| 1. |
|
|
| 2. |
- Heijne, Annette, et al.
(författare)
-
"I don't opt out of things because I think I will get a sore knee, but I don't expose myself to stupid risks either" : Patients' experiences of a second ACL injury-an interview study
- 2021
-
Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347.
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this qualitative study was to describe women's experiences with anterior cruciate ligament reconstruction (ACLR) and a subsequent ACL rupture, and to identify potential facilitators and barriers for coping with rehabilitation after the second injury.METHODS: Eight women between 17 and 36 years (mean 26, SD 6.5) who had experienced ACLR, followed by another ACL rupture, participated in the study. Semi-structured interviews were conducted, and data were analyzed using qualitative content analysis.RESULTS: One overarching theme, "Rehabilitation after a second ACL injury-A lifelong adaptive coping process", emerged from analyses. Undergoing a second rehabilitation is described as a process of adaptation, beginning with the first injury and still ongoing, more than 5 years later. Participants applied different coping strategies to adapt to these life-altering injuries, but the common denominator was of major life adjustments with no return to previous activity levels. Initially, after the reinjury, it was about coping with the catastrophe of the dreaded second injury. Over time, they accepted their "new" life and reset their recovery/rehabilitation goal not just as "return to sport" but rather as a "personal life goal".CONCLUSION: Undergoing a second ACL injury is a long process that challenges the patient's coping skills. Given these results, rehabilitation programs need to be more person centred according to the patients-adjusted life goals.LEVEL OF EVIDENCE: 3.
|
|
| 3. |
- Heijne, Annette
(författare)
-
Rehabilitation after anterior cruciate ligament reconstruction using patellar tendon or hamstring grafts : open and closed kinetic chain exercises
- 2007
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of this thesis was to improve the knowledge of appropriate exercises, the influence of preoperative factors for good clinical outcome as well as the patient s experience of the rehabilitation after anterior cruciate ligament (ACL) reconstruction with patellar tendon or hamstring graft. Methods: The strain in the anteromedial bundle of the ACL was measured with the strain gauge technique in nine patients scheduled for meniscectomy. The measurement was performed during a step-up, a step-down, a lunge and a one-leg sit to stand exercise (Study I). Sixty-eight patients, 36 males and 32 females, with either patellar tendon graft (34 patients) or hamstring graft (34 patients) were randomly allocated to either early (4 th postoperative week) or late start (12 th postoperative week) of open kinetic chain (OKC) quadriceps exercises. The four groups consisted of patellar tendon reconstruction, early start (P4) or late start (P12), hamstring tendon reconstruction, early start (H4) or late start (H12). Range of motion, anterior knee laxity, pivot shift, postural sway, thigh muscle torques and anterior knee pain were evaluated prior to surgery and 3, 5 and 7 months after surgery (Study II). The variables investigated in Study II, and demographic data were calculated in a multiple regression model to find the strongest predictors of the 12 months outcome, measured with two subgroups of KOOS (Function in sport and recreation; Quality of life), one-leg hop test, and Tegner Activity Scale (Study III). Ten patients were interviewed focusing on expectations and challenges from injury to one year after ACL reconstruction. The transcribed interviews were analyzed using a qualitative thematic content interpreted analysis (Study IV). Results: No significant differences in ACL strain were shown between exercises. There was a significant increase in ACL strain towards extension in all studied exercises (Study I). No significant group differences were found in range of motion, postural sway and anterior knee pain 3, 5 and 7 months, postoperatively. The H4 group showed a higher mean difference of laxity over time of 1.0 mm than the P4 group (p=0.04) and 1.2 mm than the H12 group (p=0.01). All groups, except for the P4 group reached preoperative values of quadriceps torques, while the H4 and the H12 groups showed significantly lower hamstring torques at the 7 months follow-up compared with preoperatively (Study II). Step-wise regression showed that absence/less preoperative AKP and low knee influence on pre-operative activity level explained 31 % in Sport/Rec KOOS outcome. Additionally, high scores on the AKP score predicted the outcome alone to 14 % in QOL KOOS. Absence of or minor AKP was the strongest predictor for Sport/Rec KOOS and QOL KOOS. Patellar tendon graft in favor of hamstring tendon graft and a short time (< 6 months) between injury and ACL surgery partly explained a higher level of activity (TAS). Absence of cartilage damage explained 6 % of good outcome as measured with the one-leg hop test (Study III). The participants perceived no real choice between operative and non-operative treatment. Only surgery symbolized a full return to the pre-injury level of sport activity, and surgery was understood as the only way to become a completely restored functional human being . A major source of frustration was that the meaning of and progress during the rehabilitation did not match their expectations. Three different responses to the challenge of a prolonged rehabilitation were expressed: going for it , being ambivalent , and giving in . Fear of re-injury was common; however some participants decided not to return to their pre-injury level of sporting activity due to other reasons than physical limitations or fear of re-injury (Study IV). Conclusion: The studied exercises did not produce greater strain on the ACL than the traditional two-legged squat. Early start of OKC quadriceps exercises leads to greater anterior knee laxity than late start after hamstring ACL reconstruction as well as after patellar tendon ACL reconstruction. No group differences in postural sway and AKP were found. The evaluated preoperative variables could partly predict clinical outcomes. Absence of or minor AKP before surgery was the strongest predictor for the outcome 12 months after ACL reconstruction. Preoperative information in terms of the meaning and extent of rehabilitation would have been helpful as well as guidance in realistic goal-setting and coaching throughout the entire rehabilitation process.
|
|
| 4. |
- Nilsson, Ola B., et al.
