| 1. |
- Ageberg, Eva, et al.
(author)
-
Balance in Single-limb Stance in Healthy Subjects - Reliability of Testing. Procedure and The Effect of Short-duration Sub-maximal Cycling
- 2003
-
In: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 4
-
Journal article (peer-reviewed)abstract
- Background: To assess balance in single-limb stance, center of pressure movements can be registered by stabilometry with force platforms. This can be used for evaluation of injuries to the lower extremities. It is important to ensure that the assessment tools we use in the clinical setting and in research have minimal measurement error. Previous studies have shown that the ability to maintain standing balance is decreased by fatiguing exercise. There is, however, a need for further studies regarding possible effects of general exercise on balance in single-limb stance. The aims of this study were: 1) to assess the test-retest reliability of balance variables measured in single-limb stance on a force platform, and 2) to study the effect of exercise on balance in single-limb stance, in healthy subjects. Methods: Forty-two individuals were examined for test-retest reliability, and 24 individuals were tested before (pre-exercise) and after (post-exercise) short-duration, sub-maximal cycling. Amplitude and average speed of center of pressure movements were registered in the frontal and sagittal planes. Mean difference between test and retest with 95% confidence interval, the intraclass correlation coefficient, and the Bland and Altman graphs with limits of agreement, were used as statistical methods for assessing test-retest reliability. The paired t-test was used for comparisons between pre- and post-exercise measurements. Results: No difference was found between test and retest. The intraclass correlation coefficients ranged from 0.79 to 0.95 in all stabilometric variables except one. The limits of agreement revealed that small changes in an individual's performance cannot be detected. Higher values were found after cycling in three of the eight stabilometric variables. Conclusions: The absence of systematic variation and the high ICC values, indicate that the test is reliable for distinguishing among groups of subjects. However, relatively large differences in an individual's balance performance would be required to confidently state that a change is real. The higher values found after cycling, indicate compensatory mechanisms intended to maintain balance, or a decreased ability to maintain balance. It is recommended that average speed and DEV 10; the variables showing the best reliability and effects of exercise, be used in future studies.
|
|
| 2. |
- Ageberg, Eva, et al.
(author)
-
Balance in single-limb stance in patients with anterior cruciate ligament injury - Relation to knee laxity, proprioception, muscle strength, and subjective function
- 2005
-
In: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 33:10, s. 1527-1535
-
Journal article (peer-reviewed)abstract
- Background: It has been shown previously that an anterior cruciate ligament injury may affect postural control, measured by balance in single-limb stance. To our knowledge, no studies have reported the influence of measures of impairment on postural control after such an injury. Purpose: To assess the influence of knee laxity, proprioception, and muscle strength on balance in single-limb stance and to study the correlation between balance in single-limb stance and subjective estimation of extremity function. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 36 patients with a unilateral, nonoperated, nonacute anterior cruciate ligament injury were examined with regard to anterior knee laxity, proprioception, muscle strength, and stabilometry (amplitude and average speed of the center of pressure movements). Subjective estimation of extremity function was measured on a visual analog scale. Results: The multiple regression analysis showed that high knee laxity values were associated with high amplitude values and low average speed. Poor proprioception and high muscle strength values were associated with low average speed among the women only. Low amplitude values correlated with better subjective function. Conclusion: Anterior knee laxity, proprioception, and muscle strength seem to play a role in maintaining balance in single-limb stance. Patients with low amplitude values in stabilometry were those with better subjective function.
|
|
| 3. |
|
|
| 4. |
- Ageberg, Eva, et al.
(author)
-
Cocreating injury prevention training for youth team handball : bridging theory and practice
- 2022
-
In: BMJ Open Sport and Exercise Medicine. - London : BMJ Publishing Group Ltd. - 2055-7647. ; 8:2
-
Journal article (peer-reviewed)abstract
- Although it is advocated that end-users are engaged in developing evidence-based injury prevention training to enhance the implementation, this rarely happens. The € Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)' uses an ecological participatory design incorporating the perspectives of multiple stakeholders throughout the project. Within the I-PROTECT project, the current study aimed to describe the development of holistic injury prevention training specifically for youth handball players through using knowledge from both end-users (coaches and players) and researchers/handball experts. Employing action evaluation within participatory action research, the cyclical development process included three phases: research team preparation, handball expert-based preparation and end-user evaluation to develop injury prevention training incorporating both physical and psychological perspectives. To grow the knowledge of the interdisciplinary research team, rethinking was conducted within and between phases based on participants' contributions. Researchers and end-users cocreated examples of handball-specific exercises, including injury prevention physical principles (movement technique for upper and lower extremities, respectively, and muscle strength) combined with psychological aspects (increase end-user motivation, task focus and body awareness) to integrate into warm-up and skills training within handball practice. A cyclical development process that engaged researchers/handball experts and end-users to cocreate evidence-based, theory-informed and context-specific injury prevention training specifically for youth handball players generated a first pilot version of exercises including physical principles combined with psychological aspects to be integrated within handball practice. © 2022 BMJ Publishing Group. All rights reserved. © 2022 BMJ Publishing Group. All rights reserved.
|
|
| 5. |
- Ageberg, Eva, et al.
