SwePub
Sök i SwePub databas

  Utökad sökning

Träfflista för sökning "WFRF:(Björklund Martin 1961 ) "

Sökning: WFRF:(Björklund Martin 1961 )

  • Resultat 1-45 av 45
Sortera/gruppera träfflistan
   
NumreringReferensOmslagsbildHitta
1.
  • Björklund, Martin, 1961-, et al. (författare)
  • Effects of tailored versus non-tailored treatment on pain and pressure pain threshold in women with nonspecific neck pain : a randomized controlled trial
  • 2014
  • Konferensbidrag (refereegranskat)abstract
    • Aim of the investigation: The evidence for physiotherapy treatments of nonspecific neck pain is modest despite a large increase of intervention studies the last decade. One reason could be different underlying causes for pain in individuals with nonspecific neck pain, and that identification of sub-groups or individual needs is seldom accounted for in studies. In the absence of causal treatment options, a tailored treatment approach based on an explicit clinical decision model guided by assessment of function, clinical signs and symptoms, should be considered. Our aim was to evaluate tailored treatment based on such a decision model, targeting women with nonspecific neck pain. Our main hypothesis was that the tailored treatment (T) would have better short, intermediate and long-term effects on pain intensity and pressure pain threshold for the trapezius muscles than either non-tailored treatment (NT) (same treatment components but applied quasi-randomly) or treatment-as-usual (TAU) (no treatment from the study, no restrictions). We further hypothesized that T or NT has better effect than TAU. For details, cf. Current Controlled Trials registration ISRCTN49348025 and published study protocol.Methods: 120 working women with minimum six weeks duration of neck pain were randomized to the T, NT or TAU groups. All participants had more than “no disability” but less than “complete disability” according to the Neck Disability Index, and reported impaired capacity on the quality or quantity to work the preceding month. Main exclusion criteria were trauma-related neck pain, specific diagnoses and generalized pain or concomitant low back pain. The decision model for tailored treatment was based on tests and symptoms with defined cut-off levels comprising the following main categories: reduced cervical mobility, impaired neck-shoulder strength and motor control, trapezius myalgia, cervicogenic headache and impaired eye-head-neck control (cf. published study protocol). Assessment was performed one week before and after the 11-weeks intervention, with follow-ups 6-months (intermediate-term) and 12-months (long-term) after the intervention. Outcome variables were pain intensity (Numeric Rating Scale, NRS, 0 – 10) and pressure pain threshold (PPT) of the upper trapezius muscles (kPa). PPT was not measured at long-term follow-up.  Preliminary statistical analyses for the predefined hypotheses were performed with analysis of covariance (ANCOVA) with baseline outcome values as covariates. This was supplemented with pairwise Bonferroni-compensated comparisons in case of significance of factor group.Results: 86% of the participants completed the intervention, and the attrition was similar across groups. Preliminary results for the short term evaluation showed a reduction in NRS from an average of 4.4 and 4.5 to 2.5 in the T and NT groups, respectively, which was significantly greater compared to the TAU group (p=0.024 and p=0.014 for T and NT). For the PPT, there was no difference between T and NT groups at the short term evaluation, but close to a significantly increased threshold for the T compared to the TAU group (p=0,058). No differences were found between treatment groups on the intermediate and long-term evaluations for neither of the two outcome variables.Conclusions: The results indicate that tailored treatment for women with nonspecific neck pain may not be more effective, with respect to pain reduction, compared to non-tailored treatment. The hypothesis of superiority of tailored or non-tailored treatment over treatment-as-usual was partly supported for the short-term evaluation. However, the short-term results should be interpreted with caution since the impact of higher attention given to the participants in T and NT groups is not known. Reference:1. Björklund M, Djupsjöbacka M, Svedmark Å, Häger C. (2012) Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests. A study protocol of a randomized controlled trial. BMC Musculoskeletal Disorders. May 20;13(1):75
  •  
2.
  • Berglund, Martin, 1981-, et al. (författare)
  • Parsing unranked tree languages, folded once
  • 2023
  • Ingår i: Fundamentals of computation theory. - : Springer Nature. - 9783031435867 ; , s. 60-73
  • Konferensbidrag (refereegranskat)abstract
    • A regular unranked tree folding consists of a regular unranked tree language and a folding operation that merges, i.e., folds, selected nodes of a tree to form a graph; the combination is a formal device for representing graph languages. If, in the process of folding, the order among edges is discarded so that the result is an unordered graph, then two applications of a fold operation is enough to make the associated parsing problem NP-complete. However, if the order is kept, then the problem is solvable in non-uniform polynomial time. In this paper we address the remaining case where only one fold operation is applied, but the order among edges is discarded. We show that under these conditions, the problem is solvable in non-uniform polynomial time.
  •  
3.
  • Berglund, Martin, 1981-, et al. (författare)
  • Parsing unranked tree languages, folded once
  • 2024
  • Ingår i: Algorithms. - : MDPI. - 1999-4893. ; 17:6
  • Tidskriftsartikel (refereegranskat)abstract
    • A regular unranked tree folding consists of a regular unranked tree language and a folding operation that merges (i.e., folds) selected nodes of a tree to form a graph; the combination is a formal device for representing graph languages. If, in the process of folding, the order among edges is discarded so that the result is an unordered graph, then two applications of a fold operation are enough to make the associated parsing problem NP-complete. However, if the order is kept, then the problem is solvable in non-uniform polynomial time. In this paper, we address the remaining case, where only one fold operation is applied, but the order among the edges is discarded. We show that, under these conditions, the problem is solvable in non-uniform polynomial time.
  •  
4.
  • Berglund, Martin, 1981-, et al. (författare)
  • Transduction from trees to graphs through folding
  • 2023
  • Ingår i: Information and Computation. - : Elsevier. - 0890-5401 .- 1090-2651. ; 295
  • Tidskriftsartikel (refereegranskat)abstract
    • We introduce a fold operation that realises a tree-to-graph transduction by merging selected nodes in the input tree to form a possibly cyclic output graph. The work is motivated by the increasing use of graph-based representations in semantic parsing. We show that a suitable class of graphs languages can be generated by applying the fold operation to regular unranked tree languages. We investigate two versions of the fold operation, one that preserves a depth-first ordering between the edges, and one that does not. Finally, we demonstrate that the time complexity for the associated non-uniform membership problem is solvable in polynomial time for the order-preserving version, and NP-complete for the order-cancelling one.
  •  
5.
  • Diarbakerli, E., et al. (författare)
  • Learning from the past to plan for the future: A scoping review of musculoskeletal clinical research in Sweden 2010-2020
  • 2022
  • Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 127:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The aims of this study are to 1) determine the scope of musculoskeletal (MSK)-related clinical research in Sweden; 2) collate the amount of first-tier funding received; 3) discuss strategies and infrastructure supporting future MSK clinical trials in Sweden. Methods: A systematic scoping review protocol was applied in PubMed, Scopus, and SweCRIS databases. The articles were examined, and data were extracted in multiple stages by three blinded authors. Results: The search strategy resulted in 3,025 publications from 479 Swedish-affiliated authors. Primary health care was the basis for 14% of the publications, 84% from secondary health care, and 2% from occupational health care with a similar proportional distribution of first-tier research grant financing. Approximately one in six publications were randomized controlled trials (RCTs), while the majority were of observational cohort design. The majority of publications in primary and occupational health care were related to pain disorders (51 and 67%, respectively), especially diagnosis, prognosis, and healthcare organizational-related interventions (34%) and rehabilitation (15%) with similar proportional distribution of first-tier research grant financing. In secondary health care, rheumatic inflammatory disorder-related publications were most prevalent (30%), most frequently concerning diagnosis, prognosis, and healthcare organizational-related interventions (20%), attracting approximately half of all first-tier funding. Publications related to degenerative joint disorders (25%), fractures (16%), and joint, tendon, and muscle injuries (13%) frequently concerned surgical and other orthopedic-related interventions (16, 6, and 8%, respectively). Pain disorder-related publications (10%) as well as bone health and osteoporosis-related publications (4%) most frequently concerned diagnosis, prognosis, and healthcare organizational-related interventions (5 and 3%, respectively). Conclusions: Swedish-affiliated MSK disorder research 2010-2020 was predominantly observational cohort rather than RCT based. There was skewed first-tier funding allocation considering prevalence/incidence and burden of disease. Use of infrastructure supporting register-based RCTs, placebo-controlled RCTs, and hybrid effectiveness-implementation studies on prevention and clinical intervention is important strategies for the future in all healthcare sectors.
  •  
6.
  • Diarbakerli, Elias, et al. (författare)
  • Swedish musculoskeletal researchers view on a collaborative network and future research priorities in Swedish healthcare
  • 2024
  • Ingår i: Musculoskeletal Care. - : John Wiley & Sons. - 1478-2189 .- 1557-0681. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Musculoskeletal disorders (MSK) are a global burden causing significant suffering and economic impact. Systematic identification and targeting of research questions of highest interest for stakeholders can aid in improving MSK disorder knowledge and management.Objective: To obtain Swedish MSK researchers' opinions and views on a collaborative Swedish MSK network (SweMSK) and identify future research areas of importance for Swedish MSK research.Methods: A web-based survey was conducted July to September 2021 to collect data from 354 Swedish MSK researchers. The survey focused on the need, objectives, and structure of a SweMSK network and identified prioritised areas for future MSK research.Results: The study included 141 respondents, of which 82 were associate professors or professors. The majority (68%) supported the creation of a new musculoskeletal network. The most supported element was increased collaboration regarding nationwide and multicenter studies. Respondents recommended the creation of a homepage and the establishment of national work groups with different specific interests as the primary elements of a new network.Conclusion: The results demonstrated a need and desire for increased national research collaboration and the creation of a new musculoskeletal network. The high academic experience and active research participation of the respondents suggest the need for MSK disorder knowledge and management improvement in Sweden. Therefore, the SweMSK network may help facilitate effective collaboration and research efforts that can contribute to the advancement of MSK disorder management and care. This study may provide valuable insights for policymakers, clinicians, and researchers to improve MSK disorder care and management in Sweden.
