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1.
  • Surano, Solmaz, et al. (författare)
  • Internet-based vestibular rehabilitation versus standard care after acute onset vertigo: a study protocol for a randomized controlled trial
  • 2022
  • Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Dizziness and vertigo affect around 15% of adults annually and represent common reasons for contacting health services, accounting for around 3% of all emergency department visits worldwide. Vertigo is also associated with excessive use of diagnostic imaging and emergency care and decreased productivity, primarily because of work absenteeism. Vestibular rehabilitation is an evidence-based treatment for chronic dizziness and supervised group exercise therapy has recently been shown to be effective after vestibular neuritis, a common cause of acute onset vertigo. However, such interventions are not readily available and there is a need for more easily accessible tools. The purpose of this study is to investigate the effects on vestibular symptoms of a 6-week online vestibular rehabilitation tool after acute onset vertigo, with the aim of aiding vestibular rehabilitation by presenting a more accessible tool that can help to reduce recovery time. Methods: Three hundred twenty individuals diagnosed with acute vestibular syndrome (AVS) will be recruited from multiple hospitals in Sweden and the effects of an online vestibular rehabilitation tool, YrselTraning, on vestibular symptoms after acute onset vertigo will be compared to standard care (written instructions leaflet) in a two-armed, evaluator-blinded, multicenter randomized controlled trial. The primary outcome will be the Vertigo Symptom Scale Short Form (VSS-SF) score at 6 weeks after symptom onset. Secondary outcomes include effects of the intervention on activities of daily living, mood and anxiety, vestibular function recovery, mobility measures, health economic effects, and the reliability of the Swedish VSS-SF translation. Discussion: Participants using the online vestibular rehabilitation tool are expected to recover earlier and to a greater extent from their symptoms as compared to standard care. Since up to 50% of people with AVS without treatment develop persistent symptoms, effective treatment of AVS will likely lead to a higher quality of life and help reduce the societal costs associated with dizziness and vertigo.
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2.
  • Aasa, Ulrika, et al. (författare)
  • Variability of lumbar spinal alignment among power- and weightlifters during the deadlift and barbell back squat
  • 2022
  • Ingår i: Sports Biomechanics. - : Routledge. - 1476-3141 .- 1752-6116. ; 21:6, s. 707-717
  • Tidskriftsartikel (refereegranskat)abstract
    • The aims of the study were to evaluate the relative and absolute variability of upper (T11-L2) and lower (L2-S2) lumbar spinal alignment in power- and weightlifters during the deadlift and back squat exercises, and to compare this alignment between the two lifting groups. Twenty-four competitive powerlifters (n = 14) and weightlifters (n = 10) performed three repetitions of the deadlift and the back squat exercises using a load equivalent to 70% of their respective one-repetition maximum. The main outcome measures were the three-dimensional lumbar spinal alignment for start position, minimum and maximum angle of their spinal alignment, and range of motion measured using inertial measurement units. Relative intra-trial reliability was calculated using the two-way random model intraclass correlation coefficient (ICC) and absolute reliability with minimal detectable change (MDC). The ICC ranged between 0.69 and 0.99 and the MDC between 1 degrees-8 degrees for the deadlift. Corresponding figures for the squat were 0.78-0.99 and 1 degrees-6 degrees. In all participants during both exercises, spinal adjustments were made in both thoracolumbar and lumbopelvic areas in all three dimensions. In conclusion, when performing three repetitions of the deadlift and the squat, lumbar spinal alignment of the lifters did not change much between repetitions and did not differ significantly between power- and weightlifters.
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3.
  • Bengtsson, Victor, et al. (författare)
  • Thoracolumbar and Lumbopelvic Spinal Alignment During the Barbell Back Squat : A Comparison Between Men and Women
  • 2023
  • Ingår i: International Journal of Sports Physical Therapy. - : International Journal of Sports Physical Therapy. - 2159-2896. ; 18:4, s. 820-830
  • Tidskriftsartikel (refereegranskat)abstract
    • Background:  Maintaining neutral spinal alignment is considered important when performing the barbell back squat exercise. Since male and female lifters may differ in injury location it is important to examine whether they differ in spinal alignment during the back squat.Objectives:  The study aimed to quantify the spinal alignment in the upper and lower lumbar spine during the barbell back squat exercise in male and female lifters. Secondary aims were to compare alignment during the back squat to standing habitual lumbar spine alignment and determine whether male and female lifters differ in these aspects.Study design:  Observational, Cross-sectional.Methods:  Competitive power- and weightlifters were recruited and performed three repetitions of the barbell back squat exercise using a load equivalent to 70% of their one-repetition maximum. Spinal alignment and range of motion were measured using inertial measurement units placed on the thoracic, lumbar and sacral spine. Data was presented descriptively and comparisons between men and women as well as spinal alignment in four different positions were done with a factorial repeated measures analysis of variance.Results:  Twenty-three (14 males, 9 females) were included. During execution of the squat, spinal alignment adjustments in the lumbar spine were made in all three planes of movement, compared to the start position, in both male and female lifters. Compared to their standing habitual posture, all lifters adjusted their upper lumbar spine to a less lordotic position when in the start position of the back squat (standing upright with the barbell on their back). Only male lifters assumed a less lordotic alignment in their lower lumbar spine in the start position compared their habitual posture.Conclusions:  Adjustments of spinal alignment, predominantly in the sagittal plane, are made during execution of the back squat in both male and female lifters. Further, lifters adopt a less lordotic alignment with a heavy barbell on their upper back, more so in male than female lifters. In conclusion, it seems that spinal alignment changes noticeably during the barbell back squat.Level of evidence:  3
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4.
  • Bengtsson, Victor, et al. (författare)
  • Thoracolumbar and lumbopelvic spinal alignment during the deadlift exercise : a comparison between men and women
  • 2022
  • Ingår i: International Journal of Sports Physical Therapy. - : North American Sports Medicine Institute. - 2159-2896. ; 17:6, s. 1063-1074
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: A neutral spinal alignment is considered important during the execution of the deadlift exercise to decrease the risk of injury. Since male and female powerlifters experience pain in different parts of their backs, it is important to examine whether men and women differ in spinal alignment during the deadlift.Objectives: The purpose of this study was to quantify the spinal alignment in the upper (thoracolumbar, T11-L2) and lower (lumbopelvic, L2-S2) lumbar spine during the deadlift exercise in male and female lifters. Secondary aims were to compare lumbar spine alignment during the deadlift to standing habitual posture, and determine whether male and female lifters differ in these aspects.Study Design: Observational, Cross-sectional.Methods: Twenty-four (14 men, 10 women) lifters performed three repetitions of the deadlift exercise using 70% of their respective one-repetition maximum. Spinal alignment and spinal range of motion were measured using three inertial measurement units placed on the thoracic, lumbar and sacral spine. Data from three different positions were analyzed; habitual posture in standing, and start and stop positions of the deadlift, i.e. bottom and finish position respectively.Results: During the deadlift, spinal adjustments were evident in all three planes of movement. From standing habitual posture to the start position the lumbar lordosis decreased 13° in the upper and 20° in the lower lumbar spine. From start position to stop position the total range of motion in the sagittal plane was 11° in the upper and 22° in the lower lumbar spine. The decreased lumbar lordosis from standing habitual posture to the start position was significantly greater among men.Conclusions: Men and women adjust their spinal alignment in all three planes of movement when performing a deadlift and men seem to make greater adjustments from their standing habitual posture to start position in the sagittal plane. Level of Evidence 3.
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5.
