| 1. |
- Askling, Carl M, et al.
(författare)
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Acute first-time hamstring strains during high-speed running: a longitudinal study including clinical and magnetic resonance imaging findings
- 2007
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Ingår i: The American journal of sports medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 35:2, s. 197-206
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Tidskriftsartikel (refereegranskat)abstract
- Hamstring muscle strain is one of the most common injuries in sports. Still, knowledge is limited about the progression of clinical and magnetic resonance imaging characteristics and their association with recovery time in athletes. Hypothesis Knowing the anatomical location and extent of an acute first-time hamstring strain in athletes is critical for the prognosis of recovery time. Study Design Case series (prognosis); Level of evidence, 2. Methods Eighteen elite sprinters with acute first-time hamstring strains were prospectively included in the study. All subjects were examined, clinically and with magnetic resonance imaging, on 4 occasions after injury: at day 2 to 4, 10, 21, and 42. The clinical follow-up period was 2 years. Results All sprinters were injured during competitive sprinting, and the primary injuries were all located in the long head of the biceps femoris muscle. There was an association between the time to return to pre-injury level (median, 16; range, 6-50 weeks) and the extent of the injury, as indicated by the magnetic resonance imaging parameters. Involvement of the proximal free tendon, as estimated by MRI, and proximity to the ischial tuberosity, as estimated both by palpation and magnetic resonance imaging, were associated with longer time to return to pre-injury level. Conclusion Careful palpation during the first 3 weeks after injury and magnetic resonance imaging investigation performed during the first 6 weeks after injury provide valuable information that can be used to predict the time to return to pre-injury level of performance in elite sprinting.
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| 2. |
- Askling, Carl M, et al.
(författare)
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Acute first-time hamstring strains during slow-speed stretching: clinical, magnetic resonance imaging, and recovery characteristics
- 2007
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Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 35:10, s. 1716-1724
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Tidskriftsartikel (refereegranskat)abstract
- Hamstring strains can be of 2 types with different injury mechanisms, 1 occurring during high-speed running and the other during stretching exercises. Hypothesis A stretching type of injury to the proximal rear thigh may involve specific muscle-tendon structures that could affect recovery time. Study Design Case series (prognosis); Level of evidence, 2. Methods Fifteen professional dancers with acute first-time hamstring strains were prospectively included in the study. All subjects were examined, clinically and with magnetic resonance imaging, on 4 occasions after injury: at day 2 to 4, 10, 21, and 42. The clinical follow-up period was 2 years. Results All dancers were injured during slow hip-flexion movements with extended knee and experienced relatively mild acute symptoms. All injuries were located proximally in the posterior thigh close to the ischial tuberosity. The injury involved the semimembranosus (87%), quadratus femoris (87%), and adductor magnus (33%). All injuries to the semimembranosus involved its proximal free tendon. There were no significant correlations between clinical or magnetic resonance imaging parameters and the time to return to preinjury level (median, 50 weeks; range, 30-76 weeks). Conclusion Stretching exercises can give rise to a specific type of strain injury to the posterior thigh. A precise history and careful palpation provide the clinician enough information to predict a prolonged time until return to preinjury level. One factor underlying prolonged recovery time could be the involvement of the free tendon of the semimembranosus muscle.
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| 3. |
- Askling, Carl M, et al.
(författare)
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Proximal hamstring strains of stretching type in different sports: injury situations, clinical and magnetic resonance imaging characteristics, and return to sport
- 2008
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Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 36:9, s. 1799-1804
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Tidskriftsartikel (refereegranskat)abstract
- Hamstring strains can be of at least 2 types, 1 occurring during high-speed running and the other during motions in which the hamstring muscles reach extreme lengths, as documented for sprinters and dancers. Hypothesis Hamstring strains in different sports, with similar injury situations to dancers, also show similarities in symptoms, injury location, and recovery time. Study Design Case series (prognosis); Level of evidence, 4. Methods Thirty subjects from 21 different sports were prospectively included. All subjects were examined clinically and with magnetic resonance imaging (MRI). The follow-up period lasted until the subjects returned to or finished their sport activity. Results All injuries occurred during movements reaching a position with combined extensive hip flexion and knee extension. They were located proximally in the posterior thigh, close to the ischial tuberosity. The injuries were often complex, but 83% involved the semimembranosus and its proximal free tendon. Fourteen subjects (47%) decided to end their sports activity. For the remaining 16 subjects, the median time for return to sport was 31 weeks (range, 9-104). There were no significant correlations between specific clinical or MRI parameters and time to return to sport. Conclusions In different sports, an injury situation in which the hamstring muscles reach extensive length causes a specific injury to the proximal posterior thigh, earlier described in dancers. Because of the prolonged recovery time associated with this type of injury, correct diagnosis, based on history and palpation, and adequate information to the subject are essential.