(author)
-
Effects of neuromuscular training (NEMEX-TJR) on patient-reported outcomes and physical function in severe primary hip or knee osteoarthritis: a controlled before-and-after study
- 2013
-
In: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 14
-
Journal article (peer-reviewed)abstract
- Background: The benefits of exercise in mild and moderate knee or hip osteoarthritis (OA) are apparent, but the evidence in severe OA is less clear. We recently reported that neuromuscular training was well tolerated and feasible in patients with severe primary hip or knee OA. The aims of this controlled before-and-after study were to compare baseline status to an age-matched population-based reference group and to examine the effects of neuromuscular training on patient-reported outcomes and physical function in patients with severe primary OA of the hip or knee. Methods: 87 patients (60-77 years) with severe primary OA of the hip (n = 38, 55% women) or knee (n = 49, 59% women) awaiting total joint replacement (TJR) had supervised, neuromuscular training (NEMEX-TJR) in groups with individualized level and progression of training. A reference group (n = 43, 53% women) was included for comparison with patients' data. Assessments included self-reported outcomes (HOOS/KOOS) and measures of physical function (chair stands, number of knee bends/30 sec, knee extensor strength, 20-meter walk test) at baseline and at follow-up before TJR. Analysis of covariance (ANCOVA) was used for comparing patients and references and elucidating influence of demographic factors on change. The paired t-test was used for comparisons within groups. Results: At baseline, patients reported worse scores than the references in all HOOS/KOOS subscales (hip 27-47%, knee 14-52%, of reference scores, respectively) and had functional limitations (hip 72-85%, knee 42-85%, of references scores, respectively). NEMEX-TJR (mean 12 weeks (SD 5.6) of training) improved self-reported outcomes (hip 9-29%, knee 7-20%) and physical function (hip 3-18%, knee 5-19%) (p < 0.005). Between 42% and 62% of hip OA patients, and 39% and 61% of knee OA patients, displayed a clinically meaningful improvement (>= 15%) in HOOS/KOOS subscales by training. The improvement in HOOS/KOOS subscale ADL was greater for patients with knee OA than hip OA, while the improvement in subscale Sport/Rec was greater for patients with hip OA than knee OA. Conclusions: Both self-reported outcomes and physical function were clearly worse compared with the reference group. Neuromuscular training with an individualized approach and gradual progression showed promise for improving patient-reported outcomes and physical function even in older patients with severe primary OA of the hip or knee.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
- Ageberg, Eva, et al.
(author)
-
The effect of short-duration sub-maximal cycling on balance in single-limb stance in patients with anterior cruciate ligament injury: a cross-sectional study
- 2004
-
In: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 5
-
Journal article (peer-reviewed)abstract
- Background: It has previously been shown that an anterior cruciate ligament (ACL) injury may lead to impaired postural control, and that the ability to maintain postural control is decreased by fatigue in healthy subjects. To our knowledge, no studies have reported the effect of fatigue on postural control in subjects with ACL injury. This study was aimed at examining the effect of fatigue on balance in single-limb stance in subjects with ACL injury, and to compare the effects, and the ability to maintain balance, with that of a control group of uninjured subjects. Methods: Thirty-six patients with unilateral, non-operated, non-acute ACL injury, and 24 uninjured subjects were examined with stabilometry before (pre-exercise) and immediately after (post-exercise) short-duration, sub-maximal cycling. In addition, the post-exercise measurements were compared, to evaluate the instantaneous ability to maintain balance and any possible recovery. The amplitude and average speed of center of pressure movements were registered in the frontal and sagittal planes. The paired t-test was used for the intra-group comparisons, and the independent t-test for the inter-group comparisons, with Bonferroni correction for multiple comparisons. Results: No differences were found in the effects of exercise between the patients and the controls. Analysis of the post-exercise measurements revealed greater effects or a tendency towards greater effects on the injured leg than in the control group. The average speed was lower among the patients than in the control group. Conclusions: The results of the present study showed no differences in the effects of exercise between the patients and the controls. However, the patients seemed to react differently regarding ability to maintain balance in single-limb stance directly after exercise than the control group. The lower average speed among the patients may be an expression of different neuromuscular adaptive strategies than in uninjured subjects.
|
|
| 10. |
|
|
| 11. |
- Moesch, Karin, et al.
(author)
-
“Yeah, I mean, you’re going to handball, so you want to use balls as much as possible at training” : End-users’ perspectives of injury prevention training for youth handball players
- 2022
-
In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 19:6
-
Journal article (peer-reviewed)abstract
- Young handball players experience high injury rates. Specific injury prevention programs reduce injury rates but are not well implemented into youth players’ training. The ‘Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)’ project addresses this challenge. The aim of this study was to investigate how youth handball coaches and players experienced the recently developed I-PROTECT GO pilot program, by focusing on barriers and facilitators. Three focus group interviews were conducted with coaches and players, and their answers were analyzed using a general inductive approach. The participants appreciated the program and found it useful for their context. The participants’ statements about facilitators and barriers centered around the categories of resources, exercises, program design, and learning. Facilitators that emerged were motivating exercises (e.g., handball-specific), a helpful set-up (e.g., variation), having a clear purpose of exercises, the possibility to fulfil basic psychological needs while training, receiving instructions and feedback, and having role models. Barriers that emerged were limited space and material, difficulties with exercises, an unhelpful set-up (e.g., too repetitive), and undisciplined training. It is important to address perceived barriers and facilitators among coaches and players when developing injury prevention training programs to enhance the uptake of such training.