  •  
7.
  • Hadrévi, Jenny, et al. (författare)
  • Systemic differences in serum metabolome : a cross sectional comparison of women with localised and widespread pain and controls
  • 2015
  • Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 5
  • Tidskriftsartikel (refereegranskat)abstract
    • Chronic musculoskeletal pain exists either as localised to a single region or as widespread to multiple sites in several quadrants of the body. Prospective studies indicate that widespread pain could act as a far end of a continuum of musculoskeletal pain that started with chronic localised pain. The mechanism by which the transition from localised pain to widespread occurs is not clear, although many studies suggest it to be an altered metabolism. In this study, systemic metabolic differences between women with chronic localised neck-shoulder pain (NP), women with chronic widespread pain (CWP) and women who were healthy (CON) were assessed. Blood samples were analysed taking a metabolomics approach using gas chromatography mass spectrometry (GC-MS) and orthogonal partial least square discriminant analysis (OPLS-DA). The metabolomics analysis showed a clear systematic difference in the metabolic profiles between the subjects with NP and the CON but only a weak systematic difference between the subjects with CWP and the CON. This most likely reflects a difference in the portion of the metabolome influenced by the two pain conditions. In the NP group, the overall metabolic profile suggests that processes related to energy utilisation and lipid metabolism could be central aspects of mechanisms maintaining disorder.
  •  
8.
  • Oxfeldt, Martin, et al. (författare)
  • Danish short form Örebro Musculoskeletal Pain Screening Questionnaire: Translation, cross-cultural adaptation, and evaluation of measurement properties
  • 2024
  • Ingår i: Journal of Back and Musculoskeletal Rehabilitation. - : IOS Press. - 1053-8127 .- 1878-6324.
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND:Low back pain (LBP) is the leading cause of disability and an increasing sick leave in Denmark. Psychosocial risk factors have been linked to the development of LBP-related disability and work-absenteeism. The short form Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-sf) was developed to screen for psychosocial risk factors and assess the risk of long-term disability and work-absenteeism.OBJECTIVE:To translate and cross-culturally adapt ÖMPSQ-sf into Danish and evaluate test-retest reliability with relative and absolute reliability and internal consistency in LBP-patients in a secondary setting.METHODS:A six-step translation and cross-culturally adaptation process was used. Forty-four patients with subacute and chronic LBP were recruited at an outpatient clinic.RESULTS:Test-retest reliability (n=?= 37) was found to be excellent (ICC2.1== 0.92), Internal Consistency (n=?= 44) was adequate (Cronbach’s alpha == 0.72). Absolute reliability included Standard Error of Measurement (SEM == 3.97 points), 95% Limits of Agreement (95% LOA == 0.08, −-15.90–15.74), and Smallest Detectable Change (SDC == 10.87 points).CONCLUSION:The Danish ÖMPSQ-sf showed acceptable measurements properties in subacute and chronic LBP-patients. Further research is needed to assess other measurement properties of the ÖMPSQ-sf, in relation to validity, responsiveness, and the predictive ability before application in research or clinical practice.
  •  
9.
  •  
10.
  • Arumugam, Ashokan, et al. (författare)
  • Effects of neuromuscular training on knee proprioception in individuals with anterior cruciate ligament injury : A systematic review and GRADE evidence synthesis
  • 2021
  • Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:5
  • Forskningsöversikt (refereegranskat)abstract
    • Objective: To systematically review and summarise the evidence for the effects of neuromuscular training compared with any other therapy (conventional training/sham) on knee proprioception following anterior cruciate ligament (ACL) injury.Design: Systematic Review.Data sources: PubMed, CINAHL, SPORTDiscus, AMED, Scopus and Physical Education Index were searched from inception to February 2020.Eligibility criteria: Randomised controlled trials (RCTs) and controlled clinical trials investigating the effects of neuromuscular training on knee-specific proprioception tests following a unilateral ACL injury were included.Data extraction and synthesis: Two reviewers independently screened and extracted data and assessed risk of bias of the eligible studies using the Cochrane risk of bias 2 tool. Overall certainty in evidence was determined using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool.Results: Of 2706 articles retrieved, only 9 RCTs, comprising 327 individuals with an ACL reconstruction (ACLR), met the inclusion criteria. Neuromuscular training interventions varied across studies: whole body vibration therapy, Nintendo-Wii-Fit training, balance training, sport-specific exercises, backward walking, etc. Outcome measures included joint position sense (JPS; n=7), thresholds to detect passive motion (TTDPM; n=3) or quadriceps force control (QFC; n=1). Overall, between-group mean differences indicated inconsistent findings with an increase or decrease of errors associated with JPS by ≤2°, TTDPM by ≤1.5° and QFC by ≤6 Nm in the ACLR knee following neuromuscular training. Owing to serious concerns with three or more GRADE domains (risk of bias, inconsistency, indirectness or imprecision associated with the findings) for each outcome of interest across studies, the certainty of evidence was very low.Conclusions: The heterogeneity of interventions, methodological limitations, inconsistency of effects (on JPS/TTDPM/QFC) preclude recommendation of one optimal neuromuscular training intervention for improving proprioception following ACL injury in clinical practice. There is a need for methodologically robust RCTs with homogenous populations with ACL injury (managed conservatively or with reconstruction), novel/well-designed neuromuscular training and valid proprioception assessments, which also seem to be lacking.PROSPERO registration number CRD42018107349.
  •  
11.
  • Bergqvist, Maria, et al. (författare)
  • The impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training, long-term after stroke—as part of a randomized controlled trial
  • 2023
  • Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 21:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Visuospatial and executive impairments have been associated with poor activity performance sub-acute after stroke. Potential associations long-term and in relation to outcome of rehabilitation interventions need further exploration.Aims: To explore associations between visuospatial and executive function and 1) activity performance (mobility, self-care and domestic life) and 2) outcome after 6 weeks of conventional gait training and/or robotic gait training, long term (1–10 years) after stroke.Methods: Participants (n = 45), living with stroke affecting walking ability and who could perform the items assessing visuospatial/executive function included in the Montreal Cognitive Assessment (MoCA Vis/Ex) were included as part of a randomized controlled trial. Executive function was evaluated using ratings by significant others according to the Dysexecutive Questionnaire (DEX); activity performance using 6-minute walk test (6MWT), 10-meter walk test (10MWT), Berg balance scale, Functional Ambulation Categories, Barthel Index and Stroke Impact Scale.Results: MoCA Vis/Ex was significantly associated with baseline activity performance, long-term after stroke (r = .34-.69, p < .05). In the conventional gait training group, MoCA Vis/Ex explained 34% of the variance in 6MWT after the six-week intervention (p = 0.017) and 31% (p = 0.032) at the 6 month follow up, which indicate that a higher MoCA Vis/Ex score enhanced the improvement. The robotic gait training group presented no significant associations between MoCA Vis/Ex and 6MWT indicating that visuospatial/executive function did not affect outcome. Rated executive function (DEX) presented no significant associations to activity performance or outcome after gait training.Conclusion: Visuospatial/executive function may significantly affect activity performance and the outcome of rehabilitation interventions for impaired mobility long-term after stroke and should be considered in the planning of such interventions. Patients with severely impaired visuospatial/executive function may benefit from robotic gait training since improvement was seen irrespective of visuospatial/executive function. These results may guide future larger studies on interventions targeting long-term walking ability and activity performance.
  •  
12.
  • Björklund, Martin, 1961-, et al. (författare)
  • Cervico-thoracic and cranio-cervical strength differences between women with and without neck pain and the diagnostic performance of neck-strength tests
  • 2019
  • Ingår i: World Confederation for physical Therapy Congress 2019, Geneva 10-13 May.
  • Konferensbidrag (refereegranskat)abstract
    • Background: Cervical strength and stability is often addressed in rehabilitation of people with neck pain. These functions may be associated with emergence and retention of neck pain in cases where the neck strength does not meet daily demands. However, clear empiric support for these notions are lacking, partly due to a scarcity of well controlled dynamometry studies with large samples. First, clarification is needed whether neck strength is in fact reduced in people with neck pain and to resolve the diagnostic performance of neck strength tests.Purpose: To compare neck muscle strength of women with non-specific long-term neck pain and healthy controls. Also, to assess the diagnostic performance of neck strength tests by assessing their discriminative ability to discern women with and without neck pain.Methods: The study had a cross-sectional design with data on cervical strength derived from the baseline measurement of a randomized controlled trial (RCT). 80 women with long-term non-specific neck pain (NP) were compared with 40 healthy women (CON). The NP group was a subsample from the RCT selected so that there were no group differences (NP-CON) for body weight and physical activity. Cervical strength assessment included dynamometry of cervico-thoracic extension (CTE) and flexion (CTF) in sitting and cranio-cervical flexion (CCF) in standing, all performed with isometric maximum voluntary contraction (iMVC). Independent samples Mann-Whitney U test and T-test were used to assess group differences for iMVC of the tests. Diagnostic accuracy was further assessed with a receiver operating characteristic (ROC) curve by plotting the true positive rate (sensitivity) as a function of the false positive rate (1 - specificity). The area under the ROC curve (AUC) with 95% confidence interval was used to determine discriminative ability of the tests. The optimal cut-off value to discern NP from CON with corresponding sensitivity and specificity was also determined.Results: Women with neck pain produced significant lower iMVC in CTE (28%), CTF (26%) and CCF (33%) (all p< 0.001). The ability of CTE, CTF and CCF to discriminate between NP and CON showed moderate accuracy (AUC 0.83, 0.78 and 0.73, respectively). The cut-off value of 165.7 N in CTE had a sensitivity of 0.725 and a specificity of 0.8. The corresponding values for CTF and CCF were 85.8 N (sensitivity 0.8; specificity 0.692) and 4.2 Nm (sensitivity 0.575; specificity 0.9).Conclusion(s): The neck pain group had less neck muscle strength than controls in all tests. The diagnostic performance of the neck strength tests, judged as discriminative ability to discern neck pain from control participants, were moderate. These results support earlier findings of reduced neck strength in people with neck pain. Also, neck strength tests may have a complementary value in the assessment of neck pain persons.Implications: The results highlights that impaired neck strength, both in global cervico-thoracic and deep cranio-cervical muscles, is most likely a characteristic of people with long-term neck pain. The study also shows that strength tests could be used with fairly good discriminative precision and may thereby be valuable assessment tools.
