| 1. |
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| 2. |
- Asker, Martin, et al.
(författare)
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The effect of shoulder and knee exercise programmes on the risk of shoulder and knee injuries in adolescent elite handball players : A three-armed cluster randomised controlled trial
- 2022
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Ingår i: Sports Medicine - Open. - : Springer Science and Business Media LLC. - 2199-1170 .- 2198-9761. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The risk of injury in adolescent handball is high, and shoulder and knee injuries are among the most frequent and burdensome. The Swedish Knee Control programme reduced the risk of anterior cruciate ligament injuries in female youth football players and traumatic knee injuries in male and female youth floorball players. However, to date, Knee Control has not been evaluated in an elite youth sport setting. The literature on the prevention of shoulder injuries in sport is scarce, and there are to our knowledge no previous studies evaluating the preventative efficacy of injury prevention exercise programmes (IPEPs) on shoulder injuries in adolescent handball players.OBJECTIVES: To study the preventive efficacy of IPEPs on shoulder and knee injuries in adolescent elite handball players.METHODS: Eighteen Swedish handball-profiled secondary schools (clusters) with players aged 15-19 years, 54% males were randomised into either the Shoulder Group or Knee Group (interventions) or a Control Group. Players in the Shoulder Group were instructed to perform the Shoulder Control programme, and players in the Knee Group to perform the Knee Control programme, three times per week during May 2018 to May 2019. Control Group players continued their usual training. Outcomes were shoulder and knee injuries defined by the Oslo Sports Trauma Research Center Overuse Injury Questionnaire. Intention-to-treat analyses were performed using Cox regression models with hazard rate ratios (HRRs) with corresponding 95% confidence intervals (CI).RESULTS: Six clusters (199 players) in the Shoulder Group, six clusters (216 players) in the Knee Group and six clusters (212 players) in the Control Group were included. There were 100 shoulder injuries and 156 knee injuries. The Shoulder Group had a 56% lower shoulder injury rate, HRR 0.44 (95% CI 0.29 to 0.68), and the Knee Group had a 31% lower knee injury rate, HRR 0.69 (95% CI 0.49 to 0.97) than the Control Group. The absolute risk reduction was 11% and 8%, and the number needed to treat was 9 and 13, respectively.CONCLUSIONS: Adolescent elite handball players who performed the Shoulder Control and the Knee Control programmes had a lower risk of shoulder and knee injuries, respectively, than players who continued their usual training. Further research on how these two programmes can be combined to reduce knee and shoulder injuries in a time effective way is warranted. Trial registration ISRCTN15946352. Key points The burden of knee and shoulder injuries in handball is high. The Shoulder Control programme reduces the risk and overall burden of shoulder injuries in adolescent elite handball players. The Knee Control programme reduces the risk and overall burden of knee injuries in adolescent elite handball players.
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| 3. |
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| 4. |
- Fältström, Anne, et al.
(författare)
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Lifestyle characteristics in adolescent female football players : data from the Karolinska football Injury Cohort.
- 2022
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Ingår i: BMC Sports Science, Medicine and Rehabilitation. - : BioMed Central (BMC). - 2052-1847. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Normative values of lifestyle characteristics in adolescent female football players may be used by clinicians and coaches to take actions because the potential important for well-being, performance on the pitch, and risk of injury. The aim was to report descriptive characteristics of lifestyle factors in adolescent female football players and potential changes over 1 year.METHODS: We included 419 adolescent competitive female football players from 12 clubs and 27 teams (age 14 ± 1 years, range 12-17 years) and 286 were followed over 1 year. The players completed an extensive questionnaire regarding demographics, football-related factors, and lifestyle factors including tobacco consumption, alcohol use, medicine intake, eating and sleeping habits, well-being, stress, coping, and passion. Baseline data are presented for the total cohort and separately for 4 age groups (12, 13, 14, and 15-17 years).RESULTS: 12% skipped breakfast, 8% skipped lunch and 11% used protein supplements several days per week. 16% slept less than 8 h/night, 8% had impaired sleep with daytime consequences, and 22% stated that they were tired in daily activities several days per week. 32% experienced stress some or most days/week and 24% were classified as having psychological distress. Medicine intake (23% vs. 34%), skipping breakfast or lunch several days per week (10% vs. 47% and 20 vs. 33%), tiredness (20% vs. 27%), stress (26% vs. 40%), and psychological distress (27% vs. 37%) increased significantly (P = 0.031 to < 0.001) at the 1-year follow-up.CONCLUSION: Many adolescent female football players skip breakfast and lunch, have insufficient sleep, experience stress and are classified as having psychological distress. These factors increased over 1 year.
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| 5. |
- Fältström, Anne, et al.
(författare)
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Normative values and changes in range of motion, strength, and functional performance over 1 year in adolescent female football players : Data from 418 players in the Karolinska football Injury Cohort study.
- 2022
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Ingår i: Physical Therapy in Sport. - : Elsevier. - 1466-853X .- 1873-1600. ; 58, s. 106-116
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study normative values of range of motion (ROM), strength, and functional performance and investigate changes over 1 year in adolescent female football players.DESIGN: Cross-sectional.PARTICIPANTS: 418 adolescent female football players aged 12-17 years.MAIN OUTCOME MEASURES: The physical characteristic assessments included (1) ROM assessment of the trunk, hips, and ankles; (2) strength measures (maximal isometric and eccentric strength for the trunk, hips, and knees, and strength endurance for the neck, back, trunk and calves), and (3) functional performance (the one-leg long box jump test and the square hop test).RESULTS: Older players were stronger, but not when normalized to body weight. Only small differences in ROM regarding age were found. ROM increased over 1 year in most measurements with the largest change in hip external rotation, which increased by 6-7° (Cohen's d = 0.83-0.87). Hip (d = 0.28-1.07) and knee (d = 0.38-0.53) muscle strength and the square hop test (d = 0.71-0.99) improved over 1 year.CONCLUSIONS: Normative values for ROM and strength assessments of neck, back, trunk, hips, knees, calves and ankles are presented for adolescent female football players. Generally, fluctuations in ROM were small with little clinical meaning, whereas strength improved over 1 year.
