| 1. |
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Försäkringsmedicin för arbetsskador i rörelseorganen : lagstiftning, exponering, analys. Vol. 1 / Jorma Styf (red.)
- 2014
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Verket Försäkringsmedicin för arbetsskador i rörelseorganen består av två böcker, volym I och volym II. Denna volym I handlar om det försäkringsmedicinska gränssnittet mellan medicin och juridik när det gäller att bedöma vad som kan vara arbetsskada i rörelseorganen. Det generella arbetsskadebegreppet innebär att Försäkringskassan och domstolarna måste kartlägga och bedöma alla faktorer som kan ge upphov till den försäkrade individens aktuella besvär. Processen ska vara kunskapsstyrd men lagstiftarens krav på kunskap har varierat genom åren med olika bevisregler om vad som kan vara arbetsskada i Arbetsskadelagens mening. Därför ger volym I en bakgrund, presenterar lagstiftningen, resonerar kring epidemiologiska, statistiska och medicinska begrepp som är användbara i det försäkringsmedicinska arbetet.
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| 2. |
- Grävare Silbernagel, Karin, 1965, et al.
(författare)
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Underben
- 2018
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Ingår i: Ortopedi : patofysiologi, sjukdomar och trauma hos barn och vuxna. - : Studentlitteratur. - 9789144090849 ; , s. 379-396
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 3. |
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| 4. |
- Hellström, Christina, et al.
(författare)
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Perceived future as a life-span factor in chronic pain: Multidimensional scaling
- 2000
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Ingår i: International Journal of Psychology. - 0020-7594. ; 35:3-4, s. 264-264
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Konferensbidrag (refereegranskat)abstract
- Perceived future has been found to be a significant factor in chronic pain. In this explorative study, a new psychometric instrument, the Future scale was constructed to investigate how chronic pain patients perceive the future. By use of multidimensional scaling a two-dimensional conceptual space was constructed which showed how 107 patients clustered according to the main factors of the scale. Two dimensions were recognized: activity-passivity and preceived obstacles-coping, respectively. Further, the patients were compared to a sample from a normal population (N=104). Significant differences in perceived future related to age between these two groups were found.
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| 5. |
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| 6. |
- Hultenheim Klintberg, Ingrid, 1959, et al.
(författare)
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Early activation or a more protective regime after arthroscopic subacromial decompression--a description of clinical changes with two different physiotherapy treatment protocols--a prospective, randomized pilot study with a two-year follow-up.
- 2008
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 22:10-11, s. 951-65
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To describe clinical changes with two protocols of physiotherapy following arthroscopic subacromial decompression (ASD) over two years. Reliability of Functional Index of the Shoulder was performed. DESIGN: A prospective, randomized pilot study, within-subject design. SUBJECTS: Thirty-four shoulders (13 women), mean age 46 (SD 7) years with primary shoulder impingement, listed for arthroscopic subacromial decompression. INTERVENTIONS: The traditional group (n = 20) started with active assisted range of motion exercises on the day of surgery, dynamic exercises for the rotator cuff after six weeks and strengthening exercises after eight weeks. The progressive group (n = 14) started active assisted range of motion and dynamic exercises for the rotator cuff on the day of surgery. Strengthening exercises started after six weeks. MAIN MEASURES: A clinical evaluation was made preoperatively, six weeks, three, six, 12 and 24 months after surgery. Pain, patient satisfaction, active range of motion and muscular strength were evaluated. Shoulder function was evaluated using Constant score, Hand in neck, Pour out of a pot and Functional Index of the Shoulder. RESULTS: Both groups showed significant improvements in pain during activity and at rest, in range of motion in extension and abduction, in strength of external rotation and in function. There were no clinical differences in changes between groups. Most patients were pain-free from six months. After two years, the majority of patients achieved > or = 160 degrees in flexion, > or = 175 degrees in abduction and 80 degrees in external rotation, the traditional achieved 67 and the progressive group 87 with Constant score. CONCLUSIONS: Early activation using a comprehensive, well-defined and controlled physiotherapy protocol can be used safely after arthroscopic subacromial decompression.
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| 7. |
- Hultenheim Klintberg, Ingrid, 1959, et al.
(författare)
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Early loading in physiotherapy treatment after full-thickness rotator cuff repair: a prospective randomized pilot-study with a two-year follow-up.
- 2009
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 23:7, s. 622-38
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe the clinical changes following two different physiotherapy treatment protocols after rotator cuff repair. DESIGN: A prospective, randomized pilot study with a two-year follow-up. SUBJECTS: Five women and nine men, 55 (40-64) years old, were included. INTERVENTION: The progressive group (n = 7) started with dynamic, specific muscle activation of the rotator cuff the day after surgery as well as passive range of motion. After four weeks of immobilization the loading to the rotator cuff increased and in a progressive manner throughout the rehabilitation. In the traditional group (n = 7) the rotator cuff was protected from loading. Patients were immobilized for six weeks and started with passive range of motion the day after surgery. No specific exercises to the rotator cuff were introduced during this period. MAIN MEASURES: A clinical evaluation was made preoperatively, 3, 6, 12 and 24 months after surgery. Pain rating during activity and at rest, patient satisfaction, active range of motion and muscle strength, Constant score, hand in neck, hand in back and pour out of a pot, as well as Functional Index of the Shoulder were used. RESULTS: At two years follow-up, the progressive group and traditional group scored pain during activity visual analogue scale (VAS) 2/0 mm and pain at rest 0/0 mm, respectively. The groups attained 170/175 degrees in active abduction in standing and 70/90 degrees in passive external rotation while lying in supine. Using Constant score, the groups attained 82/77 points respectively. CONCLUSION: The present study showed that the progressive protocol produced no adverse effects compared with the traditional protocol.