|
|
| 12. |
- Tengman, Eva, 1975-
(author)
-
Long-term consequences of anterior cruciate ligament injury : knee function, physical activity level, physical capacity and movement pattern
- 2014
-
Doctoral thesis (other academic/artistic)abstract
- Knee function after more than 20 years post injury is rarely described and none of the few follow-up studies have evaluated functional performance tasks. This thesis investigated self-reported knee function, physical activity level, physical capacity and movement pattern in the long-term perspective (on average 23 years) in persons who had suffered a unilateral ACL injury, treated either with physiotherapy in combination with surgery (ACLR, n=33) or physiotherapy alone (ACLPT, n=37) and compared to age-and-gender matched controls (n=33). This thesis shows that regardless of treatment, there are significant negative long-term consequences on self-reported knee function and physical activity more than 20 years after injury. In comparison to the controls, the ACL-groups (ACLR and ACLPT) had lower knee function as measured by the Lysholm score and the Knee injury and Osteoarthritis Outcome Score (KOOS). The persons with an ACL injury also had a lower knee-specific physical activity level (Tegner activity scale), while no differences were seen in general physical activity level (International Physical Activity Questionnaire, IPAQ) compared to healthy controls. Regarding physical capacity, both ACL groups showed inferior jump capacity in the injured leg compared to the non-injured leg. However, compared to controls the ACL-injured had a relatively good jump performance. Knee extension peak torque, concentric and eccentric, was also lower for the injured leg compared to the non-injured leg for both ACLR and ACLPT. In addition, the ACLPT group showed reduced eccentric knee flexion torque of the injured leg. The non-injured leg, on the other hand, showed almost equal jump capacity and strength as controls. Balance in single-limb stance (30s) was inferior in persons who had an ACL injury. This was true for both the injured and non-injured leg and regardless of treatment. Movement pattern during the one-leg hop was analysed by a set of kinematic variables consisting of knee angles (flexion, abduction, rotation) and Centre of Mass (CoM) placement in relation to the knee and ankle joints. Both ACLR and ACLPT displayed movement pattern asymmetries between injured and non-injured legs. In comparison to controls, the ACLR group had a similar movement pattern with the exception of larger external knee rotation at Initial contact and less maximum internal rotation during the Landing. ACLPT showed several differences compared to controls both regarding knee angles and CoM placement. The ACL-injured persons with no-or-low knee osteoarthritis (OA) had better knee function as reflected by higher scores on Lysholm and KOOS subscale ‘symptom’ compared to those with moderate-to-high OA. The degree of OA had no influence on reported physical activity level, jump capacity, peak torque or the kinematic variables. In conclusion, this thesis indicates that persons with a unilateral ACL injury, regardless of treatment, have some negative long-term consequences e.g. self-reported knee function, knee-specific activity level, strength and balance deficits, when compared to age-and-gender matched controls. The results, however, also indicate that the ACL-injured can manage reasonably well in some jumps and general activity level but have an inferior performance in more knee-demanding tasks. The ACLR group had similar movement pattern with the exception of knee rotation, indicating that a reconstruction may restore the knee biomechanics to some extent. The ACLPT group on the other hand, seem to use compensatory movement strategies showing several differences compared to controls.
|
|
| 13. |
- Åkesson, Karin Sturesdotter, et al.
(author)
-
Factors associated with empowerment after participating in a supported osteoarthritis self-management program : An explorative study
- 2024
-
In: Osteoarthritis and Cartilage Open. - 2665-9131. ; 6:2
-
Journal article (peer-reviewed)abstract
- Objective: To explore factors associated with change in empowerment in patients that have participated in a 3-month Supported Osteoarthritis Self-Management Program (SOASP). Further, to evaluate empowerment in the longer term. Design: An explorative analysis including patients from a cohort study conducted in primary healthcare in Sweden was performed. Univariable linear regression models were performed to assess associations between demographics and patient-reported outcome measures (explanatory factors), respectively, and change in empowerment from baseline to 3-month follow-up (outcome variable). Long-term follow-up of empowerment was at 9 months. Results: Self-reported increase in enablement at the 3-month follow-up was associated with a greater improvement in empowerment (B = 0.041, 95% CI (0.011, 0.07), p = 0.008). Living alone was associated with less improvement in empowerment (B = −0.278, 95% CI (−0.469, −0.086), p = 0.005) compared to living together. Physical exercise >120 min per week at baseline was associated with less improvement in empowerment (B = −0.293, 95% CI (−0.583, −0.004), p = 0.047) compared to reporting no exercise at baseline. No other associations were observed (p > 0.05). Empowerment improved from baseline to the 3-month follow-up (mean 0.20 (SD 0.5), p < 0.001) but there was no change from baseline to the 9-month follow-up (mean 0.02 (SD 0.6), p = 0.641). Conclusions: Self-reported increased enablement may lead to greater improvement in empowerment after SOASP. Greater efforts may be needed to support those that live alone, are physically active, and to sustain empowerment in the longer term after SOASP. More research is needed on empowerment to provide personalized support for patients with OA after SOASP.
|
|
| 14. |
|
|
| 15. |
- Ageberg, Eva, et al.
(author)
-
15-Year Follow-up of Neuromuscular Function in Patients With Unilateral Nonreconstructed Anterior Cruciate Ligament Injury Initially Treated With Rehabilitation and Activity Modification: A Longitudinal Prospective Study.