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| 6. |
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| 7. |
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| 8. |
- Onell, Clara, et al.
(författare)
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Dietary habits in adolescent male and female handball players : the Swedish Handball Cohort
- 2023
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Ingår i: BMJ Open sport & exercise medicine. - : BMJ Publishing Group Ltd. - 2055-7647. ; 9:4
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThis cross-sectional study aimed to describe dietary habits in Swedish adolescent handball players and differences with respect to sex and school grade.MethodsParticipants in the Swedish Handball Cohort answered a web-survey assessing adherence to sports nutrition recommendations for meal frequency and meal timing, and the Nordic Nutrition Recommendations (NNR) for fruits/vegetables and fish/seafood, food exclusions and use of dietary supplements. Differences with respect to sex and school grade were estimated with generalised linear models, generating prevalence ratios (PR) with 95% CIs.ResultsA total of 1040 participants (16.6 +/- 0.9 years, 51% males) were included. Overall, 70% and 90%, respectively, met recommendations for meal frequency and meal timing, whereas adherence to recommended carbohydrate intake during training/game was met by 17%. Adherence to the NNR for fruits/vegetables and fish/seafood was met by 16% and 37%, respectively. Twenty-eight per cent reported using dietary supplements. Females reported lower frequency of meals, especially morning snacks (-0.6 days/week (95% CI -0.3 to -0.9)) and evening snacks (-0.8 days/week (95% CI -0.5 to -1.1)), higher prevalence of exclusions due to intolerances (PR 1.66 (95% CI 1.31 to 2.01)) and other reasons (PR 1.36 (95% CI 1.08 to 1.64)), higher adherence to the NNR for fruits/vegetables (PR 2.30 (95% CI 1.98 to 2.62)) and use of micronutrient supplements (PR 1.72 (95% CI 1.43 to 2.00)) compared with males. Only small differences were observed between school grades.ConclusionsSwedish adolescent handball players' dietary habits are fairly in accordance with sports nutrition recommendations but not the NNR. Females appear to display more restrictive habits than males.
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| 9. |
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| 10. |
- Schwank, Ariane, et al.
(författare)
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2022 Bern Consensus Statement on shoulder injury prevention, rehabilitation, and return to sport for athletes at all participation levels
- 2022
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 52:1, s. 11-28
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Tidskriftsartikel (refereegranskat)abstract
- SYNOPSIS: There is an absence of high-quality evidence to support rehabilitation and return-to-sport decisions following shoulder injuries in athletes. The Athlete Shoulder Consensus Group was convened to lead a consensus process that aimed to produce best-practice guidance for clinicians, athletes, and coaches for managing shoulder injuries in sport. We developed the consensus via a 2-round Delphi process (involving more than 40 content and methods experts) and an in-person meeting. This consensus statement provides guidance with respect to load and risk management, supporting athlete shoulder rehabilitation, and decision making during the return-to-sport process. This statement is designed to offer clinicians the flexibility to apply principle-based approaches to managing the return-to-sport process within a variety of sporting backgrounds. The principles and consensus of experts working across multiple sports may provide a template for developing additional sport-specific guidance in the future. J Orthop Sports Phys Ther 2022;52(1):11-28. doi:10.2519/jospt.2022.10952.
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| 11. |
- Tranaeus, Ulrika, 1959-, et al.
(författare)
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Study protocol for a prospective cohort study identifying risk factors for sport injury in adolescent female football players : the Karolinska football Injury Cohort (KIC).
- 2022
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Ingår i: BMJ Open. - London : BMJ Publishing Group Ltd. - 2044-6055. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Football is a popular sport among young females worldwide, but studies concerning injuries in female players are scarce compared with male players. The aim of this study is to identify risk factors for injury in adolescent female football players.METHODS AND ANALYSIS: The Karolinska football Injury Cohort (KIC) is an ongoing longitudinal study that will include approximately 400 female football academy players 12-19 years old in Sweden. A detailed questionnaire regarding demographics, health status, lifestyle, stress, socioeconomic factors, psychosocial factors and various football-related factors are completed at baseline and after 1 year. Clinical tests measuring strength, mobility, neuromuscular control of the lower extremity, trunk and neck are carried out at baseline. Players are followed prospectively with weekly emails regarding exposure to football and other physical activity, health issues (such as stress, recovery, etc), pain, performance and injuries via the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O). Players who report a substantial injury in the OSTRC-O, that is, not being able to participate in football activities, or have reduced their training volume performance to a moderate or major degree, are contacted for full injury documentation. In addition to player data, academy coaches also complete a baseline questionnaire regarding coach experience and education.ETHICS AND DISSEMINATION: The study was approved by the Regional Ethical Review Authority at Karolinska Institutet, Stockholm, Sweden (2016/1251-31/4). All participating players and their legal guardians give their written informed consent. The study will be reported in accordance with the Strengthening the Reporting of Observational studies in Epidemiology. The results will be published in peer-reviewed academic journals and disseminated to the Swedish football movement through stakeholders and media.
