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1.	Michaelson, Magdalena, et al. (author) Jämförelse mellan closed kinetic chain exercise och open kinetic chain exercise : en litterturstudie 1999 Reports (other academic/artistic)
2.	Michaelson, Peter, et al. (author) Head stability and vertica lposture in patients with whiplash associated disorders and work related neck pain 2004 In: Proceedings of the 8th International Federation of Orthopaedic Manipulative therapists' Conference. - : IFOMT. Conference paper (other academic/artistic)
3.	Michaelson, Peter, et al. (author) Vertical posture and head stability in patients with chronic neck pain. 2003 In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 35:5, s. 229-235 Journal article (peer-reviewed)abstract OBJECTIVE: To evaluate postural performance and head stabilization of patients with chronic neck pain. DESIGN: A single-blind comparative group study. SUBJECTS: Patients with work-related chronic neck pain (n = 9), with chronic whiplash associated disorders (n = 9) and healthy subjects (n = 16). METHODS: During quiet standing in different conditions (e.g. 1 and 2 feet standing, tandem standing, and open and closed eyes) the sway areas and the ability to maintain the postures were measured. The maximal peak-to-peak displacement of the centre of pressure and the head translation were analysed during predictable and unpredictable postural perturbations. RESULTS: Patients with chronic neck pain, in particular those with whiplash-associated disorders, showed larger sway areas and reduced ability to successfully execute more challenging balance tasks. They also displayed larger sway areas and reduced head stability during perturbations. CONCLUSION: The results show that disturbances of postural control in chronic neck pain are dependent on the aetiology, and that it is possible to quantify characteristic postural disturbances in different neck pain conditions. It is suggested that the dissimilarities in postural performance are a reflection of different degrees of disturbances of the proprioceptive input to the central nervous system and/or of the central processing of such input.
4.	Aasa, Björn, et al. (author) A characterisation of pain, disability, kinesiophobia and physical capacity in patients with predominantly peripherally mediated mechanical low back pain 2011 In: Physiotherapy. - 0031-9406 .- 1873-1465. ; 97:Suppl. 1, s. eS18- Journal article (peer-reviewed)abstract Purpose: The specific objectives were to: 1) describe the level of pain intensity, disability, activity limitation, kinesiophobia and physical capacity in patients with predominantly peripherally mediated mechanical back pain, and 2) investigate whether differences between these patients in physical and psychosocial factors can be distinguished when the patients are further sub-grouped.Relevance: To improve assessment among patients with chronic low back pain (CLBP) it is important to investigate the prevalence of physical and psychosocial features in homogenous sub-groups.Participants: Seventy-one patients with CLBP, 20-60 years old, with peripherally mediated mechanical pain at the the moment for the study, were included and each patient was sub-classified into one of five sub-groups based on their pain behaviour and functional movement pattern (flexion n=20, flexion/lateral shift, n=11, active extension n=23 , passive extension n=8, and multidirectional pattern n=9).Methods: Data on pain intensity (Visual Analogue Scale), disability (the Roland and Morris Questionnaire), activity limitation (the Patient Specific Functional Scale), kinesiophobia (the Tampa Scale of Kinesiophobia) and physical capacity (lifting capacity and trunk extensor endurance) was collected.Analysis: Mean and standard deviation for parametric and median and interquartile range for non-parametric data were used for descriptive statistics. One-way ANOVA for normally distributed data and Kruskal-Wallis for non-normally distributed data were used for analyses of differences between the sub-groups. The subjects were also divided into two age-groups (20-40 and 41-60 years) and measures of physical capacity were compared to women and men at the ages of 34 and 50, respectively, in the general Swedish population using one sample T-test.Results: The patients reported low to moderate pain intensity (3.1/10±2.4), disability (RMDQ (7.27/24 ±4.2) and kinesiophobia (33.4/68 ±7) and these levels were lower than reported levels in other studies including more heterogenous groups of patients with CLBP. The patiens reported activity limitations (PSFS 13/30±23). Lifting capacity and trunk extensor endurance were significantly lower than in the general population in the youngest age-group. No significant differences in pain intensity, disability, kinesiophobia or physical capacity were found between the sub-groups.Conclusions: This research highlights that patients with predominantly peripherally mediated mechanical back pain may differ from other sub-groups of patients with CLBP (e.g., patients with central sensitization as dominating pain mechanism) regarding physical and psychosocial factors. The individual variation in pain intensity, disability, kinesiophbia and physical capacity among the patients indicates the importance to assess these factors in every patient. Due to the fact that there were few patients in the sub-groups, further research is necessary to explore whether there are differences, that we were not able to disingjish, between patients with different movement patterns.
5.	Aasa, Björn, et al. (author) A characterisation of pain, disability, kinesiophobia and physical capacity in patients with predominantly peripherally mediated mechanical low back pain 2011 Conference paper (peer-reviewed)
6.	Aasa, Björn, et al. (author) Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain : a randomized controlled trial 2015 In: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 45:2, s. 77-85 Journal article (peer-reviewed)abstract Study Design Randomized controlled trial. Background Low back pain is a common disorder. Patients with low back pain frequently have aberrant and pain-provocative movement patterns that often are addressed with motor control exercises. Objective To compare the effects of low-load motor control (LMC) exercise and those of a high-load lifting (HLL) exercise. Methods Seventy participants with recurrent low back pain, who were diagnosed with nociceptive mechanical pain as their dominating pain pattern, were randomized to either LMC or HLL exercise treatments. Participants were offered 12 treatment sessions over an 8-week period. All participants were also provided with education regarding pain mechanisms. Methods Participants were assessed prior to and following treatment. The primary outcome measures were activity (the Patient-Specific Functional Scale) and average pain intensity over the last 7 days (visual analog scale). The secondary outcome measure was a physical performance test battery that included 1 strength, 3 endurance, and 7 movement control tests for the lumbopelvic region. Results Both interventions resulted in significant within-group improvements in pain intensity, strength, and endurance. The LMC group showed significantly greater improvement on the Patient-Specific Functional Scale (4.2 points) compared with the HLL group (2.5 points) (P<.001). There were no significant between-group differences in pain intensity (P = .505), strength, and 1 of the 3 endurance tests. However, the LMC group showed an increase (from 2.9 to 5.9) on the movement control test subscale, whereas the HLL group showed no change (from 3.9 to 3.1) (P<.001). Conclusion An LMC intervention may result in superior outcomes in activity, movement control, and muscle endurance compared to an HLL intervention, but not in pain intensity, strength, or endurance.
7.	Aasa, Björn, et al. (author) Low- versus high-load motor control exercise to reduce disability in patients with persistent peripherally mediated mechanical low back pain 2012 In: Rendez vous of hands and minds. Conference paper (peer-reviewed)
8.	Aasa, Ulrika, et al. (author) Effects of low- and high-load motor control exercises on lumbar curvature during stance in patients with low back pain 2012 In: Rendez vous of hands and minds. Conference paper (peer-reviewed)
9.	Berglund, Lars, 1986- (author) Deadlift training for patients with mechanical low back pain : a comparison of the effects of a high-load lifting exercise and individualized low-load motor control exercises 2016 Doctoral thesis (other academic/artistic)abstract Disability due to low back pain is common. While evidence exist that exercise is effective in reducing pain and disability, it is still largely undetermined which kind of exercises that are most effective. The overall aim of this thesis was to evaluate and compare the effects of a high-load lifting exercise and individualized low-load motor control exercises for patients with nociceptive mechanical low back pain. A secondary aim was to evaluate which patients benefit from training with a high-load lifting exercise.All four papers in this thesis were based on a randomized controlled trial including 70 participants with nociceptive mechanical low back pain as their dominating pain pattern. Participants were randomized into training with either a high-load lifting exercise (HLL), the deadlift, (n=35) or individualized low-load motor control exercises (LMC) (n=35). Both interventions included aspects of pain education. All participants were offered twelve sessions during an eight week period. The effects of the interventions were evaluated directly after and twelve months after the end of the intervention period. Outcome measures were pain intensity, activity, disability, physical performance, lumbo-pelvic alignment and lumbar multifidus muscle thickness.There was a significant between-group effect in favour of the LMC intervention regarding improvements in activity, movement control tests and some tests of trunk muscle endurance. For pain intensity there were no significant differences between groups. A majority of participants in both intervention groups showed clinically meaningful improvements from baseline to two and twelve month follow-up regarding pain intensity and activity. There were no significant differences between HLL and LMC regarding the effect on lumbo-pelvic alignment or lumbar multifidus thickness. The participants who benefit the most from the HLL intervention were those with a low pain intensity and high performance in the Biering-Sørensen test at baseline.The results of this thesis showed that the HLL intervention was not more effective than the LMC intervention. The LMC was in fact more effective in improving activity, performance in movement control tests and some tests of trunk muscle endurance, compared to the HLL intervention.The results imply that the deadlift, when combined with education, could be considered as an exercise to produce clinically relevant improvements on pain intensity in patients who prefer a high-load exercise. However, before considering deadlift training, the results suggest that pain intensity and performance in the Biering-Sørensen test should be evaluated.