  • Bergenheim, M, et al. (författare)
  • Ensamble coding of muscle stretches in afferent populations containing different types of muscle afferents
  • 1996
  • Ingår i: Brain Research. - : Elsevier BV. - 0006-8993 .- 1872-6240. ; 734:1-2, s. 157-166
  • Tidskriftsartikel (refereegranskat)abstract
    • Ensemble coding of simple mechanical stimuli (small sinusoidal stretches) was studied in simultaneously recorded mixed ensembles of primary- and secondary muscle spindle afferents (MSAs), and Golgi tendon organ (GTO) afferents recorded from L7-S1 dorsal root filaments. The experiments were made on 48 recorded afferents (29 primary MSAs, 6 secondary MSAs and 13 GTO afferents) in chloralose anaesthetised cats. For the analyses, we used a combination of principal component analysis and algorithms for quantification of stimulus discrimination. Mixed ensembles of primary- and secondary MSAs, and GTO afferents, discriminated significantly better between different muscle stretches than ensembles of only one or two types of these afferents. All kinds of ensembles showed a successive increase in discriminative ability with increased ensemble size, and this ability seemed to level at larger populations. However, the increase in discriminative ability was significantly greater for the mixed ensembles. It is hypothesised that the main reason for the greater discriminative ability achieved by mixed ensembles, might be that the variation in response profiles (sensitivity tuning) among the individual afferents of the mixed ensemble will be larger than that for ensembles of only one type of afferent. Finally, the results in the present study give experimental support to some of the teleological arguments in favour of the ensemble coding theory.
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6.
  • Bergman, Frida, 1984- (författare)
  • Active workstations : a NEAT way to prevent and treat overweight and obesity?
  • 2018
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Modern society is triggering sedentary behaviours in different domains. Different strategies can be used to reduce the time spent sitting and increase physical activity in the office environment, which is one domain where sedentary time is often high. One such strategy could be to install treadmill workstations. With these, the office workers can walk on a treadmill while performing their usual work tasks at the computer. However, the long-term effects of these workstations are not known. Aim: The overall aim of this thesis was to investigate the long-term effects on sedentary behaviour, physical activity and associated health factors of installing treadmill workstations in offices compared to regular office work.Method: In this randomized controlled trial, 80 sedentary, middle-aged, healthy office workers with overweight or obesity were individually randomized into either an intervention or a control group. Those in the intervention group had a treadmill workstation installed at their sit-stand desk, to use for at least one hour per day for 13 months. They further received boosting e-mails at four time-points during the study. Participants in the control group continued to work as normal at their sit-stand office desk. All participants also received a health consultation at the beginning of the study, where they got to discuss physical activity and diet recommendations. Measurements reported include physical activity and sedentary behaviour, anthropometric measurements, body composition, metabolic outcomes, stress, depression and anxiety, cognitive function, structural brain images and interview data. Linear mixed models were used for the main statistical analyses of the quantitative data. An exploratory approach was also undertaken, using orthogonal partial least squares regression on the baseline data. Finally, interview data from participants in the intervention group were analysed using a modified Grounded Theory approach.Results: The intervention group increased their daily walking time and their number of steps at all follow-ups compared to the control group. Concomitantly, a decrease in moderate-to-vigorous intensity physical activity (MVPA) was observed within both groups, mainly during weekends. No intervention effects were observed on any of the body, cognitive or brain volume measurements. Our exploratory analyses revealed a significant association between smaller hippocampal volume and percentage sitting time among participants over 51 years of age. From the interview data, we discovered a core category, “The Capacity to Benefit”. The categories were described as the ideal types the Convinced, the Competitive, the Responsible and the Vacillating, based on the principal characteristics of the participants representing their different motivational status and strategies to reach the goal of benefitting from the intervention.  Conclusion: It is possible to increase daily physical activity in office environments by introducing treadmill workstations. Future interventions should adapt strategies for the individuals based on their motivational level, but should also workwith the social and physical environment and with factors within the organization to gain the best effects of these interventions.
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7.
  • Bergman, Frida, Medicine doktor, 1984-, et al. (författare)
  • Increasing Physical Activity In Office Workers - An RCT Of Treadmill Workstations
  • 2018
  • Ingår i: Medicine & Science in Sports & Exercise. - : Lippincott Williams & Wilkins. - 0195-9131 .- 1530-0315. ; 50:5, s. 47-47
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • PURPOSE: Our primary hypothesis was that an intervention with treadmill workstations would increase time spent walking. Secondary hypotheses were a decrease in time spent sitting with a concomitant increase in time spent standing and in light intensity physical activity (LPA) leading to positive effects on body measurements and body composition.METHODS: The intervention group received a treadmill workstation at their office desk during 13 months. Daily time spent sitting, standing and walking and number of steps was measured with activPAL®. Daily time in LPA and MVPA was measured with Actigraph®. Body weight, BMI and waist circumference were measured according to standardized protocols. Dual X-ray Absorptiometry was used to estimate body composition. Mixed models was used for the statistical analysis, with group, day of week (weekday/ weekend), time point and gender as fixed effects and age as a covariate. p<0.05 was considered significant.RESULTS: Eighty participants were included. The intervention group significantly increased their time spent walking at all follow-ups, with a difference at 13 months of 22 minutes (p<0.01) and 1645 steps per day (p<0.05), respectively, versus controls. Concomitantly, they decreased their MVPA with 13 minutes per day (p<0.001) at weekdays at 13 months versus baseline. We also found a decrease in LPA with 19 minutes per day (p<0.05), and of 17 minutes per day for MVPA (p<0.001) at 13 months versus baseline at weekends. The control group increased their time spent sitting with 25 minutes per day (p<0.05) and decreased the time spent standing with 35 minutes per day at weekdays (p<0.001) compared to baseline. There was also a decrease in LPA with 14 minutes per day (p<0.01) and in MVPA with 6 minutes per day (p<0.01) versus baseline during weekdays, with a decrease in sitting time with 36 minutes (p<0.05) at weekends. There were no significant changes in body measurements or body composition.CONCLUSION: It is possible to increase daily walking time by introducing treadmill workstations at offices. A decreased MVPA within the intervention group may contribute to lack of effects on body measurements and body composition. It is therefore important that future interventions aim at both reducing sedentary time as well as increasing, or at least remaining, MVPA levels.
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8.
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9.
  • Bergman, Frida, 1984-, et al. (författare)
  • Treadmill workstations in office workers who are overweight or obese : a randomised controlled trial
  • 2018
  • Ingår i: The Lancet Public Health. - : The Lancet Publishing Group. - 2468-2667. ; 3:11
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Treadmill workstations that enable office workers to walk on a treadmill while working at their computers might increase physical activity in offices, but long-term effects are unknown. We therefore investigated whether treadmill workstations in offices increased daily walking time.Methods: We did a randomised controlled trial of healthy office workers who were either overweight or obese. We recruited participants from 13 different companies, which comprised 17 offices, in Umeå, Sweden. We included people who were aged 40-67 years, had sedentary work tasks, and had a body-mass index (BMI) between 25 kg/m2 and 40 kg/m2. After the baseline measurement, we stratified participants by their BMI (25-30 kg/m2 and >30 to 40 kg/m2); subsequently, an external statistician randomly assigned these participants (1:1) to either the intervention group (who received treadmill workstations for optional use) or the control group (who continued to work at their sit-stand desks as usual). Participants in the intervention group received reminders in boosting emails sent out to them at four occasions during the study period. Researchers were masked to group assignment until after analysis of the primary outcome. After the baseline measurement, participants were not masked to group belongings. The primary outcome was total daily walking time at weekdays and weekends, measured at baseline, 2 months, 6 months, 10 months, and 13 months with the accelerometer activPAL (PAL Technologies, Glasgow, UK), which was worn on the thigh of participants for 24 h a day for 7 consecutive days. We used an intention-to-treat approach for our analyses. This trial is registered with ClinicalTrials.gov, number NCT01997970, and is closed to new participants.Findings: Between Nov 1, 2013, and June 30, 2014, a total of 80 participants were recruited and enrolled (n=40 in both the intervention and control groups). Daily walking time during total time awake at weekdays increased between baseline and 13 months by 18 min (95% CI 9 to 26) in the intervention group and 1 min (-7 to 9) in the control group (difference 22 min [95% CI 7 to 37], pinteraction=0·00045); for weekend walking, the change from baseline to 13 months was 5 min (-8 to 18) in the intervention group and 8 min (-5 to 21) in the control group (difference -1 min [-19 to 17]; pinteraction=0·00045). Neither measure met our predetermined primary outcome of 30 min difference in total walking time between the intervention and control group, so the primary outcome of the trial was not met. One adverse event was reported in a participant who accidently stepped on their Achilles tendon.Interpretation: In a sedentary work environment, treadmill workstations result in a statistically significant but smaller-than-expected increase in daily walking time. Future studies need to investigate how increasing physical activity at work might have potentially compensatory effects on non-work activity.