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| 12. |
- Asker, Martin, et al.
(författare)
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A prospective cohort study identifying risk factors for shoulder injuries in adolescent elite handball players: the Karolinska Handball Study (KHAST) study protocol
- 2017
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Ingår i: BMC Musculoskeletal Disorders. - : BIOMED CENTRAL LTD. - 1471-2474. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Handball is a physical contact sport that includes frequent overhead throwing, and this combination leads to a high rate of shoulder injuries. Several factors have been associated with shoulder injuries in overhead athletes, but strong scientific evidence is lacking for most suggested risk factors. We therefore designed the Karolinska Handball Study (KHAST) with the aim to identify risk factors for shoulder injuries in adolescent male and female elite handball players studying at handball-profiled secondary schools in Sweden. Secondary objectives are to investigate whether shoulder function changes during the competition season and whether the physical profile of the players changes during their time in secondary school. Methods: Players aged 15 to 19 years were included during the pre-season period of the 2014-2015 and the 2015-2016 seasons. At inclusion, players signed informed consent and filled in a questionnaire regarding playing position, playing level, previous handball experience, history of shoulder problems and athletic identity. Players also completed a detailed test battery at baseline evaluating the shoulder, neck and trunk. Players were then prospectively monitored weekly during the 2014-2015 and/or 2015-2016 competitive seasons regarding injuries and training/match workload. Results from the annual routine physical tests in the secondary school curriculum including bench press, deep squat, hand grip strength, clean lifts, squat jumps, counter movement jumps, amp;lt;30 m sprints, chins, dips and Coopers test will be collected until the end of the competitive season 2017-2018. The primary outcome is the incidence of shoulder injuries and shoulder problems. The secondary outcome is the prevalence of shoulder injuries and shoulder problems. Discussion: Shoulder problems are frequent among handball players and a reduction of these injuries is therefore warranted. However, in order to introduce appropriate preventive measures, a detailed understanding of the underlying risk factors is needed. Our study has a high potential to identify important risk factors for shoulder injuries in adolescent elite handball players owing to a large study sample, a high response rate, data collection during consecutive seasons, and recording of potential confounding factors.
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| 13. |
- Asker, Martin, et al.
(författare)
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Female adolescent elite handball players are more susceptible to shoulder problems than their male counterparts
- 2018
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : SPRINGER. - 0942-2056 .- 1433-7347. ; 26:7, s. 1892-1900
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Tidskriftsartikel (refereegranskat)abstract
- Shoulder problems are frequent among senior elite handball players. The objective of this study was to assess the prevalence of shoulder problems among adolescent elite handball players and to investigate potential differences in gender, school grade, playing position and playing level. During the 2014 and 2015 pre-season periods, 471 players (age 15-18 years, 54% female) completed a comprehensive baseline questionnaire regarding history of any shoulder pain and shoulder problems experienced during the past season. The players were monitored weekly for one competition season (September-April) regarding shoulder problems and the amount of match and training. Generalised linear models with a binomial link function were used to calculate a prevalence ratio (PR) with 95% confidence interval (CI) to compare the subgroups of players. In total, 110 players (23%) reported having substantial shoulder problems (defined as moderate/severe reduction in training volume, or moderate/severe reduction in performance, or complete inability to participate) at some point during the follow-up season, of which almost half reported complete inability to participate. Of those players reporting substantial problems, 43% (95% CI 39-48) did so for at least 3 consecutive weeks during the season. The prevalence was significantly higher in female players (PR 1.46, 95% 1.04-2.06) and in backcourt players (PR 1.58, 95% CI 1.08-2.32), but no differences were found for school grade (PR 1.21 95% CI 0.88-1.67) or playing level (PR 1.09 95% CI 0.76-1.56). The prevalence of substantial shoulder problems in adolescent elite handball players is high, especially among females, and this warrants further studies on risk factors for shoulder injury and the development of prevention strategies in handball players already before the age of 15. These findings also highlight the importance of introducing a clinical monitoring programme on a routine basis and improving the medical support, taking gender-related aspects into consideration, at handball-profiled secondary schools. II.
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| 14. |
- Asker, Martin, et al.
(författare)
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Preseason clinical shoulder test results and shoulder injury rate in adolescent elite handball players : a prospective study
- 2020
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 50:2, s. 67-74
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Prospective cohort study.BACKGROUND: Shoulder injuries are common in handball. Shoulder weakness, scapular dyskinesia and range of motion (ROM) deficits are associated with shoulder injury in adults, but studies of adolescent players are scarce.OBJECTIVE: To investigate if elite adolescent female and male handball players with shoulder muscle weakness, deficits in shoulder rotation ROM or joint position sense (JPS), or scapular dyskinesia in preseason have an increased shoulder injury rate compared to players not having these characteristics.METHODS: 341 uninjured players (452 player-seasons, 50% females) had isometric external rotational (IER), internal rotational (IIR), abduction (IABD) and eccentric external rotational (EER) shoulder strength, shoulder ROM, JPS, and scapular dyskinesia measured during pre-season. Players were monitored weekly regarding match- and training hours and shoulder injuries during one or two seasons. We used multivariable Cox proportional hazard models to calculate hazard rate ratios (HRR) related to the first injury with 95% confidence intervals (95% CI).RESULTS: 48 new shoulder injuries were reported during the two seasons. In females, the HRR for IER was 2.37 (95% CI 1.03-5.44), for IIR 2.44 (95% CI 1.06-5.61), and for scapular dyskinesia 1.53 (95% CI 0.36-6.52). In males, the HRR for IER was 1.02 (95% CI 0.44-2.36), for IIR 0.74 (95% CI 0.31-1.75), and for scapular dyskinesia 3.43 (95% CI 1.49-7.92). There were no associations between new shoulder injuries and deficits in ROM or JPS.CONCLUSION: In adolescent elite handball, male players with pre-season scapula dyskinesia, and female players with pre-season internal or external rotation shoulder weakness, had an increased shoulder injury rate. J Orthop Sports Phys Ther, Epub 27 Nov 2019. doi:10.2519/jospt.2020.9044.