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| 4. |
- Askling, Carl M, et al.
(författare)
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Total proximal hamstring ruptures : clinical and MRI aspects including guidelines for postoperative rehabilitation.
- 2013
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 21:3, s. 515-33
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this article is to provide a state-of-the-art review for treatment of acute, total proximal hamstring tendon ruptures. For total proximal hamstring tendon ruptures, early (<2-3 w) surgical refixation minimizes muscle atrophy and facilitates a somewhat predictable time course for healing and rehabilitation. A postoperative rehabilitation program is detailed that has been used by one physical therapist for the past 7 years on over 200 patients with surgical repair for total proximal hamstring tendon rupture. One re-rupture has occurred, 7 months after surgery, following the rehabilitation program described herein. The rehabilitation program, including avoidance of postoperative bracing, appears effective for total proximal hamstring ruptures. Early surgery together with a specific rehabilitation program appears to be the treatment of choice for timely and safe return to sport and an active lifestyle. Level of evidence V.
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| 5. |
- Askling, Carl M, et al.
(författare)
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Acute hamstring injuries in Swedish elite football : a prospective randomised controlled clinical trial comparing two rehabilitation protocols.
- 2013
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 47:15, s. 953-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hamstring injury is the single most common injury in European professional football and, therefore, time to return and secondary prevention are of particular concern.OBJECTIVE: To compare the effectiveness of two rehabilitation protocols after acute hamstring injury in Swedish elite football players by evaluating time needed to return to full participation in football team-training and availability for match selection.STUDY DESIGN: Prospective randomised comparison of two rehabilitation protocols.METHODS: Seventy-five football players with an acute hamstring injury, verified by MRI, were randomly assigned to one of two rehabilitation protocols. Thirty-seven players were assigned to a protocol emphasising lengthening exercises, L-protocol and 38 players to a protocol consisting of conventional exercises, C-protocol. The outcome measure was the number of days to return to full-team training and availability for match selection. Reinjuries were registered during a period of 12 months after return.RESULTS: Time to return was significantly shorter for the players in the L-protocol, mean 28 days (1SD±15, range 8-58 days), compared with the C-protocol, mean 51 days (1SD±21, range 12-94 days). Irrespective of protocol, stretching-type of hamstring injury took significantly longer time to return than sprinting-type, L-protocol: mean 43 vs 23 days and C-protocol: mean 74 vs 41 days, respectively. The L-protocol was significantly more effective than the C-protocol in both injury types. One reinjury was registered, in the C-protocol.CONCLUSIONS: A rehabilitation protocol emphasising lengthening type of exercises is more effective than a protocol containing conventional exercises in promoting time to return in Swedish elite football.
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| 6. |
- Askling, Carl M, et al.
(författare)
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Acute hamstring injuries in Swedish elite sprinters and jumpers : a prospective randomised controlled clinical trial comparing two rehabilitation protocols.