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10.
  • Bergman, Frida, Medicine doktor, 1984-, et al. (författare)
  • Walking Time Is associated With Hippocampal Volume in Overweight and Obese Office Workers
  • 2020
  • Ingår i: Frontiers in Human Neuroscience. - : Frontiers Media S.A.. - 1662-5161. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To investigate the long-term effects on cognition and brain function after installing treadmill workstations in offices for 13 months.Methods: Eighty healthy overweight or obese office workers aged 40–67 years were individually randomized to an intervention group, receiving a treadmill workstation and encouraging emails, or to a control group, continuing to work as usual. Effects on cognitive function, hippocampal volume, prefrontal cortex (PFC) thickness, and circulating brain-derived neurotrophic factor (BDNF) were analyzed. Further, mediation analyses between changes in walking time and light-intensity physical activity (LPA) on changes in BDNF and hippocampal volume between baseline and 13 months, and multivariate analyses of the baseline data with percentage sitting time as the response variable, were performed.Results: No group by time interactions were observed for any of the outcomes. In the mediation analyses, positive associations between changes in walking time and LPA on changes in hippocampal volume were observed, although not mediated by changes in BDNF levels. In the multivariate analyses, a negative association between percentage sitting time and hippocampal volume was observed, however only among those older than 51 years of age.Conclusion: Although no group by time interactions were observed, our analyses suggest that increased walking and LPA may have positive effects on hippocampal volume and that sedentary behavior is associated with brain structures of importance for memory functions.Trial Registration: www.ClinicalTrials.gov as NCT01997970.
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11.
  • Bäcklund, Tomas, et al. (författare)
  • Novel, clinically applicable method to measure step-width during the swing phase of gait
  • 2020
  • Ingår i: Physiological Measurement. - : Institute of Physics Publishing (IOPP). - 0967-3334 .- 1361-6579. ; 41:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Step-width during walking is an indicator of stability and balance in patients with neurological disorders, and development of objective tools to measure this clinically would be a great advantage. The aim of this study was to validate an in-house-developed gait analysis system (Striton), based on optical and inertial sensors and a novel method for stride detection, for measuring step-width during the swing phase of gait and temporal parameters.Approach: The step-width and stride-time measurements were validated in an experimental setup, against a 3D motion capture system and on an instrumented walkway. Further, test-retest and day-to-day variability were evaluated, and gait parameters were collected from 87 elderly persons (EP) and four individuals with idiopathic normal pressure hydrocephalus (iNPH) before/after surgery.Main results: Accuracy of the step-width measurement was high: in the experimental setup mean error was 0.08 +/- 0.25 cm (R = 1.00) and against the 3D motion capture system 0.04 +/- 1.12 cm (R = 0.98). Test-retest and day-to-day measurements were equal within +/- 0.5 cm. Mean difference in stride time was -0.003 +/- 0.008 s between Striton and the instrumented walkway. The Striton system was successfully applied in the clinical setting on individuals with iNPH, which had larger step-width (6.88 cm, n = 4) compared to EP (5.22 cm, n = 87).Significance: We conclude that Striton is a valid, reliable and wearable system for quantitative assessment of step-width and temporal parameters during gait. Initial measurements indicate that the newly defined step-width parameter differs between EP and patients with iNPH and before/after surgery. Thus, there is potential for clinical applicability in patients with reduced gait stability.
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12.
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13.
  • Bäcklund, Tomas, 1958-, et al. (författare)
  • Single sensor measurement of heel-height during the push-off phase of gait
  • 2021
  • Ingår i: Physiological Measurement. - : Institute of Physics (IOP). - 0967-3334 .- 1361-6579. ; 42:10
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: In healthy gait a forceful push-off is needed to get an efficient leg swing and propulsion, and a high heel lift makes a forceful push-off possible. The power of the push-off is decreased with increased age and in persons with impaired balance and gait. The aim of this study was to evaluate whether a wearable equipment (Striton) and algorithms to estimate vertical heel-height during gait from a single optical distance sensor is reliable and feasible for clinical applications.Approach: To assess heel-height with the Striton system an optical distance sensor was used to measure the distance to the floor along the shank. An algorithm was created to transform this measure to a vertical distance. The heel-height was validated in an experimental setup, against a 3D motion capture system (MCS), and test-retest and day-to-day tests were performed on 10 elderly persons. As a reference material 83 elderly persons were included, and heel-height was measured before and after surgery in four patients with the neurological disorder idiopathic normal pressure hydrocephalus (iNPH).Main results: In the experimental setup the accuracy was high with a maximum error of 2% at all distances, target colours and inclination angles, and the correlation to the MCS was R = 0.94. Test-retest and day-to-day tests were equal within ±1.2 cm. Mean heel-height of the elderly persons was 16.5 ± 0.6 cm and in the patients with iNPH heel-height was increased from 11.2 cm at baseline to 15.3 cm after surgery.Significance: Striton can reliably measure heel-height during gait, with low test-retest and day-to-day variability. The system was easy to attach, and simple to use, which makes it suitable for clinical applications.
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14.
  • Dahlgren, Gunilla, et al. (författare)
  • Correlations between Ratings and Technical Measurements in Hand-Intensive Work
  • 2023
  • Ingår i: Bioengineering. - : MDPI AG. - 2306-5354. ; 10:7
  • Tidskriftsartikel (refereegranskat)abstract
    • An accurate rating of hand activity and force is essential in risk assessment and for the effective prevention of work-related musculoskeletal disorders. However, it is unclear whether the subjective ratings of workers and observers correlate to corresponding objective technical measures of exposure. Fifty-nine workers were video recorded while performing a hand-intensive work task at their workplace. Self-ratings of hand activity level (HAL) and force (Borg CR10) using the Hand Activity Threshold Limit Value(& REG;) were assessed. Four ergonomist observers, in two pairs, also rated the hand activity and force level for each worker from video recordings. Wrist angular velocity was measured using inertial movement units. Muscle activity in the forearm muscles flexor carpi radialis (FCR) and extensor carpi radialis (ECR) was measured with electromyography root mean square values (RMS) and normalized to maximal voluntary electrical activation (MVE). Kendall's tau-b correlations were statistically significant between self-rated hand activity and wrist angular velocity at the 10th, 50th, and 90th percentiles (0.26, 0.31, and 0.23) and for the ratings of observers (0.32, 0.41, and 0.34). Significant correlations for force measures were found only for observer-ratings in five of eight measures (FCR 50th percentile 0.29, time > 10%MVE 0.43, time > 30%MVE 0.44, time < 5% -0.47) and ECR (time > 30%MVE 0.26). The higher magnitude of correlation for observer-ratings suggests that they may be preferred to the self-ratings of workers. When possible, objective technical measures of wrist angular velocity and muscle activity should be preferred to subjective ratings when assessing risks of work-related musculoskeletal disorders.
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15.
  • Dahlgren, Gunilla, et al. (författare)
  • Ratings of Hand Activity and Force Levels among Women and Men Who Perform Identical Hand-Intensive Work Tasks
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:24, s. 16706-
  • Tidskriftsartikel (refereegranskat)abstract
    • We compared hand activity and force ratings in women and men doing identical hand-intensive work tasks. Musculoskeletal disorders are more common in women and hand-intensive work leads to an increased risk of these disorders. Knowledge of the gender influence in the rating of work exposure is lacking. The aim of this study was to investigate whether women and men performing identical hand-intensive work tasks were equally rated using hand activity and normalized peak force levels with the Hand Activity Threshold Limit Value((R)). Fifty-six workers participated, comprising 28 women-men pairs. Four observers-two woman-man pairs-were also involved. Self-ratings and observers' ratings of hand activity and force level were collected. The results of these ratings showed no significant gender differences in self-rated hand activity and force, as well as observer-rated hand activity. However, there was a significant gender difference in the observer-rated force, where the women were rated higher (mean (SD): women 3.9 (2.7), men 3.1 (1.8) (p = 0.01)). This difference remained significant in the adjusted model (p = 0.04) with grip strength and forearm-finger anthropometrics. The results provide new insights that observers' estimates of force can be higher in women compared with men in the same work tasks. Force should be further investigated and preferably compared to objective measurements.