  •  
13.
  • Björklund, Martin, 1961- (författare)
  • Effects of repetitive work on proprioception and of stretching on sensory mechanisms : implications for work-related neuromuscular disorders
  • 2004
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aims of the thesis were (i) to investigate the impact of repetitive low-intensity work exposure on proprioception and (ii) to examine effects of muscle stretching (especially sensory effects and effects on muscle nociception) and to relate its application to the prevention, alleviation and/or treatment of work-related neuromuscular disorders. The effects of low-intensity repetitive work on the shoulder proprioception were tested in healthy subjects. The effect of working time on the retention of subjective fatigue and their relation to changes in proprioception, and the immediate effect of stretching on shoulder proprioception were investigated. A new method to test the stretchability of the rectus femoris muscle was investigated for reliability and validity and used to assess the effects of a two-week stretching regimen on range of motion and on subjective stretch sensation. Finally, the interactions between innocuous muscle stretch and nociceptive chemical stimulation on discharge behavior of nociceptive dorsal horn neurons in the feline spinal cord were explored. The main findings were as follows: 1) The repetitive low-intensity work to fatigue diminished the shoulder proprioception; the working time as well as the retention of subjective fatigue were partly related to the extent of changed proprioception. 2) There was no effect of acute muscle stretching on the proprioception. 3) The new method for testing muscle stretchability proved valid and reliable. A two-week stretching regimen increased the tolerance to stretch torque, but the range of motion remained unchanged. 4) Half of the nociceptive dorsal horn neurons that responded to close arterial injections of bradykinin were modulated by muscle stretching applied directly after the injections. Altogether, the results give credence to the hypothesis of an involvement of sensory information distortion due to repetitive low-intensity work exposure in the development of work-related neuromuscular disorders. Increased tolerance to stretch torque may be an important mechanism in explaining improvements following stretch treatment. The spinal interactions between innocuous stretch and nociceptive muscle afferent inputs indicate a possible mechanism involved in stretching-induced pain alleviation.
  •  
14.
  • Björklund, Martin, et al. (författare)
  • Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests : a study protocol of a randomized controlled trial
  • 2012
  • Ingår i: BMC Musculoskeletal Disorders. - : BioMed Central. - 1471-2474. ; 13
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: A major problem with rehabilitation interventions for neck pain is that the condition may have multiple causes, thus a single treatment approach is seldom efficient. The present study protocol outlines a single blinded randomised controlled trial evaluating the effect of tailored treatment for neck-shoulder pain. The treatment is based on a decision model guided by standardized clinical assessment and functional tests with cut-off values. Our main hypothesis is that the tailored treatment has better short, intermediate and long-term effects than either non-tailored treatment or treatment-as-usual (TAU) on pain and function. We sub-sequentially hypothesize that tailored and non-tailored treatment both have better effect than TAU.METHODS: 120 working women with minimum six weeks of nonspecific neck-shoulder pain aged 20-65, are allocated by minimisation with the factors age, duration of pain, pain intensity and disability in to the groups tailored treatment (T), non-tailored treatment (NT) or treatment-as-usual (TAU). Treatment is given to the groups T and NT for 11 weeks (27 sessions evenly distributed). An extensive presentation of the tests and treatment decision model is provided. The main treatment components are manual therapy, cranio-cervical flexion exercise and strength training, EMG-biofeedback training, treatment for cervicogenic headache, neck motor control training. A decision algorithm based on the baseline assessment determines the treatment components given to the each participant of T- and NT-groups. Primary outcome measures are physical functioning (Neck Disability Index) and average pain intensity last week (Numeric Rating Scale). Secondary outcomes are general improvement (Patient Global Impression of Change scale), symptoms (Profile Fitness Mapping neck questionnaire), capacity to work in the last 6 weeks (quality and quantity) and pressure pain threshold of m. trapezius. Primary and secondary outcomes will be reported for each group with effect size and its precision.DISCUSSION: We have chosen not to include women with psychological ill-health and focus on biomedical aspects of neck pain. Future studies should aim at including psychosocial aspects in a widened treatment decision model. No important adverse events or side-effects are expected.Trial registration: Current Controlled Trials registration ISRCTN49348025.
  •  
15.
  •  
16.
  • Björklund, Martin, 1961-, et al. (författare)
  • Office-cycling while working : An innovative concept to prevent and reduce musculoskeletal pain in office workers - a controlled feasibility study
  • 2015
  • Konferensbidrag (refereegranskat)abstract
    • Background: According to the World Health Organization, WHO, a sedentary lifestyle is the single largest health risk for a number of diseases including musculoskeletal disorders and metabolic diseases. The negative health effects of excessive sitting are not compensated for by shorter bouts of increased physical activity. However, evidence shows that increased physical activity reduces musculoskeletal pain, which is very prevalent in those who are inactive. About 50-70 % of those who work at a computer report musculoskeletal pain and spend on average about 5 hours/day with very low energy metabolism. Work places are therefore an important arena for prevention and intervention by means of reducing sedentary time and increasing physical activity both for general health benefits and effects on the musculoskeletal pain.Purpose: To test the feasibility of office-cycling in an office work place and explore its potential effects on musculoskeletal pain in office workers.Methods: Twenty office workers (ages 27-61, 5 males) with musculoskeletal pain participated in this three-week controlled pilot field study. The intervention group (n=10), had access to an innovative customized cycle ergometer (OfficeBiking®) at their regular office workstation whilst performing their usual work tasks. Offie-cycling was an alternative to sitting/standing by their height adjustable office desk; they were instructed to bike as often as comfortable. The control group (n=10) was instructed to continue to work as usual. The experiences of office-cycling and how it influenced work performance was studied with a questionnaire. Musculoskeletal pain was evaluated using pain drawings and pain ratings and participants' total pain was calculated by adding each individuals' self-reported pain from their three most painful areas (NRS 0-10).Results: Importantly, office-cycling did not reduce self-reported work performance; the majority (9/10) would like daily access; and made suggestions to improve the user-friendliness of the bike. Office-cycling was used regularly (median, 11/15 workdays; median active time 59 min/day IQR 39;91). There was no observed difference regarding either number of self-reported areas of pain (NSAP) or general musculoskeletal pain (GMP) between the intervention group and the control group at baseline. Self-reported GMP decreased in 8 persons in the intervention group which was one more than in the control group (n=7). NSAP decreased in the intervention group (n=7; md -1,0 IQR -2,3;0,0); and the control group (n=5; md -0,5 IQR -1,3;0,3). The difference in total pain (intervention end-baseline) revealed a clinically important change in the intervention group (NRS -2,5, IQR -8,8;4,0) but not in the control group (NRS 0,0 IQR -6,2;2,5).Conclusions: The results suggest that office-cycling is a feasible method for use in work place interventions with some promising results. Future research suggestions are: underlying mechanisms regarding effects of physical activity on pain in parallel with controlled studies in laboratory environments to investigate dose-effects for metabolic expenditure and optimal pain reduction whilst office-cycling.Implications: The results in this feasibility study indicate a promising potential of the innovative office-cycling concept to prevent and reduce musculoskeletal pain in sedentary office workers.
  •  
17.
  • Björklund, Martin, 1961-, et al. (författare)
  • Responsiveness and minimal important change for the ProFitMap-neck questionnaire and the Neck Disability Index in women with neck-shoulder pain
  • 2017
  • Ingår i: Quality of Life Research. - : Springer Science and Business Media LLC. - 0962-9343 .- 1573-2649. ; 26:1, s. 161-170
  • Tidskriftsartikel (refereegranskat)abstract
    • PurposeThe aim was to determine the responsiveness and minimal important change (MIC) of the questionnaire ProFitMap-neck that measures symptoms and functional limitations in people with neck pain. The same measurement properties were determined for Neck Disability Index (NDI) for comparison purposes.MethodsLongitudinal data were derived from two randomized controlled trials, including 103 and 120 women with non-specific neck pain, with questionnaire measurements performed before and after interventions. Sensitivity and specificity to discriminate between improved and non-improved participants, based on categorization of a global rating of change scale (GRCS), were determined for the ProFitMap-neck indices and NDI by using area under receiver operator curves (AUC). Correlations between the GRCS anchor and change scores of the questionnaires were also used to assess responsiveness. The change score that showed the highest combination of sensitivity and specificity was set for MIC.ResultsThe ProFitMap-neck indices showed similar responsiveness as NDI with AUC exceeding 0.70 (Range: ProFitMap-neck, 0.74 – 0.83; NDI, 0.75 – 0.86). The MIC in the two samples ranged between 6.6 – 13.6% for ProFitMap-neck indices and 5.2 and 6.3% for NDI. Both questionnaires had significant correlations with GRCS (Spearman’s rho 0.47 – 0.72).ConclusionsValidity of change scores was demonstrated for the ProFitMap-neck indices with adequate ability to discriminate between improved and non-improved participants. Values of minimal important change were presented.
  •  
18.
  • Björklund, Martin, 1961- (författare)
  • The ProFitMap-neck questionnaire.
  • 2014. - 1
  • Ingår i: Neck pain : new perspectives : 14th Physiatric Summer School : 15.-16.08.2013, Helsinki. - Helsinki : Rehabilitation Orton, Invalid Foundation. - 9789529657742 ; , s. 61-68
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
  •  
19.