10.	Berglund, Lars, et al. (author) Effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness : a randomized controlled trial 2017 In: Spine. - : Wolters Kluwer. - 0362-2436 .- 1528-1159. ; 42:15, s. E876-E882 Journal article (peer-reviewed)abstract STUDY DESIGN:Randomized controlled trial.OBJECTIVE:The aim of this study was to compare the effects of low-load motor control (LMC) exercises and a high-load lifting (HLL) exercise, on lumbar multifidus (LM) thickness on either side of the spine and whether the effects were affected by pain intensity or change in pain intensity.SUMMARY OF BACKGROUND DATA:There is evidence that patients with low back pain (LBP) may have a decreased size of the LM muscles with an asymmetry between sides in the lower back. It has also been shown that LMC training can affect this asymmetry. It is, however, not known whether a high-load exercise has the same effect.METHODS:Sixty-five participants diagnosed with nociceptive mechanical LBP were included and randomized into LMC exercises or a HLL exercise, the deadlift. The LM thickness was measured using rehabilitative ultrasound imaging (RUSI), at baseline and after a 2-month training period.RESULTS:There were no differences between interventions regarding effect on LM muscle thickness. However, the analysis showed a significant effect for asymmetry. The thickness of the LM muscle on the small side increased significantly compared with the large side in both intervention groups, without influence of pain at baseline, or change in pain intensity.CONCLUSION:At baseline, there was a difference in thickness of the LM muscles between sides. It seems that exercises focusing on spinal alignment may increase the thickness of the LM muscles on the small side, irrespective of exercise load. The increase in LM thickness does not appear to be mediated by either current pain intensity or the magnitude of change in pain intensity.
11.	Berglund, Lars, et al. (author) Effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness : a randomized controlled trial 2017 In: Spine. - : Wolters Kluwer. - 0362-2436 .- 1528-1159. ; 42:15, s. E876-E882 Journal article (peer-reviewed)abstract Study Design: Randomized controlled trialObjective: The aim of this study was to compare the effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness among patients with nociceptive mechanical low back pain.Summary of Background Data: There is evidence that patients with low back pain may have a decreased size of the lumbar multifidus muscles with an asymmetry between left/right sides in the lower back. It has also been shown that low-load motor control training can affect this asymmetry; essentially, it is effective in equalizing side differences in lumbar multifidus muscle size. It is, however, not known whether a high-load exercise has the same effect.Methods: Sixty-five participants diagnosed with nociceptive mechanical low back pain were included and randomized into low-load motor control exercises or a high-load lifting exercise, the deadlift. The lumbar multifidus thickness at the fifth lumbar vertebra was measured, using rehabilitative ultrasound imaging, at baseline and after a 2-month training period.Results: There were no differences between interventions regarding effect on lumbar multifidus muscle thickness. However, the linear mixed model analysis showed a significant effect for asymmetry. The thickness of the lumbar multifidus muscle on the small side increased significantly compared to the large side in both intervention groups.Conclusions: There was a difference in thickness of the lumbar multifidus muscles between sides. It seems that exercises focusing on spinal alignment may increase the thickness of the lumbar multifidus muscles on the small side, irrespective of exercise load.
12.	Berglund, Lars, et al. (author) Sagittal lumbopelvic alignment in patients with low back pain and the effects of a high-load lifting exercise and individualized low-load motor control exercises : a randomized controlled trial 2018 In: The spine journal. - : Elsevier. - 1529-9430 .- 1878-1632. ; 18:3, s. 399-406 Journal article (peer-reviewed)abstract Background Context Assessment of posture and lumbopelvic alignment is often the main focus in the classification and treatment of patients with low back pain (LBP). However, little is known regarding the effects of motor control interventions on objective measures of lumbopelvic alignment.Purpose The primary aim of this study was to describe the variation of sagittal lumbopelvic alignment in patients with nociceptive mechanical LBP. The secondary aim was to compare the effects of a high-load lifting exercise (HLL) and low-load motor control exercises (LMC) on the change in lumbopelvic alignment with a special emphasis on patients with high and low degrees of lumbar lordosis (lu) and sacral angle (sa).Study Design This study is a secondary analysis of a randomized controlled trial evaluating the effects of HLL and LMC.Patient Sample Patients from the primary study, that is, patients categorized with nociceptive mechanical LBP, who agreed to participate in the radiographic examination were included (n=66).Outcome Measures Lateral plain radiographic images were used to evaluate lumbopelvic alignment regarding the lumbar lordosis and the sacral angle as outcomes, with posterior bend as an explanatory variable.Materials and Methods The participants were recruited to the study from two occupational health-care facilities. They were randomized to either the HLL or the LMC intervention group and offered 12 supervised exercise sessions. Outcome measures were collected at baseline and following the end of intervention period 2 months after baseline. Between- and within-group analyses of intervention groups and subgroups based on the distribution of the baseline values for the lumbar lordosis and the sacral angle, respectively (LOW, MID, and HIGH), were performed using both parametric and non-parametric statistics.Results The ranges of values for the present sample were 26.9–91.6° (M=59.0°, standard deviation [SD]=11.5°) for the lumbar lordosis and 18.2–72.1° (M=42.0°, SD=9.6°) for the sacral angle. There were no significant differences between the intervention groups in the percent change of eitheroutcome measure. Neither did any outcome change significantly over time within the intervention groups. In the subgroups, based on the distribution of respective baseline values, LOWlu showed a significantly increased lumbar lordosis, whereas HIGHsa showed a significantly decreased sacral angle following intervention.Conclusions This study describes the wide distribution of values for lumbopelvic alignment for patients with nociceptive mechanical LBP. Further research is needed to investigate subgroups of other types of LBP and contrast findings to those presented in this study. Our results also suggest that retraining of the lumbopelvic alignment could be possible for patients with LBP.
13.	Berglund, Lars, et al. (author) Styrketräning som behandling vid långvariga ländryggsbesvär 2017 In: Fysioterapi. - Stockholm : Fysioterapeuterna. - 1653-5804. ; :4, s. 28-33 Research review (other academic/artistic)abstract Fysisk träning är viktigt för en god hälsa och fungerar även som behandlingsform vid många sjukdomar, så även ländryggsbesvär. Styrketräning har visat sig vara en mer effektiv träningsform än till exempel aerob träning vid behandling av långvariga ländryggsbesvär. I dagsläget finns det ingen konsensus kring vilket det mest effektiva styrketräningsupplägget kan vara. Den vanligaste designen av styrketräningsprogram vid ländryggsbesvär tycks vara ett upplägg med syftet att förbättra styrkan/uthålligheten av ryggsträckarmuskulaturen och därigenom uppnå smärtlindring och funktionsförbättring. I en studie från Umeå universitet och Luleå tekniska universitet har träning av marklyft för patienter med långvariga ländryggsbesvär utvärderats. Marklyftsträningen förväntades öka deltagarnas bålstyrka samtidigt som den fokuserade på förbättring av rörelsekontroll kring såväl höft som ländrygg. När den åtta veckor långa träningsperioden var slut, visade det sig att gruppen som tränat marklyft hade ökat sin bålstyrka, minskat smärta, ökat funktionsförmåga och hälsorelaterad livskvalitet i samma omfattning som gruppen som tränade individanpassad träning av rörelsekontroll. Men de hade inte förbättrats lika mycket gällande rörelsekontroll eller vardagsfunktion. Vidare forskning pågår vid Umeå universitet om skador i samband med tung styrketräning samt lyftteknikens betydelse för skador och besvär vid tung styrketräning.