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16.
  • Grip, Helena, et al. (författare)
  • Does the Femoral Head Size in Hip Arthroplasty Influence Lower Body Movements during Squats, Gait and Stair Walking? : A Clinical Pilot Study Based on Wearable Motion Sensors
  • 2019
  • Ingår i: Sensors. - : MDPI. - 1424-8220. ; 19:14
  • Tidskriftsartikel (refereegranskat)abstract
    • A hip prosthesis design with larger femoral head size may improve functional outcomes compared to the conventional total hip arthroplasty (THA) design. Our aim was to compare the range of motion (RoM) in lower body joints during squats, gait and stair walking using a wearable movement analysis system based on inertial measurement units (IMUs) in three age-matched male groups: 6 males with a conventional THA (THAC), 9 with a large femoral head (LFH) design, and 8 hip- and knee-asymptomatic controls (CTRL). We hypothesized that the LFH design would allow a greater hip RoM, providing movement patterns more like CTRL, and a larger side difference in hip RoM in THAC when compared to LFH and controls. IMUs were attached to the pelvis, thighs and shanks during five trials of squats, gait, and stair ascending/descending performed at self-selected speed. THAC and LFH participants completed the Hip dysfunction and Osteoarthritis Outcome Score (HOOS). The results showed a larger hip RoM during squats in LFH compared to THAC. Side differences in LFH and THAC groups (operated vs. non-operated side) indicated that movement function was not fully recovered in either group, further corroborated by non-maximal mean HOOS scores (LFH: 83 +/- 13, THAC: 84 +/- 19 groups, vs. normal function 100). The IMU system may have the potential to enhance clinical movement evaluations as an adjunct to clinical scales.
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17.
  • Grip, Helena, et al. (författare)
  • Validity and reliability of wearable motion sensors for clinical assessment of shoulder function in brachial plexus birth injury
  • 2022
  • Ingår i: Sensors. - : MDPI. - 1424-8220. ; 22:23
  • Tidskriftsartikel (refereegranskat)abstract
    • The modified Mallet scale (MMS) is commonly used to grade shoulder function in brachial plexus birth injury (BPBI) but has limited sensitivity and cannot grade scapulothoracic and glenohumeral mobility. This study aims to evaluate if the addition of a wearable inertial movement unit (IMU) system could improve clinical assessment based on MMS. The system validity was analyzed with simultaneous measurements with the IMU system and an optical camera system in three asymptomatic individuals. Test–retest and interrater reliability were analyzed in nine asymptomatic individuals and six BPBI patients. IMUs were placed on the upper arm, forearm, scapula, and thorax. Peak angles, range of motion, and average joint angular speed in the shoulder, scapulothoracic, glenohumeral, and elbow joints were analyzed during mobility assessments and MMS tasks. In the validity tests, clusters of reflective markers were placed on the sensors. The validity was high with an error standard deviation below 3.6°. Intraclass correlation coefficients showed that 90.3% of the 69 outcome scores showed good-to-excellent test–retest reliability, and 41% of the scores gave significant differences between BPBI patients and controls with good-to-excellent test–retest reliability. The interrater reliability was moderate to excellent, implying that standardization is important if the patient is followed-up longitudinally.
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18.
  • Holmner, Åsa, et al. (författare)
  • How stable is lung function in patients with stable chronic obstructive pulmonary disease when monitored using a telehealth system? : A longitudinal and home-based study
  • 2020
  • Ingår i: BMC Medical Informatics and Decision Making. - : BioMed Central. - 1472-6947. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Many telehealth systems have been designed to identify signs of exacerbations in patients with chronic obstructive pulmonary disease (COPD), but few previous studies have reported the nature of recorded lung function data and what variations to expect in this group of individuals. The aim of the study was to evaluate the nature of individual diurnal, day-to-day and long-term variation in important prognostic markers of COPD exacerbations by employing a telehealth system developed in-house.Methods: Eight women and five men with COPD performed measurements (spirometry, pulse oximetry and the COPD assessment test (CAT)) three times per week for 4-6 months using the telehealth system. Short-term and long-term individual variations were assessed using the relative density and weekly means respectively. Quality of the spirometry measurements (forced expiratory volume in one second (FEV1) and inspiratory capacity (IC)) was assessed employing the criteria of American Thoracic Society (ATS)/European Respiratory Society (ERS) guidelines.Results: Close to 1100 measurements of both FEV1 and IC were performed during a total of 240 patient weeks. The two standard deviation ranges for intra-individual short-term variation were approximately +/- 210 mL and +/- 350 mL for FEV1 and IC respectively. In long-term, spirometry values increased and decreased without notable changes in symptoms as reported by CAT, although it was unusual with a decrease of more than 50 mL per measurement of FEV1 between three consecutive measurement days. No exacerbation occurred. There was a moderate to strong positive correlation between FEV1 and IC, but weak or absent correlation with the other prognostic markers in the majority of the participants.Conclusions: Although FEV1 and IC varied within a noticeable range, no corresponding change in symptoms occurred. Therefore, this study reveals important and, to our knowledge, previously not reported information about short and long-term variability in prognostic markers in stable patients with COPD. The present data are of significance when defining criteria for detecting exacerbations using telehealth strategies.
  •  
19.
  • Hoshi, Kei, 1970-, et al. (författare)
  • Bridging the contextual reality gap in blended reality space : the case of AGNES
  • 2011
  • Ingår i: Include 2011 Proceedings. - 9781907342295
  • Konferensbidrag (refereegranskat)abstract
    • This research explores where the contextual reality gap emerges in social sharing of knowledge, understanding and experience generated between users (also between a designer and a user) in different contexts. It then examines how this 'contextual reality gap' can be bridged effectively in the sharing of meaning through mediated communication within emergent virtual/physical space, in what we call Blended Reality Space. As a concrete example, we refer to our current project, AGNES, developing User-sensitive Home-based Systems for Successful Ageing in a Networked Society, funded under the Ambient Assisted Living (AAL) Joint programme. Finally, we propose a conceptual framework for managing, structuring and composing contexts in designing interactive systems, a new approach we refer to as the Contextual Reality Framework.
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20.
  • Hoshi, Kei, 1970-, et al. (författare)
  • Designing blended reality space : conceptual foundations and applications
  • 2011
  • Ingår i: BCS-HCI '11. - : BCS Learning & Development. ; , s. 217-226
  • Konferensbidrag (refereegranskat)abstract
    • The present paper starts with a crucial discussion about the imbalance between technological and human concerns in the context of human-computer interaction, an imbalance that has arisen partly from the mechanistic aspect and its impact on interaction design. We then introduce the concept of Blended Reality Space, interactive mixed reality environments where the physical and the virtual are seamlessly combined and affect each other. The conceptual grounding and practical examples that illustrate our approach to interaction design are then discussed, adopting a standard figurative representation of blends. This helps understanding the role of blending that meaningfully bridges unbalanced separations between cognition and action, and the physical and the virtual. As a concrete example, the AGNES project, which is aimed at developing “user sensitive home-based systems for successful ageing in a networked society”, is introduced. We believe that the emphasis on ʻbalanceʼ or appropriate blending is very important in the development of better interactive systems for health, capitalizing on seamless combinations of the virtual and the physical in Blended Reality Space.
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21.