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| 8. |
- Karladani, Abbas, 1954, et al.
(författare)
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Ankle arthrodesis using dowel bone graft and cancellous-bone screws: a mechanical study in cadavers
- 2004
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Ingår i: Acta Orthop Scand. - 0001-6470. ; 75:4, s. 471-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There are numerous techniques for ankle arthrodesis. MATERIAL AND METHODS: We studied the stability of an ankle arthrodesis with the use of two cross-screws combined with dowel graft technique in 14 fresh-frozen ankles from amputees. The arthrodesis was performed by a dowel graft technique, in the coronal plane in 7 specimens (group 1) and in the diagonal plane in the remaining 7 (group 2). Allocation into the two groups took place after normalization according to the bone mineral content of the specimens. All ankles were fixed with two 6.5-mm diameter cancellous-bone screws, with the ankle in neutral position. Tibiotalar motion was measured during 5 Nm torque loading in plantar flexion-dorsiflexion, abduction-adduction and eversion-inversion planes of the ankle joint. Two testing sequences were performed and the mean value of both tests in each direction was used for the analysis. RESULTS: In all 3 planes, the torque applied caused more motion with the dowel graft in the coronal plane (group 1) than with the graft in the diagonal plane (group 2). The differences between the two groups were significant for abduction-adduction and eversion-inversion planes. Statistical analysis of differences between the first and second test showed significantly greater stiffness in group 2 than in group 1 in plantar flexion-dorsiflexion torque. INTERPRETATION: The placement of a dowel graft in the diagonal plane in comparison to the coronal plane significantly increased the initial stability of an ankle arthrodesis.
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| 9. |
- Kjellby-Wendt, Gunilla, 1965, et al.
(författare)
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Early active rehabilitation after surgery for lumbar disc herniation: a prospective, randomized study of psychometric assessment in 50 patients.
- 2001
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Ingår i: Acta orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 72:5, s. 518-24
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Tidskriftsartikel (refereegranskat)abstract
- In a randomized study, using psychometric assessment, we evaluated two training programs before and after surgical treatment of lumbar disc herniation. 26 patients were treated according to an early active training program (treatment group). 24 patients followed a traditional less active training program (control group). Before surgery, the patients filled in the following questionnaires 3 and 12 months after surgery: Multidimensional Pain Inventory (MPI), State and Trait Anxiety Inventory, and Beck Depression Inventory. Pain was assessed by the patient's pain drawing and a visual analog scale. Both groups improved as regards pain severity and state of anxiety. The MPI parameter, pain interference, improved more in the early active treatment group than in the control group. This suggests that the early active training program has a positive effect on the way patients cope with pain in their daily lives.
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| 10. |
- Kjellby-Wendt, Gunilla, 1965, et al.
(författare)
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Results of early active rehabilitation 5-7 years after surgical treatment for lumbar disc herniation.
- 2002
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Ingår i: Journal of spinal disorders & techniques. - 1536-0652. ; 15:5, s. 404-9
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Tidskriftsartikel (refereegranskat)abstract
- A prospective and randomized study was conducted of 52 patients who were treated by two home training programs after surgical treatment of lumbar disc herniation. Twenty-six patients followed an early active treatment program, and 26 patients followed a less active training program (control group). Forty-nine patients (82%) answered a questionnaire 5-7 years postoperatively. The reoperation rate was two of 49 patients. None of these patients had followed the early active treatment program. Patients with signs of depression before surgery were not significantly less satisfied with the outcome than patients with no signs of depression before surgery.
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| 11. |
- Kjellby-Wendt, Gunilla, 1965, et al.
(författare)
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The predictive value of psychometric analysis in patients treated by extirpation of lumbar intervertebral disc herniation.
- 1999
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Ingår i: Journal of spinal disorders. - 0895-0385. ; 12:5, s. 375-9
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Tidskriftsartikel (refereegranskat)abstract
- The authors studied the predictive value of a psychometric evaluation of 50 patients (14 women, 36 men) with a mean age of 40 years who were treated by extirpation of a lumbar disc herniation. Patient satisfaction was evaluated by an unbiased observer. The Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and a Pain Visual Analogue Scale (PVAS) were used to assess pain and psychological distress before surgery and 3 and 12 months after surgery. Two years after surgery, 37 patients were contented with the surgical outcome and 10 patients were not. Three patients did not return the questionnaire. Before surgery, the patients who later became discontented were more depressed, more anxious, and experienced more pain. In a discriminant analysis, a combination of BDI, STAI, and PVAS scores correctly classified 78% of the discontented and 76% of the contented patients. The study shows psychometric analysis is a valuable tool for predicting the outcome of surgical treatment for lumbar disc herniation.
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| 12. |
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| 13. |
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| 14. |
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| 15. |
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| 16. |
- Lundberg, Mari, 1969, et al.
(författare)
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Kinesiophobia among patients with musculoskeletal pain in primary healthcare.
- 2006
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Ingår i: Journal of rehabilitation medicine. - : Medical Journals Sweden AB. - 1650-1977. ; 38:1, s. 37-43
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Tidskriftsartikel (refereegranskat)abstract
- To describe the occurrence of kinesiophobia and to investigate the association between kinesiphobia and pain variables, physical exercise measures and psychological characteristics in patients with musculoskeletal pain.
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| 17. |
- Lundberg, Mari, 1969, et al.
