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- Bergman, Stefan, 1959-, et al.
(författare)
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Chronic Widespread Pain in Adolescents Is Highly Associated to Stress and Anxiety
- 2015
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Ingår i: Arthritis & Rheumatology. - Hoboken, NJ : John Wiley & Sons. - 2326-5191 .- 2326-5205. ; 67:Suppl. S10
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Tidskriftsartikel (refereegranskat)abstract
- Background/Purpose: Chronic widespread pain (CWP), one of the hallmarks of fibromyalgia, is not uncommon in adolescents and it has previously been shown that adolescents with pain often become young adults with pain. CWP often co-varies with anxiety, depression, and stress symptoms in adults, but the knowledge regarding this is small in youth and young adults.The aim was to study the associations between CWP, anxiety, depression and stress in adolescents attending first year of high school.Methods: A computerized questionnaire to 296 adolescents attending Swedish high school, with validated questions regarding presence and distribution of pain (Epipain mannequin), stress symptoms (ELO question), anxiety and depression (Hospital Anxiety and Depression Scale – HADS), and health related quality of life (HRQL as measured by EQ5D). Pain was considered chronic when persistent for more than three months, and the subgroup CWP was defined according to the 1990 ACR criteria for fibromyalgia. Statistical analyses in SPSS v21 with comparison of means by Student’s t-test and proportions by chi2-test or Fischer’s exact test.Results: 257 (87%) out of 296 eligible students, mean (SD) age 16.1 (0.7) and 65.8% girls, responded to the questionnaire. Prevalence of chronic pain was 20.8% and that of the subgroup CWP was 4.7%, without any gender differences (boys 18.2% vs girls 22.2%; p=0.224, and 3.4% vs 5.4%; p=0.692). High level (4 or 5 on a 5 point scale) of stress symptoms were less common in boys (16.0% vs 28.2%; p=0.015), as was possible or probable anxiety (17.1% vs 44.4%; p<0.001), but not depression (10.3% vs 12.5%; p=0.764). Students with high level of stress reported CWP five times more often than those with less stress (30.4% vs 5.8%; p=0.001). Students with probable anxiety reported CWP ten times more often than students with no anxiety (17.6% vs 1.8%; p=0.001), and CWP was also more common, but not statistically significant, in students with probable depression (20.0% vs 3.1%; p=0.163). Those reporting CWP had significantly lower HRQL (0.58 vs 0.87; p=0.038) than students with no chronic pain.Conclusion: The high prevalence of chronic pain and the strong associations between CWP and reports of stress and anxiety in adolescents highlights that a multifactorial background to chronic pain must be considered early in life. An apparent lower score in EQ5D also indicates that the presence of CWP has an marked impact on HRQL also in adolescents.
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- Brorsson, Sofia, 1973-, et al.
(författare)
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Differences in muscle activity during hand-dexterity tasks between women with arthritis and a healthy reference group
- 2014
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Ingår i: BMC Musculoskeletal Disorders. - London, England : Springer Science and Business Media LLC. - 1471-2474. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Impaired hand function is common in patients with arthritis and it affects performance of daily activities; thus, hand exercises are recommended. There is little information on the extent to which the disease affects activation of the flexor and extensor muscles during these hand-dexterity tasks. The purpose of this study was to compare muscle activation during such tasks in subjects with arthritis and in a healthy reference group. Methods: Muscle activation was measured in m. extensor digitorium communis (EDC) and in m. flexor carpi radialis (FCR) with surface electromyography (EMG) in women with rheumatoid arthritis (RA, n = 20), hand osteoarthritis (HOA, n = 16) and in a healthy reference group (n = 20) during the performance of four daily activity tasks and four hand exercises. Maximal voluntary isometric contraction (MVIC) was measured to enable intermuscular comparisons, and muscle activation is presented as %MVIC. Results: The arthritis group used a higher %MVIC than the reference group in both FCR and EDC when cutting with a pair of scissors, pulling up a zipper and-for the EDC-also when writing with a pen and using a key (p < 0.02). The exercise "rolling dough with flat hands" required the lowest %MVIC and may be less effective in improving muscle strength. Conclusions: Women with arthritis tend to use higher levels of muscle activation in daily tasks than healthy women, and wrist extensors and flexors appear to be equally affected. It is important that hand training programs reflect real-life situations and focus also on extensor strength.
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| 5. |
- Brorsson, Sofia, 1973-, et al.