  • Höglund, Gustav, et al. (författare)
  • The importance of inertial measurement unit placement in assessing upper limb motion
  • 2021
  • Ingår i: Medical Engineering and Physics. - : Elsevier. - 1350-4533 .- 1873-4030. ; 92, s. 1-9
  • Tidskriftsartikel (refereegranskat)abstract
    • Motion analysis using inertial measurement units (IMU) has emerged as an alternative to optical motion capture. However, the validity and reliability of upper limb measurements varies significantly between studies. The objective of this study was to determine how sensor placement affects kinematic output in the assessment of motion of the arm, shoulder, and scapula. IMUs were placed proximally/distally on arms, and medially/laterally on the scapula, in a group of eleven healthy participants, while performing nine different motion tasks. Linear regressions and mixed models analysed how these different sensor placements affected the estimated joint motion by establishing the linear relationship between sensors placed on the same body segment. The placement of sensors affected the measured kinematic output considerably, most prominent affect was seen for sensor placement on scapula during flexion and abduction, and on forearm during pronation/supination. The slope of the linear regression lines was 2.5 during flexion, 2.7 during abduction, and 1.8 for forearm pronation/supination. The results of this study suggest that the forearm sensor should be placed on the dorsal side of the forearm, at the distal end; the upper arm sensor should be placed laterally, on the distal part of the arm; and the sensor on the scapula should be placed cranially, along the spine of scapula.
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22.
  • Magaard, Gustaf, et al. (författare)
  • Identifying sub-acute rehabilitation needs among individuals after transient ischaemic attack using rehab-compass as a simple screening tool in the outpatient clinic
  • 2019
  • Ingår i: Journal of Rehabilitation clinical communications. - : Medical Journals Sweden AB. - 2003-0711. ; 2
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To evaluate comprehensive unmet rehabilitation needs by using a novel graphic screening tool, Rehab-Compass, among individuals in the sub-acute stage after first-ever transient ischaemic attack.Methods: A pilot prospective cohort study investigated 47 individuals with first-ever transient ischaemic attack in an outpatient clinic setting. By using Rehab-Compass, based on well-validated patient-reported outcome measure questionnaires, this study examined comprehensive unmet rehabilitation needs among individuals at 4-month follow-up after the onset of transient ischaemic attack.Results: Rehab-Compass identified that most participants were independent in their daily lives (modified Rankin Scale; mRS 0–1) with a relatively good quality of life (median EuroQol 5 dimensions (EQ-5D) 0.85), but certain limitations in participation in their daily lives. Rehab-Compass showed that, at 4 months after transient ischaemic attack, the most common condition affected was mood (reported by 89% of participants), followed by bladder function (70%), sexual life (52%), strength (51%) and fatigue (26%). Symptoms of depression and anxiety were reported by 6% and 17% of participants, respectively.Conclusion: This pilot study indicates that Rehab-Compass might be a suitable simple screening tool for use in the outpatient clinic setting to identify the multidimensional rehabilitation needs of individuals after transient ischaemic attack.
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23.
  • Mejtoft, Thomas, Universitetslektor, 1976-, et al. (författare)
  • Medtech innovation guide : an empiric model to support medical technology innovation
  • 2022
  • Ingår i: Health and Technology. - : Springer. - 2190-7188 .- 2190-7196. ; 12:5, s. 911-922
  • Tidskriftsartikel (refereegranskat)abstract
    • Innovation has become increasingly important for most industries to cope with rapid technological changes as well as changing societal needs. Even though there are many sectors with specific needs when it comes to supporting innovation, the medical technology sector is facing several unique challenges that both increases the lead-time from idea to finished product and decreases the number of innovations that are developed. This paper presents a proposed innovation guide that has been developed and evaluated as a support for the innovation process within medical technology research. The guide takes the unique characteristics of the medical technology sector into account and serves as a usable guide for the innovator. The complete guide contains both a structure for the process and a usable web application to support the journey from idea to finished products and services. The paper also includes a new readiness level, Sect. 4.2 to provide support both when developing and determining the readiness for clinical implementation of a medical technology innovation.
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24.
  • Muala, Ala, et al. (författare)
  • Small airways effects of exposure to wood smoke
  • 2019
  • Ingår i: European Respiratory Journal. - Sheffield : European Respiratory Society Journals. - 0903-1936 .- 1399-3003. ; 54
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
  •  
25.
  • Månsson, Linda, et al. (författare)
  • Co-Creation with Older Adults to Improve User-Experience of a Smartphone Self-Test Application to Assess Balance Function
  • 2020
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:11
  • Tidskriftsartikel (refereegranskat)abstract
    • This co-creation study aimed to develop a smartphone self-test application for balance and leg strength in collaboration between older adults and the research team. The paper describes older participants' preferences for, and their contribution to, the application design. Technology to assess movements is available in smartphones with built-in sensors, and one of the challenges is to develop a valuable self-test for older adults. The participants contributed to the design of the application's instructions and user interface. Multiple data collection methods were used: user-test with Think aloud method, mock-ups, homework assignment as co-researcher, audio and video recordings. Qualitative content analysis with a deductive-inductive approach was used, guided by the Optimized Honeycomb model for user experience (UX) as a categorization matrix. The analysis resulted in 17 subcategories within the seven facets of the UX Honeycomb model (findable, accessible, usable, desirable, credible, useful, and valuable), and describes the older participants' preferences and experiences. The main results were participants' desire to know why, to get clear and appropriate information, and expectations of the self-test to be useful. It was feasible and valuable to develop the self-test application in co-creation with the intended user-group, in order to get direct feedback and suggestions for the development.
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26.
  • Månsson, Linda, 1973- (författare)
  • Digital fall prevention for older adults : Feasibility of a self-managed exercise application and development of a smartphone self-test for balance and leg strength
  • 2021
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • As the numbers of older adults grow, fall prevention is vital to reduce health care needs due to falls and to increase quality of life. Balance and strength exercises have been found to be effective in fall prevention, however, long-term adherence is often poor. The growth of digital technology in society has generated opportunities for fall prevention with eHealth. The aim of this thesis was to evaluate the feasibility and use of a new digital fall prevention exercise programme, and to develop and investigate a smartphone self-test application for balance and leg strength. Three different studies included community-dwelling older adults ≥ 70 years, who were able to rise from a chair and stand without support. A feasibility study evaluated a new digital exercise programme (DP) compared to a paper booklet exercise programme (PB) for self-managed fall prevention in a four-month controlled participant preference trial (n = 67) (Paper I & II). Self-reported data on adherence, falls efficacy, and functional ability were collected and analysed, along with performance-based measures of gait speed, balance, and chair stand test. In Paper II the feasibility was explored of using the self-reported scales and performance-based outcome measures. A self-test application was also developed (Paper III) in co-creation with 10 participants, who met during five sessions to design the application’s instructions and user interface. The participants’ preference for and their contribution to the application design was analysed with qualitative content analysis with a deductive-inductive approach. A concurrent validity study (n = 31) (Paper IV) assessed the correlations between variables from the self-test prototype and outcome measures from clinical instruments. Results from the feasibility study show that 43% chose the DP and 57% PB, and the attrition rate was 17% and 37% respectively. Both groups had similar adherence, but for the subgroup that exercised most, participants in the DP group reported significantly more exercise time (Paper I). Participants in both groups reported a boost in balance after the intervention, and in the DP group also improved leg strength. Significantly more participants continued to use the DP at 12 months. The self-managed exercise intervention (Paper II) resulted in improvements in functional leg strength, which positively correlated with exercise time, but no other performance-based outcomes showed any significant improvements. Performance-based measurements of balance as well as the self- reported balance confidence and fear of falling revealed ceiling effects. Pre-assessments of self-reported outcomes and performance-based measures showed significant but low correlations, no such correlations were seen in change scores. The deductive-inductive analysis of the co-creation process resulted in 17 subcategories within the seven facets of the Optimized Honeycomb model for iii user experience (Paper III). The main results were that participants desired clear and appropriate information to understand why things were done in a certain way, and their contributions enhanced the user experience of the self-test. The concurrent validity testing of the self-test prototype (IV) showed low to moderate correlations for the strength test but limited correlations for the balance test. In conclusion the DP group showed comparable adherence to the programme as the PB group, as well as to previous studies, indicating it was feasible to use the new DP. DP participants also reported better exercise maintenance after 12 months. Positive self-reported effects were expressed in addition to leg strength improvement. Outcome measures for balance and falls efficacy revealed ceiling effects, consequently, these instruments might not be suitable for assessments in all community-dwelling older adults. In particular, for balance related outcomes there is a need for new more sensitive measurements. The co-creation of the smartphone self-test was feasible and valuable for user experience, but further validity and reliability testing are needed before it can serve as an independent assessment tool. 