(författare)
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Kinesiophobia among physiological overusers with musculoskeletal pain
- 2009
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Ingår i: Eur J Pain. - 1532-2149. ; 13:6, s. 655-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Kinesiophobia has been established as an important factor among patients with musculoskeletal pain. Most research has been performed among patient groups described in terms of disuse. Little, however, is known about the impact of affective factors among patients with overuse injuries caused by exercise. AIM: The aims were to investigate the occurrence of kinesiophobia among patients with exercise induced pain (overuse group) as compared to a reference group (chronic low back pain, CLBP), and to investigate kinesiophobia in relation to the type of pain and levels of exercise in the overuse group. METHODS: All patients were referred with unspecific pain to the orthopaedic clinic in order to make a specific diagnosis. The overuse group consisted of 146 patients with exercise induced leg pain, and the reference group consisted of 154 patients with CLBP. All patients completed questionnaires regarding age, pain duration, severity of pain and subjective rating of kinesiophobia (TSK). The overuse group was subgrouped verified by an exercise test and diagnostic criteria and completed questionnaires about the level of exercise. RESULTS: More than 60% of the overusers presented with kinesiophobia, but they did not differ as compared to the reference group. No difference in kinesiophobia was found in the overuse subgroups divided after type of pain. The highest level of kinesiophobia was found among the non-exercisers. CONCLUSIONS: The results of this study point out the need for further elaborating on the concepts of use, overuse and disuse in relation to the fear-avoidance model.
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| 18. |
- Lundberg, Mari, 1969, et al.
(författare)
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On what patients does the Tampa Scale for Kinesiophobia fit?
- 2009
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Ingår i: Physiotherapy theory and practice. - : Informa UK Limited. - 1532-5040 .- 0959-3985. ; 25:7, s. 495-506
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Tidskriftsartikel (refereegranskat)abstract
- The Tampa Scale of Kinesiophobia (TSK) has been used for a decade and is a valuable tool in researching pain-related fear. A variety of different factor models exist, however, and there are inconsistencies as to which model to use. The purpose of the study was twofold: 1) to thoroughly review existing factor models and 2) to empirically evaluate the previously proposed factor models in a large sample with persistent musculoskeletal pain. Subjects included 578 of 711 (81%) consecutive patients (aged 18-65 years) with persistent musculoskeletal pain from three different orthopedic outpatient clinics. We reviewed all existing factor models and performed confirmatory factor analyses on the existing models. Our review identified 11 factor models of the TSK. The identified models were tested on a large Swedish sample. All models were rejected because of unacceptable goodness-of-fit statistics in that specific sample. This study supports the fact that TSK is a multidimensional construct. Rather than searching for new factor solutions, future research should be devoted to forming a consensus for the conceptual and operational definitions of the construct kinesiophobia and the application of the Tampa Scale for Kinesiophobia. Physiotherapists are encouraged to take part in building new theories.
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| 19. |
- Lundberg, Mari, 1969, et al.
(författare)
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THE IMPACT OF FEAR-AVOIDANCE MODEL VARIABLES ON DISABILITY IN PATIENTS WITH SPECIFIC- OR NON-SPECIFIC CHRONIC LOW BACK PAIN.
- 2011
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Ingår i: Spine. - 1528-1159.
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: Study Design: A prospective cross-sectional design.Objective: The objectives were to describe the occurrence and to investigate the association of the fear-avoidance model variables (pain intensity, kinesiophobia, depression, and disability) in patients with specific- or non-specific chronic low back pain (CLBP).Summary of Background Data: Affective factors, particularly fear, have proven to be central in the explanation and understanding of chronic pain. The fear-avoidance model has shown that fearful patients with CLBP are at risk of becoming trapped in a vicious cycle of pain, fear, disability, and depressive symptoms. Little is known about the relationship between these factors in patients sub-grouped as specific- or non-specific CLBP.Methods: All 147 patients (81 women, 66 men) were examined by an orthopaedic surgeon and diagnosed as either specific- or non-specific CLBP based on that examination. Hierachical multiple regression analysis was used to assess the ability of four independent variables (back pain intensity, VAS; kinesiophobia, TSK; depressed mood, Zung) to predict levels of disability, after controlling for the influence of age and gender.Results: Both groups (specific- and non-specific CLBP) presented elevated values on the fear-avoidance model variables. All the independent fear-avoidance variables contributed in a statistically significant manner to predict disability in patients with specific CLBP, 67.0%, F (5, 59) = 24.46, p<0.000. In patients with non-specific CLBP, all variables except kinesiophobia predicted disability in a statistically significant manner, 63.0%, F (5, 59) = 22.64, p <0.000.Conclusions: We conclude that persistent musculoskeletal pain affects the individual in a similar manner, regardless of the cause of the pain. In clinical terms, this means that pain must be analyzed and treated as a parallel process to searching for the cause of the pain.
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| 20. |
- Macdonald, Warren, 1954, et al.
(författare)
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Improved tibial cutting accuracy in knee arthroplasty.
- 2004
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Ingår i: Medical engineering & physics. - : Elsevier BV. - 1350-4533. ; 26:9, s. 807-12
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Tidskriftsartikel (refereegranskat)abstract
- Initial stability and development of long-term fixation for cementless tibial components at the knee both depend on the accuracy of fit between implanted components and prepared bone surfaces. Tibial surfaces prepared for total knee replacement with conventional saw-blades and guides were shown by Toksvig-Larsen to vary by over 2 mm, from a flat surface at the point of maximum variation, and all points varied with a standard deviation of up to 0.4 mm. Surface cutting errors are caused by flexion of the saw-blade and blade angulation from the ideal alignment, due to poor guidance or control by the saw-block or guide. Most conventional knee instrumentation relies on flat surface or slotted cutting blocks, constraining the moving saw-blade against one or two guide surfaces. Improved cutting action was achieved by constraining the saw from the pivot point of the blade, and controlling motion of this constraint with parallel action slides. Using this saw-guide and an improved saw-blade, tibial cuts were made in mock arthroplasty procedures on twenty four cadaveric tibiae in mortuo. Analysis of Variance and Tukey's HSD test showed that the improved saw technique yielded significantly better flatness (p < 0.03) and greatly improved roughness (p < 0.0005).