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| 15. |
- Asker, Martin, et al.
(författare)
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Risk factors for, and prevention of, shoulder injuries in overhead sports : a systematic review with best-evidence synthesis.
- 2018
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 52:20, s. 312-1319
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: To assess the evidence for risk factors and prevention measures for shoulder injuries in overhead sports.DESIGN: Systematic review with best-evidence synthesis.DATA SOURCES: Medline (Ovid), PubMed (complementary search), Embase (Elsevier), Cochrane (Wiley), SPORTDiscus (Ebsco) and Web of Science Core Collection (Thomson Reuters), from 1 January 1990 to 15 May 2017.ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials, cohort studies and case-control studies on risk factors or prevention measures for shoulder injuries in overhead sports. The eligible studies were quality assessed using the Scottish Intercollegiate Guidelines Network criteria.RESULTS: Of 4778 studies identified, 38 were eligible for quality review and 17 met the quality criteria to be included in the evidence synthesis. One additional quality study presented a shoulder injury prevention programme. Most studies focused on baseball, lacrosse or volleyball (n=13). The risk factors examined included participation level (competition vs training) (n=10), sex (n=4), biomechanics (n=2) and external workload (n=2). The evidence for all risk factors was limited or conflicting. The effect of the prevention programme within the subgroup of uninjured players at baseline was modest and possibly lacked statistical power.CONCLUSIONS: All investigated potential risk factors for shoulder injury in overhead sports had limited evidence, and most were non-modifiable (eg, sex). There is also limited evidence for the effect of shoulder injury prevention measures in overhead sports.PROSPERO TRIAL REGISTRATION NUMBER: CRD42015026850.
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| 16. |
- Asker, Martin
(författare)
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Shoulder injuries in adolescent elite handball players
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Handball is a physically demanding sport that includes jumping, running, side-cutting movements and frequent throwing. A high prevalence of shoulder problems and pain has been reported in adult handball players but the research on adolescent elite players is scarce. Several factors have been associated with shoulder injuries in handball players, but strong scientific evidence is lacking for most of the suggested risk factors. Objectives: The objectives of this thesis were to determine the prevalence of shoulder problems in adolescent elite handball players, to present reference values of shoulder strength in adolescent elite handball players and to investigate if adolescent elite hand- ball players with pre-season shoulder weakness, decreased shoulder range of motion (ROM), scapular dyskinesia or deceased joint position sense (JPS) have higher shoulder injury rates compared to players without these characteristics. Methods: The thesis is based on data from the Karolinska Handball Study, a prospective cohort study with, in total, 471 Swedish adolescent elite handball players (622 player seasons) from 10 handball-profiled secondary schools. At baseline the players filled in a questionnaire and then shoulder strength, JPS, ROM and scapula dyskinesia were measured. Thereafter, the players were monitored on a weekly basis regarding injuries and amount of handball training and matches. Prevalence ratios (PR) and hazard rate ratios (HRR) were calculated and any differences in shoulder strength between sex, playing position, school grade and playing level as well as side-to-side differences in shoulder strength were evaluated using t-tests. Results: In total, 110 players (23%) reported substantial shoulder problems during the competitive season. The prevalence was higher among females (PR 1.46, 95% 1.04-2.06) and backcourt players compared to 6-metre players (PR 1.58, 95% CI 1.08-2.32). Male players were stronger in all measures, regardless of normalisation to bodyweight or not (p<0.0001). Both male and female players were stronger in the dominant arm (p<0.001). In general, wing players and backcourt players were stronger than line players and goalkeepers. In females, the HRR for new shoulder injuries in players with lower isometric external rotational strength (IER) was 2.37 (95% CI 1.03-5.44), lower isometric internal rotational strength (IIR) 2.44 (95% CI 1.06-5.61), and in those with scapular dyskinesia 1.53 (95% CI 0.36-6.52). In males, the HRR for weaker IER was 1.02 (95% CI 0.44-2.36), for lower IIR 0.74 (95% CI 0.31-1.75), and for scapular dyskinesia 3.43 (95% CI 1.49-7.92). There were no associations between new shoulder injuries and deficits in ROM or JPS. Conclusions: The prevalence of substantial shoulder problems in adolescent elite hand- ball players is higher among females and backcourt players. Male players are stronger than female players in terms of both absolute strength and when normalised by body-weight. In both male and female players, wing players and backcourt players are, in general, stronger than line players and goalkeepers when normalised by bodyweight. Male players with pre-season scapula dyskinesia, and female players with pre-season internal or external rotation shoulder weakness, had an increased shoulder injury rate.
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| 17. |
- Johansson, Fred, et al.