  •  
20.
  • Bohman, Tony, et al. (författare)
  • Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain : a longitudinal cohort study.
  • 2019
  • Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 9:4
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To develop predictive models for short-term and long-term clinically important improvement in women with non-specific chronic disabling neck pain during the clinical course of physiotherapy.DESIGN: Longitudinal cohort study based on data from a randomised controlled trial evaluating short-term and long-term effects on sensorimotor function over 11 weeks of physiotherapy.PARTICIPANTS AND SETTINGS: Eighty-nine women aged 31-65 years with non-specific chronic disabling neck pain from Gävle, Sweden.MEASURES: The outcome, clinically important improvement, was measured with the Patient Global Impression of Change Scale (PGICS) and the Neck Disability Index (NDI), assessed by self-administered questionnaires at 3, 9 and 15 months from the start of the interventions (baseline). Twelve baseline prognostic factors were considered in the analyses. The predictive models were built using random-effects logistic regression. The predictive ability of the models was measured by the area under the receiver operating characteristic curve (AUC). Internal validity was assessed with cross-validation using the bootstrap resampling technique.RESULTS: Factors included in the final PGICS model were neck disability and age, and in the NDI model, neck disability, depression and catastrophising. In both models, the odds for short-term and long-term improvement increased with higher baseline neck disability, while the odds decreased with increasing age (PGICS model), and with increasing level of depression (NDI model). In the NDI model, higher baseline levels of catastrophising indicated increased odds for short-term improvement and decreased odds for long-term improvement. Both models showed acceptable predictive validity with an AUC of 0.64 (95% CI 0.55 to 0.73) and 0.67 (95% CI 0.59 to 0.75), respectively.CONCLUSION: Age, neck disability and psychological factors seem to be important predictors of improvement, and may inform clinical decisions about physiotherapy in women with chronic neck pain. Before using the developed predictive models in clinical practice, however, they should be validated in other populations and tested in clinical settings.
  •  
21.
  • Degerstedt, Frida, 1974- (författare)
  • Equity among children and youth with cerebral palsy : physical leisure activity, physical education, physiotherapy and quality of life
  • 2023
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background & aim: Cerebral palsy (CP) is the most common reason for movement difficulties among children and youth in Sweden. Physiotherapy is usually introduced early in order to develop mobility and prevent further impairment, which in turn facilitates activity and participation. Physiotherapy is closely connected with physical activity, both as a goal and a mean, and physical activity contributes to aspects of health, in turn associated with quality of life (QoL). Physical education in school as well as physical leisure activity are important parts of the total physical activity participation among children and youth. Participation in physical leisure activity and physical education, as well as access to physiotherapeutic interventions, is insufficiently explored from an equity perspective regarding function, gender and ethnicity or birth country. The overall aim of the current thesis is to explore participation in physiotherapeutic interventions, physical leisure activity and physical education, as well as analyze the association between physical activity and quality of life, from an equity perspective for children and adolescents with CP in Sweden.Methods: The four papers that comprise this thesis are based upon three empirical studies: a National cross-sectional registry study (Papers I and II), based on the National Quality Registry Cerebral Palsy Follow-up Program (CPUP); an interview study with a qualitative approach (Paper III); and a national QoL survey complemented with registry data (IV). Quantitative data were analyzed with multivariable logistic-, linear- or quantile regressions. For the interview study, qualitative content analysis was used.Results: The number of participants in the registry studies were 2855 aged 0-18 years (Paper I) and 1935 aged 6-18 years (Paper II). The interview study (Paper III) included 11 participants aged 15-18 years, and the survey study (Paper IV) 149 participants, aged 15-18 years. Being born in Sweden entailed higher odds for participating in physiotherapy, physical leisure activity, physical education and physiotherapy, respectively, compared to those born outside Sweden (Paper I) or outside Europe (Paper II). More severe gross motor function difficulties were positively associated with higher odds of receiving physiotherapy, and negatively associated with physical activity participation (Paper II). Participants in the interviews report several examples of exclusion, struggles and (in-) sufficient support and inclusion through the categories ‘Exclusion and lack of support’, ‘Resistance, struggle and guilt’, and ‘Empowerment and support’. Gender as a vector in physical activity is mainly seen through the qualitative results, referring to physical education (Paper III). Frequent participation in physical leisure activity was associated with the domain Communication and physical health. Domains of QoL that referred to participation or function were negatively associated with having greater motor function difficulties, although not significantly associated with domains of social- and school wellbeing. Pain and bother is negatively associated with all five domains of QoL. Low educational level among the caregivers was associated with higher QoL-scores in the domain of social well-being (Paper IV).Discussion & Conclusions: The results that reveals differences regarding birth country indicates the relevance to raise awareness about possible inequity in participation in physical leisure activity, physical education, and physiotherapy for children and youth who have CP, as a prerequisite for improvement. Physiotherapists, school, and leisure sport leaders, as well as their organizations, need to be attentive to norms and bias in order to prevent inequity and discrimination due to for example birth country, gender or function, and provide support, which is included in the compensatory assignment of the schools and health care. This is emphasized by the experiences of exclusion expressed by participating youth with CP. Frequent physical activity participation is in part associated with higher QoL while Pain and bother is negatively associated with QoL, as is partly gross motor function difficulties. Prevention and treatment of pain and facilitation of physical activity is therefore important for children and youth with CP. Future studies should carefully consider targeting youth with a non-Nordic birth country and with large gross motor function difficulties or associated difficulties to widen knowledge about equity in physical activity- and physiotherapy participation, and QoL.
  •  
22.
  •  
23.
  • Degerstedt, Frida, et al. (författare)
  • Inequity in physiotherapeutic interventions for children with Cerebral Palsy in Sweden - a national registry study
  • 2020
  • Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 109:4, s. 774-782
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: The aim of this study was to investigate the distribution of physiotherapeutic interventions for children with Cerebral Palsy in Sweden from an equity perspective, considering sex, country of birth and geographical region.METHOD: This national cross-sectional registry study includes children with Cerebral Palsy aged 0-18 years who participated in 2015 in the Swedish national quality registry, the Cerebral Palsy follow-up program, CPUP. Comparisons and associations between physiotherapeutic interventions and sex, country of birth and geographical regions were conducted using Chi2 and logistic regression analysis, controlling for cognitive level, level of motor function, age group and dominating symptom.RESULTS: Of the 2855 participants, 2201 (79%) had received physiotherapy. Children born in Sweden had 1.60 times higher odds (95% CI 1.10-2.33) of receiving physiotherapy compared with children born in foreign countries. Distribution of physiotherapeutic interventions differed significantly between geographical regions. No associations between sex and physiotherapeutic interventions were observed.CONCLUSION: The results of this study indicate inequity in care in Sweden towards children with Cerebral Palsy born in other counties. Further, physiotherapeutic interventions were not equally distributed in different.
  •  
24.
  •  
25.
  • Degerstedt, Frida, et al. (författare)
  • Unequal physical activity among children with cerebral palsy in Sweden : A national registry study
  • 2021
  • Ingår i: Health Science Reports. - : John Wiley & Sons. - 2398-8835. ; 4:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To examine the extent to which sex, country of birth, and functional aspects influence participation in physical education and physical leisure activity among children with cerebral palsy (CP) in Sweden.Methods: This national cross-sectional registry study included children with CP aged 6 to 18 years who participated in the Swedish national quality registry, the Cerebral Palsy Follow-up Program, CPUP, in 2015. Comparisons and associations between sex, country of birth, and functional aspects and physical leisure/physical education were examined using chi-squared and multivariable logistic regression analysis.Results: The study included 1935 children. Of them, 1625 (87%) reported participating in physical education and 989 (53%) reported participating in physical leisure activity. Children born in Sweden had higher odds of participating in physical education (OR: 1.99; 95% CI: 1.20-3.28) and physical leisure activity (OR: 2.51; 95% CI: 1.70-3.72) compared with children born outside Europe. Greater impairment of gross motor function was associated with lower participation levels. Boys participated slightly more frequently in leisure activities than girls.Conclusion: Enhancing social inclusion with regard to disability, birth country, and sex are important and achievable goals for policymakers and practitioners for promoting participation in physical activity for children and adolescents with CP.
  •  
26.
  • Gold, Judith, et al. (författare)
  • Biochemical biomarkers for MSDs : systematic review results
  • 2016
  • Konferensbidrag (refereegranskat)abstract
    • Background. Although the potential for musculoskeletal disorder (MSD) biomarkers to detect subclinical disease and monitor MSD severity was discussed more than 20 years ago, only one review on biochemical biomarkers exclusive to humans has been published (Saxton 2000). The aim of this study was to systematically summarize biochemical biomarker research in neck and upper extremity MSDs that could appear in a work-related context. Two research questions guided the review: (1) Are there biochemical markers associated with neck and upper extremity MSDs? (2) Are there biochemical markers associated with the severity of neck and upper extremity MSDs?Methods: A literature search was conducted in PubMed and SCOPUS. 87 studies met primary inclusion criteria. Following a quality screen, data were extracted from 44 sufficient-quality articles.Results. Most of the 87 studies were cross-sectional and utilized convenience samples of patients as both cases and controls. A response rate was explicitly stated in only 11 (13%) studies. Less than half of the studies controlled for potential confounding through restriction or in the analysis. Most sufficient-quality studies were conducted in older populations (mean age in one or more analysis group > 50 yrs). In sufficient-quality articles, 82% demonstrated at least one statistically significant association between the MSD(s) and biomarker(s) studied. Evidence suggested that: (a) the collagen repair marker TIMP-1 is decreased in fibroproliferative disorders, (b) 5-HT (serotonin) is increased in trapezius myalgia, and (c) triglycerides are increased in a variety of MSDs. Only five studies showed an association between a biochemical marker and MSD severity.Discussion. While some MSD biomarkers were identified, limitations in the articles examined included possible selection bias, confounding, spectrum effect (potentially heterogeneous biomarker associations in populations according to symptom severity or duration) and insufficient attention to co-morbid conditions. A list of recommendations for future studies is provided.