- 2007
-
In: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 35:12, s. 2109-2117
-
Journal article (peer-reviewed)abstract
- Background: It has been suggested that neuromuscular function is of importance in the overall outcome after anterior cruciate ligament (ACL) injury. Hypothesis: Good neuromuscular function can be achieved and maintained over time in subjects with ACL injury treated with rehabilitation and activity modification but without reconstructive surgery. Study Design: Case series; Level of evidence, 4. Methods: One hundred consecutive patients (42 women and 58 men) with acute ACL injury at a nonprofessional, recreational or competitive activity level were assessed 1, 3, and 15 years after injury. Their mean age at inclusion was 26 years (range, 15-43 years). All patients initially underwent rehabilitation and were advised to modify their activity level, especially by avoiding contact sports. Patients with recurrent giving-way episodes or secondary meniscal injuries that required fixation were subsequently excluded and underwent reconstruction of the ACL. Sixty-seven patients (71% of those available for follow-up) with unilateral nonreconstructed injury remained at the 15-year follow-up. Fifty-six of these 67 patients were examined with the single-legged hop test for distance and knee muscle strength. The limb symmetry index (LSI), calculated by dividing the result for the injured leg by that of the uninjured leg and multiplying by 100, was used for comparisons over time (paired t test). Results: The LSI for the single-legged hop test was higher at the 3-year follow-up (mean, 98.5%; standard deviation [SD], 7.6%) than at the 15-year follow-up (mean, 94.8%; SD, 10.5%) (mean difference, -3.7%; 95% confidence interval [Cl], -6.1% to -1.2%; P = .004). The LSI for isometric extension was higher at the 15-year follow-up (mean, 97.2%; SD, 13.7%) than at the 1-year follow-up (mean, 88.2%; SD, 15.4%) (mean difference, 9.0%; 95% Cl, 3.7% to 14.4%; P = .001). At the 15-year follow-up, between 69% and 85% of the patients had an LSI >= 90%. Conclusions: Good functional performance and knee muscle strength can be achieved and maintained over time in the majority of patients with ACL injury treated with rehabilitation and early activity modification but without reconstructive surgery.
|
|
| 16. |
|
|
| 17. |
- Ageberg, Eva, et al.
(author)
-
Agreement between test procedures for the single-leg hop for distance and the single-leg mini squat as measures of lower extremity function
- 2018
-
In: BMC Sports Science, Medicine and Rehabilitation. - : Springer Science and Business Media LLC. - 2052-1847. ; 10:15
-
Journal article (peer-reviewed)abstract
- Background: Different test procedures are often used within performance-based measures, causing uncertainty as to whether results can be compared between studies. Thus, the aim of this study was to assess agreement between different test procedures for the single-leg hop for distance (SLHD) and the single-leg mini squat (SLMS), respectively, two commonly used tasks for assessing deficiency in lower extremity muscle function.Methods: Twenty-three participants (20-42 years) with lower extremity injury performed the SLHD with arms free and with arms behind back, and the Limb Symmetry Index (LSI; injured leg divided by uninjured and multiplied by 100) was calculated. Another group of 28 participants (mean 18-38 years) performed five SLMSs at a pre-defined speed and maximum number of SLMSs during 30 seconds, and were visually observed and scored as either having a knee-over-foot or a knee-medial-to-foot position (KMFP).Results: No systematic difference between test procedures for the LSI of the SLHD was noted (p=0.736), Cohen's kappa = 0.42. The Bland & Altman plot showed wide limits of agreement between test procedures, with particularly poor agreement for participants with abnormal LSI (<90%). Ten participants were scored as having a KMFP during five SLMSs at a predefined speed, while five had a KMFP during maximum number of SLMSs during 30 seconds (p=0.063, Cohen's kappa = 0.56).Conclusions: The moderate agreement between the two test procedures for the SLHD and the SLMS, respectively, indicate that results from these different test procedures should not be compared across studies. SLHD with arms behind back, and five SLMSs at a pre-defined speed, respectively, were the most sensitive procedures to detect individuals with poor functional performance.
|
|
| 18. |
|
|
| 19. |
- Ageberg, Eva, et al.
(author)
-
Co-creating holistic injury prevention training for youth handball : Development of an intervention targeting end-users at the individual, team, and organizational levels
- 2024
-
In: BMC Sports Science, Medicine and Rehabilitation. - : BioMed Central (BMC). - 2052-1847. ; 16:1
-
Journal article (peer-reviewed)abstract
- BackgroundInterventions that are co-created with end-users, and that are informed by behavior change or implementation theories, support implementation in real world settings. However, injury prevention programs for youth athletes have typically been developed by experts with no, or insufficiently described, end-user involvement and without guidance by theories. The aim of the current study was to describe the development of a holistic injury prevention intervention for youth handball targeting end-users at different levels, through using knowledge from end-users and researchers/experts and applying relevant behavior change and implementation theories.MethodsKnowledge from researchers/experts (sports medicine, sport psychology, handball, physical therapy, strength and conditioning (n = 14)) and end-users (coaches, players, club administrators, n = 16), and applying relevant implementation (Consolidated Framework for Implementation Research, CFIR), behavior change (Health Action Process Approach, HAPA) and motivational (Self-Determination Theory, SDT) theories, were used to co-design the intervention. Early end-users (coaches (n = 6), players (n = 3) and a club administrator (n = 1)) were interviewed for initial feedback.ResultsThe intervention consisted of end-user-targeted information and training that was made available in a specifically developed interactive mobile application with modules for players, coaches, club administrators, and caregivers. Information for all end-users included benefits and principles of physical and psychological injury prevention training, load-management, motivation, and communication. Information about implementation was developed for club administrators specifically. For coaches, training to do with their teams included handball-specific injury prevention exercises (legs, shoulders, core) combined with psychological aspects (motivation, task focus, body awareness) to integrate within warm-up and handball skills training. Training for players included handball-specific multi-joint strength, power, and explosive exercises (legs, shoulders, core) and sport psychology exercises (self-awareness, relaxation, being in the present moment, prevent and handle stress). To support self-management, adoption, and motivation, programs were provided, and players and coaches could change, add, progress the difficulty of exercises, and build their own programs. Initial feedback from early end-users was generally positive.ConclusionsUtilizing an approach where researchers/experts and end-users co-created injury prevention training specifically for youth handball, an intervention was generated that included information and holistic training targeting end-users at the individual (players, caregivers), team (coaches), and organizational (club administrators) levels.