(författare)
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Athletic Identity and Shoulder Overuse Injury in Competitive Adolescent Tennis Players: The Smash Cohort Study
- 2022
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Ingår i: Frontiers in Sports and Active Living. - : Frontiers Media S.A.. - 2624-9367. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Our primary aim was to determine if athletic identity is prospectively associated with shoulder overuse injuries. Secondly, we aimed to determine if athletic identity is prospectively associated with playing through pain and to describe how athletic identity relates to sex, age, playing level, weekly training load, and match volume.Methods: A cohort of 269 adolescent tennis players were followed over a period of 52 weeks. Cox regression was used to estimate the hazard rate ratio (HRR) of first-time shoulder overuse injury associated with every 10-unit increase on the Athletic Identity Measurement Scale (AIMS).Results: The adjusted HRR of shoulder overuse injury was 0.89 (95% CI: 0.36-2.20) and the odds ratio of playing through pain was 2.41 (95% CI: 0.74-8.96) for every 10 unit increase on AIMS. The level of athletic identity was higher among players at the national level than among players at the regional level and was weakly correlated to weekly hours of tennis matches, tennis training, and fitness training.Conclusions: Our results indicate that higher levels of athletic identity may be associated with a lower incidence of shoulder overuse injuries, and potentially with playing through pain, although these results are inconclusive due to wide confidence intervals.
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| 18. |
- Johansson, Fredrik, et al.
(författare)
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Eccentric and isometric shoulder rotation strength and range of motion : Normative values for adolescent competitive tennis players
- 2022
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Ingår i: Frontiers in Sports and Active Living. - : Frontiers Media SA. - 2624-9367. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this cross-sectional study was to investigate isometric internal rotation (IR), external rotation (ER), abduction (ABD), and eccentric external rotation (eccER) shoulder strength and rotational range of motion (ROM) in adolescent male and female competitive tennis players. Additional aims of the study were to provide a tennis-specific normative database based on a large sample of players to deepen the knowledge regarding shoulder strength and ROM for adolescent competitive tennis players, and to discuss differences based on sex, age, and level of play. Shoulder strength and ROM was assessed in 301 adolescent competitive tennis players, 176 boys and 125 girls with a mean age of 14.6 and 14.4 years, respectively. Outcome variables of interest were isometric IR and ER strength, ABD strength, eccER shoulder strength, intermuscular strength ratios ER/IR and eccER/IR, IR ROM, ER ROM, and total range of motion (TROM). A General Linear Model two-way ANOVA was used to analyze differences in sex, age, and level of play. The findings of this study demonstrated age, side, and sex differences in the shoulder isometric strength, the eccER strength and ROM in adolescent competitive tennis players. Furthermore, when strength was expressed as ratios ER/IR and eccER/IR both sexes showed a lower ratio for eccER/IR in national players (0.95 ± 0.22 and 0.95 ± 0.23) compared to regional players (1.01 ± 0.32 and 1.07 ± 0.29) for male and female players, respectively. In conclusion, this paper presents a tennis-specific normative database for shoulder rotation strength and ROM in adolescent male and female competitive players. The key points in this evaluation are strength values normalized to body mass, intermuscular ratios, and TROM.
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| 19. |
- Kilbo Edlund, Karl, et al.
(författare)
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High-resolution dispersion modelling of PM2.5, PM10, NOx and NO2 exposure in metropolitan areas in Sweden 2000‒2018 – large health gains due to decreased population exposure
- 2024
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Ingår i: Air Quality, Atmosphere and Health. - 1873-9318 .- 1873-9326.
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Tidskriftsartikel (refereegranskat)abstract
- Ambient air pollution remains the major environmental cause of disease. Accurate assessment of population exposure and small-scale spatial exposure variations over long time periods is essential for epidemiological studies. We estimated annual exposure to fine and coarse particulate matter (PM2.5, PM10), and nitrogen oxides (NOx, NO2) with high spatial resolution to examine time trends 2000‒2018, compliance with the WHO Air Quality Guidelines, and assess the health impact. The modelling area covered six metropolitan areas in Sweden with a combined population of 5.5 million. Long-range transported air pollutants were modelled using a chemical transport model with bias correction, and locally emitted air pollutants using source-specific Gaussian-type dispersion models at resolutions up to 50 × 50m. The modelled concentrations were validated using quality-controlled monitoring data. Lastly, we estimated the reduction in mortality associated with the decrease in population exposure. The validity of modelled air pollutant concentrations was good (R2 for PM2.5 0.84, PM10 0.61, and NOx 0.87). Air pollution exposure decreased substantially, from a population weighted mean exposure to PM2.5 of 12.2µgm−3 in 2000 to 5.4µgm−3 in 2018. We estimated that the decreased exposure was associated with a reduction of 2719 (95% CI 2046–3055) premature deaths annually. However, in 2018, 65%, 8%, and 42% of residents in the modelled areas were still exposed to PM2.5, PM10, or NO2 levels, respectively, that exceeded the current WHO Air Quality Guidelines for annual average exposure. This emphasises the potential public health benefits of reductions in air pollution emissions.
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| 20. |
- Kilbo Edlund, Karl, et al.
(författare)
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Long-term ambient air pollution and coronary atherosclerosis : results from the Swedish SCAPIS study
- 2024
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Ingår i: Atherosclerosis. - : Elsevier. - 0021-9150 .- 1879-1484.