- 2014
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 48:7, s. 532-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hamstring strain is a common injury in sprinters and jumpers, and therefore time to return to sport and secondary prevention become of particular concern.OBJECTIVE: To compare the effectiveness of two rehabilitation protocols after acute hamstring injury in Swedish elite sprinters and jumpers by evaluating time needed to return to full participation in the training process.STUDY DESIGN: Prospective randomised comparison of two rehabilitation protocols.METHODS: Fifty-six Swedish elite sprinters and jumpers with acute hamstring injury, verified by MRI, were randomly assigned to one of two rehabilitation protocols. Twenty-eight athletes were assigned to a protocol emphasising lengthening exercises, L-protocol, and 28 athletes to a protocol consisting of conventional exercises, C-protocol. The outcome measure was the number of days to return to full training. Re-injuries were registered during a period of 12 months after return.RESULTS: Time to return was significantly shorter for the athletes in the L-protocol, mean 49 days (1SD±26, range 18-107 days), compared with the C-protocol, mean 86 days (1SD±34, range 26-140 days). Irrespective of protocol, hamstring injuries where the proximal free tendon was involved took a significantly longer time to return than injuries that did not involve the free tendon, L-protocol: mean 73 vs 31 days and C-protocol: mean 116 vs 63 days, respectively. Two reinjuries were registered, both in the C-protocol.CONCLUSIONS: A rehabilitation protocol emphasising lengthening type of exercises is more effective than a protocol containing conventional exercises in promoting time to return in Swedish elite sprinters and jumpers.
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| 7. |
- Askling, Carl M., et al.
(författare)
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Acute Hamstring Muscle Injury : Types, Rehabilitation, and Return to Sports
- 2015
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Ingår i: Sports injuries. - Berlin : Springer. - 9783642365690 ; , s. 2137-2147
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Bokkapitel (refereegranskat)abstract
- Acute hamstring muscle injury is the most frequent cause of acute posterior thigh pain, but referred pain to this area is also common. This chapter will focus only on acute hamstring injuries that are detectable on MRI (structural hamstring injuries). Hamstring injuries remain a challenge for clinicians, athletes, and coaches given the high incidence rate and often with persistent symptoms. The primary objective of all rehabilitation protocols is to return the athlete as soon as possible to the prior level of performance with a minimal risk of injury recurrence. The aim of this chapter is to describe the management of acute hamstring injuries including clinical examination, rehabilitation exercises, and return-to-sport criteria.
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| 8. |
- Askling, Carl, et al.
(författare)
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Sports related hamstring strains--two cases with different etiologies and injury sites.
- 2000
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 10:5, s. 304-7
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Tidskriftsartikel (refereegranskat)abstract
- Hamstring strains are common injuries in sports. Knowledge about their etiology and localization is, however, limited. The two cases described here both had acute hamstring strains, but the etiologies were entirely different. The sprinter was injured when running at maximal speed, whereas the hamstring strain in the dancer occurred during slow stretching. Also the anatomical localizations of the injuries clearly differed. Magnetic resonance imaging (MRI) revealed pathological changes in the distal semitendinosus muscle in the sprinter and the proximal tendon of the semimembranosus muscle in the dancer. Subjectively, both athletes severely underestimated the recovery time. These case observations suggest a possible link between etiology and localization of hamstring strains.
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| 9. |
- Bröms, G., et al.
(författare)
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Disease characteristics at time of diagnosis of adult onset inflammatory bowel disease and the risk of venous thromboembolism in the modern era - A Swedish nationwide cohort study 2007-2021
- 2024
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Ingår i: Journal of Crohn's & Colitis. - : Oxford University Press. - 1873-9946 .- 1876-4479. ; 18:Suppl. 1, s. I1945-I1947