(författare)
-
Cotranslational folding of spectrin domains via partially structured states
- 2017
-
Ingår i: Nature Structural & Molecular Biology. - : Springer Science and Business Media LLC. - 1545-9993 .- 1545-9985. ; 24:3, s. 221-225
-
Tidskriftsartikel (refereegranskat)abstract
- How do the key features of protein folding, elucidated from studies on native, isolated proteins, manifest in cotranslational folding on the ribosome? Using a well-characterized family of homologous α-helical proteins with a range of biophysical properties, we show that spectrin domains can fold vectorially on the ribosome and may do so via a pathway different from that of the isolated domain. We use cryo-EM to reveal a folded or partially folded structure, formed in the vestibule of the ribosome. Our results reveal that it is not possible to predict which domains will fold within the ribosome on the basis of the folding behavior of isolated domains; instead, we propose that a complex balance of the rate of folding, the rate of translation and the lifetime of folded or partly folded states will determine whether folding occurs cotranslationally on actively translating ribosomes.
|
|
| 5. |
- Rasmussen Barr, Eva, et al.
(författare)
-
Rehabilitering vid ryggbesvär
- 2018
-
Ingår i: Motorisk kontroll och inlärning. - : Studentlitteratur AB. - 9789144103600 ; , s. 207-218
-
Bokkapitel (refereegranskat)
|
|
| 6. |
- Tian, Pengfei, et al.
(författare)
-
Folding pathway of an Ig domain is conserved on and off the ribosome
- 2018
-
Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 115:48, s. E11284-E11293
-
Tidskriftsartikel (refereegranskat)abstract
- Proteins that fold cotranslationally may do so in a restricted configurational space, due to the volume occupied by the ribosome. How does this environment, coupled with the close proximity of the ribosome, affect the folding pathway of a protein? Previous studies have shown that the cotranslational folding process for many proteins, including small, single domains, is directly affected by the ribosome. Here, we investigate the cotranslational folding of an all-beta Ig domain, titin I27. Using an arrest peptide-based assay and structural studies by cryo-EM, we show that I27 folds in the mouth of the ribosome exit tunnel. Simulations that use a kinetic model for the force dependence of escape from arrest accurately predict the fraction of folded protein as a function of length. We used these simulations to probe the folding pathway on and off the ribosome. Our simulations-which also reproduce experiments on mutant forms of I27-show that I27 folds, while still sequestered in the mouth of the ribosome exit tunnel, by essentially the same pathway as free I27, with only subtle shifts of critical contacts from the C to the N terminus.
|
|
| 7. |
- Torstensen, Tom Arild, et al.
(författare)
-
How does exercise dose affect patients with long-term osteoarthritis of the knee? A study protocol of a randomised controlled trial in Sweden and Norway : the SWENOR Study
- 2018
-
Ingår i: BMJ Open. - 2044-6055. ; 8:5
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Osteoarthritis (OA) of the knee is characterised by knee pain, disability and degenerative changes, and places a burden on societies all over the world. Exercise therapy is an often-used modality, but there is little evidence of what type of exercise dose is the most effective, indicating a need for controlled studies of the effect of different dosages. Thus, the aim of the study described in this protocol is to evaluate the effects of high-dose versus low-dose medical exercise therapy (MET) in patients with knee OA.METHODS AND ANALYSIS: This is a multicentre prospective randomised two-arm trial with blinded assessment and data analysis. We are planning to include 200 patients aged 45-85 years with symptomatic (pain and decreased functioning) and X-ray verified diagnosis of knee OA. Those eligible for participation will be randomly allocated to either high-dose (n=100) or low-dose (n=100) MET. All patients receive three supervised treatments each week for 12 weeks, giving a total of 36 MET sessions. The high-dose group exercises for 70-90 min compared with 20-30 min for the low-dose group. The high-dose group exercises for a longer time, and receives a greater number of exercises with more repetitions and sets. Background and outcome variables are recorded at inclusion, and outcome measures are collected after every sixth treatment, at the end of treatment, and at 6-month and 12-month follow-ups. Primary outcome is self-rated knee functioning and pain using the Knee Injury and Osteoarthritis Outcome Score (KOOS). The primary end point is at the end of treatment after 3 months, and secondary end points are at 6 months and 12 months after the end of treatment.ETHICS AND DISSEMINATION: This project has been approved by the Regional Research Ethics Committees in Stockholm, Sweden, and in Norway. Our results will be submitted to peer-reviewed journals and presented at national and international conferences.TRIAL REGISTRATION NUMBER: NCT02024126; Pre-results.
|
|