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Despite firm evidence for an association between long-term ambient air pollution exposure and cardiovascular morbidity and mortality, results from epidemiological studies on the association between air pollution exposure and atherosclerosis have not been consistent. We investigated associations between long-term low-level air pollution exposure and coronary atherosclerosis.Methods: We performed a cross-sectional analysis in the large Swedish CArdioPulmonary bioImaging Study (SCAPIS, n = 30 154), a random general population sample. Concentrations of total and locally emitted particulate matter <2.5 μm (PM2.5), <10 μm (PM10), and nitrogen oxides (NOx) at the residential address were modelled using high-resolution dispersion models. We estimated associations between air pollution exposures and segment involvement score (SIS), coronary artery calcification score (CACS), number of non-calcified plaques (NCP), and number of significant stenoses, using ordinal regression models extensively adjusted for potential confounders.Results: Median 10-year average PM2.5 exposure was 6.2 μg/m3 (range 3.5–13.4 μg/m3). 51 % of participants were women and 51 % were never-smokers. None of the assessed pollutants were associated with a higher SIS or CACS. Exposure to PM2.5 was associated with NCP (adjusted OR 1.34, 95 % CI 1.13, 1.58, per 2.05 μg/m3). Associations with significant stenoses were inconsistent.Conclusions: In this large, middle-aged general population sample with low exposure levels, air pollution was not associated with measures of total burden of coronary atherosclerosis. However, PM2.5 appeared to be associated with a higher prevalence of non-calcified plaques. The results suggest that increased risk of early-stage atherosclerosis or rupture, but not increased total atherosclerotic burden, may be a pathway for long-term air pollution effects on cardiovascular disease.
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| 21. |
- Kilbo Edlund, Karl, et al.
(författare)
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Long-term ambient air pollution and coronary atherosclerosis: Results from the Swedish SCAPIS study.
- 2024
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Ingår i: Atherosclerosis. - 1879-1484.
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Tidskriftsartikel (refereegranskat)abstract
- Despite firm evidence for an association between long-term ambient air pollution exposure and cardiovascular morbidity and mortality, results from epidemiological studies on the association between air pollution exposure and atherosclerosis have not been consistent. We investigated associations between long-term low-level air pollution exposure and coronary atherosclerosis.We performed a cross-sectional analysis in the large Swedish CArdioPulmonary bioImaging Study (SCAPIS, n=30154), a random general population sample. Concentrations of total and locally emitted particulate matter <2.5μm (PM2.5), <10μm (PM10), and nitrogen oxides (NOx) at the residential address were modelled using high-resolution dispersion models. We estimated associations between air pollution exposures and segment involvement score (SIS), coronary artery calcification score (CACS), number of non-calcified plaques (NCP), and number of significant stenoses, using ordinal regression models extensively adjusted for potential confounders.Median 10-year average PM2.5 exposure was 6.2μg/m3 (range 3.5-13.4μg/m3). 51% of participants were women and 51% were never-smokers. None of the assessed pollutants were associated with a higher SIS or CACS. Exposure to PM2.5 was associated with NCP (adjusted OR 1.34, 95% CI 1.13, 1.58, per 2.05μg/m3). Associations with significant stenoses were inconsistent.In this large, middle-aged general population sample with low exposure levels, air pollution was not associated with measures of total burden of coronary atherosclerosis. However, PM2.5 appeared to be associated with a higher prevalence of non-calcified plaques. The results suggest that increased risk of early-stage atherosclerosis or rupture, but not increased total atherosclerotic burden, may be a pathway for long-term air pollution effects on cardiovascular disease.
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| 22. |
- Lidell, Martin, 1970, et al.
(författare)
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The recombinant C-terminus of the human MUC2 mucin forms dimers in Chinese-hamster ovary cells and heterodimers with full-length MUC2 in LS 174T cells.
- 2003
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Ingår i: The Biochemical journal. - 0264-6021. ; 372:Pt 2, s. 335-45
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Tidskriftsartikel (refereegranskat)abstract
- The entire cDNA corresponding to the C-terminal cysteine-rich domain of the human MUC2 apomucin, after the serine- and threonine-rich tandem repeat, was expressed in Chinese-hamster ovary-K1 cells and in the human colon carcinoma cell line, LS 174T. The C-terminus was expressed as a fusion protein with the green fluorescent protein and mycTag sequences and the murine immunoglobulin kappa-chain signal sequence to direct the protein to the secretory pathway. Pulse-chase studies showed a rapid conversion of the C-terminal monomer into a dimer in both Chinese-hamster ovary-K1 and LS 174T cells. Disulphide-bond-stabilized dimers secreted into the media of both cell lines had a higher apparent molecular mass compared with the intracellular forms. The MUC2 C-terminus was purified from the spent culture medium and visualized by molecular electron microscopy. The dimer nature of the molecule was visible clearly and revealed that each monomer was attached to the other by a large globular domain. Gold-labelled antibodies against the mycTag or green fluorescent protein revealed that these were localized to the ends opposite to the parts responsible for the dimerization. The C-terminus expressed in LS 174T cells formed heterodimers with the full-length wild-type MUC2, but not with the MUC5AC mucin, normally expressed in LS 174T cells. The homodimers of the MUC2 C-termini were secreted continuously from the LS 174T cells, but no wild-type MUC2 secretion has been observed from these cells. This suggests that the information for sorting the MUC2 mucin into the regulated secretory pathway in cells having this ability is present in parts other than the C-terminus of MUC2.
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| 23. |
- Mikkelsen Omsland, Truls, et al.