14.	Berglund, Lars, et al. (author) Which patients with low back pain benefit from deadlift training? 2015 In: Journal of Strength and Conditioning Research. - 1064-8011 .- 1533-4287. ; 29:7, s. 1803-1811 Journal article (peer-reviewed)abstract Recent studies have indicated that the deadlift exercise may be effective in decreasing pain intensity and increasing activity for most, but not all, patients with a dominating mechanical low back pain pattern. This study aimed to evaluate which individual factors measured at baseline could predict activity, disability, and pain intensity in patients with mechanical low back pain after an 8-week training period involving the deadlift as a rehabilitative exercise. Thirty-five participants performed deadlift training under the supervision of a physical therapist with powerlifting experience. Measures of pain-related fear of movement, hip and trunk muscle endurance and lumbopelvic movement control were collected at baseline. Measures of activity, disability and pain intensity were collected at baseline and at follow-up. Linear regression analyses were used to create models to predict activity, disability and pain intensity at follow-up. Results showed that participants with less disability, less pain intensity and higher performance on the Biering-Sørensen test, which tests the endurance of hip and back extensor muscles, at baseline benefit from deadlift training. The Biering-Sørensen test was the strongest predictor since it was included in all predictive models. Pain intensity was the next best predictor as it was included in two predictive models. Thus, for strength and conditioning professionals who use the deadlift as a rehabilitative exercise for individuals with mechanical low back pain, it is important to ensure that clients have sufficient back extensor strength and endurance and a sufficiently low pain intensity level to benefit from training involving the deadlift exercise.
15.	Berglund, Lars, et al. (author) Which patients with persistent mechanical low back pain will respond to high load motor control training? 2011 In: Physiotherapy. - 0031-9406 .- 1873-1465. ; 97:Suppl. 1, s. eS124-eS125 Journal article (peer-reviewed)abstract Purpose: The aim of this study was to explore variables influencing success or failure of eight weeks of high load motor control training with the conventional deadlift exercise.Relevance: Researching viable exercises for rehabilitation of specific sub-groups of persistent low back pain is relevant for physical therapists in order to develop tailored treatment regimes for patients with persistent low back pain. This study contributes to this research by exploring which variables characterize the ideal patient for the conventional deadlift exercise.Participants: Thirty-five patients with persistent mechanical low back pain were recruited consecutively from two occupational health care services in Umeå, Sweden . Inclusion and exclusion criteria were designed to include patients with persistent mechanical low back pain.Methods: The study design was a prospective cohort study. The intervention consisted of eight weeks of training with the conventional deadlift exercise. To discriminate between patients with a successful or failed outcome of treatment, change in the patient-specific functional scale was used and a cut-off at 50 % improvement was set. Possible predictive variables collected at baseline included physical activity level, pain intensity (Visual Analogue Scale), activity limitation (the Roland and Morris Disability Questionnaire and the Patient-Specific Functional Scale), kinesiophobia (Tampa Scale of Kinesiophobia), specific anamnestic questions regarding patients' history and symptoms of low back pain, test of active movement control of the low back, trunk muscle endurance(Prone bridge test, Side-bridge test, Biering-Sörensen test) and lift strength (static two-hand lift test), two-point discrimination of the low back and ultrasound imaging of the mm. multifidi.Analysis: Student´s T-test for normally distributed continuous data, Mann Whitney for non-normally distributed continuous data and chi-square tests or Fisher´s Exact tests for categorical variables were used for analyses of differences between the success and the failure group.Results: No significant differences between groups were found in background, anamnestic or physical performance variables. After eight weeks of training, 15 patients (43 %) were categorized as treatment success and 20 patients (57 %) were categorized as treatment failure according to the cut-off set for the PSFS. The patients reported difficulty in performing a wide variation of activities, ranging from not being able to sit for longer than 15 minutes, to stand upright and watch their children play football games, and to not being able to run long distances, play football or perform different lifting tasks.Conclusions: We conclude that the conventional deadlift exercise may be considered a possible exercise to improve patients' activity limitations, if administered by a therapist experienced in resistance training and analyzing movement patterns. However, further research is needed to explore which variables can define patients in the successful and in the failure group, respectively.Implications: The results of this study imply that the conventional deadlift exercise can be used in treatment of patients with mechanical low back pain in order to increase activity limitation. However, it is still unclear on what grounds treatment with the conventional deadlift exercise is indicated to achieve these results.
16.	Berglund, Lars, et al. (author) Which patients with persistent mechanical low back pain will respond to high load motor control training? 2011 Conference paper (peer-reviewed)
17.	Calner, Tommy, et al. (author) Effects of a self-guided, web-based activity programme for patients with persistent musculoskeletal pain in primary healthcare : A randomized controlled trial 2017 In: European Journal of Pain. - : John Wiley & Sons. - 1090-3801 .- 1532-2149. ; 21:6, s. 1110-1120 Journal article (peer-reviewed)abstract BACKGROUNDWeb-based interventions for pain management are increasingly used with possible benefits, but never used in addition to multimodal rehabilitation (MMR). MMR is recommended treatment for persistent pain in Sweden. The aim was to evaluate the effects of a self-guided, web-based programme added to MMR for work ability, pain, disability and health-related quality of life.METHODSWe included 99 participants with persistent musculoskeletal pain in a randomized study with two intervention arms: (1) MMR and web-based intervention, and (2) MMR. Data was collected at baseline, 4 and 12 months. Outcome measures were work ability, working percentage, average pain intensity, pain-related disability, and health-related quality of life.RESULTSThere were no significant effects of adding the web-based intervention to MMR regarding any of the outcome variables.CONCLUSIONSThis trial provides no support for adding a self-guided, web-based activity programme to MMR for patients with persistent musculoskeletal pain.SIGNIFICANCEThe comprehensive self-guided, web-based programme for activity, Web-BCPA, added to multimodal treatment in primary health care had no effect on work ability, pain, disability or health-related quality of life. Future web-based interventions should be tailored to patients' individual needs and expectations
18.	Calner, Tommy, et al. (author) Experiences of physiotherapy treatment of persons with persistent musculoskeletal pain Other publication (other academic/artistic)abstract The aim of this study was to explore and describe experiences of physiotherapy treatment of people with persistent musculoskeletal pain. Eleven participants with persistent musculoskeletal pain from the back, neck, or shoulders were included in the study. Data were collected by interviews using a semi-structured interview guide and were analysed with qualitative content analysis. The analysis resulted in one main category “Towards acceptance and management of pain” which was formulated and built up by the four categories “Establishing and maintaining alliance”, “Being active, taking initiative and facing challenge”, “Appreciating guidance, incentive and a sounding board” and “Acquired knowledge and developed awareness”. The main category and the categories describe how the participants used knowledge, awareness, movements and exercises learned from the physiotherapy treatment to develop strategies to manage pain and the process of acceptance. A trustful alliance with the physiotherapist and a continuous dialogue was important. The participants were actively involved in the process when exercises, activities and other treatment modalities were individualized. This was rewarding but also an effort and a challenge. The physiotherapist’s initiatives and actions were considered important as incentive and support.
19.	Calner, Tommy, et al. (author) “I know what I want but I’m not sure how to get it” : Expectations of physiotherapy treatment of persons with persistent pain 2016 In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 25, s. e142-e143 Journal article (other academic/artistic)
20.	Calner, Tommy, et al. (author) I know what I want but I’m not sure how to get it : expectations of physiotherapy treatment of persons with persistent pain 2017 In: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 33:3, s. 198-205 Journal article (peer-reviewed)abstract Expectations of physiotherapy treatment of patients with persistent pain have been shown to influence treatment outcome and patient satisfaction, yet this is mostly explored and described in retrospective. The aim of the study was to explore and describe the expectations people with persistent pain have prior to physiotherapy treatment. Ten participants with persistent musculoskeletal pain from the back, neck, or shoulders were included in the study. Data were collected by interviews using a semi-structured interview guide and were analyzed with qualitative content analysis. The analysis resulted in one main category: “The multifaceted picture of expectations” and four categories: 1) Standing in the doorway: curious and uncertain; 2) Looking for respect, confirmation and knowledge; 3) Expecting treatment, regular training, and follow up; and 4) Having dreams, being realistic, or feeling resigned. The main category and the categories describe a multifaceted picture of the participants’ expectations, gradually developed and eventually encompassing several aspects: good dialog and communication, the need to be confirmed as individuals, and getting an explanation for the pain. The results also show that the participants expected tailored training with frequent follow-ups and their expectations of outcome ranged from hope of the best possible results to realistic or resigned regarding pain relief and activity levels.