|
|
| 20. |
- Ageberg, Eva, et al.
(author)
-
Co-creating injury prevention education and training for youth handball players targeting end-users at the individual, team and organizational levels
- 2023
-
In: Osteoarthritis and Cartilage. - : Elsevier. - 1063-4584 .- 1522-9653. ; 31, s. S19-S20
-
Journal article (other academic/artistic)abstract
- Purpose: Research has established that physical and psychological injury prevention training is effective in reducing injuries in youth team sports, but public health impact tends to be limited because such training is not widely, properly, or sustainably implemented. Insufficient involvement of end-users at the individual and organizational levels has been identified as a main barrier to implementation. Against this backdrop, the ‘Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)’ project was initiated through dialogue between end-users and researchers with the goal of making injury prevention training an integral part of regular practice in youth handball through a series of studies. We have conducted studies within I-PROTECT and identified numerous barriers and facilitators, and address these determinants when designing the intervention.
|
|
| 21. |
|
|
| 22. |
- Ageberg, Eva
(author)
-
Consequences of a ligament injury on neuromuscular function and relevance to rehabilitation - using the anterior cruciate ligament-injured knee as model.
- 2002
-
In: Journal of Electromyography & Kinesiology. - 1873-5711. ; 12:3, s. 12-205
-
Journal article (peer-reviewed)abstract
- The purpose of this article is to survey current knowledge concerning the consequences of a ligament injury on neuromuscular function and its relevance to rehabilitation, in relation to clinical practice. Although it deals with the ACL-injured knee, these views may also apply to other joints. The effects of a ligament injury on neuromuscular function are first considered - i.e., proprioception, postural control, muscle strength, functional performance, movement and activation pattern, central mechanisms, motor control and learning. The treatment and effects of rehabilitation on neuromuscular function are then discussed. The survey is concluded by discussing the clinical significance.
|
|
| 23. |
|
|
| 24. |
- Ageberg, Eva, et al.
(author)
-
Effect of leisure time physical activity on severe knee or hip osteoarthritis leading to total joint replacement: a population-based prospective cohort study
- 2012
-
In: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 13:73
-
Journal article (peer-reviewed)abstract
- Background: Studies on leisure time physical activity as risk factor or protective factor for knee or hip osteoarthritis (OA) show divergent results. Longitudinal prospective studies are needed to clarify the association of physical activity with future OA. The aim was to explore in a prospective population-based cohort study the influence of leisure time physical activity on severe knee or hip OA, defined as knee or hip replacement due to OA. Methods: Leisure time physical activity was reported by 28320 participants (mean age 58 years (SD 7.6), 60% women) at baseline. An overall leisure time physical activity score, taking both duration and intensity of physical activities into account, was created. The most commonly reported activities were also used for analysis. The incidence of knee or hip replacement due to OA over 11 years was monitored by linkage with the Swedish hospital discharge register. Cox's proportional hazards model (crude and adjusted for potential confounding factors) was used to assess the incidence of total joint replacement, or osteotomy (knee), in separate analyses of leisure time physical activity. Results: There was no significant overall association between leisure time physical activity and risk for knee or hip replacement due to OA over the 11-year observation time. For women only, the adjusted RR (95% CI) for hip replacement was 0.66 (0.48, 0.89) (fourth vs. first quartile), indicating a lower risk of hip replacement in those with the highest compared with the lowest physical activity. The most commonly reported activities were walking, bicycling, using stairs, and gardening. Walking was associated with a lower risk of hip replacement (adjusted RR 0.76 (95% CI 0.61, 0.94), specifically for women (adjusted RR 0.75 (95% CI 0.57, 0.98)). Conclusions: In this population-based study of middle-aged men and women, leisure time physical activity showed no consistent overall relationship with incidence of severe knee or hip OA, defined as joint replacement due to OA, over 11 years. For women, higher leisure time physical activity may have a protective role for the incidence of hip replacement. Walking may have a protective role for hip replacement, specifically for women.
|
|
| 25. |
- Ageberg, Eva, et al.