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| 21. |
- Möller, Michael, 1957, et al.
(författare)
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The reliability of isokinetic testing of the ankle joint and a heel-raise test for endurance
- 2005
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Ingår i: Knee Surg Sports Traumatol Arthrosc. - 0942-2056. ; 13:1, s. 60-71
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to investigate the reliability of different methods used for isokinetic testing of calf muscle strength and endurance. The detailed evaluation of test-retest reliability serves the purpose of establishing reliable research tools when evaluating patients who have sustained an Achilles tendon rupture. The test-retest reliability of isokinetic measurements at the ankle for eccentric and concentric muscle action was calculated in ten healthy male volunteers using intra-class correlation (ICC) and coefficient of variation (CV). Three different positions were compared at the angular velocities of 30 degrees /s and 180 degrees /s for right and left ankles. The ICC for plantar flexion was 0.37-0.95, whilst it was 0.00-0.96 for dorsiflexion. The corresponding CVs were 4.0-19.9 and 2.4-19.8 respectively. The test-retest reliability of standardised heel-raises, Achilles tendon width, calf circumference and ankle range of motion revealed ICC values of 0.71-0.98 and CVs of 0.67-19.1. The test-retest interval was 5 to 7 days. We conclude that all three positions studied for the isokinetic evaluation of calf muscle function are equally reliable concerning plantar flexion at the ankle joint. The same level of reliability was also found in the evaluation of the standing heel-raise test and the isokinetic dorsiflexion test, except for dorsiflexion in the supine position. The reliability of the investigated methods was only fair despite the use of a detailed and standardised test protocol.
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| 22. |
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| 23. |
- Nilsson, Andreas, 1973, et al.
(författare)
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Evaluation of a fiber-optic technique for recording intramuscular pressure in the human leg.
- 2016
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Ingår i: Journal of clinical monitoring and computing. - : Springer Science and Business Media LLC. - 1573-2614 .- 1387-1307. ; 30:5, s. 699-705
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate a forward-sensing fiber-optic pressure technique for recording of intramuscular pressure (IMP) in the human leg and investigate factors that may influence IMP measurements used in diagnosing compartment syndromes. IMP in the tibialis anterior muscle was recorded simultaneously by a fiber-optic technique and needle-injection technique in 12 legs of 7 healthy subjects. Both measurement catheters were placed in parallel with the muscle fibers to the same depth, as verified by sonography. IMP recordings were performed at rest before, during and after applying a model of abnormally elevated IMP (simulated compartment syndrome). IMP was elevated by venous obstruction induced by a thigh tourniquet of a casted leg. IMP was also measured during injections of 0.1ml of saline into the muscle through the catheters. IMP at baseline was 5.1 (SD=2.6) mmHg measured with the fiber-optic technique and 7.1 (SD=2.5) mmHg with the needle-injection technique (p<0.001). It increased to 48.5 (SD=6.9) mmHg and 47.6 (SD=6.6) mmHg respectively, during simulated compartment syndrome. IMP increased significantly following injection of 0.1ml of saline, measured by both techniques. It remained increased 1min after injection. The fiber-optic technique was able to record pulse-synchronous IMP oscillations. The fiber-optic technique may be used for IMP measurements in a muscle with both normal and abnormally elevated IMP. It has good dynamic properties allowing for measurement of IMP oscillations. Saline injection used with needle-injection systems to ensure catheter patency compromises IMP readings at least one minute after injection.
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| 26. |
- Olaya-Contreras, Patricia, 1964, et al.
(författare)
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Biopsychosocial function analyses changes the assessment of the ability to work in patients on long-term sick-leave due to chronic musculoskeletal pain: The role of undiagnosed mental health comorbidity.
- 2013
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 41:3, s. 247-255
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To study the prevalence of somatic and mental health comorbidity and the use of opioid medication among patients on long-term sick-leave due to chronic musculoskeletal pain (CMP); to compare an orthopaedic-based assessment of ability to work with a team assessment; to investigate the relationship between intensity of pain and psychosocial characteristics in this group. Methods: A cross-sectional study was carried out with 174 consecutive patients on sick-leave for a mean of 21 months. All were referred from the Social Insurance Office for orthopaedic evaluation and assessment of the ability to work. Of them, only 83/174 patients were referred by the Office for psychiatric evaluation. Results: Neck pain was the main cause of disability. Patients with neck pain often suffered pain in more than two sites, and greater intensity of pain. Thirty-four percent of all participants had been prescribed opioid medication before consultation. Degrees of disability, unemployment, low degree of education and to be an immigrant were related to intensity of pain. Unrecognized psychiatric disorders changed the main cause of inability to work in 69% of patients who underwent both orthopaedic and psychiatric evaluation. Conclusions: An evaluation based on biopsychosocial function is valuable in reaching an accurate assessment of the patient's diagnosis, and ability to work in CMP. Ability to work and degree of sick-leave in patients on long-term sick-leave is determined to a large extent by undiagnosed mental health comorbidities, and not solely somatic complaints.