21.	Calner, Tommy (author) Persistent musculoskeletal pain : A web-based activity programme for behaviour change, does it work? Expectations and experiences of the physiotherapy treatment process 2018 Doctoral thesis (other academic/artistic)abstract This thesis concerned persons with persistent musculoskeletal pain in primary health care and had three aims. The first aim was to evaluate the effects of a web-based programme for behaviour change. The second aim was to create and evaluate a multimodal intervention. The third aim was to explore and describe expectations andexperiences of the physiotherapy treatment process.In Study I, we evaluated the effects of a web-based activity programme for behaviour change added to multidisciplinary rehabilitation (MDR) in primary health care. Ninety-nine participants were randomized to 1) MDR with an additional web-based programme, and 2) MDR. Outcome measures were work ability, pain intensity, pain-relate disability and health-related quality of life. There were no significant effects of the web-based programme for any outcome measure at 4 or 12 months. In conclusion, this study provides no support for adding a self-guided web-based programme to MDR in primary health care.In Study II, we evaluated first the web-based programme from Study I compared to the waiting list. Effect measures were workability, pain intensity, disability and self-efficacy. Thereafter, we evaluated the effects and process of a novel multimodal intervention consisting of the web-based programme with additional individual counselling, and individually tailored physiotherapy treatment. Ten participants were included in the study. Effects were evaluated using a Single Subject Experimental Design (SSED) and the process was evaluated by interviews with the participants and log data of usage of the modalities. There were no conclusive effects of the self-managed web-based programme as compared to the waiting list. The SSED analyses of the multimodal intervention showed promising short-term results regarding disability and pain intensity, but no conclusive results for work ability or self-efficacy. The multi-modal intervention process seemed successfully implemented, and the importance of physiotherapy and, to some extent counselling, was emphasized by the participants. In conclusion, the newly designed multimodal intervention in primary health care seemed feasible and showed some promising short-term effects, while the implementation of a self-managed web-based programme as a single intervention seemed without effect.In Study III, qualitative interviews were conducted with ten participants to explore their expectations of physiotherapy. Data were analysed with qualitative content analysis and the findings described a multi-faceted picture of the participants’ expectations, encompassing several aspects regarding the treatment process and outcome. Regarding the treatment process, participants expected a good dialogue, to be confirmed as individuals, and to get an explanation for their pain. The participants expected tailored training with frequent follow-ups and their expectations of outcome ranged from hope of the best possible results to being realistic or resigned.In Study IV, qualitative interviews were conducted with 11 participants to explore their experiences in physiotherapy treatment. Data were analysed with qualitative content analysis. The findings show how the participants described how they used knowledge, awareness, movements and exercises learned from the physiotherapy treatment to develop strategies to manage pain and the process of acceptance. There were experiences involving the importance of establishing an alliance with the physiotherapist, based on trust and with a continuous dialogue. When exercises, activities and other treatment modalities were individualized, participants were actively involved in the process. This was rewarding but was also considered an effort and a challenge. The physiotherapist’s initiatives and actions were considered important for incentive and support.In conclusion, we found no effects of the web-based activity programme on behaviour change for persons with persistent musculoskeletal pain. The newly designed multi-modal intervention in primary health care seemed feasible and showed some promising short-term effects. Expectations of physiotherapy treatment were multi-faceted, encompassing both process and outcome. After finishing physiotherapy, the participants described how they used knowledge, awareness, movements and exercises learned from the physiotherapy treatment to develop strategies to manage pain and the process of acceptance. The importance of alliance and incentives for activities throughout the physiotherapy treatment process were also described.
22.	Calner, Tommy, et al. (author) Physiotherapy in combination with personalized counseling and a web-based programme for persistent pain : an early stage evaluation Other publication (other academic/artistic)abstract ObjectiveWe evaluated first a self-managed web-based programme for activity compared to waiting list for persons with persistent musculoskeletal pain suited for primary health care. Thereafter, we evaluated the effects and process of a novel multimodal treatment intervention combining the web programme with counselling and physiotherapy. DesignA weekly comparison of measures of outcome data between those using the self-managed web-based programme to those on a waiting list. After that a Single Subject Experimental Design (SSED) evaluation of the multimodal intervention, structured interviews and log data. SettingClinical setting in primary health care. SubjectsTen participants with persistent musculoskeletal pain. InterventionFirst, only a self-managed web-based programme for activity. Thereafter a multimodal intervention combining the web programme with counselling and physiotherapy. Main measuresEffect measures were work ability, pain intensity, disability and self-efficacy. Process evaluation by interviews of the participants and log data of usage of the modalities. ResultsThere were no conclusive effects of the self-managed web-based programme as compared to waiting list. The SSED analyses of the multi-modal showed promising short-term results regarding disability and pain intensity, but no conclusive results for work ability or self-efficacy. The multimodal intervention process seemed successfully implemented, and the importance of physiotherapy and to some extent counselling was emphasized by the participants. Conclusion For persons with persistent musculoskeletal pain, the newly designed multimodal intervention in primary care seemed feasible and showed some promising short-terms effects, while the implementation of a self-managed web-based programme as a single intervention seemed without effect.
23.	Calner, Tommy, et al. (author) Physiotherapy treatment experiences of persons with persistent musculoskeletal pain : A qualitative study 2021 In: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 37:1, s. 28-37 Journal article (peer-reviewed)abstract The aim of this study was to explore and describe the physiotherapy treatment experiences of persons with persistent musculoskeletal pain. Eleven participants with persistent musculoskeletal pain in the back, neck, or shoulders were included in the study. Data was collected via semi-structured interviews and were analysed with qualitative content analysis. The analysis resulted in the theme "Towards acceptance and management of pain", comprising four sub-themes: 1) Establishing and maintaining a therapeutic alliance; 2) Being active, taking initiative and facing challenges; 3) Appreciating guidance, incentive and having a sounding board; and 4) Acquired knowledge and new body awareness change behaviours. The theme and sub-themes describe how the participants used increased knowledge, awareness, movements and exercises learned from the physiotherapy treatment to develop strategies for managing pain and the process of acceptance. A trusting relationship and continual dialogue with the physiotherapist was considered to be important. The participants were actively involved in the process as exercises, activities and other treatment modalities were individualized. This was rewarding but also challenging and required effort on their part. The physiotherapist's initiatives and actions were an important incentive and means of support.
24.	Gard, Gunvor, et al. (author) Multimodal pain rehabilitation (MMR) with additional tailored web-based pain rehabilitation : an RCT study 2014 Conference paper (other academic/artistic)
25.	Harden, Jennifer W., et al. (author) Field information links permafrost carbon to physical vulnerabilities of thawing 2012 In: Geophysical Research Letters. - 0094-8276 .- 1944-8007. ; 39, s. L15704- Journal article (peer-reviewed)abstract Deep soil profiles containing permafrost (Gelisols) were characterized for organic carbon (C) and total nitrogen (N) stocks to 3 m depths. Using the Community Climate System Model (CCSM4) we calculate cumulative distributions of active layer thickness (ALT) under current and future climates. The difference in cumulative ALT distributions over time was multiplied by C and N contents of soil horizons in Gelisol suborders to calculate newly thawed C and N. Thawing ranged from 147 PgC with 10 PgN by 2050 (representative concentration pathway RCP scenario 4.5) to 436 PgC with 29 PgN by 2100 (RCP 8.5). Organic horizons that thaw are vulnerable to combustion, and all horizon types are vulnerable to shifts in hydrology and decomposition. The rates and extent of such losses are unknown and can be further constrained by linking field and modelling approaches. These changes have the potential for strong additional loading to our atmosphere, water resources, and ecosystems. Citation: Harden, J. W., et al. (2012), Field information links permafrost carbon to physical vulnerabilities of thawing, Geophys. Res. Lett., 39, L15704, doi: 10.1029/2012GL051958.