  •  
27.
  • Gold, Judith, et al. (författare)
  • Systematic review of quantitative imaging biomarkers for neck and shoulder musculoskeletal disorders
  • 2017
  • Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 18
  • Forskningsöversikt (refereegranskat)abstract
    • BackgroundThis study systematically summarizes quantitative imaging biomarker research in non-traumatic neck and shoulder musculoskeletal disorders (MSDs). There were two research questions: 1) Are there quantitative imaging biomarkers associated with the presence of neck and shoulder MSDs?, 2) Are there quantitative imaging biomarkers associated with the severity of neck and shoulder MSDs?MethodsPubMed and SCOPUS were used for the literature search. One hundred and twenty-five studies met primary inclusion criteria. Data were extracted from 49 sufficient quality studies.ResultsMost of the 125 studies were cross-sectional and utilized convenience samples of patients as both cases and controls. Only half controlled for potential confounders via exclusion or in the analysis. Approximately one-third reported response rates. In sufficient quality articles, 82% demonstrated at least one statistically significant association between the MSD(s) and biomarker(s) studied. The literature synthesis suggested that neck muscle size may be decreased in neck pain, and trapezius myalgia and neck/shoulder pain may be associated with reduced vascularity in the trapezius and reduced trapezius oxygen saturation at rest and in response to upper extremity tasks. Reduced vascularity in the supraspinatus tendon may also be a feature in rotator cuff tears. Five of eight studies showed an association between a quantitative imaging marker and MSD severity.ConclusionsAlthough research on quantitative imaging biomarkers is still in a nascent stage, some MSD biomarkers were identified. There are limitations in the articles examined, including possible selection bias and inattention to potentially confounding factors. Recommendations for future studies are provided.
  •  
28.
  • Grinberg, Adam, 1980-, et al. (författare)
  • An electroencephalography-based approach to evaluate movement-related anxiety in physically active adults and following anterior cruciate ligament injury
  • 2022
  • Konferensbidrag (refereegranskat)abstract
    • Background: Psychophysiological consequences often persist following musculoskeletal trauma and can result in vastly decreased quality of life. Re-injury anxiety is particularly common among individuals following anterior cruciate ligament (ACL) injury. Existing assessments of re-injury anxiety are, however, restricted to subjective suboptimal questionnaires, which may result in under-reporting and thus poorer injury management. We propose a novel approach to objectively quantify arousal response to movement-related anxiety. A new experimental paradigm was implemented to induce and record a conditioned electrophysiological response to a sudden perturbation, experienced to be potentially injurious.Objective: To explore the feasibility of detecting anxiety-associated electrocortical response and to evaluate its discriminative ability between asymptomatic individuals and those who had experienced an ACL injury.Methods: Physically-active asymptomatic persons and individuals post-ACL reconstruction stood blindfolded on a perturbation platform capable of generating high-acceleration translations (1.5 m/s2). Auditory stimuli were repeatedly presented in four-second intervals, as either low- or high-frequency tones. Half of the high-frequency tones were followed 1.5 seconds later by a destabilizing perturbation in one of eight randomized directions. The two tone conditions were thus termed ‘Neutral’ and ‘Anxiety’, as the high-frequency tone was intended to invoke an arousal response in anticipation of a potential perturbation. Event-related potentials (ERP) were computed for nine electrodes by averaging 100 Neutral and 100 Anxiety trials. Significant ERP components were identified using functional data analysis. Paired difference-waves’ amplitudes (Neutral - Anxiety) were compared between groups.Results: ERP correlates of anxiety were detected for both groups in frontal and central midline locations, with an observable contingent negative variation (CNV) from 500 ms post-stimulus in Anxiety compared with Neutral trials. This ERP component is reflective of a threat-induced arousal response, associated with attention and expectancy of an anxiety-relevant event. Preliminary data indicate no group differences in CNV amplitudes.Conclusions: Objective evaluation of an arousal response to movement-related anxiety was found to be feasible, resulting in a threat-induced CNV. Further investigation will elucidate the discriminative power of such an approach to differentiate between individuals with high and low re-injury anxiety, as well as potential associations with existing patient-reported outcome measures.
  •  
29.
  • Grinberg, Adam, 1980-, et al. (författare)
  • An electroencephalography-based approach to evaluate movement-related anxiety in physically-active persons
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • Psychological consequences often persist following musculoskeletal trauma and can result in vastly decreased quality of life. Re-injury anxiety is reported to hinder return to sports and can itself be a precursor for secondary injuries. Existing assessments of re-injury anxiety are restricted to subjective questionnaires, which may result in under-reporting and thus poorer injury management. In the current study, we introduced an experimental approach to objectively quantify movement-related anxiety using a threat-conditioning paradigm. We aimed to explore the feasibility of such an approach among non-injured persons.Ten physically-active individuals stood blindfolded on a platform capable of generating high-acceleration translations in eight different directions. Consecutive auditory stimuli were presented (four-second intervals), as either high- (conditioned stimulus; CS+) or low- (neutral stimulus; CS–) tones. Half of the CS+ trials were followed by a perturbation in a pseudo-random order. Event-related potentials were computed for nine electrodes by averaging 100 X CS– and 100 X CS+ trials. Significant latencies for CS– – CS+ comparisons were identified using interval-wise testing. Mean-amplitudes for significant intervals were used to detect a channel effect.Large negative CS+ waveforms were observed from 302-627ms post-stimulus and continuing until the end of the trials, most prominently over frontal and central midline locations (p ≤ 0.025). This effect, inferred as a contingent negative variation wave (CNV), may be reflective of threat-induced arousal response.Our test paradigm was found to be feasible, with a CNV suggested as a potential biomarker for re-injury anxiety. Further validation is needed, as well as exploring the discriminative power of such an approach between individuals with and without previous injury.
  •  
30.
  • Grinberg, Adam, 1980-, et al. (författare)
  • Electrocortical activity associated with movement-related fear : a methodological exploration of a threat-conditioning paradigm involving destabilising perturbations during quiet standing
  • 2024
  • Ingår i: Experimental Brain Research. - : Springer Nature. - 0014-4819 .- 1432-1106. ; 242:8, s. 1903-1915
  • Tidskriftsartikel (refereegranskat)abstract
    • Musculoskeletal trauma often leads to lasting psychological impacts stemming from concerns of future injuries. Often referred to as kinesiophobia or re-injury anxiety, such concerns have been shown to hinder return to physical activity and are believed to increase the risk for secondary injuries. Screening for re-injury anxiety is currently restricted to subjective questionnaires, which are prone to self-report bias. We introduce a novel approach to objectively identify electrocortical activity associated with the threat of destabilising perturbations. We aimed to explore its feasibility among non-injured persons, with potential future implementation for screening of re-injury anxiety. Twenty-three participants stood blindfolded on a translational balance perturbation platform. Consecutive auditory stimuli were provided as low (neutral stimulus [CS–]) or high (conditioned stimulus [CS+]) tones. For the main experimental protocol (Protocol I), half of the high tones were followed by a perturbation in one of eight unpredictable directions. A separate validation protocol (Protocol II) requiring voluntary squatting without perturbations was performed with 12 participants. Event-related potentials (ERP) were computed from electroencephalography recordings and significant time-domain components were detected using an interval-wise testing procedure. High-amplitude early contingent negative variation (CNV) waves were significantly greater for CS+ compared with CS– trials in all channels for Protocol I (> 521-800ms), most prominently over frontal and central midline locations (P ≤ 0.001). For Protocol II, shorter frontal ERP components were observed (541-609ms). Our test paradigm revealed electrocortical activation possibly associated with movement-related fear. Exploring the discriminative validity of the paradigm among individuals with and without self-reported re-injury anxiety is warranted.
  •  
31.