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Studies from mainly before the wide use of targeted therapies and guidelines for thromboprophylaxis indicate that patients with inflammatory bowel disease (IBD) are at a doubled risk of venous thromboembolism (VTE). We studied the risk of VTE in a modern-day cohort of patients with IBD, overall and in subgroups of disease characteristics.Methods: Using Swedish healthcare registers, we identified a nationwide population-based cohort of 55,252 patients with incident IBD between 2007 and 2021 with a median follow-up time of 6.5 years. Patients were matched by age, sex, calendar year and county of residence with up to ten reference individuals from the general population (N=536,067). The primary outcome was VTE, including pulmonary embolism and deep vein thrombosis. Incidence rates per 1,000 person-years and hazard ratios (HR) were calculated for IBD in general and according to disease subtype, sex, age and disease characteristics at diagnosis. HRs stratified by matching variables (model 1) and additionally adjusted for comorbidities and socioeconomic factors (model 2) were estimated by using Cox regression.Results: The incidence rate of VTE among patients with IBD was 5.03 per 1,000 person-years compared with 2.34 per 1,000 person-years among reference individuals (Table 1). This corresponded to a doubled incidence of VTE (HR=2.18, 95% confidence interval (CI)=2.07-2.29, model 1). Adjusting further for covariates in model 2 had only minor effects on the HR. The HR was consistent across IBD subtypes and sex. The relative risk was higher for those with younger age (18-39 years) at IBD diagnosis (HR 2.52, 95% CI: 2.22-2.83) with a risk difference of 1.25 per 1,000 person-years. The IR, 10.64 per 1,000 person-years, and risk difference, 5.42 per 1,000 person-years, was the highest for those with elderly onset (≥60 years) IBD. There was a stronger association for those with extensive ulcerative colitis (E3), primary sclerosing cholangitis, extraintestinal manifestations and perianal disease. HRs for VTE were persistently elevated across follow-up time, but was higher during the first year of follow-up (Figure 1).Conclusion: The risk of VTE was doubled in these modern-day data and remained elevated across follow-up time. Disease characteristics associated with higher inflammatory burden at diagnosis and older age are markers of increased risk. This underscores the importance of continuous vigilance and individual assessment of risk factors for VTE in patients with IBD.
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| 10. |
- Exarchou, Sofia, et al.
(författare)
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The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations: a nationwide register study
- 2015
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Ingår i: Arthritis Research & Therapy. - : Springer Science and Business Media LLC. - 1478-6354 .- 1478-6362. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Prevalence estimates of ankylosing spondylitis vary considerably, and there are few nationwide estimates. The present study aimed to describe the national prevalence of clinically diagnosed ankylosing spondylitis in Sweden, stratified according to age, sex, geographical, and socio-economic factors, and according to subgroups with ankylosing spondylitis-related clinical manifestations and pharmacological treatment. Methods: All individuals diagnosed with ankylosing spondylitis according to the World Health Organization International Classification of Disease codes, between 1967 and 2009, were identified from the National Patient Register. Data regarding disease manifestations, patient demographics, level of education, pharmacological treatment, and geographical region were retrieved from the National Patient Register and other national registers. Results: A total of 11,030 cases with an ankylosing spondylitis diagnosis (alive, living in Sweden, and 16 to 64 years old in December 2009) were identified in the National Patient Register, giving a point prevalence of 0.18% in 2009. The prevalence was higher in northern Sweden, and lower in those with a higher level of education. Men had a higher prevalence of ankylosing spondylitis (0.23% versus 0.14%, P < 0.001), a higher frequency of anterior uveitis (25.5% versus 20.0%, P < 0.001) and were more likely to receive tumor necrosis factor inhibitors than women (15.6% versus 11.8% in 2009, P < 0.001). Women were more likely than men to have peripheral arthritis (21.7% versus 15.3%, P < 0.001), psoriasis (8.0% versus 6.9%, P = 0.03), and treatment with oral corticosteroids (14.0% versus 10.4% in 2009, P < 0.001). Conclusion: This nationwide, register-based study demonstrated a prevalence of clinically diagnosed ankylosing spondylitis of 0.18%. It revealed phenotypical and treatment differences between the sexes, as well as geographical and socio-economic differences in disease prevalence.
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| 11. |
- Toller, Carl Nils Konrad, 1993-, et al.
(författare)
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Issues in Capturing and Utilizing Non-Functional Requirements along the Road to Servitization
- 2022
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Ingår i: Proceedings of the Design Society 2022. - : Cambridges Institutes Press. ; , s. 623-632
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Konferensbidrag (refereegranskat)abstract
- The design process aims to maximize the value in the end solution. For traditional manufacturing firms pursuing a servitization strategy, non-functional requirements become more important compared to before. Therefore, this paper investigates issues in capturing and utilizing non-functional requirements for value creation in a servitizing firm. A single case study was conducted, which resulted in six issues across the design process. It was evident from the research that the firm requires new support to enable a better inclusion of non-functional requirements in the design process.
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