26.	Holmberg, David, et al. (author) Treating persistent low back pain with deadlift training – A single subject experimental design with a 15-month follow-up 2012 In: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 14:2, s. 61-70 Journal article (peer-reviewed)abstract Low back pain (LBP) is a common disorder in the western world. Persistent LBP can be caused by pathological changes in the discs and disturbed neuromuscular activation, which can cause hypotrophy of the strong type 2 muscle fibers of the extensors. Deadlift (DL) is an exercise that may address all these pathological transformations. The aim of the study was to investigate the effect of DL training on patients with persistent LBP. A single subject experimental design with an AB-design and multiple baselines was applied in this pilot study. Two patients with discogenic LBP and one with arthrogenic LBP were treated with DL training over 8–10 weeks. A follow-up was performed at 15 months. The subjects with discogenic LBP showed positive response to DL training regarding pain intensity and functional status, but the exercise did not affect their mental health. The subject with arthrogenic LBP did not seem to have positive effect from DL training. As a result of this pilot study, the authors hypothesize that DL training may be a successful treatment for subjects with LBP of discogenic origin.
27.	Hugelius, Gustaf, et al. (author) Estimated stocks of circumpolar permafrost carbon with quantified uncertainty ranges and identified data gaps 2014 In: Biogeosciences. - : Copernicus GmbH. - 1726-4170 .- 1726-4189. ; 11:23, s. 6573-6593 Journal article (peer-reviewed)abstract Soils and other unconsolidated deposits in the northern circumpolar permafrost region store large amounts of soil organic carbon (SOC). This SOC is potentially vulnerable to remobilization following soil warming and permafrost thaw, but SOC stock estimates were poorly constrained and quantitative error estimates were lacking. This study presents revised estimates of permafrost SOC stocks, including quantitative uncertainty estimates, in the 0-3m depth range in soils as well as for sediments deeper than 3m in deltaic deposits of major rivers and in the Yedoma region of Siberia and Alaska. Revised estimates are based on significantly larger databases compared to previous studies. Despite this there is evidence of significant remaining regional data gaps. Estimates remain particularly poorly constrained for soils in the High Arctic region and physiographic regions with thin sedimentary overburden (mountains, highlands and plateaus) as well as for deposits below 3mdepth in deltas and the Yedoma region. While some components of the revised SOC stocks are similar in magnitude to those previously reported for this region, there are substantial differences in other components, including the fraction of perennially frozen SOC. Upscaled based on regional soil maps, estimated permafrost region SOC stocks are 217 +/- 12 and 472 +/- 27 Pg for the 0-0.3 and 0-1 m soil depths, respectively (+/- 95% confidence intervals). Storage of SOC in 0-3m of soils is estimated to 1035 +/- 150 Pg. Of this, 34 +/- 16 PgC is stored in poorly developed soils of the High Arctic. Based on generalized calculations, storage of SOC below 3m of surface soils in deltaic alluvium of major Arctic rivers is estimated as 91 +/- 52 Pg. In the Yedoma region, estimated SOC stocks below 3mdepth are 181 +/- 54 Pg, of which 74 +/- 20 Pg is stored in intact Yedoma (late Pleistocene ice-and organic-rich silty sediments) with the remainder in refrozen thermokarst deposits. Total estimated SOC storage for the permafrost region is similar to 1300 Pg with an uncertainty range of similar to 1100 to 1500 Pg. Of this, similar to 500 Pg is in non-permafrost soils, seasonally thawed in the active layer or in deeper taliks, while similar to 800 Pg is perennially frozen. This represents a substantial similar to 300 Pg lowering of the estimated perennially frozen SOC stock compared to previous estimates.
28.	Karlsson Sundbaum, Johanna, 1969- (author) Studies of drug safety in the treatment of rheumatoid arthritis 2020 Doctoral thesis (other academic/artistic)abstract Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting mainly smaller joints. Patients are at risk for complications as joint destruction, but starting treatment soon after onset of disease, has reduced the risk for complications. Methotrexate (MTX) is the anchor drug in the treatment of RA and has proven effects on both inflammatory symptoms and joint destruction. apy. Identifying patients at risk for MTX-induced hepatotoxicity before treatment could be a way to minimize the risk for Adverese effects.Following the introduction of pre-treatment screening, the risk of tuberculosis (TB) among patients with RA starting biologic treatment has decreased. By contrast, the risk remains several-fold increased in RA patients non-exposed to biological treatment. Knowledge about risk factors for TB and TB characteristics in this group of patients, and thus optimal clinical risk stratification and preven-tion, is still limited.In Paper I, only a small number of ALT tests (7%) performed during MTX therapy in RA patients, capture an elevation of ALT > upper limit of normal (ULN). ALT >1.5 × ULN was observed in 44 (21%) patients and the strongest predictor was a pre-treatment elevation of ALT. Recurrent elevations occurred in 70% of patients who continued treatment, and the proportion was similar in those with and without interventions. The results support a more individualized approach to monitoring and handling of ALT elevations during MTX therapy. In Paper II MTHFR A1298C (rs1801131) was nominally associated with ALT >1.5 x ULN within 6 months after the start of MTX (OR=1.7 [95% CI 1.04-2.9], p=0.03). In a multi-ple regression analysis for ALT >1.5 X ULN within 6 months of treatment start, including known risk factors for ALT elevation and MTHFR A1298C, the C-statistic was 0.734. A mod-el containing clinical risk factors and MTHFR A1298C might be used for prediction of ALT elevation in MTX treated patients. In Paper III a Genome-Wide Association Study (GWAS) and analysis of candidate Single Nucleotide Polymorphisms (SNPs) were performed. Four SNPs in and upstream of the ribonucleoprotein, PTB Binding 2 gene on chromosome 1 were associated with max ALT within 6 months on a genome wide level (p<5x10-8). Our results indicate that the RAVER2 and/or JAK1 genes might play a role in MTX- induced hepatotoxici-ty, but further studies are necessary for confirmation of the results. In Paper IV, we performed a population based case-control study. Several RA-associated risk factors (treatment with leflunomide, azathioprine or prednisolone and concomitant obstructive lung disease) may contribute to the increased TB risk in biologics-naïve RA patients. We could not confirm previous findings of an association with the use of moderate to high doses of prednisolone (≥15 mg). TB risk seems difficult to predict with precision in the individual biologics-naïve patient based on RA-associated risk factors. This suggests TB screening should be considered in biologics-naïve patients.In conclusion, results from these studies suggest that several factors could increase the risk of AEs in RA patients. The risk might be reduced by utilizing prediction models that include knowledge about the medical history of the individual patient and genetic data in combination with screening for TB.
29.	Linder, Martin, et al. (author) Laterality judgments in people with low back pain-a cross-sectional observational and test-retest reliability study 2016 In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 21, s. 128-133 Journal article (peer-reviewed)abstract BackgroundDisruption of cortical representation, or body schema, has been indicated as a factor in the persistence and recurrence of LBP. This has been observed through impaired laterality judgment ability and it has been suggested that this ability is affected in a spatial rather than anatomical manner.ObjectivesWe compared laterality judgment performance of foot and trunk movements between people with LBP with or without leg pain and healthy controls, and investigated associations between test performance and pain. We also assessed the test-retest reliability of the Recognise OnlineTM software when used in a clinical and a home setting.DesignCross-sectional observational and test-retest study.MethodsThirty individuals with LBP and 30 healthy controls performed judgment tests of foot and trunk laterality once supervised in a clinic and twice at home.ResultsNo statistically significant group differences were found. LBP intensity was negatively related to trunk laterality accuracy (p=0.019). Intraclass correlation values ranged from 0.51-0.91. Reaction time improved significantly between test occasions while accuracy did not.ConclusionsLaterality judgments were not impaired in subjects with LBP compared to controls. Further research may clarify the relationship between pain mechanisms in LBP and laterality judgment ability. Reliability values were mostly acceptable, with wide and low confidence intervals, suggesting test retest reliability for Recognise OnlineTM could be questioned in this trial. A significant learning effect was observed which should be considered in clinical and research application of the test.
30.	Michaelson, Peter (author) Aktivitet: Patienters erfarenheter av tidigt insatt rehabilitering vid Sunderby sjukhus efter whiplashtrauma : en enkätstudie 2008 Conference paper (pop. science, debate, etc.)