  • Grinberg, Adam, 1980- (författare)
  • Sensorimotor function following anterior cruciate ligament injury : movement control, proprioception and neuropsychological perspectives
  • 2023
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background: The high incidence of anterior cruciate ligament (ACL) injuries in sports suggests an involvement of both biomechanical and neurocognitive risk factors. Athletes are constantly exposed to challenging sports scenarios, which are often characterised by high-intensity movements combined with a multi-stimuli environment and continuous psychological pressure. Post-injury loss of knee proprioception and long-term injury-associated neuroplasticity arguably place an athlete in a disadvantage when coping with such situations when returning to sports (RTS). This is postulated to contribute to a high rate of re-injuries, seen despite achieving RTS eligibility. Psychological factors such as re-injury fears and anxieties are also suggested to influence central sensorimotor processing and to therefore play a role in the generation and control of functional movements. Their assessment is however based on suboptimal tools, particularly when administered to the athletic population. In general, current clinical assessments focus primarily on coarse outcome measures while disregarding aspects such as multi-joint control and the influence of psychological aspects on motor performance. This thesis focuses on the role of proprioception and re-injury anxiety on functional movement control following ACL injury and reconstruction (ACLR), with implications for risks of re-injury.Methods: This thesis is comprised of four cross-sectional studies (Papers I-IV), that stem from two data collections performed in a motion analysis laboratory. Paper I introduces a novel obstacle clearance test aimed to functionally assess proprioception and sensorimotor control. The goal of the test was to cross an obstacle, downward vision occluded, aiming for minimal foot clearance. Individuals following ACLR and rehabilitation were compared to both mildly active uninjured persons (CTRL) and elite athletes (ATH). A kinematic analysis, using 3D motion capture, included estimates of lower limb movement accuracy, variability and symmetry. Paper II evaluates knee proprioception among the same individuals using a weight-bearing knee joint position sense (JPS) test, and outcomes were compared with associated outcomes from the obstacle clearance test. Paper III explores whether self-reported fear of re-injury is manifested in the biomechanics (kinematics and electromyography) of a standardised rebound side-hop test (SRSH). An ACLR group was stratified into high-fear and low-fear subgroups based on one discriminating question, and compared also to uninjured controls. In Paper IV, a threat-conditioning test paradigm is introduced, aiming to invoke and measure a neurophysiological arousal response to movement-related fear, among uninjured individuals. Conditioned auditory stimuli were occasionally followed by unexpected perturbations of the base of support, and compared with neutral stimuli. Electroencephalography was continuously registered and event-related potentials were explored as potential anxiety biomarkers.Results: Kinematic asymmetry was observed for the ACLR group during obstacle crossing, both for individual joints and for multi-joint movement and velocity curves. In addition, trailing leg trajectory variability during higher obstacle crossings was lower for ACLR compared to both control groups. The less physically-active CTRL group demonstrated less crossing accuracy (larger obstacle distances and JPS errors) compared to both ACLR and ATH. Moderate positive correlations were observed between knee JPS absolute errors and obstacle distances, for the injured leg of the ACLR group only. Individuals with ACLR, classified as having high fear, demonstrated higher biceps femoris amplitudes and anterior-posterior co-contraction index during landing. Side-hop performance was also distinguishable for ACLR (regardless of fear allocation) with greater hip and knee flexion, while high-fear individuals also had more trunk flexion. Perturbation-related fearful response was reflected as a high-amplitude contingent negative variation (CNV) wave in response to conditioned compared to neutral stimuli. The CNV wave was observed over all electrode cites but most significantly over frontal and central cortical areas.Conclusions: Even following rehabilitation, individuals with ACLR showed unique sensorimotor function, characterised by less trajectory variability and greater multi-joint asymmetry when proprioception was challenged (i.e., downward vision occluded). However, knee JPS did not seem to be deficient among these individuals, but instead more related to physical activity, than to the ACLR history. Correlations to JPS errors, seen exclusively for the ACLR leg might suggest a tendency to focus attention more internally when crossing an obstacle (generally an external focus task), though this should be investigated further. Higher levels of self-reported fear of re-injury were manifested in the biomechanics of side hops, with seemingly stiffer landings and protective neuromuscular strategy. This has potential implications for joint degeneration hastening as well as reduced motor adaptability, implying a risk for re-injury. Finally, the balance-perturbation test paradigm seemed to provoke threat-associated arousal in the form of a CNV wave among uninjured individuals. The CNV wave should further be explored as a potential biomarker for re-injury anxiety. Future research should implement this paradigm on individuals with different levels of self-reported movement-related fears and anxieties, striving for a more holistic approach in rehabilitation following ACLR.
  •  
32.
  • Hallman, David, 1979-, et al. (författare)
  • Sick leave due to musculoskeletal pain : determinants of distinct trajectories over 1 year
  • 2019
  • Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 92:8, s. 1099-1108
  • Tidskriftsartikel (refereegranskat)abstract
    • PurposeThis study aimed to identify sub-groups of workers with different trajectories of sick leave due to musculoskeletalpain over 1 year, and to investigate the extent to which the identified trajectories are associated with personal, occupational,lifestyle, and pain-related factors at baseline.MethodsData on 981 blue- and white-collar workers were analyzed in the DPHACTO cohort (2012–2014). The numberof days on sick leave due to pain was reported using text messages at 4-week intervals across 1 year. Latent class growthanalysis was used to distinguish sub-groups with different trajectories of sick leave. A web-based questionnaire at baselinewas used to assess personal, occupational (physical and psychosocial), lifestyle, and pain-related factors. Multinomial regressionmodels were constructed to determine associations between baseline factors and trajectories of sick leave (referencingno sick leave), with adjustment for potential confounders.ResultsFour distinct sub-groups were identified, with trajectories of sick leave due to pain ranging from no sick leave(prevalence 76%; average 0.5 days/year) to some days and increasing sick leave due to pain over 1 year (2%; 89 days/year).The increasing trajectory of sick leave was associated with higher perceived physical exertion, more time in manual work,less social community and influence at work, less leisure-time physical activity, smoking, and more severe symptoms (e.g.,multisite pain, low back pain intensity, and pain interference).ConclusionsWe identified four distinct trajectories of sick leave due to musculoskeletal pain. The sub-group with increasingsick leave due to pain was associated with several modifiable physical and psychosocial factors at work and outside work,which may have implications for prevention.
  •  
33.
  • Hallman, David, 1979-, et al. (författare)
  • Symposium: Arbete, individ och nacksmärta : Forskning vid Forte-centret “Kroppen i arbete – från problem till potential”
  • 2018
  • Ingår i: FALF KONFERENS 2018 Arbetet - problem eller potential för en hållbar livsmiljö? 10-12 juni 2018 i Gävle. - Gävle : Gävle University Press. - 9789188145284 ; , s. 102-
  • Konferensbidrag (refereegranskat)abstract
    • Besvär ifrån kroppens muskler och leder såsom nack- och ryggbesvär är fortfarande ett stort problem inom arbetslivet. Muskuloskeletal diagnos är den vanligaste orsaken till lång sjukfrånvaro inom privat sektor och näst vanligast inom kommuner och landsting. Orsakerna till dessa besvär kan vara relaterade till exponering både under arbete och på fritid, men även till individfaktorer. Vår forskargrupp har en bred ansats för att fylla kunskapsluckor inom detta område och kommer att presentera resultat från flera forskningsprojekt i symposiet Arbete, individ och nacksmärta.Långvarigt sittande har blivit alltmer vanligt förekommande i många yrkesgrupper. Långvarigt sittande och låg fysisk aktivitet har också uppmärksammats som ett betydande hälsoproblem i dagens arbetsliv och även som en möjlig riskfaktor för smärta i nacke-skuldra. Men forskningen om betydelsen av långvarigt sittande för smärta i nacke-skuldra är fortfarande begränsad. Likaså är det oklart om huvudets hållning vid sittandet och nackens funktion, exempelvis nackens rörelsefunktion och styrka, har betydelse för besvärsutveckling. Statiskt arbete med nacken i vridna och böjda positioner misstänks vara en riskfaktor för nack-skuldersmärta i yrken såsom tandläkare, men det är oklart varför vissa exponerade individer drabbas medan andra inte får ont. För de med långvarig smärta krävs ofta rehabiliterande åtgärder, och hur väl dessa åtgärder lyckas kan även det vara beroende av individens fysiska och psykosociala arbetsmiljö. Individens arbetsmiljö påverkar således inte bara risken för om man får besvär utan kan också ha betydelse för hur rehabiliteringen av besvären lyckas.Syftet med detta symposium är att presentera studier från Centrum för belastningsskadeforskning som handlar om nacksmärta i arbetslivet, sammanfatta kunskapsläget inom området och diskutera hur arbetet kan utformas för att bli hållbart och inkluderande. De forskningsexempel som presenteras berör stillasittande och hållning i arbetslivet och dess tänkbara konsekvenser för nacksmärta och hälsa, riskfaktorer för nacksmärta i tandläkaryrket och arbetsmiljöns betydelse för resultatet av rehabilitering vid nacksmärta. Symposiet avslutas med en frågestund och gemensam diskussion.
  •  
34.
  • Kristan, Matej, et al. (författare)
  • The first visual object tracking segmentation VOTS2023 challenge results
  • 2023
  • Ingår i: 2023 IEEE/CVF International conference on computer vision workshops (ICCVW). - : Institute of Electrical and Electronics Engineers Inc.. - 9798350307443 - 9798350307450 ; , s. 1788-1810
  • Konferensbidrag (refereegranskat)abstract
    • The Visual Object Tracking Segmentation VOTS2023 challenge is the eleventh annual tracker benchmarking activity of the VOT initiative. This challenge is the first to merge short-term and long-term as well as single-target and multiple-target tracking with segmentation masks as the only target location specification. A new dataset was created; the ground truth has been withheld to prevent overfitting. New performance measures and evaluation protocols have been created along with a new toolkit and an evaluation server. Results of the presented 47 trackers indicate that modern tracking frameworks are well-suited to deal with convergence of short-term and long-term tracking and that multiple and single target tracking can be considered a single problem. A leaderboard, with participating trackers details, the source code, the datasets, and the evaluation kit are publicly available at the challenge website1
  •  
35.
  • Richter, Hans O., et al. (författare)
  • Long-term adaptation to neck/shoulder pain and perceptual performance in a hand laterality motor imagery test
  • 2010
  • Ingår i: Perception. - : Sage Publications. - 0301-0066 .- 1468-4233. ; 39:1, s. 119-130
  • Tidskriftsartikel (refereegranskat)abstract
    • The effect of neck/shoulder pain on the performance in a hand laterality motor imagery test was studied. Responses to the Cooper and Shepard (1975, Journal of Experimental Psychology: Human Perception and Performance 104 48–56) hand laterality test were explored in twenty-four individuals with chronic non-specific neck pain and twenty-one subjects with chronic neck pain of traumatic origin (whiplash-associated disorder). Twenty-two controls were also included in the study. Digitalised right- or left-hand stimuli were presented at five different stimulus angles (0°, 45° laterally, 90° laterally, 135° laterally, and 180°). The experimental task was to decide the laterality as fast and accurately as possible. The performance, both reaction time (RT) and accuracy, of the two experimental groups was contrasted with that of the control group. The main results revealed that the subjects afflicted with whiplash injury on the average exhibited a faster response pattern than symptom-free healthy controls. Despite their musculoskeletal deficits and experience of pain these volunteers also exhibited a preserved speed–accuracy tradeoff. Longer duration of time with symptoms of neck pain was, moreover, associated with progressively faster RTs. These results point to perceptual learning and may reflect different stages of adaptation to neck pain.
  •  
36.