(author)
-
Facilitators to support the implementation of injury prevention training in youth handball: A concept mapping approach
- 2019
-
In: Scandinavian Journal of Medicine and Science in Sports. - : WILEY. - 0905-7188 .- 1600-0838. ; 29:2, s. 275-285
-
Journal article (peer-reviewed)abstract
- There is a need for research to identify effective implementation strategies for injury prevention training within real-world community sports. The aim of this ecological participatory study was to identify facilitators, among stakeholders at multiple levels, that could help injury prevention training become part of regular training routines in youth team handball. Concept mapping, a mixed-method approach for qualitative data collection and quantitative data analysis, was used. Stakeholders (n = 196) of two community team handball clubs (29% players, 13% coaches, 38% caregivers, 11% club, district and national handball administrators, 9% unknown) participated in a brainstorming process. After the research team synthesized the 235 generated statements, 50 stakeholders (34% players, 22% coaches, 24% caregivers, 20% administrators) sorted 89 unique facilitator statements into clusters and rated them for importance and feasibility. Multidimensional scaling and hierarchical cluster analysis yielded five clusters (stress value 0.231): "Understanding and applying knowledge," "Education, knowledge, and consistency," "Set-up and exercises," "Inspiration, motivation, and routines," and "Club policy and expert collaboration." The cluster "Understanding and applying knowledge" had the highest mean importance (3.17 out of 4) and feasibility (2.93) ratings. The 32 statements rated as both highly important and feasible (Go-zone) indicate action is required at the individual (end-users) and organizational (policymakers) levels to implement injury prevention training. Results suggest that developing evidence-based context-specific injury prevention training, incorporating physiological, biomechanical and psychological components, and an associated context-specific implementation plan in partnership with all stakeholders should be a high priority to facilitate the implementation of injury prevention training in youth team handball.
|
|
| 26. |
- Ageberg, Eva, et al.
(author)
-
Feasibility of neuromuscular training in patients with severe hip or knee OA: The individualized goal-based NEMEX-TJR training program
- 2010
-
In: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 11
-
Journal article (peer-reviewed)abstract
- Background: Although improvements are achieved by general exercise, training to improve sensorimotor control may be needed for people with osteoarthritis (OA). The aim was to apply the principles of neuromuscular training, which have been successfully used in younger and middle-aged patients with knee injuries, to older patients with severe hip or knee OA. We hypothesized that the training program was feasible, determined as: 1) at most acceptable self-reported pain following training; 2) decreased or unchanged pain during the training period; 3) few joint specific adverse events related to training, and 4) achieved progression of training level during the training period. Methods: Seventy-six patients, between 60 and 77 years, with severe hip (n = 38, 55% women) or knee OA (n = 38, 61% women) underwent an individualized, goal-based neuromuscular training program (NEMEX-TJR) in groups for a median of 11 weeks (quartiles 7 to 15) prior to total joint replacement (TJR). Pain was self-reported immediately after each training session on a 0 to 10 cm, no pain to pain as bad as it could be, scale, where 0-2 indicates safe, > 2 to 5 acceptable and > 5 high risk pain. Joint specific adverse events were: not attending or ceasing training because of increased pain/problems in the index joint related to training, and self-reported pain > 5 after training. The level of difficulty of training was registered. Results: Patients with severe OA of the hip or knee reported safe pain (median 2 cm) after training. Self-reported pain was lower at training sessions 10 and 20 (p = 0.04) and unchanged at training sessions 5 and 15 (p = 0.170, p = 0.161) compared with training session 1. There were no joint specific adverse events in terms of not attending or ceasing training. Few patients (n = 17, 22%) reported adverse events in terms of self-reported pain > 5 after one or more training sessions. Progression of training level was achieved over time (p < 0.001). Conclusions: The NEMEX-TJR training program is feasible in patients with severe hip or knee OA, in terms of safe self-reported pain following training, decreased or unchanged pain during the training period, few joint specific adverse events, and achieved progression of training level during the training period.
|
|
| 27. |
|
|
| 28. |
|
|
| 29. |
|
|
| 30. |
|
|
| 31. |
|
|
| 32. |
- Ageberg, Eva, et al.
(author)
-
Individual factors affecting stabilometry and one-leg hop test in 75 healthy subjects, aged 15-44 years
- 2001
-
In: Scandinavian Journal of Medicine & Science in Sports. - 1600-0838. ; 11:1, s. 47-53
-
Journal article (peer-reviewed)abstract
- The aims of this study were: 1) to investigate whether single-limb stabilometry and a one-leg hop test are influenced by age, sex, height, weight or activity level in healthy subjects, 2) to examine possible differences between the right and the left leg, 3) to determine Limb Symmetry Index (LSI) values, and 4) to study the relation between the stabilometric variables, that is, average speed (AS) and amplitude of center of pressure (CP) movements. Seventy-five healthy subjects (39 women) were studied, with a mean age of 29.5 years (SD 8.2, range 15-44), mean height 175 cm (SD 8.6, range 155-194), mean weight 67.8 kg (SD 9.7, range 50-90) and median value 8 (quartiles 8-9, range 7-10) on a 1-10 activity-level scale. AS was higher among the men compared to the women and increased with increasing age. The females hopped shorter distances than the males. The hop distance decreased with increasing age among the women. Height, weight and activity level within the actual range had no significant influence on stabilometric or hop-test values. When comparing patients with healthy subjects, they should be matched according to sex and age, with an age difference of less than 10 years within pairs.
|
|
| 33. |
- Ageberg, Eva, et al.