31.	Michaelson, Peter, et al. (author) Deadlift versus low load motor control for patients with mechanical low back pain 2016 In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 25, s. e78- Journal article (peer-reviewed)
32.	Michaelson, Peter, et al. (author) Factors predicting pain reduction in chronic back and neck pain after multimodal treatment. 2004 In: The Clinical Journal of Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0749-8047 .- 1536-5409. ; 20:6, s. 447-454 Journal article (peer-reviewed)abstract OBJECTIVES: To determine whether treatment related pain reduction on the short- and long-term is predicted by different baseline variables, and with different accuracy, in patients with chronic low back pain as compared with those with chronic neck pain. DESIGN AND METHODS: A single blinded prospective cohort study based on patients with chronic musculoskeletal pain in the lower back (N = 167) or the neck (N = 136) who completed a 4-week multimodal rehabilitation program. At admission, each patient was evaluated on 17 potential predictors, including pain characteristics and physical, sociodemographic, and psychosocial-behavioral variables. Changes in self-reported pain intensity in the lower back or the neck between the pretreatment evaluation and those performed immediately after, and 12 months after the rehabilitation program, were assessed. RESULTS: Logistic regression models revealed that change in pain intensity could be predicted with good specificity but with poor sensitivity both for patients with chronic low back pain and chronic neck pain. Significant predictors among the neck pain patients were high endurance, low age, high pain intensity, few other symptoms, low need of being social, to do things with others, and to be helped, along with optimistic attitudes on how the pain will interfere with daily life. Among the low back pain patients, high pain intensity, low levels of pain severity, and high affective distress were important predictors. Variables such as sex, sick leave history, working status, accident, pain duration, and depressive symptoms demonstrated no predictive value. Short- and long-term pain outcome was equally predictable and predicted by almost the same variables. CONCLUSIONS: Patients who reported unchanged or increased pain after multimodal treatment could be predicted with good accuracy, whereas those who reported decreased pain were more difficult to identify. Treatment-related pain alteration in chronic low back pain seems to be predicted by partly different variables than in chronic neck pain.
33.	Michaelson, Peter, et al. (author) Faktorer som förutsäger smärtreduktion efter multimodal behandling av kronisk smärta i nacke och ländrygg 2003 In: Med forskning som drivkraft. Conference paper (other academic/artistic)
34.	Michaelson, Peter, et al. (author) High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain : a randomized controlled trial with 24-month follow-up 2016 In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 48:5, s. 456-463 Journal article (peer-reviewed)abstract Objective: The aim of this study was to compare the effects of a high load lifting exercise with low load motor control exercises on pain intensity, disability and health-related quality of life for patients with mechanical low back pain. Design: A randomized controlled trial. Subjects: Patients with mechanical low back pain as their dominating pain mechanism. Methods: The intervention programme consisted of a high load lifting exercise, while the control group received low load motor control exercises over 8 weeks (12 sessions) with pain education included in both intervention arms. The primary outcome was pain intensity and disability, and the secondary outcome was health-related quality of life. Results: Each intervention arm included 35 participants, analysed following 2-, 12- and 24-month follow-up. There was no significant difference between the high load lifting and low load motor control interventions for the primary or secondary outcome measures. Between 50% and 80% of participants reported a decrease in perceived pain intensity and disability for both short-and long-term follow-up. Conclusion: No difference was observed between the high low load lifting and low load motor control interventions. Both interventions included retraining of movement patterns and pain education, which might explain the positive results over time.
35.	Michaelson, Peter, et al. (author) Objective evaluation of sen-sorimotor disturbances in chronic neck pain – implications for rehabilitation of specific dysfunctions Other publication (other academic/artistic)
36.	Michaelson, Peter, et al. (author) Preprioception and kinematics in chronic neck pain : a comparison of whiplash- and work-related pain 2003 In: Abstract of the 4th Conference on progress in motor control. Conference paper (other academic/artistic)
37.	Michaelson, Peter (author) Sensorimotor characteristics in chronic neck pain : possible pathophysiological mechanisms and implications for rehabilitation 2004 Doctoral thesis (other academic/artistic)abstract Pain from the musculoskeletal system is very common in the modern society. Chronic musculoskeletal pain syndromes causes not only individual suffering but also dysfunctions of movements and postural control, as large costs for the society. In spite of significant efforts, there is a shortage of knowledge on effective prevention, diagnoses and rehabilitation of different chronic musculoskeletal pain syndromes. The general aims of this thesis was to investigate the predictive value of physical, sociodemographic, and psychosocial-behavioural variables for pain reduction after multimodal rehabilitation in patients with chronic low back or neck pain, and to develop and evaluate tests for objective and quantitative evaluation of characteristic sensorimotor disturbances in chronic neck pain. Logistic regression models revealed that unchanged pain intensity could be predicted with good precision while reduced pain intensity after rehabilitation was poorly predicted by the baseline variables. Altered pain intensity in chronic low back pain was predicted by high pain intensity, low levels of pain severity and high affective distress, while reduced pain intensity for patients with chronic neck pain were predicted by high endurance, low age, high pain intensity, low need of being social along with optimistic attitudes on how the pain will interfere with daily life, and few vegetative symptoms. One of the conclusions was that objective measures of specific sensorimotor disturbances should improve the precision by which treatment-induced effects can be assessed and predicted. A study was designed to objectively and quantitatively evaluate a large numbers of different sensorimotor characteristics in a small group of patients with chronic neck pain of different aetiology (whiplash-related and insidious). Kinematic data was recorded during different motor tasks, involving cervical rotations, arm movements and standing. In comparison to a group of asymptomatic control subjects, patients with chronic neck pain was characterised by slower movements, poor balance, reduced cervical stability during perturbations, altered smoothness of movement (jerk index), and reduced movement precision (variable error and variability in range of motion). The sensorimotor variables velocity of arm movements and cervical stability, could correctly classified nearly 90% of the subjects as having chronic neck pain or being asymptomatic. There was a large diversity of sensorimotor disturbances among the individual patients. This was confirmed in a regression model that failed to separate the groups insidious neck pain (sensitivity 44%) and WAD (sensitivity 67%). By investigating associations between the different sensorimotor variables, close relations was found between the repositioning acuity and variability in range of motion, and between standing balance and cervical stability/ standing balance during perturbation. These two groups of variables were only weakly related to each other and to smoothness of movement and movement velocity. The results indicate that chronic neck pain is characterised by specific sensorimotor deficits, and that there are common pathophysiological mechanisms in chronic neck pain of different aetiology. However, the lack of associations between several sensorimotor disturbances indicates that different mechanisms are involved. The thesis indicates that objective sensorimotor tests should be used to improve the quality of functional assessments in chronic neck pain. Methods that objectively and quantitatively measure e.g. movement precision, balance and cervical stability are also needed in order to evaluate current treatment methods and to develop new rehabilitation programs for specific sensorimotor deficits.
38.	Mikaelsson, Katarina, et al. (author) Aktivitet: Fysisk aktivitet och sittande hos gymnasieungdomar i Norrbotten 2012 Conference paper (pop. science, debate, etc.)
39.	Mikaelsson, Katarina, et al. (author) Inactivity in adolescents, what are the effects on physical capacity? 2011 In: Physiotherapy. - 0031-9406 .- 1873-1465. ; 97:Suppl. 1, s. eS808- Journal article (peer-reviewed)abstract Purpose: The aim of the study was to investigate the effect of physical activity on physical capacity among graduates from upper secondary school.Relevance: Physical activity and physical fitness are important health related parameters, which both have declined the last decades. Adolescents who are about to leave compulsory school and physical education are supposed to peak regarding physical capacity. Therefore it is interesting to investigate the effect physical inactivity (according to WHO-recommendation) have on physical performance.Participants: The participants where third grade students (38 female and 61 male) from upper secondary school (18 - 20 years).Methods: International Physical Activity Questionnaire (IPAQ) was used to estimate the level of physical activity. The participants were divided, in accordance with World Health Organizations recommendations for physical activity, to A) physically inactive or B) physically active. Physical fitness was tested using the Åstrand bicycle test and functional tests of muscular strength and balance.Analysis: By Student's independent t-test, separate for females and males, differences in aerobic capacity, push-ups, grip strength, vertical jump height, sit-ups and balance, between physically inactive and active were tested.Results: Maximum oxygen uptake differed significantly between physically inactive and active males (mean ± SD: 3.0 ± 0.6 l/kg, vs. 3.6 ± 0.7 p = 0.002) and females (2.5± 0.3 l/kg, vs. 3.0 ± 0.6 p = 0.016). There was a difference among physically inactive and active males regarding push-ups (28.5 ± 7.0 vs. 37.1 ± 9.0, p < 0.001) and sit-ups (39.6 ± 19.4 vs. 59.2 ± 30.2, p = 0.010). No significant differences were found regarding vertical jump or grip strength among males, any of the muscle strength measurements among females, and balance (in any sex).Conclusions: The level of physical activity was related to aerobic capacity in both sexes, but did not seem to have the same impact on muscular fitness and balance, especially concerning the females. Since aerobic capacity is an important parameter in preventing future health problems, it is crucial to engage all adolescents in physical activity.Implications: According to this study physical activity have positive effects on aerobic capacity, without similar trend in muscle strength. Addressing strength training, as complement to aerobic training should be recommended regardless of level of physical activity performed. Therefore we see a future need for promoting and designing detailed guidelines regarding strength training for children and adolescents.