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| 27. |
- Olaya-Contreras, Patricia, 1964, et al.
(författare)
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Comparison between the Beck Depression Inventory and psychiatric evaluation of distress in patients on long-term sick leave due to chronic musculoskeletal pain
- 2010
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Ingår i: Journal of Multidisciplinary Healthcare. - 1178-2390. ; 3, s. 161-167
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Chronic musculoskeletal pain (CMP) is associated with psychological distress and long-term disability. Underlying diagnoses causing long-term sickness absence due to CMP have not been explored enough. In a somatic health care setting, it is important to identify mental health comorbidity to facilitate the selection of appropriate treatment. The objectives of this study were to compare the scores of depressed mood obtained on the Beck Depression Inventory (BDI) with the diagnosis of depression made by a psychiatrist, and to study the prevalence of undiagnosed mental health comorbidity in these patients. METHODS AND PATIENTS: 83 consecutive patients on sick leave (mean duration 21 months) due to CMP who had been referred by the Social Insurance Office to an orthopedist and a psychiatrist for assessment of the patient's diagnoses and capacity to work. The mean age was 45 (23-61) years, 58% were women and 52% were immigrants. The accuracy of measurements was calculated using the Diagnostic Statistical Manual of Mental Disorders IV as the Gold standard. RESULTS: Psychiatric illness was diagnosed in 87% of the patients. The diagnosis was depression in 56%, other psychiatric illnesses in 31%, whereas 13% were mentally healthy. Of all the patients, only 10% had a previous psychiatric diagnosis. The median value of the BDI score was 26 points in depressed patients, whereas it was 23 in patients with other psychiatric diagnoses. The sensitivity of the BDI to detect depression was 87.5%. We found good agreement between the BDI score and a diagnosis of depression. CONCLUSION: Undiagnosed psychiatric disorders were commonly seen in patients with CMP. The high sensitivity of the BDI scores enables the screening of mental health comorbidity in patients with a somatic dysfunction. The test is a useful tool for detecting distress in patients who are on long-term sick leave due to CMP and who need additional treatment.
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| 28. |
- Olaya-Contreras, Patricia, 1964, et al.
(författare)
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Cross-validation of the Depression, Anxiety, and Positive Outlook Scale (DAPOS) for Clinical Use
- 2011
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Ingår i: The Clinical journal of pain. - 0749-8047 .- 1536-5409. ; 27:4, s. 330-337
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The main objective of this study was to investigate different psychometric properties of the Swedish version of the Depression, Anxiety, and Positive Outlook Scale (DAPOS) in patients with chronic musculoskeletal pain in an orthopedic setting. METHODS: A total of 449 participants took part in the study, including 288 patients with chronic musculoskeletal pain and 161 participants in a reference group. Internal consistency, convergent validity, and measurement invariance of the constructs of DAPOS were investigated across sex and diagnostic groups. The Beck Depression Inventory and the Spielberger Anxiety Inventory were used for measures of convergent validity. Multigroup confirmatory factor analysis was performed to test measurement invariance of the theoretical constructs of DAPOS. RESULTS: Internal consistency was good for all 3 constructs, and correlations concerned with convergent validity were found to be acceptable to good. With regard to cross-validation, the 3 constructs of DAPOS were strictly measurement invariant with respect to sex. Across diagnostic groups, the constructs of anxiety and positive outlook were almost strictly measurement invariant, although there were some restrictions of measurement invariance for the construct of depression. DISCUSSION: To be able to rely on an instrument with as few items as DAPOS, the cross-validation of its constructs for sex and diagnostic groups is a valuable information, particularly when investigated in patients with musculoskeletal pain. Based on these results, we recommend that DAPOS could replace longer and more time-consuming screening tests in clinical settings.
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| 29. |
- Olaya-Contreras, Patricia, 1964, et al.
(författare)
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Illness behavior in patients on long-term sick leave due to chronic musculoskeletal pain
- 2009
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Ingår i: Acta Orthopaedica. - 1745-3674. ; 80:3, s. 380-5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Methods for identification of patients with illness behavior in orthopedic settings are still being debated. The purpose of this study was to test the association between illness behavior, depressed mood, pain intensity, self-rated disability, and clinical status in patients with chronic musculoskeletal pain (CMP). METHODS: We examined 174 consecutive sick-listed patients (90 women). Musculoskeletal function was estimated by range of motion, muscle strength, and motor and sensory function. The degree of illness behavior was measured by Waddell signs (WS), RESULTS: WS were observed in 47/174 (27%) of the patients, 16% of whom manifested excessive illness behaviour. In general, more patients with WS were depressed (OR = 4.4; 95% CI: 1.8-11) and experienced greater pain (OR = 2.9; CI: 1.1-7.7). No abnormal physical function could be observed in two-thirds of the patients. Other predictive factors for manifesting WS at the clinical examinations were longer sick leave and previous full sick leave (p < 0.05). INTERPRETATION: Excessive illness behavior is related to psychological distress in patients with CMP and long-term disability. Thus, some patients may also require psychological assessment. Looking for WS during consultation is useful for targeting other factors that may be important in the diagnostic process.
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| 30. |
- Olaya-Contreras, Patricia, 1964, et al.