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27.
  • Månsson, Linda, et al. (författare)
  • Evaluation of Concurrent Validity between a Smartphone Self-Test Application and Clinical Tests for Balance and Leg Strength
  • 2021
  • Ingår i: Sensors. - : MDPI. - 1424-8220. ; 21:5
  • Tidskriftsartikel (refereegranskat)abstract
    • The evolving use of sensors to objectively assess movements is a potentially valuable addition to clinical assessments. We have developed a new self-test application prototype, MyBalance, in the context of fall prevention aimed for use by older adults in order to independently assess balance and functional leg strength. The objective of this study was to investigate the new self-test application for concurrent validity between clinical instruments and variables collected with a smartphone. The prototype has two test procedures: static standing balance test in two positions, and leg strength test performed as a sit-to-stand test. Thirty-one older adults were assessed for balance and functional leg strength, in an outpatient physiotherapy setting, using seven different clinical assessments and three sensor-tests. The results show that clinical instruments and sensor measurements correlate to a higher degree for the smartphone leg strength test. For balance tests, only a few moderate correlations were seen in the Feet Together position and no significant correlations for the Semi Tandem Stance. This study served as a first step to develop a smartphone self-test application for older adults to assess functional balance at home. Further research is needed to test validity, reliability, and user-experience of this new self-test application.
  •  
28.
  • Stenlund, Tobias, et al. (författare)
  • Assessing postural load among drivers exposed to shock-type whole-body vibration using inertial measurements units : Results from measurements on standardized courses
  • 2019
  • Konferensbidrag (refereegranskat)abstract
    • Background: Lower back and neck pain is common among persons who drive vehicles in their profession. The vehicle occupants are exposed to whole-body vibration (WBV) that may include mechanical shocks which are believed to increase the likelihood of injury further. Mechanical shocks are especially generated when driving on rough terrain and may challenge drivers' postural equilibrium. Little is known about the contribution of postural load to injury risk and thus objective measurements are necessary.Purpose: The purpose of the study was to assess the feasibility of registering and analyzing seated postural load and shock-type WBV synchronously using inertial measurement units (IMUs) among drivers of forest machines during terrain-like conditions.Methods: Five male participants (18-34 years old) drove a forest machine 6 times over three different standardized steal obstacles along a gravel course using a predefined speed and posture. Participants then drove the same vehicle 3 times over natural obstacles along a terrain course using a self-selected speed and posture. Three IMUs were affixed along the spine (at S2, Th2 and C4) and one to the head of participants as well as one to the seat. Data from the IMUs regarding accelerations and orientation in sagittal, frontal and horizontal plane were then analyzed.Results: Postural load, expressed as the range of motions (ROMs) in the upper neck, lower neck, trunk and pelvis were less than 22° in all directions during maneuvers on the standardized course. The size of obstacle and the vehicle speed had significant effects on the ROMs. No significant differences between courses were evident regarding seat accelerations and angular velocities at the drivers head. The WBV analysis of the terrain course indicated that mechanical shocks were prevalent but exceeded the exposure action value for only one driver and not the exposure limit value according to health and safety requirements within the European Union (EU directive 2002/44/EC).Conclusion(s): IMUs may objectively be used to register and present seated postural load and shock-type WBV exposure synchronously when driving on terrain. There seems to be a low risk of injuries from mechanical shocks since the magnitude of postural load (ROMs) during tested conditions was not considered to increase injury risk even though vehicle speed and the size of obstacles had a significant effect.Implications: Postural load when driving a forest machine during terrain-like conditions appears low in this study but more long-term field measurements on more drivers are needed before definite conclusions can be made. IMUs are regarded as promising tools for registering and representing seated postural load and shock-type WBV exposure. Future development could provide drivers with feedback regarding potentially injurious postures and/or high shock-type WBV exposure.
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29.
  • Stenlund, Tobias, et al. (författare)
  • Double-sided Mechanical Shocks Provoke Larger Seated Postural Reactions Compared to Single-Sided Mechanical Shocks
  • 2018
  • Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 43:8, s. E482-E487
  • Tidskriftsartikel (refereegranskat)abstract
    • STUDY DESIGN: Human volunteers were exposed experimentally to single-sided mechanical shocks (SSMS) and double-sided mechanical shocks (DSMS) while seated.OBJECTIVE: To describe and contrast seated postural reactions due to SSMS or DSMS in healthy male adults.SUMMARY OF BACKGROUND DATA: Mechanical shocks to the body, caused when driving on irregular terrain, are suggested to be hazardous to the spine and may be associated with the reported musculoskeletal pain of the back and neck among professional drivers. However, very little is known about the characteristics of seated postural reactions and the biomechanical effects caused by mechanical shocks.METHODS: Twenty healthy male subjects (18-43 years old) were exposed while seated to 5 SSMS and 15 DSMS in lateral directions. The second acceleration in the DSMS was in the opposite direction to the first acceleration and was either fast, medium or slow depending on the speed of direction change. Surface electromyography (EMG) was recorded in muscles of the upper neck, trapezius, erector spinae and external oblique while kinematics were recorded with inertial sensors placed at the neck, trunk and pelvis. Muscle activity was normalized to maximum voluntary contractions (MVC).RESULTS: The EMG amplitudes were significantly higher (0.6-1%; p < 0.001) for the fast DSMS compared to all other shocks. Range of motion (ROM) of the neck and trunk was greater during the DSMS compared to the SSMS. Evoked muscle activity was less than 2% MVC in the trapezius, less than 10% MVC in the erector spinae and upper neck while the activity exceeded 10% MVC in the external oblique muscles.CONCLUSION: Fast DSMS in lateral directions appear more demanding compared to SSMS, demonstrating augmented seated postural reactions. However, the present mechanical shocks employed did not seem to induce postural reactions with regard to ROM or muscle activity of a magnitude likely to cause musculoskeletal overload.LEVEL OF EVIDENCE: 4.
  •  
30.
  • Stenlund, Tobias, et al. (författare)
  • Seated postural loads caused by shock-type whole-body vibration when driving over obstacles
  • 2020
  • Ingår i: International Journal of Forest Engineering. - : Taylor & Francis. - 1494-2119 .- 1913-2220. ; 31:3, s. 184-191
  • Tidskriftsartikel (refereegranskat)abstract
    • Operators of mobile machines within forestry work long hours in seated postures while being exposed to whole-body vibration (WBV) that is associated with pain in the lower back and neck. Still, little is known about the contribution from postural loads. In this study postural loads and shock-type WBV exposure on drivers operating a forwarder during terrain-like conditions was measured and quantified using inertial measurement units (IMUs). Five male drivers drove a forwarder repeatedly over standardized steel obstacles using a predefined speed and posture followed by driving over natural obstacles along a terrain course using a self-selected speed and posture. IMUs were affixed along the spine, on the back of the head of the driver and on the seat to detect orientation, velocity, and acceleration. The result shows that the methodology for measuring WBV and postural load with IMUs is feasible. Postural loads, expressed as range of motions (ROMs), when driving over a single standardized obstacle at a speed of 3.3 km/h were up to 21 degrees in the neck segments. Increasing vehicle speed and size of obstacles increased postural loads. The terrain course resulted in higher ROMs in all body segments compared to a standardized obstacle, a difference in sideway seat acceleration but no differences regarding angular velocities of the head. Mechanical shocks at the seat were prevalent but the action limit value was exceeded only for one driver. Postural loads remained small during all conditions indicating that the spine can remain stable during exposure to shock-type WBV of this nature.
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31.