40.	Mikaelsson, Katarina, et al. (author) Is self-rated physical activity a good indicator of physical capacity and is time spent sitting negative for physical capacity? 2011 In: Physiotherapy. - 0031-9406 .- 1873-1465. ; 97:Suppl. 1, s. eS805- Journal article (peer-reviewed)abstract Purpose: The aim of this study was to relate levels of physical activity to physical capacity and to study whether time sitting influences physical capacity among students in upper secondary school.Relevance: Physical activity and physical fitness are important health related parameters. Modern living habits with increased time spent on sedentary behaviors like watching TV and computer gaming have a potential for a negative influence. This calls for reliable and cost-effective measures of physical activities as indicators of physical capacity as tools for identifying people with an inactive lifestyle.Participants: Research participants where 99 third grade students (38 female, 61 male) from upper secondary school in Sweden (18-20 years).Methods: Levels of physical activity was established using the International Physical Activity Questionnaire (IPAQ) and determined for both 1) Level of activity (Total, Vigorous, Moderate, Walking), 2) IPAQ-classification Amount of activity (High, Medium, Low) and 3) Time sitting. Physical fitness was measured using the Åstrand bicycle test and functional tests of muscular strength.Analysis: The relation between 1) Level of activity, 2) IPAQ- amount of activity and 3) Time sitting and physical capacity was investigated by separate linear regression analyses.Results: There were a relation between Total level of activity and A) aerobic capacity (l/min2) (R2 = 0.1, p = 0.001), B) push-ups (R2 = 0.05, p = 0.011), and C) sit-ups (R2 = 0.046, p = 0.016), while other measure of physical capacity was non significant. An identical pattern was reveled for activity performed on Vigorous level with A) aerobic capacity (l/min2) (R2 = 0.2, p < 0.000), B) push-ups (R2 = 0.16, p < 0.000) and C) sit-ups (R2 = 0.082, p = 0.023). For activity on Moderate level the only significant relation was with aerobic capacity (R2 = 0.033, p = 0.033). For Walking no relation was significant. Regarding the IPAQ-classification of High-, Medium, and Low physical activity, no relation with any measures of physical capacity was found. Further, surprisingly, no relation was found between Time sitting and any measures of physical capacity.Conclusions: The results imply that the intensity of physical activity is of importance for achieving high aerobic capacity, while the amount of activity is not. Further, our results indicate that time sitting is not related to physical capacity.Implications: The self-rated questionnaire IPAQ can be questioned for use as a direct indicator of health parameters as physical capacity. Further, it seems that the intensity of activity is of importance for physical performance.
41.	Mikaelsson, Katarina, et al. (author) Physical capacity in physically active and non-active adolescents 2011 In: Journal of Public Health. - : Springer Nature. - 2198-1833 .- 1613-2238 .- 0943-1853. ; 19:2, s. 131-138 Journal article (peer-reviewed)abstract Aim: The aim of this study was to investigate differences in physical capacity between physically active and non-active men and women among graduates from upper secondary school.Subject and methods: Research participants were graduates (38 women and 61 men) from upper secondary school. Physical activity was determined using the International Physical Activity Questionnaire, and participants were dichotomously characterized as being physically active or physically non-active according to the recommendations of the World Health Organization (WHO). Aerobic capacity was measured using the Åstrand cycle ergometer test. Participants also underwent tests of muscular strength and balance.Results: Maximum oxygen uptake differed significantly between physically active and non-active men (mean ± SD 3.6±0.7 vs 3.0±0.6 l/kg, p=0.002) and women (3.0± 0.6 vs 2.5±0.3 l/kg, p=0.016). There was a difference among physically active and non-active men regarding push-ups (37.1±9.0 vs 28.5±7.0, p<0.001) and sit-ups (59.2±30.2 vs 39.6±19.4, p=0.010). No significant differences were found regarding vertical jump or grip strength among men, any of the muscle strength measurements among women, and balance (in any sex).Conclusion: Activity levels had impact on aerobic capacity in both sexes, but did not seem to have the same impact on muscular strength and balance, especially in women.
42.	Mikaelsson, Katarina, et al. (author) Physically inactive adolescents’ experiences of engaging in physical activity 2020 In: European Journal of Physiotherapy. - : Taylor & Francis. - 2167-9169 .- 2167-9177. ; 22:4, s. 191-196 Journal article (peer-reviewed)abstract Purpose: This study aimed to describe physically inactive adolescents’ experiences and reflections about engaging in physical activity. Methods: Nine graduate students from the third year of upper secondary school (six women and three men) participated in this study. Narrative interviews were used for data collection and qualitative content analysis was used to analyse the interviews. Results: The analysis revealed three themes ‘Acknowledging resistance and barriers to performing physical activity’, ‘Knowing that it is good is not enough’, and ‘Feeling included and accepted is fun and motivating’. These themes show that the adolescent’s experienced barriers, acknowledged pros and cons and identified possibilities to be physically active. Conclusions: Identifying experiences that impact on inactive adolescents’ attitude and willingness to perform physical activity can be useful to understand the needs of the individual. By relating these experiences to the different stages of the transtheoretical model, this study could provide valuable knowledge for designing future interventions to enhance physical activity in this target group.
43.	Mikaelsson, Katarina, et al. (author) Relationship between physical capacity and physical activity in adolescents 2012 In: Gazzetta Medica Italiana. - 0393-3660 .- 1827-1812. ; 171:5, s. 639-651 Journal article (peer-reviewed)abstract Aim. Physical activity and physical capacity are important health related parameters for all age-groups. Yet, little is known about the relationship between physical activity and physical capacity amongst adolescents about to leave compulsory education. The aim of the study was to investigate how physical capacities are related to self-reported energy expenditure on physical activities at different levels of physical activity and amount of time spent sitting among graduates of upper secondary school. Methods. In total, 99 third grade students participated from upper secondary school. Levels of physical activity and the amount of time spent sitting were assessed using the International Physical Activity Questionnaire (IPAQ). The energy expenditure was calculated based on the activity determined by the IPAQ. The participants' physical capacity was tested using VO2max, muscle strength and balance measures. The relationship between physical activity and physical capacity was addressed using linear regression models. Results. There was significant relationship between Total METs and aerobic capacity (R2 = 0.15), push-ups (R2 = 0.08) and sit-ups (R2 = 0.07). A stronger significant relationship was revealed for activity performed on Vigorous activity METs for aerobic capacity (R2 = 0.23), push-ups (R2 = 0.18) and sit-ups (R2 = 0.10). The regression analyses for Moderate activity METs, Walking activity METs and time spent Sitting showed no significant relationship to any measures of physical capacity. Conclusion. For adolescents, the intensity of physical activity is of importance for achieving high aerobic capacity, and the amount of time spent sitting does not influence physical capacity.
44.	Mishra, U., et al. (author) Empirical estimates to reduce modeling uncertainties of soil organic carbon in permafrost regions : a review of recent progress and remaining challenges 2013 In: Environmental Research Letters. - : IOP Publishing. - 1748-9326. ; 8:3, s. 035020- Journal article (peer-reviewed)abstract The vast amount of organic carbon (OC) stored in soils of the northern circumpolar permafrost region is a potentially vulnerable component of the global carbon cycle. However, estimates of the quantity, decomposability, and combustibility of OC contained in permafrost-region soils remain highly uncertain, thereby limiting our ability to predict the release of greenhouse gases due to permafrost thawing. Substantial differences exist between empirical and modeling estimates of the quantity and distribution of permafrost-region soil OC, which contribute to large uncertainties in predictions of carbon-climate feedbacks under future warming. Here, we identify research challenges that constrain current assessments of the distribution and potential decomposability of soil OC stocks in the northern permafrost region and suggest priorities for future empirical and modeling studies to address these challenges.