  • Röijezon, Ulrik, 1970-, et al. (författare)
  • A novel method for neck coordination exercise : a pilot study on persons with chronic non-specific neck pain
  • 2008
  • Ingår i: Journal of NeuroEngineering and Rehabilitation. - : BioMed Central (BMC). - 1743-0003. ; 5, s. 36-
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Chronic neck pain is a common problem and is often associated with changes in sensorimotor functions, such as reduced proprioceptive acuity of the neck, altered coordination of the cervical muscles, and increased postural sway. In line with these findings there are studies supporting the efficacy of exercises targeting different aspects of sensorimotor function, for example training aimed at improving proprioception and muscle coordination. To further develop this type of exercises we have designed a novel device and method for neck coordination training. The aim of the study was to investigate the clinical applicability of the method and to obtain indications of preliminary effects on sensorimotor functions, symptoms and self-rated characteristics in non-specific chronic neck painMETHODS: The study was designed as an uncontrolled clinical trial including fourteen subjects with chronic non-specific neck pain. A new device was designed to allow for an open skills task with adjustable difficulty. With visual feedback, subjects had to control the movement of a metal ball on a flat surface with a rim strapped on the subjects' head. Eight training sessions were performed over a four week period. Skill acquisition was measured throughout the intervention period. After intervention subjects were interviewed about their experience of the exercise and pain and sensorimotor functions, including the fast and slow components of postural sway and jerkiness-, range-, position sense-, movement time- and velocity of cervical rotation, were measured. At six-month follow up, self-rated pain, health and functioning was collected.RESULTS: The subjects improved their skill to perform the exercise and were overall positive to the method. No residual negative side-effects due to the exercise were reported. After intervention the fast component of postural sway (p = 0.019) and jerkiness of cervical rotation (p = 0.032) were reduced. The follow up showed decreased disability (one out of three indices) and fear of movement, and increased general health (three out of eight dimensions).CONCLUSION: The results support the clinical applicability of the method. The improvements in sensorimotor functions may suggest transfer from the exercise to other, non-task specific motor functions and justifies a future randomized controlled trial.
  •  
37.
  • Röijezon, Ulrik, 1970-, et al. (författare)
  • Kinematics of fast cervical rotations in persons with chronic neck pain : a cross-sectional and reliability study
  • 2010
  • Ingår i: BMC Musculoskeletal Disorders. - : BioMed Central. - 1471-2474. ; 11, s. 222-
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • BackgroundAssessment of sensorimotor function is useful for classification and treatment evaluation of neck pain disorders. Several studies have investigated various aspects of cervical motor functions. Most of these have involved slow or self-paced movements, while few have investigated fast cervical movements. Moreover, the reliability of assessment of fast cervical axial rotation has, to our knowledge, not been evaluated before.MethodsCervical kinematics was assessed during fast axial head rotations in 118 women with chronic nonspecific neck pain (NS) and compared to 49 healthy controls (CON). The relationship between cervical kinematics and symptoms, self-rated functioning and fear of movement was evaluated in the NS group. A sub-sample of 16 NS and 16 CON was re-tested after one week to assess the reliability of kinematic variables. Six cervical kinematic variables were calculated: peak speed, range of movement, conjunct movements and three variables related to the shape of the speed profile.ResultsTogether, peak speed and conjunct movements had a sensitivity of 76% and a specificity of 78% in discriminating between NS and CON, of which the major part could be attributed to peak speed (NS: 226 ± 88 °/s and CON: 348 ± 92 °/s, p < 0.01). Peak speed was slower in NS compared to healthy controls and even slower in NS with comorbidity of low-back pain. Associations were found between reduced peak speed and self-rated difficulties with running, performing head movements, car driving, sleeping and pain. Peak speed showed reasonably high reliability, while the reliability for conjunct movements was poor.ConclusionsPeak speed of fast cervical axial rotations is reduced in people with chronic neck pain, and even further reduced in subjects with concomitant low back pain. Fast cervical rotation test seems to be a reliable and valid tool for assessment of neck pain disorders on group level, while a rather large between subject variation and overlap between groups calls for caution in the interpretation of individual assessments.
  •  
38.
  • Sandlund, Jonas, et al. (författare)
  • Acuity of goal-directed arm movements to visible targets in chronic neck pain
  • 2008
  • Ingår i: Journal of Rehabilitation Medicine. - : Foundation of Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 40:5, s. 366-374
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To evaluate end-point acuity in goal-directed arm movements in subjects with chronic neck pain, while taking the trade-off between speed and accuracy into account, and to evaluate associations between reduced acuity and self-rated characteristics.Design: Single-blinded, controlled, comparative group study.Subjects: Forty-five subjects with chronic non-traumatic, non-specific neck pain (n = 24) and whiplash-associated disorders (n = 21). Healthy subjects served as controls (n = 22). The groups were age- and sex-matched.Methods: Subjects performed fast and accurate pointing movements to a visual target. Group differences in end-point variability, controlled for peak velocity, were evaluated. Associations between end-point variability and self-rated symptoms, functioning, self-efficacy and kinesiophobia were analysed.Results: End-point acuity, controlled for peak velocity, was reduced for both neck-pain groups. Similar spatial error patterns across all groups indicated no direction-specific reduction. For both neck-pain groups, associations were found between end-point acuity and neck movement deficits, physical functioning and, in whiplash, also balance and pain.Conclusion: Acuity of goal-directed arm movements can be reduced in chronic neck pain. Associations between acuity and self-rated characteristics support the clinical validity of the results and indicate that impaired neck function contributes to reduced end-point acuity. The results can be of importance for characterization and rehabilitation of neck disorders.
  •  
39.
  • Svedmark, Åsa, et al. (författare)
  • Associations between symptoms and physical test outcomes in women with non-specific neck pain: cross-sectional and longitudinal analyses
  • 2019
  • Konferensbidrag (refereegranskat)abstract
    • Background: Non-specific neck pain has a multifaceted symptom picture and the relationship is obscure between individual improvement on physical function and the neck patient's self-rated status.Purpose: The present aim was to determine the associations between physical test outcomes involving the neck and shoulder region, and self-reported neck symptoms before and after a treatment intervention in women with non-specific neck pain.Methods: Data were obtained for 120 women (aged 20-65) who had participated in a previous randomized controlled trial. Data were used from all participants at baseline for cross-sectional analysis and from 69 women for longitudinal analysis (Change-scores). Associations between self-reported neck problems (pain, disability and symptoms from the neck) and physical test outcomes (Neck-Strength, Cervical Axial-Range of Motion and Peak-Speed of cervical rotation) were estimated with linear regression analyses.Results: Self-rated neck pain was only significantly associated to the physical outcome measure Peak-Speed of cervical rotation, i.e., increased pain related to lower speed. This was true at baseline and for Change-scores at 9 months. Increased neck disability and frequency of symptoms were associated to lower Neck Strength and reduced Peak-Speed at baseline, and to reduced Peak-Speed and Cervical Axial-Range of Motion at 3 and 9 months, respectively. Peak-Speed and Cervical Axial-ROM were thus the physical test outcomes with associations to self-rated changes in neck symptoms. At the 9-month follow-up, 26% of the variance of frequency of symptom changes was explained by changes in Cervical Axial-ROM and Peak-Speed, which were also inter-correlated (r=0.55).Conclusion(s): The results indicate that changes in physical functioning, tested as cervical mobility and strength, have only a modest relation to the course of self-rated condition in neck disorders.Implications: The present study calls for reconsideration regarding acting mechanisms behind the apparent effect of, e.g., strength training on neck pain disorders. The specificity and usefulness of various assessments for decision-making, treatment and evaluation might be questioned.Key-Words: Neck pain, Neck strength, Range of motionFunding acknowledgements: Swedish Council for Working Life and Social Research (2009-1403), AFA Insurance (090288), The Centre for Environmental Research (1152383).Ethics approval: Did this work require ethics approval?:YesInstitution: Regional ethical review board in Uppsala SwedenEthics Committee: Regional ethical review board in Uppsala SwedenEthics number: No 2011/081
  •  
40.
  •  
41.
  • Svedmark, Åsa, 1961-, et al. (författare)
  • Is tailored treatment superior to non-tailored treatment for pain and disability in women with non-specific neck pain? : A randomized controlled trial
  • 2016
  • Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 17
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The evidence for the effect of treatments of neck pain is modest. In the absence of causal treatments, a possibility is to tailor the treatment to the individuals' functional limitations and symptoms. The aim was to evaluate treatment effects of a tailored treatment versus a non-tailored treatment. Our hypothesis was that tailored treatment (TT) would have better effect on pain intensity and disability than either non-tailored treatment (NTT) (same treatment components but applied quasi-randomly) or treatment-as-usual (TAU) (no treatment from the study, no restrictions). We further hypothesized that TT and NTT would both have better effect than TAU.METHOD: One hundred twenty working women with subacute and chronic non-specific neck pain were allocated to 11 weeks of either TT, NTT or TAU in a randomized controlled trial with follow-ups at 3, 9 and 15 months. The TT was designed from a decision model based on assessment of function and symptoms with defined cut-off levels for the following categories: reduced cervical mobility, impaired neck-shoulder strength and motor control, impaired eye-head-neck control, trapezius myalgia and cervicogenic headache. Primary outcomes were pain and disability. Secondary outcomes were symptoms, general improvement, work productivity, and pressure pain threshold of m. trapezius.RESULTS: Linear mixed models analysis showed no differences between TT and NTT besides work productivity favoring TT at 9- and 15-months follow-ups. TT and NTT improved significantly more than TAU on pain, disability and symptoms at 3-month follow-up. General improvement also favored TT and NTT over TAU at all follow-ups.CONCLUSION: Tailored treatment according to our proposed decision model was not more effective than non-tailored treatment in women with subacute and chronic neck pain. Both tailored and non-tailored treatments had better short-term effects than treatment-as-usual, supporting active and specific exercise therapy, although therapist-patient interaction was not controlled for. Better understanding of the importance of functional impairments for pain and disability, in combination with a more precise tailoring of specific treatment components, is needed to progress.TRIAL REGISTRATION: Current Controlled Trials ISRCTN 49348025. Registered 2 August 2011.