(författare)
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Inter- och intrareliabilitet av tester i Karolinska Football Injury Cohort, KIC-studien
- 2020
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Ingår i: Tidskriften Idrottsmedicin 2020:4. ; , s. 29-
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Konferensbidrag (refereegranskat)abstract
- BAKGRUNDIdrottsskador är vanligt förekommande hos unga fotbollsspelande flickor och för att kunna förebygga skador är det viktigt att identifiera riskfaktorer. Tidigare forskning har föreslagit både interna och externa riskfaktorer för skador såväl som fotbollsspecifika faktorer. De fotbollsspecifika faktorer kan undersökas genom fysiska tester som mäter rörlighet och styrka. För att kunna säkerställa att testsvaren är så pålitligliga som möjligt föreslås att inter- och intrareliabilitet undersöks.SYFTESyfte med denna studie var att undersöka inter-och intrareliabilitet på 15 tester som ingår i Karolinska football injury cohort-studiens baslinjemätning. METODStudien genomfördes vid fyra tillfällen under liknande förhållanden. Sammanlagt fanns åtta teststationer och varje teststation hade en till två testledare, sammanlagt 12 personer. Deltagarna i studien var n=25 unga fotbollsspelande flickor, 14–16 år, och n= 22 högskolestudenter, 20-35 år. Deltagarna följde ett schema för i vilken ordning testerna skulle göras och fortsatte så tills alla testerna genomförts två gånger. Testerna bestod av styrka, uthållighet, koordination, koncentration samt rörlighet i fotled, knä, höft, bål och nacke. Mätningarna användes som underlag för beräkning av inter- och intrareliabilitet. RESULTATIntrareliabiliteten var i 40 av 41 mätningar av unga fotbollsspelande flickor i 19 tester ”Substantial” till ”Almost Perfect” med Intraclass Correlation Coefficients (ICC) 0,60–1,00. Interreliabiliteten hos samma grupp flickor var i 19 av 33 mätningar av 22 tester ”Substantial till ”Almost Perfect” (ICC: 0,60–1,00).Intrareliabiliteten i mätningarna av studenterna var i 41 av 41 mätningar av 19 tester ”Substantial” till ”Almost Perfect” (ICC 0,60–1,00). Interreliabiliteten för samma grupp i 27 av 32 mätningar av 22 tester var ICC: 0,60–1,00.KONKLUSIONResultatet från denna studie visar att majoriteten av testerna har tillfredsställande inter- och intrareliabilitet och kan användas till screening i studier inom idrottsmedicin.
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| 24. |
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| 25. |
- Onell, Clara
(författare)
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Lifestyle behaviors and musculoskeletal conditions in university students and high school athletes
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Musculoskeletal conditions impose a large burden of disability in young populations. University students are prone to neck and back pain, with potential negative impact on physical, mental, and academic functioning. In adolescent athletes, musculoskeletal injuries are common and may result in discontinued sports participation as well as impaired physical and mental health. University students and adolescent athletes tend to have unhealthy lifestyle behaviors. University students report unhealthy behaviors such as high sitting time, low physical activity levels and unhealthy dietary habits. Adolescent athletes are physically active but tend to have inadequate dietary habits in relation to their physiological demands, including insufficient intakes of total energy and carbohydrates.Identifying modifiable risk factors for musculoskeletal conditions is the first step towards prevention, and knowledge about the role of lifestyle behaviors for these conditions is limited. The overarching purpose with this doctoral thesis was to deepen the knowledge about lifestyle behaviors and their role for the risk of musculoskeletal conditions in university students and high school athletes.Methods, results, and conclusions: Study I and II are based on the Sustainable UNiversity Life (SUN) study, a cohort study including 4262 students at Swedish universities. The participants reported different aspects of health, lifestyle behaviors and attitudes through web-surveys every third month for one year in 2019-2021.In Study I, the aim was to assess changes in lifestyle behaviors during the COVID-19 pandemic, compared to before, in 1877 university students (73% women, mean age 26.5 ± 6.8 years). Physical activity levels, sitting time, meal frequency and risk use of alcohol, tobacco and illicit drugs were measured at a pre-pandemic baseline and at two periods during the first six months of the pandemic, the follow-up 1 (FU1) and follow-up 2 (FU2). Population means and differences with 95% confidence interval (CI) in lifestyle behaviors were calculated with generalized estimating equations. The study found that weekly exercise decreased by -7.7 minutes (95% CI -12.6, -2.8) whereas weekly daily activities increased by 14.2 minutes (95% CI 7.9, 20.5) between the pre-pandemic baseline and FU2. Furthermore, daily sitting time decreased by -1.4 hours (95% CI -1.7, -1.2) during this period. Small changes were observed for meal frequency, whereas for risk use of alcohol, tobacco and illicit drugs, changes were only minor. The conclusion of Study I is that lifestyle behaviors in Swedish university students slightly improved during the first six months of the COVID-19 pandemic compared to before.In Study II, the aim was to assess the association between an unhealthy lifestyle and incident activity-limiting neck/back problems (ALNBP) in university students. Physical inactivity, high sitting time, meal skipping, and risky use of alcohol, tobacco and illicit drugs were combined into an unhealthy lifestyle, categorized as ≥3 unhealthy lifestyle behaviors. A total of 3492 university students (60% women, mean age 24.5 ± 6.0 years) without ALNBP the past three months at baseline were included. Cox regression models were built to assess the association between an unhealthy lifestyle and incident ALNBP, reported as a hazard rate ratio (HRR). Being exposed to an unhealthy lifestyle generated a HRR of 1.35 (95% CI 1.12 to 1.63) of ALNBP, compared to not being exposed to an unhealthy lifestyle. The conclusion of Study II is that an unhealthy lifestyle is associated with incident activity-limiting neck/back problems in university students.Study III and IV are based on the Swedish Handball Cohort (SHC), a cohort study including 