45.	Nordin, Catharina, et al. (author) Effects of the Web Behavior Change Program for Activity and Multimodal Pain Rehabilitation : Randomized Controlled Trial 2016 In: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 18:10, s. 24-41 Journal article (peer-reviewed)abstract BACKGROUND:Web-based interventions with a focus on behavior change have been used for pain management, but studies of Web-based interventions integrated in clinical practice are lacking. To emphasize the development of cognitive skills and behavior, and to increase activity and self-care in rehabilitation, the Web Behavior Change Program for Activity (Web-BCPA) was developed and added to multimodal pain rehabilitation (MMR).OBJECTIVE:The objective of our study was to evaluate the effects of MMR in combination with the Web-BCPA compared with MMR among persons with persistent musculoskeletal pain in primary health care on pain intensity, self-efficacy, and copying, as part of a larger collection of data. Web-BCPA adherence and feasibility, as well as treatment satisfaction, were also investigated.METHODS:A total of 109 participants, mean age 43 (SD 11) years, with persistent pain in the back, neck, shoulder, and/or generalized pain were recruited to a randomized controlled trial with two intervention arms: (1) MMR+WEB (n=60) and (2) MMR (n=49). Participants in the MMR+WEB group self-guided through the eight modules of the Web-BCPA: pain, activity, behavior, stress and thoughts, sleep and negative thoughts, communication and self-esteem, solutions, and maintenance and progress. Data were collected with a questionnaire at baseline and at 4 and 12 months. Outcome measures were pain intensity (Visual Analog Scale), self-efficacy to control pain and to control other symptoms (Arthritis Self-Efficacy Scale), general self-efficacy (General Self-Efficacy Scale), and coping (two-item Coping Strategies Questionnaire; CSQ). Web-BCPA adherence was measured as minutes spent in the program. Satisfaction and Web-BCPA feasibility were assessed by a set of items.RESULTS:Of 109 participants, 99 received the allocated intervention (MMR+WEB: n=55; MMR: n=44); 88 of 99 (82%) completed the baseline and follow-up questionnaires. Intention-to-treat analyses were performed with a sample size of 99. The MMR+WEB intervention was effective over time (timegroup) compared to MMR for the two-item CSQ catastrophizing subscale (P=.003), with an effect size of 0.61 (Cohen d) at 12 months. There were no significant between-group differences over time (timegroup) regarding pain intensity, self-efficacy (pain, other symptoms, and general), or regarding six subscales of the two-item CSQ. Improvements over time (time) for the whole study group were found regarding mean (P<.001) and maximum (P=.002) pain intensity. The mean time spent in the Web-based program was 304 minutes (range 0-1142). Participants rated the items of Web-BCPA feasibility between 68/100 and 90/100. Participants in the MMR+WEB group were more satisfied with their MMR at 4 months (P<.001) and at 12 months (P=.003).CONCLUSIONS:Adding a self-guided Web-based intervention with a focus on behavioral change for activity to MMR can reduce catastrophizing and increase satisfaction with MMR. Patients in MMR may need more supportive coaching to increase adherence in the Web-BCPA to find it valuable.
46.	Nordin, Catharina, et al. (author) It's about me : patients’ Experiences of Patient Participation in the Web Behavior Change Program for Activity in Combination With Multimodal Pain Rehabilitation 2017 In: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 19:1, s. 62-72 Journal article (peer-reviewed)abstract BackgroundPatients’ participation in their health care is recognized as a key component in high-quality health care. Persons with persistent pain are recommended treatments with a cognitive approach from a biopsychosocial explanation of pain, in which a patient’s active participation in their rehabilitation is in focus. Web-based interventions for pain management have the potential to increase patient participation by enabling persons to play a more active role in rehabilitation. However, little is known about patients’ experiences of patient participation in Web-based interventions in clinical practice.ObjectiveThe objective of our study was to explore patients’ experiences of patient participation in a Web Behavior Change Program for Activity (Web-BCPA) in combination with multimodal rehabilitation (MMR) among patients with persistent pain in primary health care.MethodsQualitative interviews were conducted with 15 women and 4 men, with a mean age of 45 years. Data were analyzed with qualitative content analysis.ResultsOne theme, “It’s about me,” and 4 categories, “Take part in a flexible framework of own priority,” “Acquire knowledge and insights,” “Ways toward change,” and “Personal and environmental conditions influencing participation,” were developed. Patient participation was depicted as being confirmed in an individualized and structured rehabilitation framework of one’s own choice. Being confirmed was fundamental to patient participation in the interaction with the Web-BCPA and with the health care professionals in MMR. To acquire knowledge and insights about pain and their life situation, through self-reflection in the solitary work in the Web-BCPA and through feedback from the health care professionals in MMR, was experienced as patient participation by the participants. Patient participation was described as structured ways to reach their goals of behavior change, which included analyzing resources and restrictions, problem solving, and evaluation. The individual’s emotional and cognitive resources and restrictions, as well as health care professionals and significant others’ attitudes and behavior influenced patient participation in the rehabilitation. To some extent there were experiences of restrained patient participation through the great content of the Web-BCPA.ConclusionsPatient participation was satisfactory in the Web-BCPA in combination with MMR. The combined treatment was experienced to increase patient participation in the rehabilitation. Being confirmed through self-identification and finding the content of the Web-BCPA trustworthy was emphasized. Patient participation was experienced as a learning process leading to new knowledge and insights. Higher user control regarding the timing of the Web-BCPA and therapist guidance of the content may further increase patient participation in the combined treatment.
47.	Röijezon, Ulrik, et al. (author) Proprioceptive Disturbance in Chronic Neck Pain: Discriminate Validity and Reliability of Performance of the Clinical Cervical Movement Sense Test 2022 In: Frontiers in Pain Research. - : Frontiers Media S.A.. - 2673-561X. ; 3 Journal article (peer-reviewed)abstract Chronic neck pain is associated with sensorimotor dysfunctions, which may develop symptoms, affect daily activities, and prevent recovery. Feasible, reliable, and valid objective methods for the assessment of sensorimotor functions are important to identify movement impairments and guide interventions. The aim of this study was to investigate the discriminative validity of a clinical cervical movement sense test, using a laser pointer and an automatic video-based scoring system. Individuals with chronic neck pain of idiopathic onset (INP), traumatic onset (TNP), and healthy controls (CON) were tested. Associations between movement sense and neck disability were examined and the repeatability of the test was investigated. A total of 106 participants (26 INP, 28 TNP, and 52 CON) were included in a cross-sectional study. Acuity, Speed, Time, and NormAcuity (i.e., normalized acuity by dividing acuity with movement time) were used as outcome measures. ANOVAs were used for group comparisons and Pearson correlations for associations between movement sense variables and neck disability index (NDI). Notably, 60 of the participants (30 CON, 17 INP, and 13 TNP) performed the test on a second occasion to explore test-retest reliability. Results revealed a reduced NormAcuity for both INP and TNP compared with CON (p < 0.05). The neck pain groups had similar Acuity but longer Time compared with CON. Among TNP, there was a fair positive correlation between Acuity and NDI, while there was a negative correlation between Acuity and NDI among INP. Reliability measures showed good to excellent ICC values between tests, but standard error of measurements (SEM) and minimal detectable change (MDC) scores were high. The results showed that NormAcuity is a valuable measure to identify disturbed cervical movement sense among INP and TNP. While Acuity was similar between the groups, different strategies, such as longer Time, to perform the task among neck patient groups were used. Few differences were identified between the neck pain groups, but altered strategies may exist. Reliability was acceptable, and the test is feasible to perform in the clinic. However, the technical complexity of the automated image analysis is a concern. Future developments will provide more feasible solutions.
48.	Sjölander, Per, et al. (author) Prediction of treatment outcome based on psychosocial characteristics of patients with musculoskeletal pain 2000 Conference paper (other academic/artistic)
49.	Sjölander, Per, et al. (author) Proprioceptive signature of cursive writing in humans 2004 In: Proceedings of the 8th International Federation of Orthopaedic Manupulative Therapists' Conference IFOMT. Conference paper (pop. science, debate, etc.)
50.	Sjölander, Per, et al. (author) Sensorimotor control and kinematics during neck rotations in patients with whiplash associated disorders and work-related neck pain 2004 In: Proceedings of the 8th International Federation of Orthopaedic Manupulative Therapists' Conference. - : IFOMT. Conference paper (other academic/artistic)

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