(författare)
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Hand flexor and extensor muscle activity in daily activities and hand exercises in women with rheumatoid arthritis or hand osteoarthritis
- 2012
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Ingår i: Annals of the Rheumatic Diseases. - London, United Kingdom : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 71:Suppl. 3, s. 754-754
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Tidskriftsartikel (refereegranskat)abstract
- Background: Impaired hand grip function is common and occurs early in the course of disease in patients with rheumatoid arthritis (RA) and hand osteoarthritis (HOA), affecting daily life activities and quality of life.Objectives: To evaluate muscle force and muscle activity in forearm flexors and extensors during daily activities and clinically well-known hand exercises in women with RA and HOA compared with healthy controls Methods: The RA group was consecutively included from a specialist clinic and had a disease duration of at least one year. Women with HOA were allocated from out-patients primary health care clinics in the same area and clinically diagnosed with symptomatic HOA. The age matched control group had no history of hand/arm injuries, inflammatory or muscle disease. Full active finger extension ability was required for all subjects. Hand force (Newton) was measured with EX-it (extension) and Grippit (flexion), both validated instruments. Muscle activity was measured in m. extensor digitorum communis (EDC) and m. flexor carpi radialis (FCR) with surface EMG (S-EMG) on the dominant hand while performing four daily activities (ADL) and four hand exercises and described as percent of maximal voluntary isometric contraction (% MVIC) based on data from EX-it and Grippit. Pain was measured with Visual Analogue Scale (VAS) 0-10 (best to worst). Differences between groups were analyzed and controlled for age.Results: Fifty-six women were included; 20 with RA (age mean (SD) 59.2 (10.7) years, VAS pain 2.2 (1.6)), 16 with HOA (age 67.5 (9.3) years, VAS pain 4.1 (1.9)) and 20 healthy controls (age 56.0 (9.7) years). Women with RA and HOA showed decreased extension and flexion force compared with healthy women (p<0.03).There was a tendency towards higher % MVIC in all tests for women with RA or HOA compared with healthy women, with a statistically significant difference between HOA and healthy women for EDC (p<0.05).ADL activities “writing with a pen”, and “cutting with scissors” showed the highest % MVIC in both EDC and FCR in all groups. The exercises “isolated opposition”, and “rolling the dough with flat hands”, had high % MVIC in EDC, while “squeezing the dough” and “isolated opposition” had high % MVIC in FCR.Conclusions: Women with RA and HOA tend to use a higher % MVIC than healthy women in many daily activities and in hand exercises. Strengthening exercises should include both extensor and flexor specific training.Disclosure of Interest: None Declared
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| 6. |
- Brorsson, Sofia, 1973-, et al.
(författare)
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Qualitative differences in the muscle activities in the forearm flexor and extensor muscles in healthy men and women in different ages
- 2012
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 71:Suppl. 3, s. 755-755
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Tidskriftsartikel (refereegranskat)abstract
- Background:Balance between flexor and extensor muscle activity is essential for optimal function. This has been demonstrated previously for the lower extremity, trunk and shoulder function, but information on the relationship in hand function is lacking.Objectives:The purpose of this study was to evaluate whether there are qualitative differences in finger extension force, grip force, force duration, force balance and the muscle activities in the forearm flexor and extensor muscles in healthy men and women in different ages.Methods:Healthy controls (men, n=65, women, n=40) were included. Primary outcome was muscle activity measured with S-EMG and finger flexion- and finger extension force in Newton (N). The maximal force from the first trial was used as reference value (maximal voluntary isometric contraction, MVIC). The S-EMG activity of the m. extensor digitorum communis (EDC) and the m. flexor carpi radialis (FCR) were measured on the dominant hand when performing seven clinically often used hand exercises. Hand function was also evaluated with the self-reported questioner Quick DASH and VAS pain and VAS stiffness.Results:The force balance between finger extension and flexion force was statistically significant for both men (r=0.51, p=0.000) and women (r=0.78, p=0.000). The finger extension force was not influenced by age, but flexion force was significantly correlated to age. The coefficient of determination showed that age and gender can explain 45-55% of differences in the force measurements. Muscle activity from hand exercises was significant related to gender for EDC and muscle activity in FCR showed significantly relation to age. Only 3 of the 7 hand exercise were adjustable for both men and women unrelatedly to age. Concerning the muscle activation in EDC and FCR in daily activities, the age and gender explain 31% respectively 19% of the differences.Conclusions:This study shows that there are differences between men and women's hand force capacity and that gender and age can explain 45-55% of the differences. Furthermore this study shows that the EDC muscle is related to gender and FCR is related to age. In a longer perspective this information is useful for designing optimal training program for adjusted for gender and age.References:Greig M, Wells R. A systematic exploration of distal arm muscle activity and perceived exertion while applying external forces and moments. Ergonomics. [Research Support, Non-U.S. Gov't]. 2008 Aug;51(8):1238-57.Nordenskiold U, Grimby G. Assessments of disability in women with rheumatoid arthritis in relation to grip force and pain. Disabil Rehabil. 1997 Jan;19(1):13-9.Kapandji I. The physiology of the joints - annotated diagrams of the mechanics of the human joints. Edingburgh London, Melborne and New York: Churchill Livingstone; 1982.Brorsson S, Nilsdotter A, Sollerman C, Baerveldt AJ, Hilliges M. A new force measurement device for evaluating finger extension function in the healthy and rheumatoid arthritic hand. Technol Health Care. 2008;16(4):283-92.Disclosure of Interest: None Declared
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| 8. |
- Brorsson, Sofia, 1973-, et al.