  • Wadell, Karin, et al. (författare)
  • Longitudinal, home-based study of lung function, saturation and disease-related symptoms in COPD
  • 2018
  • Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Many telehealth (TH) systems have been designed to identify signs of COPD exacerbations, but few previous studies have reported the nature of recorded lung function data and what variations to expect in stable versus unstable patients.Aims: To evaluate the nature of individual diurnal, day-to-day and long-term variation in important prognostic markers of COPD exacerbations in a heterogeneous patient group by employing a newly developed TH system.Methods: Eight women and five men with COPD performed measurements (FEV1, IC, SpO2 and CAT) three times per week during 4-6 months using the TH system. Feasibility was based on the repeatability and quality of the FEV1 and IC measurements, as defined by ERS/ATS guidelines. Short-term and long-term individual variations were assessed using the relative density and mean (SD) respectively.Results: Close to 1100 FEV1 and IC measurements respectively were performed during a total of 240 patient weeks. The 2SD ranges for intra-individual variation were ± 210 mL and ± 350 mL for FEV1 and IC respectively. The values both increased and decreased without corresponding influence on symptoms (CAT) or SpO2 and no exacerbation was reported. However, it was unusual with a decrease of more than 50 mL per measurement in FEV1 between three consecutive measurement days.Conclusions: This study reveals important and, to our knowledge, previously not reported information about short and long-term variability in lung function measurements in stable patients with COPD, of significance when defining criteria for detecting exacerbations with TH systems.
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32.
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33.
  • Wahlström, Viktoria, et al. (författare)
  • Effects of a multicomponent physical activity promoting program on sedentary behavior, physical activity and body measures : a longitudinal study in different office types
  • 2019
  • Ingår i: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health (NOROSH). - 0355-3140 .- 1795-990X. ; 45:5, s. 493-504
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The aim of this study was to investigate effects of a multicomponent program promoting physical activity on sedentary behavior, physical activity, and body measures, when relocating from cell offices to either a flex or cell office.Methods: The Active Office Design (AOD) study is a longitudinal non-randomized controlled study performed in a municipality in northern Sweden. A subsample of 86 participants were randomly recruited from the AOD study to objectively measure sedentary behavior and physical activity, using ActivPAL and ActiGraph, before and after relocation to the two different office types. The multicomponent program promoting physical activity was performed in both offices. Data were analyzed using linear mixed models.Results: Eighteen months after relocation, the total number of steps per work day increased by 21% in the flex office and 3% in the cell office group, compared to baseline. Moderate and vigorous physical activity (MVPA) during work hours increased by 42% in the flex office group and 19% in the cell office group. No changes were seen regarding sitting time at work. Small additive effects for walking and MVPA were seen for both groups during non-work time. Weight increased in the flex office group.Conclusions: This long-term study shows that a multicomponent workplace intervention can lead to increased walking time, steps, and MVPA in a flex compared to a cell office. Small additive increases of physical activity were seen during non-work time in both groups. More long-term controlled studies are needed to confirm these results.
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34.
  • Wahlström, Viktoria, 1972- (författare)
  • Interventions for increased physical activity among office workers
  • 2019
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The positive association between physical activity (PA) and health is well established. Technical developments in modern life have created major changes in our societies and working life, and a growing body of research has identified sedentary behavior (SB) as an independent risk factor for type 2 diabetes, cardiovascular disease, and cancer as well as for premature mortality. To promote health, it is important to find ways to decrease SB and incorporate PA in office settings, for example, by using new office designs and behavioral interventions. The aim of this thesis was to evaluate two workplace interventions among office workers to determine if these led to increased PA and reduced SB, and to describe underlying factors behind these results. The thesis is based on two workplace interventions. The first intervention was the Inphact treadmill study, a 13-month randomized controlled trial where treadmill workstations were installed and participants were instructed to use the treadmill for at least one hour per workday. The second intervention was the Active Office Design (AOD) study. This study included a multicomponent PA promoting program, implemented in parallel with an office relocation to either traditional cell offices or to a flex office with activity-based work (ABW). The two groups in the AOD study were followed from 6 months before relocation to 18 months after.  Objectively measured data for SB, PA, and body measurements were collected in both studies. In the Inphact treadmill study, body composition, metabolic outcomes, self-reported energy and stress, and depression and anxiety scores were also measured. In the AOD study, measurements of health and lifestyle, musculoskeletal disorders, workload, work tasks, utilization of possibilities to be active at work, and perceptions of the performed PA promoting program were assessed via questionnaires. In addition, interview data were collected via focus groups and individual interviews. Linear mixed models were used for the main statistical analyses of the quantitative data. To explore the factors that influence SB and PA at work we combined factor analysis of mixed data with multiple linear regression.Interview data were analyzed using qualitative content analysis and a deductive approach to a process evaluation model.  In both study populations, sitting time was low and stand­ing time was high already at baseline, compared to other studies on office workers. In the Inphact treadmill study, the intervention group showed increased walking time during workdays compared to the control group for all follow-up measurements. At the same time, a decrease in moderate-to-vigorous PA (MVPA) was observed in both the intervention and control groups during leisure time. No intervention effects were seen on body measurements, body composition, metabolic outcomes, stress, or anxiety during the treadmill intervention.  In the AOD study, employees relocated to flex offices increased their walking time and MVPA during work hours to a greater extent than those relocated to cell offices, but neither group changed the amount of time spent sitting at work. Contrary to the Inphact treadmill study, no compensatory effects were seen during leisure time. The exploratory analysis resulted in six employee character-types, where the “harmonic and healthy” and “engaged with high workload” tended to sit more and to stand less, while the character type with “high BMI, creative and collaborative work” tended to sit less and stand more. The process evaluation of the intervention revealed a strong culture to encourage PA within the organization and that the intervention was supported by management. The timing of the program was questioned, and activities to support the relocation to the flex office with ABW were requested. Social acceptance for standing and walking at work increased, although the need for the intervention was debated due to the strong culture of facilitating PA at work already in place prior to the study. In conclusion, we showed long-term increases in PA were achieved in office workers, but the changes did not lead to improvements in body measurements and metabolic balance during the follow-up period. The two studies showed conflicting results regarding compensatory effects during leisure. Participants in the Inphact treadmill study decreased their MVPA during leisure, while no compensatory effects were seen in the AOD-study. Our results suggest a possible ceiling effect for the amount sitting time can be reducedin office workers, and that SB and PA in offices is influenced by many factors, such as organizational culture, physical environment, work tasks, work load and physical comfort. Together, the studies in this thesis confirm the importance of carefully tailored worksite interventions for decreasing SB and increasing PA at work. 
  •  
35.
  • Wahlström, Viktoria, et al. (författare)
  • Underlying Factors Explaining Physical Behaviors among Office Workers-An Exploratory Analysis
  • 2020
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:24
  • Tidskriftsartikel (refereegranskat)abstract
    • Studies using technical measurements of physical behavior show wide interindividual variations. This study aimed to explore underlying factors related to sitting, standing and walking among office workers. Cross-sectional data for background characteristics, work-related variables, and device-based measures for sitting, standing and walking were collected among office workers in either a cell office or a flex office with activity-based work. Data were analyzed by Factor Analysis of Mixed Data (FAMD) and multiple robust linear regression. The FAMD resulted in the combination of underlying factors describing six character types. The (1) harmonic and healthy, (2) disabled with poor health, (3) manager that spend a lot of time in meetings and has very high workload, (4) engaged with high workload, (5) employee with creative and computer intense work, with high workload and, (6) employee with high BMI with creative and collaborative work. Regression analysis showed that the character type that was "engaged with high workload" sat more and stood less, while the character type with "high BMI and with creative and collaborative work" sat less. The results suggest that physical behavior among office workers is influenced by a complex combination of factors, which should be taken into account in the evaluation of future studies of larger cohorts.
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36.
  •  
37.