(author)
-
Influence of supervised and nonsupervised training on postural control after an acute anterior cruciate ligament rupture: a three-year longitudinal prospective study
- 2001
-
In: Journal of Orthopaedic and Sports Physical Therapy. - 0190-6011. ; 31:11, s. 632-644
-
Journal article (peer-reviewed)abstract
- STUDY DESIGN: Prospective randomized longitudinal clinical trial with matched controls. OBJECTIVES: To investigate the long-term effect of training on postural control and extremity function after an acute anterior cruciate ligament (ACL) injury. BACKGROUND: ACL injuries may cause severe problems with recurrent giving way of the knee and reduced functional capacity. The effect of an acute ACL injury and the effect of various training programs on postural control, as well as the relation between postural control and extremity function after such an injury, have not been studied longitudinally. METHODS: Sixty-three consecutive patients, 35 men and 28 women (median age 24 years, quartiles 19-33 years), with an acute nonoperated ACL injury, randomized to neuromuscular supervised or self-monitored training, were examined with stabilometry (amplitude and average speed of center of pressure movements) and a one-leg hop test for distance after 6 weeks (stabilometry only), and after 3, 12, and 36 months, and were compared to a control group. RESULTS: Regardless of treatment, center of pressure amplitude was persistently higher in both the injured and uninjured legs during the 3-year follow-up, but average speed was less affected or unaffected compared to the control group. The one-leg hop had normalized in the neuromuscular group at the 12-month follow-up, but was shorter in both legs throughout the 3-year period in the self-monitored group. The median value (quartiles) for injured/uninjured legs at 3 months was 150 cm (120-174 cm)/177 cm (140-199 cm), at 12 months was 174 cm (140-200 cm)/180 cm (150-202 cm), and at 36 months was 172 cm (146-200 cm)/178 cm (150-200 cm) in the self-monitored group, compared to the control group (median 186 cm, quartiles 177-216 cm). CONCLUSIONS: The higher center of pressure amplitude in both legs over the 3-year period indicate persistently impaired postural control in single-limb stance. However, functional performance, as measured with the one-leg hop test, was restored by neuromuscular training, but not by self-monitored training.
|
|
| 34. |
|
|
| 35. |
|
|
| 36. |
- Ageberg, Eva, et al.
(author)
-
Knee extension and flexion muscle power after anterior cruciate ligament reconstruction with patellar tendon graft or hamstring tendons graft: a cross-sectional comparison 3 years post surgery
- 2009
-
In: Knee Surg Sports Traumatol Arthrosc. - : Springer Science and Business Media LLC. - 1433-7347 .- 0942-2056. ; 17:2, s. 162-9
-
Journal article (peer-reviewed)abstract
- Hamstring muscles play a major role in knee-joint stabilization after anterior cruciate ligament (ACL) injury. Weakness of the knee extensors after ACL reconstruction with patellar tendon (PT) graft, and in the knee flexors after reconstruction with hamstring tendons (HT) graft has been observed up to 2 years post surgery, but not later. In these studies, isokinetic muscle torque was used. However, muscle power has been suggested to be a more sensitive and sport-specific measures of strength. The aim was to study quadriceps and hamstring muscle power in patients with ACL injury treated with surgical reconstruction with PT or HT grafts at a mean of 3 years after surgery. Twenty subjects with PT and 16 subjects with HT grafts (mean age at follow up 30 years, range 20-39, 25% women), who were all included in a prospective study and followed the same goal-based rehabilitation protocol for at least 4 months, were assessed with reliable, valid, and responsive tests of quadriceps and hamstring muscle power at 3 years (SD 0.9, range 2-5) after surgery. The mean difference between legs (injured minus uninjured), the hamstring to quadriceps (H:Q, hamstring divided by quadriceps) ratio, and the limb symmetry index (LSI, injured leg divided by uninjured and multiplied by 100) value, were used for comparisons between the groups (analysis of variance). The mean difference between the injured and uninjured legs was greater in the HT than in the PT group for knee flexion power (-21.3 vs. 7.7 W, p = 0.001). Patients with HT graft had lower H:Q ratio in the injured leg than the patients with PT graft (0.63 vs. 0.77, p = 0.012). They also had lower LSI for knee flexion power than those in the PT group (88 vs. 106%, p < 0.001). No differences were found between the groups for knee extension power. The lower hamstring muscle power, and the lower hamstring to quadriceps ratio in the HT graft group than in the PT graft group 3 years (range 2-5) after ACL reconstruction, reflect imbalance of knee muscles after reconstruction with HT graft that may have a negative effect on dynamic knee-joint stabilization.
|
|
| 37. |
|
|
| 38. |
|
|
| 39. |
|
|
| 40. |
|
|
| 41. |
|
|
| 42. |
|
|
| 43. |
- Ageberg, Eva, et al.
(author)
-
Neuromuscular exercise as treatment of degenerative knee disease.
- 2015
-
In: Exercise and Sport Sciences Reviews. - 1538-3008. ; 43:1, s. 14-22
-
Research review (peer-reviewed)abstract
- Exercise is recommended as first-line treatment of degenerative knee disease. Our hypothesis is that neuromuscular exercise is feasible and at least as effective as tradionally used strength or aerobic training, but aims to more closely target the sensorimotor deficiencies and functional instability associated with the degenerative knee disease than traditionally used training methods.SUMMARY FOR TABLE OF CONTENTS PAGECurrent data suggests that the effect from neuromuscular exercise on pain and function is comparable to the effects seen from other forms of exercise.
|
|
| 44. |
|
|
| 45. |
|
|
| 46. |
|
|
| 47. |
|
|
| 48. |
- Ageberg, Eva, et al.
(author)
-
Normalized motor function but impaired sensory function after unilateral non-reconstructed ACL injury: patients compared with uninjured controls.
