, affective disorders, anxiety disorders, brain tumor, childhood and adolescent disorders (developmental disorders), dementia, eating disorders, epilepsy, mental retardation, migraine, multiple sclerosis, neuromuscular disorders, Parkinson's disease, personality disorders, psychotic disorders, sleep disorders, somatoform disorders, stroke, and traumatic brain injury. Epidemiologic panels were charged to complete the literature review for each disorder in order to estimate the 12-month prevalence, and health economic panels were charged to estimate best cost-estimates. A cost model was developed to combine the epidemiologic and economic data and estimate the total cost of each disorder in each of 30 European countries (EU27+Iceland, Norway and Switzerland). The cost model was populated with national statistics from Eurostat to adjust all costs to 2010 values, converting all local currencies to Euro, imputing costs for countries where no data were available, and aggregating country estimates to purchasing power parity adjusted estimates for the total cost of disorders of the brain in Europe 2010.RESULTS: The total cost of disorders of the brain was estimated at €798 billion in 2010. Direct costs constitute the majority of costs (37% direct healthcare costs and 23% direct non-medical costs) whereas the remaining 40% were indirect costs associated with patients' production losses. On average, the estimated cost per person with a disorder of the brain in Europe ranged between €285 for headache and €30,000 for neuromuscular disorders. The European per capita cost of disorders of the brain was €1550 on average but varied by country. The cost (in billion €PPP 2010) of the disorders of the brain included in this study was as follows: addiction: €65.7; anxiety disorders: €74.4; brain tumor: €5.2; child/adolescent disorders: €21.3; dementia: €105.2; eating disorders: €0.8; epilepsy: €13.8; headache: €43.5; mental retardation: €43.3; mood disorders: €113.4; multiple sclerosis: €14.6; neuromuscular disorders: €7.7; Parkinson's disease: €13.9; personality disorders: €27.3; psychotic disorders: €93.9; sleep disorders: €35.4; somatoform disorder: €21.2; stroke: €64.1; traumatic brain injury: €33.0. It should be noted that the revised estimate of those disorders included in the previous 2004 report constituted €477 billion, by and large confirming our previous study results after considering the inflation and population increase since 2004. Further, our results were consistent with administrative data on the health care expenditure in Europe, and comparable to previous studies on the cost of specific disorders in Europe. Our estimates were lower than comparable estimates from the US.DISCUSSION: This study was based on the best currently available data in Europe and our model enabled extrapolation to countries where no data could be found. Still, the scarcity of data is an important source of uncertainty in our estimates and may imply over- or underestimations in some disorders and countries. Even though this review included many disorders, diagnoses, age groups and cost items that were omitted in 2004, there are still remaining disorders that could not be included due to limitations in the available data. We therefore consider our estimate of the total cost of the disorders of the brain in Europe to be conservative. In terms of the health economic burden outlined in this report, disorders of the brain likely constitute the number one economic challenge for European health care, now and in the future. Data presented in this report should be considered by all stakeholder groups, including policy makers, industry and patient advocacy groups, to reconsider the current science, research and public health agenda and define a coordinated plan of action of various levels to address the associated challenges.RECOMMENDATIONS: Political action is required in light of the present high cost of disorders of the brain. Funding of brain research must be increased; care for patients with brain disorders as well as teaching at medical schools and other health related educations must be quantitatively and qualitatively improved, including psychological treatments. The current move of the pharmaceutical industry away from brain related indications must be halted and reversed. Continued research into the cost of the many disorders not included in the present study is warranted. It is essential that not only the EU but also the national governments forcefully support these initiatives.
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| 9. |
- Gustavsson, Roland, et al.
(författare)
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Autenticitet i förvaltning och bevarande
- 2004
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Ingår i: Bebyggelsehistorisk tidskrift. - : Föreningen Bebyggelsehistorisk tidskrift. - 0349-2834 .- 2002-3812. ; :48, s. 52-58
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Tidskriftsartikel (refereegranskat)
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| 10. |
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