  • Öhberg, Fredrik, 1969-, et al. (författare)
  • A neural network appoach to real-time spike discrimination during simultaneous recording from several multi-unit nerve filaments
  • 1996
  • Ingår i: Journal of Neuroscience Methods. - : Elsevier BV. - 0165-0270 .- 1872-678X. ; 64:2, s. 181-187
  • Tidskriftsartikel (refereegranskat)abstract
    • A multi-channel, real-time, unsupervised spike discriminator was developed in order to reconstruct single spike trains from several simultaneously recorded multi-unit nerve filaments. The program uses a Self Organising Map (SOM) algorithm for the classification of the spikes. In contrast to previous similar techniques, the described method is made for use on a PC, and the method may thus be implemented at relatively low cost. In order to test the accuracy of the program, a robustness test was performed, where noise with different RMS levels was superimposed on the spikes. Furthermore, the maximal classification rate was determined. The program is easy to use, since the only manual inputs needed are the voltage threshold for spike detection, and the number of units present in each recorded nerve filament.
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38.
  • Öhberg, Fredrik, 1969- (författare)
  • Biomechanical methods and error analysis related to chronic musculoskeletal pain
  • 2009
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background Spinal pain is one of humanity’s most frequent complaints with high costs for the individual and society, and is commonly related to spinal disorders. There are many origins behind these disorders e.g., trauma, disc hernia or of other organic origins. However, for many of the disorders, the origin is not known. Thus, more knowledge is needed about how pain affects the neck and neural function in pain affected regions. The purpose of this dissertation was to improve the medical examination of patients suffering from chronic whiplash-associated disorders or other pain related neck-disorders. Methods A new assessment tool for objective movement analysis was developed. In addition, basic aspects of proprioceptive information transmission, which can be of relevance for muscular tension and pain, are investigated by studying the coding of populations of different types of sensory afferents by using a new spike sorting method. Both experiments in animal models and humans were studied to accomplish the goals of this dissertation. Four cats where were studied in acute animal experiments. Mixed ensembles of afferents were recorded from L7-S1 dorsal root filaments when mechanical stimulating the innervated muscle. A real-time spike sorting method was developed to sort units in a multi-unit recording. The quantification of population coding was performed using a method based on principal component analysis. In the human studies, 3D neck movement data were collected from 59 subjects with whiplash-associated disorders (WAD) and 56 control subjects. Neck movement patterns were identified by processing movement data into parameters describing the rotation of the head for each subject. Classification of neck movement patterns was performed using a neural network using processed collected data as input. Finally, the effect of marker position error on the estimated rotation of the head was evaluated by computer simulations. Results Animal experiments showed that mixed ensembles of different types of afferents discriminated better between different muscle stimuli than ensembles of single types of these afferents. All kinds of ensembles showed an increase in discriminative ability with increased ensemble size. It is hypothesized that the main reason for the greater discriminative ability might be the variation in sensitivity tuning among the individual afferents of the mixed ensemble will be larger than that for ensembles of only one type of afferent. In the human studies, the neural networks had a predictivity of 0.89, a sensitivity of 0.90 and a specificity of 0.88 when discriminating between control and WAD subjects. Also, a systematic error along the radial axis of the rigid body added to a single marker had no affect on the estimated rotation of the head. Conclusion The developed spike sorting method, using neural networks, was suitable for sorting a multiunit recording into single units when performing neurophysiological experiments. Also, it was shown that neck movement analysis combined with a neural network could build the basis of a decision support system for classifying suspected WAD or other pain related neck-disorders.
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39.
  • Öhberg, Fredrik, 1969-, et al. (författare)
  • Comparison between two mobile applications measuring shoulder elevation angle–A validity and feasibility study
  • 2021
  • Ingår i: Medical Engineering and Physics. - : Elsevier. - 1350-4533 .- 1873-4030. ; 98, s. 1-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Pain in the shoulder complex affects the working population where work with elevated arms is a risk factor. The aim of the present study was to compare a mobile application for measurements of arm elevation, ErgoExposure, against an existing mobile application, ErgoArmMeter, in a laboratory setting and to test the feasibility in a field trial. Eleven persons performed three tasks in the laboratory setting: static, dynamic, and simulated work tasks, where the applications were validated against an optical tracking system (OTS). Also, ErgoExposure was tested by a teacher in a real-world situation. Limits of agreement for the static task varied between -6.1° to 4.2° (ErgoExposure) and between -7.6° to 5.2° (ErgoArmMeter). The average root mean square difference for dynamic and simulated work tasks was 3.4° (ErgoExposure) and 7.7° (ErgoArmMeter). From the field trial, different work tasks produced distinct exposure variation analysis patterns. Both apps showed similar results compared to OTS, but ErgoExposure was more accurate than ErgoArmMeter.
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40.
  • Öhberg, Fredrik, 1969-, et al. (författare)
  • Home-based system for recording pulmonary function and disease-related symptoms in patients with chronic obstructive pulmonary disease, COPD : a pilot study
  • 2016
  • Ingår i: SM Journal of Pulmonary Medicine. - : SM Group. - 2574-240X. ; 2:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Many patients with Chronic Obstructive Pulmonary Disease (COPD) suffer from acute exacerbations characterized by an increase in symptoms beyond normal day-to-day variation. The prognosis of patients with frequent exacerbations is poor and effort to curb these worsening episodes has great potential to improve the patient’s quality of life and to reduce associated costs. Telemonitoring has been proposed as a promising strategy in this respect. However, information on what physical signs or symptoms that should be recorded and how recorded data should be interpreted is largely missing in the literature.Methods: A new home-based system, based on a tablet computer, which can guide COPD patients to perform spirometry (inspiratory capacity, IC and forced expiratory volume in one and six seconds, FEV1 and FEV6) and record symptoms (COPD assessment test, CAT) was developed. The system was evaluated for 8-12 weeks in four patients with moderate to severe COPD with the aims to; i) assess the feasibility of the system to be used unsupervised by COPD patients and, ii) to evaluate the quality and ability of recorded parameters to reveal early signs of an exacerbation. Pearson bivariate correlation was performed between all outcome measures and descriptive information about inherent subject properties were presented.Results: The system was well accepted by all study subjects and the study generated a total of 253 measurements of which 94.5% were considered acceptable for analysis. One of the subjects developed an acute exacerbation towards the end of the study, whereas the other three subjects remained stable. Descriptive analysis of the data suggest that trends in the CAT score may indicate changes in health status and that IC tends to be more responsive to these changes compared to FEV1.Conclusion: The system developed in this study is well suited to be used unsupervised by COPD patients. Recorded data, in particular CAT, may be sensitive enough to detect early signs of an acute COPD exacerbation, although more data is needed to fully resolve the nature of such an association.
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41.
  • Öhberg, Fredrik, 1969-, et al. (författare)
  • Portable Sensors Add Reliable Kinematic Measures to the Assessment of Upper Extremity Function
  • 2019
  • Ingår i: Sensors. - : MDPI. - 1424-8220. ; 19:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Ordinal scales with low resolution are used to assess arm function in clinic. These scales may be improved by adding objective kinematic measures. The aim was to analyze within-subject, inter-rater and overall reliability (i.e., including within-subject and inter-rater reliability) and check the system's validity of kinematic measures from inertial sensors for two such protocols on one person. Twenty healthy volunteers repeatedly performed two tasks, finger-to-nose and drinking, during two test sessions with two different raters. Five inertial sensors, on the forearms, upper arms and xiphoid process were used. Comparisons against an optical camera system evaluated the measurement validity. Cycle time, range of motion (ROM) in shoulder and elbow were calculated. Bland-Altman plots and linear mixed models including the generalizability (G) coefficient evaluated the reliability of the measures. Within-subject reliability was good to excellent in both tests (G = 0.80-0.97) and may serve as a baseline when assessing upper extremities in future patient groups. Overall reliability was acceptable to excellent (G = 0.77-0.94) for all parameters except elbow axial rotation in finger-to-nose task and both elbow axial rotation and flexion/extension in drinking task, mainly due to poor inter-rater reliability in these parameters. The low to good reliability for elbow ROM probably relates to high within-subject variability. The sensors provided good to excellent measures of cycle time and shoulder ROM in non-disabled individuals and thus have the potential to improve today's assessment of arm function.
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