(författare)
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Measurement invariance for gender and psychometric properties of the Depression, Anxiety and Positive Outlook Scale (DAPOS) in chronic musculoskeletal pain
- 2009
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Ingår i: European Journal of Pain. - : Blackwell Publishing Ltd. - 1532-2149. ; 13:S1
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Konferensbidrag (refereegranskat)abstract
- Background and Aims: The measure of psychological distress is of importance because pain-related anxiety and depression have predictive value in identifying disability in chronic musculoskeletal pain (CMP). The main purpose of this study was to investigate the three-factor structure invariance of the DAPOS scale, across gender, at the orthopaedic settings. Methods and Patients: Patients with (CMP) 288 and 161 controls completed the new DAPOS-questionnaire. DAPOS was validated with the BDI and the STAI-S-T. Confirmatory factor analysis (CFA) was performed to test the multidimensionality of the theoretical construct of the DAPOS, using the maximum likelihood CFA. The model fit was established according to the overall c2 value, CMIN degrees of freedom, and CMIN/DF as with the goodness of fit statistics. To tests the invariant factorial structure of the DAPOS across gender, we employed the AMOS multi-group analyses. Results: The first-order CFA analyses indicated that the model met the specified criteria for goodness of fit (RMSEA = 0.049 CI = 0.034–0.064; CFI = 0.98; TLI = 0.978). The correlations for the latent variables, negative and positive, were all statistically significant (p < 0.001). We found invariance across gender for both levels. At the configural (RMSEA = 0.041 CI = 0.030–0.052; CFI = 0.986; TLI = 0.976), and at the metric level as well (RMSEA = 0.040 CI = 0.029–0.051; CFI = 0.970; TLI = 0.976. Conclusions: Our results show that the factor structure of DAPOS is stable in terms of test-retest and across gender validation. Conclusively, DAPOS is useful to screen distress in clinical pain settings showing equivalence in its structure across gender.
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| 31. |
- Olaya-Contreras, Patricia, 1964, et al.
(författare)
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The effect of the stay active advice on physical activity and on the course of acute severe low back pain.
- 2015
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Ingår i: BMC sports science, medicine and rehabilitation. - : Springer Science and Business Media LLC. - 2052-1847. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Disability due to acute low back pain (ALBP) runs parallel with distress and physical inactivity. If low back pain persists, this may lead to long-term sick leave and chronic back pain. This prospective randomized study evaluated the effect on physical activity and on the course of ALBP of two different treatment advices provided in routine care.
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| 32. |
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| 33. |
- Rennerfelt, Kajsa, et al.
(författare)
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Changes in Muscle Oxygen Saturation Have Low Sensitivity in Diagnosing Chronic Anterior Compartment Syndrome of the Leg
- 2016
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Ingår i: Journal of Bone and Joint Surgery-American Volume. - : Ovid Technologies (Wolters Kluwer Health). - 0021-9355. ; 98A:1, s. 56-61
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Tidskriftsartikel (refereegranskat)abstract
- Background: Near-infrared spectroscopy measures muscle oxygen saturation (StO(2)) in the skeletal muscle and has been proposed as a noninvasive tool for diagnosing chronic anterior compartment syndrome (CACS). The purpose of this study was to investigate the diagnostic value of changes in StO(2) during and after exercise in patients with CACS. Methods: The study comprised 159 consecutive patients with exercise-induced leg pain. Near-infrared spectroscopy was used to measure StO(2) continuously before, during, and after an exercise test. One minute post-exercise, intramuscular pressure was recorded in the same muscle. The cohort was divided into patients with CACS (n = 87) and patients without CACS (n = 72) according to the CACS diagnostic criteria. Reoxygenation at rest after exercise was calculated as the time period required for the level of muscular StO(2) to reach 50% (T-50), 90% (T-90), and 100% (T-100) of the baseline value. Results: The lowest level of StO(2) during exercise was 1% (range, 1% to 36%) in the patients with CACS and 3% (range, 1% to 54%) in the patients without CACS. The sensitivity was 34% and the specificity was 43% when an StO(2) level of <= 8% at peak exercise was used to indicate CACS. The sensitivity and the specificity were only 1% when an StO(2) level of <= 50% at peak exercise was used to indicate CACS. The time period for reoxygenation was seven seconds (range, one to forty-three seconds) at T-50, twenty-eight seconds (range, seven to seventy-seven seconds) at T-90, and forty-two seconds (range, seven to 200 seconds) at T-100 in the patients with CACS and ten seconds (range, one to forty-nine seconds) at T-50, thirty-two seconds (range, four to 138 seconds) at T-90, and forty-eight seconds (range, four to 180 seconds) at T-100 in the patients without CACS. When thirty seconds or more at T-90 was set as the cutoff value for a prolonged time for reoxygenation, indicating a diagnosis of CACS, the sensitivity was 38% and the specificity was 50%. Conclusions: Changes in muscle oxygen saturation during and after an exercise test that elicits leg pain cannot be used to distinguish between patients with CACS and patients with other causes of exercise-induced leg pain.
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| 34. |
- Rennerfelt, Kajsa, et al.
(författare)
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Patient pain drawing is a valuable instrument in assessing the causes of exercise-induced leg pain.
- 2018
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Ingår i: BMJ open sport & exercise medicine. - : BMJ. - 2055-7647. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- We validated patientpain drawing (PPD) in establishing the diagnosis of chronic anterior compartment syndrome (CACS) in patients with exercise-induced leg pain.The study comprised 477 consecutive patients, all suspected of having CACS. The diagnosis was based on the patient's history, a thorough clinical examination and measurements of intramuscular pressure (IMP) following an exercise test. Patients completed a PPD before their hospital visit. Two independent orthopaedic surgeons diagnosed the causes of leg pain based only on the PPD at least 1year after admission. Based on the results of diagnostic tests, the patients were divided into three groups: CACS (n=79), CACS with comorbidity (n=89) and non-CACS (n=306).The sensitivity of the PPD to identify CACS correctly was 67% (observer 1) and 75% (observer 2). The specificity was 65% and 54%, respectively. The interobserver agreement (n=477) was 80%, and the kappa value was 0.55. The interobserver agreement was 77%, and the kappa value was 0.48 among 168 CACS patients with or without comorbidity. The interobserver agreement was 85%, and the kappa value was 0.56 in 79 CACS, and CACS was correctly diagnosed in 79% (observer 1) and 82% (observer 2). The test-retest showed the same results for the two observers, with an intraobserver agreement of 84%, while the test-retest reliability coefficient was 0.7. Comorbidity was found in 53% of CACS patients.PPD might be a valuable instrument in diagnosing the causes of exercise-induced leg pain. It is useful in identifying CACS with and without comorbidity.