- 2008
-
In: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 1433-7347 .- 0942-2056. ; 16, s. 449-456
-
Journal article (peer-reviewed)abstract
- Improvement in motor function after anterior cruciate ligament (ACL) injury is achieved by appropriate rehabilitation. However, it has been questioned whether training after injury can lead to sensory improvement. We hypothesized that motor function can be restored after unilateral non-reconstructed ACL injury, whereas the sensory function cannot, i.e., there would be no difference in functional performance or knee muscle strength between subjects with ACL injury and uninjured controls, but the subjects with ACL injury would have poorer kinesthesia than the uninjured controls. This is a Cross-Sectional Study, wherein 56 (20 women and 36 men) individuals with unilateral non-reconstructed ACL injury were assessed at a mean of 15 years (SD 1.4 years) after the initial injury. All patients initially underwent rehabilitation and were advised to modify their activity level, in order to cope with the ACL insufficiency. At 15 years, they had good subjective function and acceptable activity level. Twenty-eight (14 women and 14 men) uninjured subjects served as controls. Patients and controls were assessed with the one-leg hop test for distance, isometric and isokinetic knee muscle strength, and kinesthesia (the threshold to detection of passive motion). The individuals with ACL injury had the same or better functional performance, measured by the one-leg hop test for distance, and knee muscle strength compared with the uninjured controls. Kinesthesia was poorer in the patient group than in the control group. The results indicate that motor function can be restored but that the sensory function is persistently disturbed after ACL injury.
|
|
| 49. |
- Ageberg, Eva, et al.
(author)
-
Planning injury prevention training for youth handball players : Application of the generalisable six-step intervention development process
- 2020
-
In: Injury Prevention. - : BMJ. - 1353-8047 .- 1475-5785. ; 26:2, s. 164-169
-
Journal article (peer-reviewed)abstract
- Background: Youth handball players are vulnerable to injuries. Because there is no available injury prevention training specifically developed for youth handball players targeting both upper and lower limbs or incorporating psychological aspects of injury, we undertook the € Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)' project. We used an ecological participatory design incorporating the perspectives of multiple stakeholders (health beneficiaries, programme deliverers and policy makers). The aim of this paper was to describe the process of developing the I-PROTECT model, featuring injury prevention training and an accompanying implementation strategy. Design: We used the generalisable six-step intervention development process, outlined to guide researchers when developing implementable, evidence-based sports injury prevention interventions, to develop the I-PROTECT model. The six-step process involves establishing a research-stakeholder collaborative partnership to (1) identify and synthesise research evidence and clinical experience; (2) consult with relevant experts; (3) engage end users to ensure their needs, capacity and values are considered; (4) test the feasibility and acceptability of the intervention; (5) evaluate the intervention against theory; and (6) obtain feedback from early implementers. Two community handball clubs in southern Sweden, offering organised training for youth male and female players, and the district handball federation, participate in the intervention development. Drafts of the I-PROTECT model will be developed and revised with key stakeholder advice and input throughout all six steps. Conclusion: The I-PROTECT model described will be an end user-driven intervention, including evidence-based, theory-informed and context-specific injury prevention training for youth handball, and an associated implementation strategy.
|
|
| 50. |
- Ageberg, Eva
(author)
-
Postural Control in Single-limb Stance. In Individuals with Anterior Cruciate Ligament Injury and Uninjured Controls
- 2003
-
Doctoral thesis (other academic/artistic)abstract
- The overall aims of this work were to evaluate a method of assessing postural control, measured by balance in single-limb stance on a force platform, and to study balance in single-limb stance in individuals with non-operated anterior cruciate ligament (ACL) injury in comparison with that of uninjured controls. Ninety-nine patients (99) with ACL injury and 141 uninjured subjects were included in the studies. The tests included in the various studies were: balance in single-limb stance (amplitude and average speed of center of pressure (CP) movements), the one-leg hop test for distance, proprioception, knee muscle strength, knee joint laxity, subjective estimation of extremity function, and short-duration sub-maximal cycling. The training methods used were neuromuscular, and self-monitored training. Balance in single-limb stance and the one-leg hop test were found to be reliable and appropriate tests for distinguishing between groups of subjects (Papers I and IV). Relatively large differences in an individual’s balance measurements would, however, be required to confidently state that a change is real (Paper IV). Balance in single-limb stance and the one-leg hop test were influenced by age and sex (Paper II). When comparing patients with uninjured subjects these factors were, therefore, matched. The patients seemed to exhibit larger CP movements at a lower speed (Paper III) or CP movements at a lower speed with retained amplitude (Paper V) compared with the uninjured subjects. Regardless of training method and therapeutic approach, CP amplitude was persistently higher in both legs during the follow-up compared with uninjured subjects (Paper III). However, functional performance, as measured with the one-leg hop test for distance, was restored by neuromuscular training, but not by self-monitored training (Paper III). Higher values of CP movements were found in the patients and the uninjured subjects after short-duration, sub-maximal cycling, indicating compensatory mechanisms aimed at maintaining balance in single-limb stance, or a decreased ability to maintain balance (Papers IV and V). The injured leg in the patients was more affected by cycling than the legs of the control group (Paper V). Anterior knee laxity, proprioception, and muscle strength seem to play a role in maintaining balance in single-limb stance in patients with ACL injury (Paper VI). Low amplitudes of CP movements correlated with better subjective extremity function, whereas no correlation was found between average speed of CP movements and subjective function (Paper VI). Thus, the method studied for assessing postural control in single-limb stance can be useful in the evaluation of neuromuscular function after knee injury.
|
|