1334 adolescent handball players enrolled to a handball-profiled high school in Sweden. Participants responded to a baseline web-survey with questions about current and previous injuries, training, and dietary habits, among others, in the beginning of the handball season in 2020/2021, 2021/2022 and 2022/2023.Participants were monitored weekly throughout the handball season with questions about their amount of handball training and matches the preceding week, sleep habits, injuries, and injury consequences, among others, reported through a mobile application.In Study III, the aim was to describe dietary habits in 1040 adolescent handball players enrolled in the SHC seasons 2020/2021 or 2021/2022 (51% males, mean age 16.6 ± 0.9 years). Differences with respect to sex and school grade were estimated with generalized linear models, generating a prevalence ratio (PR) and 95% CI. Overall, 70% and 90% of the participants met recommendations for meal frequency and meal timing, respectively, whereas adherence to recommended provision of carbohydrates was met by 17%. Sixteen percent adhered to the Nordic Nutrition Recommendations (NNR) for fruits/vegetables of ≥500 grams per week, whereas 37% adhered to the recommendations for fish/seafood of ≥2 times per week. Use of dietary supplements was reported by 28% of the participants, and 20% reported food exclusions due to other reasons than intolerances. Females reported a lower frequency of all meals, especially morning snacks and evening snacks. Also, a higher prevalence of food exclusions was observed in females, with a PR of 1.66 (95% CI 1.31to 2.01) for exclusions due to intolerances and a PR of 1.36 (95% CI 1.08, 1.64) for exclusions due to other reasons. Females also reported a higher adherence to fruits/vegetables recommendations with a PR of 2.30 (95% CI 1.98, 2.62) and use of micronutrient supplements to a larger extent with a PR of 1.72 (95% CI 1.43, 2.00), compared to their male counterparts. Small differences were observed with respect to school grade. The conclusion of Study III is that Swedish adolescent handball players’ dietary habits are somewhat in accordance with sports nutrition recommendations whereas adherence to provision of carbohydrates during matches and the NNR for fruit/vegetables and fish/seafood is low. Females seem to display more restrictive dietary habits compared to males.In Study IV, the aim was to assess the association between dietary habits and incident knee/shoulder injuries in 1144 adolescent handball players in season 2020/2021, 2021/2022 and 2022/2023 of the SHC without a knee or shoulder injury at baseline (1703 player seasons, 53% males, mean age 16.7 ± 0.9 years). Cox regression analyses estimated a HRR with the first event of a knee/shoulder injury as the outcome. A moderate-high nutritional quality, in accordance with the NNR, generated a HRR of 1.46 (95% CI 1.08, 1.98) for knee/shoulder injuries compared to low nutritional quality in adolescent female handball players. Also, ≥2 unfavorable dietary habits in relation to sports nutrition recommendations generated a HRR of 1.38 (95% CI 1.02, 1.86) compared to 1 unfavorable dietary habit in females. For poor meal timing, adjusted analyses generated a HRR of 1.20 (95% CI 0.90, 1.61) in females, compared to adequate meal timing. In adolescent male handball players, analyses generated a HRR of 1.23 (95% CI 0.69, 2.17) for low meal frequency compared to high meal frequency and a HRR of 0.83 (95% CI 0.60, 1.15) for poor meal timing. Menstrual dysfunction was assessed in females with no use of hormonal contraceptives, as a proxy for low energy availability, however, no associations were found between menstrual dysfunction and incident injuries in these females. The conclusion of Study IV is that a moderate-high nutritional quality and having more than one unfavorable dietary habit is associated with higher rate of incident knee/shoulder injuries in adolescent female handball players, while there are no or unprecise associations for meal frequency, meal timing and menstrual dysfunction. In adolescent male handball players, there are no clear associations between dietary habits and incident injuries.Overall conclusion: This doctoral thesis sheds light on aspects of lifestyle behaviors in university students and high school athletes. Population-specific unhealthy lifestyle behaviors are common in university students and high school athletes. These behaviors seem to be of importance for the risk of musculoskeletal conditions.
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| 26. |
- Pecunia, Vincenzo, et al.
(författare)
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Roadmap on energy harvesting materials
- 2023
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Ingår i: Journal of Physics. - : IOP Publishing. - 2515-7639. ; 6:4
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Tidskriftsartikel (refereegranskat)abstract
- Ambient energy harvesting has great potential to contribute to sustainable development and address growing environmental challenges. Converting waste energy from energy-intensive processes and systems (e.g. combustion engines and furnaces) is crucial to reducing their environmental impact and achieving net-zero emissions. Compact energy harvesters will also be key to powering the exponentially growing smart devices ecosystem that is part of the Internet of Things, thus enabling futuristic applications that can improve our quality of life (e.g. smart homes, smart cities, smart manufacturing, and smart healthcare). To achieve these goals, innovative materials are needed to efficiently convert ambient energy into electricity through various physical mechanisms, such as the photovoltaic effect, thermoelectricity, piezoelectricity, triboelectricity, and radiofrequency wireless power transfer. By bringing together the perspectives of experts in various types of energy harvesting materials, this Roadmap provides extensive insights into recent advances and present challenges in the field. Additionally, the Roadmap analyses the key performance metrics of these technologies in relation to their ultimate energy conversion limits. Building on these insights, the Roadmap outlines promising directions for future research to fully harness the potential of energy harvesting materials for green energy anytime, anywhere.
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| 27. |
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