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| 35. |
- Sandberg, Margareta, et al.
(författare)
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Non-invasive monitoring of muscle blood perfusion by photoplethysmography: evaluation of a new application
- 2005
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Ingår i: Acta Physiol Scand. - 0001-6772 .- 1365-201X. ; 183:4, s. 335-43
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate a specially developed photoplethysmographic (PPG) technique, using green and near-infrared light sources, for simultaneous non-invasive monitoring of skin and muscle perfusion. METHODS: Evaluation was based on assessments of changes in blood perfusion to various provocations, such as post-exercise hyperaemia and hyperaemia following the application of liniment. The deep penetrating feature of PPG was investigated by measurement of optical radiation inside the muscle. Simultaneous measurements using ultrasound Doppler and the new PPG application were performed to elucidate differences between the two methods. Specific problems related to the influence of skin temperature on blood flow were highlightened, as well. RESULTS: Following static and dynamic contractions an immediate increase in muscle perfusion was shown, without increase in skin perfusion. Liniment application to the skin induced a rapid increase in skin perfusion, but not in muscle. Both similarities and differences in blood flow measured by Ultrasound Doppler and PPG were demonstrated. The radiant power measured inside the muscle, by use of an optical fibre, showed that the near-infrared light penetrates down to the vascular depth inside the muscle. CONCLUSIONS: The results of this study indicate the potentiality of the method for non-invasive measurement of local muscle perfusion, although some considerations still have to be accounted for, such as influence of temperature on blood perfusion.
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| 36. |
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| 37. |
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| 38. |
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| 39. |
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| 40. |
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| 41. |
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| 42. |
- Zhang, Qiuxia, 1960, et al.
(författare)
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Abnormally elevated intramuscular pressure impairs muscle blood flow at rest after exercise
- 2004
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Ingår i: Scand J Med Sci Sports. - 0905-7188. ; 14:4, s. 215-20
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Tidskriftsartikel (refereegranskat)abstract
- We used photoplethysmography (PPG) to measure the relative changes in the anterior tibial muscle blood flow (MBF) in response to exercise when intramuscular pressure (IMP) was elevated (the test leg) or when IMP was normal (the control leg). The elevated IMP was induced by applying venous obstruction of 40 mmHg or 65 mmHg (thigh tourniquet) of a casted leg in eight healthy subjects. Subjects performed dorsiflexion of both feet in sitting position with or without venous obstruction. IMP at rest after exercise increased to 39.4+/-7.9 mmHg or to 58.3+/-8.4 mmHg, respectively. MBF at rest before exercise was 100%. At rest after exercise, it increased to 184+/-52.6% in the test leg when IMP was 39.4 mmHg, and to 279+/-108.3% in the control leg. MBF at rest after exercise was 156+/-58.2% in the test leg when IMP was 58.3 mmHg and 303+/-95.3% in the control leg. The abnormally elevated IMP induced by venous obstruction of a casted leg reduced MBF at rest after exercise. PPG seems to be a suitable method to measure changes in MBF in response to exercise and in experimental conditions with abnormally elevated IMP.
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| 43. |
- Zhang, Qiuxia, 1960, et al.
(författare)
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Blood flow in the tibialis anterior muscle by photoplethysmography during foot-transmitted vibration.
- 2003
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Ingår i: European journal of applied physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 90:5-6, s. 464-9
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Tidskriftsartikel (refereegranskat)abstract
- Photoplethysmography (PPG) was used to detect changes in the anterior tibial muscle blood flow (MBF) during foot-transmitted vibration in six healthy subjects. A filter was developed for reducing the vibration-induced artefacts in the PPG signal. The vibration applied was random with constant acceleration power density in the range 5-2000 Hz with an acceleration of 16-46 m s(-2) (rms). The application of the filter technique showed a dramatic reduction in the vibration-induced artefacts and distortion of the PPG signal was negligible. The mean ratio and correlation coefficient of MBF originating from filtered and non-filtered PPG signals was [mean (SD)] 0.89 (0.04) and 0.99, respectively. This made it possible to detect a relative increase in MBF of 20% during an acute vibration exposure. The results suggest that the use of the filter enables MBF to be measured by PPG during vibration, thus extending the range of applications of the PPG technique to include ergonomic conditions.
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| 44. |
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| 45. |
- Zhang, Qiuxia, 1960, et al.
(författare)
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Effects of electrical nerve stimulation on force generation, oxygenation and blood volume in muscles of the immobilized human leg.
- 2014
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Ingår i: Scandinavian journal of clinical and laboratory investigation. - : Informa UK Limited. - 1502-7686 .- 0036-5513. ; 74:5, s. 369-377
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Tidskriftsartikel (refereegranskat)abstract
- Background. Transcutaneous electrical stimulation of the common peroneal nerve may be an additional clinical tool for enhancing venous return by active and passive mechanisms of muscle action in the immobilized leg. Purposes. To determine the effects of electrical stimulation of the common peroneal nerve to (1) produce force during isometric ankle joint dorsiflexion, and (2) alter muscle oxygenation and blood volume in the resting human leg. Methods. A novel electrical stimulator was applied to 28 legs of 14 healthy subjects. The force during isometric ankle joint dorsiflexion and myoelectric responses produced by stimulation-induced leg muscle contractions were investigated. Muscle oxygen saturation, blood volume and deoxygenated haemoglobin in the tibialis anterior and medial gastrocnemius muscles were measured by near-infrared spectroscopy during venous stasis (40 mmHg thigh tourniquet), with or without electrical stimulation. Results. The force produced during ankle joint dorsiflexion at the maximal stimulation intensity was 2.25 N (0.02-14.14) in the resting leg. Changes in muscle oxygen saturation during venous stasis, with or without electrical stimulation, were similar. Electrical stimulation during venous stasis caused 4-9% and 0.2-6% less increase in total muscle blood volume and deoxygenated hemoglobin compared to venous stasis alone. Conclusions. Nerve stimulation with a newly developed device partly counteracts increases in muscle blood volume and deoxygenated hemoglobin of the resting leg during venous stasis. Clinical relevance. The device stimulates active and passive mechanisms of leg muscle action that seems to enhance venous return in patients with impaired function.
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| 46. |
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| 47. |
- Zhang, Qiuxia, 1960, et al.
(författare)
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Muscle blood flow in response to concentric muscular activity vs passive venous compression
- 2004
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Ingår i: Acta Physiol Scand. - : Wiley. - 0001-6772 .- 1365-201X. ; 180:1, s. 57-62
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To measure muscle blood flow (MBF) using photoplethysmography (PPG) following concentric muscular activity of the leg (active treatment) or passive venous compression (passive treatment) with or without venous obstruction. METHODS: In study A, blood flow in the anterior tibial muscle was measured in 15 healthy subjects with a mean age of 30 years. In study B, blood flow in the gastrocnemius muscle was measured in nine healthy subjects with a mean age of 34 years. Subjects performed concentric muscular activity in one leg. Passive venous compression by a venous foot pump was applied in the contralateral leg. RESULTS: MBF increased significantly following concentric muscular activity, but not following passive venous compression. MBF decreased in both legs when venous obstruction, induced by a thigh tourniquet, was applied. However, MBF was significantly higher following concentric muscular activity than passive venous compression. CONCLUSION: We conclude that concentric muscular activity produces higher MBF values than passive venous compression.
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| 48. |
- Zhang, Qiuxia, 1960, et al.
(författare)
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Simultaneous intramuscular pressure and surface electromyography measurement in diagnosing the chronic compartment syndrome
- 2011
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Ingår i: SCANDINAVIAN JOURNAL OF MEDICINE & SCIENCE IN SPORTS. - 0905-7188. ; 21:2, s. 190-195
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Tidskriftsartikel (refereegranskat)abstract
- We investigated the value of surface electromyography (EMG) as an aid to diagnosing the chronic compartment syndrome (CCS) by detecting elevated intramuscular pressure (IMP) at rest after an exercise test that was caused by remaining muscle contraction. IMP and EMG were measured in the anterior tibial muscle in 37 patients who were suspected to have CCS after an exercise test. At rest after the test, the EMG signal was positive in five of 37 (14%) patients, indicating that patients had remaining muscle contractions that elevated IMP. IMP exceeded 30 mmHg in 16 of 37 patients (43%). In 13 of these 16 patients, the EMG signal was silent, confirming that they had CCS. In the remaining three patients, the EMG signal was initially positive (5–34% of maximal voluntary contraction), and then became silent after communicating with the patients to relax their legs. Only one of the three patients was proven to have CCS. Other reasons for leg pain were diagnosed in 23 patients. The results demonstrated that simultaneous measurements of IMP and EMG differentiate elevated IMP at rest after exercise due to the volumetric load of the compartment muscles seen in patients with CCS and due to the remaining muscle contraction, thereby preventing a false diagnosis of CCS.
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| 49. |
- Zhang, Qiuxia, 1960, et al.
(författare)
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The magnitude of intramuscular deoxygenation during exercise is an unreliable measure to diagnose the cause of leg pain.
- 2012
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Ingår i: Scandinavian journal of medicine & science in sports. - : Wiley. - 1600-0838 .- 0905-7188. ; 22:5, s. 690-694
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Tidskriftsartikel (refereegranskat)abstract
- We measured intramuscular oxygenation in the anterior tibial muscle of 176 patients with exercise-induced leg pain by noninvasive near-infrared spectroscopy before, during, and after an exercise test that elicited the symptoms. Clinical investigation was performed after each test. Intramuscular pressure was measured in patients with nonconclusive findings. Chronic anterior compartment syndrome (CACS) was diagnosed in 47 patients, and other causes for the leg pain were diagnosed in 129 patients by clinical means. The mean level of oxygenation decreased to 33±19% in patients with CACS and to 34±19% in patients without CACS compared with baseline level (100%) at rest before exercise. The level of oxygenation was below 20% during the exercise test in 12 of 47 (26%) patients with CACS and in 30 of 129 (23%) patients without CACS. The time required for reoxygenation after the cessation of exercise was 61±34s in patients with CACS and 46±20s in patients without CACS (P<0.05). We conclude that the magnitude of intramuscular deoxygenation during exercise is an unreliable measure to diagnose CACS. However, the time for reoxygenation returning to baseline level following an exercise test is a valuable adjunct in diagnosing CACS.
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