(författare)
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Relationship between finger flexion and extension force in healthy women and women with rheumatoid arthritis
- 2012
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Ingår i: Journal of Rehabilitation Medicine. - Uppsala, Sweden : Stiftelsen Rehabiliteringsinformation. - 1650-1977 .- 1651-2081. ; 44:7, s. 605-608
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Balance between flexor and extensor muscle activity is essential for optimal function. The purpose of this pilot study was to compare the relationship between maximum finger flexion force and maximum finger extension force in women with rheumatoid arthritis and healthy women.METHODS: Twenty healthy women (median age 61 years) and 20 women with rheumatoid arthritis (median age 59.5 years, median disease duration 16.5 years) were included in the study. Finger extension force was measured with an electronic device, EX-it, and finger flexion force using Grippit. The Grip Ability Test and the score from the patient-reported outcome Disability Arm Shoulder and Hand were used to evaluate activity limitations.RESULTS: Patients with rheumatoid arthritis showed significantly decreased hand function compared with healthy controls. A correlation was found between extension force and flexion force in the healthy group (r = 0.65, p = 0.002),but not in the rheumatoid arthritis group (r = 0.25, p = 0.289).CONCLUSION: Impaired hand function appears to influence the relationship between maximum finger flexion and extension force. This study showed a difference in the relationship between maximum finger flexion and extension force in healthy controls and those with rheumatoid arthritis. © 2012 Foundation of Rehabilitation Information.
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| 9. |
- Malmborg, Julia, 1988-, et al.
(författare)
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Sleeping Problems and Anxiety is Associated to Chronic Multisite Musculoskeletal Pain in Swedish High School Students
- 2018
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 77:Suppl. 2, s. 226-226
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: The relationship between chronic multisite musculoskeletal pain (CMP) and sleep is complex, where pain can lead to sleeping problems and lack of sleep can intensify the pain perception. Most previous studies relates to adults, but adolescents may also suffer from CMP, and there is a need for more knowledge regarding the relationships between CMP and sleeping problems, stress, anxiety, depression, and health status.Objectives: To study background factors associated to CMP in first year Swedish high school students.Methods: First year Swedish high school students (n=296) were invited to complete questionnaires on chronic pain (mannequin with 18 body regions), sleeping problems (Uppsala Sleep Inventory, four items scored from 1–5), stress (ELO questions, scored from 1–5), anxiety and depression (Hospital Anxiety and Depression Scale, scored from 0–21), health status (EQ-5D, scored from 0 to 1, worst to best) and physical activity (International Physical Activity Questionnaire, categorised into low, moderate and high levels). Stress and sleeping items were dichotomized into 1–3 points (best) vs 4–5 points (worst). Individuals scoring at least severe problems (4 points) at one or more sleeping items were classified as having severe sleeping problems. HADS were categorised as non-cases (0–7), possible7–10 and probable cases (11–21 points). Students were grouped as having CMP (pain present in ≥3 regions) or not (no chronic pain or chronic pain in 1–2 regions). Multiple logistic regression analyses (adjusted for sex) with CMP as dependent variable were performed in SPSS, version 24.Results: 254 students (86% of total sample, 87 boys and 167 girls) with a mean age of 16.1 (SD 0.6) years participated in the study. CMP was present in 25 (9.8%) students with no differences between boys and girls (8.0% vs 10.8%; p=0.488). Having CMP was associated with reporting severe sleeping problems (OR 2.49, 95% CI: 1.06 to 5.81, p=0.035) with initiating sleep, maintaining sleep, early morning awakenings and/or not feeling restored after sleep in comparison to the other students. Students with CMP were more likely to be categorised as probable cases for anxiety (OR 3.06, 95% CI: 1.09 to 8.61, p=0.034), but there were no associations for possible cases for anxiety (OR 1.15, 95% CI: 0.38 to 3.51, p=0.800), possible cases (OR 2.03, 95% CI: 0.63 to 6.54), or probable cases for depression (OR 3.35, 95% CI: 0.33 to 33.83). There was a nearly significant association between stress and belonging to the CMP group (OR 2.31, 95% CI: 0.97 to 5.53, p=0.059). A higher self-reported health status was associated to a lower likelihood for CMP (OR 0.04, 95% CI: 0.01 to 0.27, p=0.001). Distribution of physical activity levels of low, moderate and high was not significantly associated to having CMP in comparison with not having it.Conclusions: One in ten high school students fulfilled criteria for having chronic multisite musculoskeletal pain. CMP was associated to sleeping problems, anxiety, and a worse health status. The results from this study may be used by school health-care professionals in their preventive work to promote student’s health.Disclosure of Interest: None declared
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