  •  
42.
  • Svedmark, Åsa, 1961- (författare)
  • Neck pain in women : effect of tailored treatment and impact of work environment
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction: Musculoskeletal pain is a common problem in the working population. In Sweden, 40% of women and 30% of men report suffering from neck and shoulder pain weekly. The underlying cause for neck pain is often not known and the treatment is commonly guided by the individual’s symptoms. However, there is a lack of knowledge on how to receive the best effect based on the individual’s symptoms and functional limitations, and therefore this has been scarcely evaluated in research. Furthermore, the impact of work exposure and stress on long-term treatment for persons with neck pain is not clear.Aims: To develop (paper 1) and to evaluate a decision model for tailored treatment in women with neck pain (paper 2). Moreover, to determine if risk factors at work and stress influence intermediate and long-term treatment results (paper 3). Further, to investigate if changes in self-reported pain and disabilities are associated with changes of physical test outcomes of the neck and shoulder region after treatment (paper 4).Methods: In an RCT, 120 working women with non-specific neck pain were randomized to three different groups – tailored treatment (TT), non-tailored treatment (NTT) or treatment-as-usual (TAU) for an 11 weeks intervention with short-term, intermediate-term and long-term follow-ups. The TT group was guided by a decision model with cut-off levels to indicate impairments. The NTT group received two established treatment components randomly from those not indicated, and TAU group did not receive any treatment within the study. The RCT primary outcomes were self-reported neck pain and neck disability. A linear mixed model was used for analysing the effects. One week after the end of intervention work exposure and stress were assessed at a work-place visit and associations to treatment results were tested for, and mixed models were used to estimate longitudinal associations. Associations between self-reported neck problems and physical outcomes were estimated with univariate and multiple regressions analysis.Results: No differences between TT and NTT were revealed for neck pain and disability. In comparison to TAU, the TT and NTT groups both showed improvements at short-term follow-up, but not at intermediate and long-term follow-up. High stress level and low self-estimated control at work were associated with more pain and disability at the intermediate and long-term follow-ups. After intervention and at the intermediate-term follow-up, reduced neck pain, disability and frequency of symptoms were associated with increased peak speed of head rotation and cervical range of motion.Conclusion: Tailored treatment according to the decision model was not superior to the non-tailored treatment in women with non-specific neck pain. One explanation for this can be the weak relationships found between neck pain and disability and physical test outcomes. Further, perceived stress and psychosocial work exposure were associated with self-reported neck problems and should be taken into account to optimize the effects in neck pain rehabilitation.
  •  
43.
  • Svedmark, Åsa, 1961-, et al. (författare)
  • Progressive Individualized EMG Biofeedback Training for Women
  • 2012
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • INTRODUCTION: The use of EMG biofeedback in workplace ergonomic intervention is well established. Its systematic application in tailored neck pain rehabilitation is, however, less developed.AIM: To introduce a tailored and gradually progressive biofeedback training program for trapezius myalgia and to assess the feasibility and the subjective experience of the program.METHODS: The study  sample was a subgroup in an ongoing randomized controlled trial (RCT) to evaluate 11- weeks of individualized neck pain rehabilitation in women  with  at least six weeks of work related nonspecific neck pain (target number of participants 105, ISRCTN49348025). The intervention period included 27 treatment sessions. The treatment decision model for the individualization of the RCT included five main treatment components of which biofeedback training was one. Each subject  was assigned two treatment components at minimum. Criterion for being assigned biofeedback training was a diagnosis of trapezius myalgia and a cut off level of pain pressure threshold, defined by previous cross sectional data. The biofeedback treatment program consisted of eight standardized exercises with  gradual progression of difficulty level followed by functional training in specific tasks individualized for each subject. The latter were disentangled with the Problem Elicitation Technique  (Bakker et al. 1995) and indicated the a ctivities that  were most important to the individual and most difficult to do because of the neck pain. In the functional training, principles of motor learning  were applied in order to enhance retention of the training tasks and transfer to new tasks and environments. The ability to perform three  standardized biofeedback exercises and the elinica I applicability of the individualized program was evaluated by subjects and therapists (n=4).RESULTS: Preliminary result from the therapist evaluation shows a positive opinion about  the biofeedback program. To date, 60% of the 105 subjects planned for the RCT have been recruited. Based on the number of subjects fulfilling the criterion so far for biofeedback training, we expect the final sample to be around 18 subjects. Results will be ready in June 2012.CONCLUSION: This study will provide valuable information on the feasibility and applicability of gradually progressive biofeedback training as part of an intervention program addressing work related non-specific neck pain.REFERENCE:Bakker C., van der Linden S., van Santen-Hoeufft M., Bolwijn  P., Hidding A. Problem elicitation to assess patient priorities in ankylos ing spondylitis and fibromyalgia. J. Rheumatol. 1995 Jul;22(7):1304-1 
  •  
44.
  •  
45.
  • Wiitavaara, Birgitta, et al. (författare)
  • How well do questionnaires on symptoms in neck-shoulder disorders capture the experiences of those who suffer from neck-shoulder disorders? : A content analysis of questionnaires and interviews
  • 2009
  • Ingår i: BMC Musculoskeletal Disorders. - : BioMed Central. - 1471-2474. ; 10:30, s. 1-14
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Previous research has indicated neck-shoulder disorders to have a fluctuating course incorporating a variety of symptoms. These findings awoke our interest to make a comparison between symptoms experienced by people affected with the disorder and the content of questionnaires that assess pain and other symptoms in neck-shoulder disorders. Thus the aims of this study were: -to explore the symptoms experienced by people with non-specific neck-shoulder problems, as well as experiences of nuances and temporal variations (fluctuations) of symptoms; -to investigate which sources were used in the development of ten questionnaires for assessing pain and other symptoms in the neck-shoulder; -to analyse the item content of the questionnaires; -to analyse the correspondence between the item content of the questionnaires and the symptoms described by the informants. METHODS: Content analysis of interviews with 40 people with non-specific neck-shoulder pain, and 10 questionnaires used to assess pain and other symptoms in neck-shoulder disorders. RESULTS: The interviews revealed a variety of symptoms indicating a bodily, mental/cognitive, and emotional engagement, and more general and severe symptoms than are usually considered in neck-shoulder questionnaires. Taking all questionnaires together many of the symptoms were considered, but most questionnaires only included a few of them. The informants were able to distinguish fluctuation of symptoms, and a variety of different qualities which were not usually considered in the questionnaires. Only two questionnaires had made use of the opinions of affected people in the development. CONCLUSION: Few of the questionnaires had made use of the experiences of affected people in the development. The correspondence between the symptoms expressed by those affected and the content of the questionnaires was low. A variety of symptoms were expressed by the interviewees, and the participants were also able to distinguish nuances and fluctuations of symptoms. The present study points to the importance of other aspects than just pain and physical functioning as clinical trial outcome measures related to neck-shoulder disorders. To develop a condition-specific questionnaire, it is important to decide on the specific symptoms for the condition. Using the experiences of those affected, in combination with relevant research and professional knowledge, can enhance the validity of the questionnaires.
  •  
Skapa referenser, mejla, bekava och länka
  • Resultat 1-45 av 45
Typ av publikation
tidskriftsartikel (20)
konferensbidrag (14)
annan publikation (4)
doktorsavhandling (4)
forskningsöversikt (2)
bokkapitel (1)
visa fler...
visa färre...
Typ av innehåll
refereegranskat (32)
övrigt vetenskapligt/konstnärligt (13)
Författare/redaktör
Björklund, Martin, 1 ... (33)
Djupsjöbacka, Mats (10)
Häger, Charlotte (7)
Häger, Charlotte, 19 ... (4)
Keisu, Britt-Inger, ... (4)
Björklund, Johanna, ... (4)
visa fler...
Mathiassen, Svend Er ... (3)
Strandberg, Johan (3)
Strong, Andrew (3)
Rolfson, Ola, 1973 (2)
Wiitavaara, Birgitta (2)
Wahlström, Jens (2)
Gerdhem, Paul (2)
Thoreson, Olof, 1981 (2)
Englund, Martin (2)
Öberg, Birgitta (2)
Sommar, Johan (2)
Holtermann, Andreas (2)
Mohaddes, Maziar, 19 ... (2)
Häger, Charlotte K., ... (2)
Sandlund, Jonas (1)
Johansson, Håkan (1)
Brulin, Christine (1)
Richter, Hans O (1)
Crenshaw, Albert G. (1)
Abbott, Allan (1)
Peolsson, Anneli (1)
Peolsson, Anneli, 19 ... (1)
Wang, Fei (1)
Mayer, Christoph (1)
Wang, Dong (1)
Dahlgren, Gunilla (1)
Bottai, Matteo (1)
Chen, Yan (1)
Kvist, Joanna (1)
Li, Xin (1)
Ng, Nawi (1)
Diarbakerli, Elias (1)
Vu, Xuan-Son, 1988- (1)
Bergenheim, Mikael (1)
Lorentzon, Ronny (1)
Zhu, Xuefeng (1)
Kosek, E (1)
van de Weijer, Joost (1)
An, Dong (1)
Antti, Henrik (1)
Felsberg, Michael (1)
Gao, Jie (1)
Arumugam, Ashokan (1)
Mikko, Sanna (1)
visa färre...
Lärosäte
Umeå universitet (33)
Högskolan i Gävle (30)
Luleå tekniska universitet (4)
Karolinska Institutet (4)
Uppsala universitet (3)
Linköpings universitet (3)
visa fler...
Göteborgs universitet (2)
Lunds universitet (2)
Högskolan Dalarna (1)
visa färre...
Språk
Engelska (44)
Svenska (1)
Forskningsämne (UKÄ/SCB)
Medicin och hälsovetenskap (41)
Samhällsvetenskap (5)
Naturvetenskap (4)

År

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy