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Sandberg, Margareta
Alternative names
Publications (10 of 13) Show all publications
Sandberg, M., Sandberg, M. & Dahl, J. (2007). Blood flow changes in the trapezius muscle and overlying skin following transcutaneous electrical nerve stimulation. Physical Therapy, 87(8), 1047-1055
Open this publication in new window or tab >>Blood flow changes in the trapezius muscle and overlying skin following transcutaneous electrical nerve stimulation
2007 (English)In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 87, no 8, p. 1047-1055Article in journal (Refereed) Published
Abstract [en]

Background and Purpose: Various researchers have studied the effects of transcutaneous electrical nerve stimulation (TENS) on hemodynamics. The purpose of this study was to examine the effects of TENS on local blood flow in the trapezius muscle and overlying skin.

Subjects: Thirty-three women who were healthy, aged 25 to 55 years, were randomly assigned to receive 1 of 3 different modes of TENS.

Methods: Skin and muscle blood flow were monitored noninvasively using a new application of photoplethysmography for 15 minutes of TENS applied at high frequency (80 Hz) and sensory-level intensity and at low frequency (2 Hz) and motor-level intensity and for 15 minutes after stimulation. Subliminal 80-Hz TENS was used as a control. Blood flow was monitored simultaneously on stimulated and nonstimulated shoulders.

Results: Blood flow in the trapezius muscle, but not skin blood flow, increased significantly with motor-level 2-Hz TENS, whereas no increase occurred with sensory-level 80-Hz TENS or subliminal 80-Hz TENS.

Discussion and Conclusion: Muscle contractions induced by motor-level 2-Hz TENS appear to be a prerequisite for increasing blood flow in the trapezius muscle. However, high stimulation intensity may prevent increased blood flow in the overlying skin.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-21302 (URN)10.2522/ptj.20060178 (DOI)17578938 (PubMedID)
Available from: 2009-10-07 Created: 2009-09-30 Last updated: 2017-12-13Bibliographically approved
Sandberg, M. (2006). Acupuncture procedures must be accurately described [1]. Acupuncture in Medicine, 24(2), 92-94
Open this publication in new window or tab >>Acupuncture procedures must be accurately described [1]
2006 (English)In: Acupuncture in Medicine, ISSN 0964-5284, Vol. 24, no 2, p. 92-94Article in journal (Other academic) Published
Abstract [en]

[No abstract available]

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-35937 (URN)29098 (Local ID)29098 (Archive number)29098 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2011-01-11
Gerdle, B. & Sandberg, M. (2006). Akuta och kroniska nociceptiva smärtor. Den biopsykosociala helhetssynen och aspekter på de neurobiologiska mekanismerna (1ed.). In: Jörgen Borg (Ed.), Rehabiliteringsmedicin - Teori och praktik: (pp. 78-89). Lund: Studenlitteratur
Open this publication in new window or tab >>Akuta och kroniska nociceptiva smärtor. Den biopsykosociala helhetssynen och aspekter på de neurobiologiska mekanismerna
2006 (Swedish)In: Rehabiliteringsmedicin - Teori och praktik / [ed] Jörgen Borg, Lund: Studenlitteratur , 2006, 1, p. 78-89Chapter in book (Other academic)
Abstract [sv]

       Kapitel om rehabiliteringsmedicinens utveckling och nuvarande plats i sjukvården samt begrepp och metodik inleder boken. I två delar ges därefter rehabiliteringsmedicinska aspekter på de dominerande sjukdomsgrupperna - komplexa smärttillstånd respektive skador och sjukdomar i nervsystemet. Som avslutning beskrivs bland annat  stressrelaterade tillstånd. Läroboken är avsedd för grundutbildning av läkare, arbetsterapeuter och sjukgymnaster, logopeder samt för läkare under AT-tjänstgöring. Den är också lämplig som introduktion i specialistutbildningen i rehabiliteringsmedicin, geriatrik, neurologi och smärtlindring. Vidareutbildningar av olika vårdyrkesgrupper kan ha nytta av boken och den kan också användas som referenslitteratur av yrkesverksamma med intresse för rehabiliteringsmedicin

Place, publisher, year, edition, pages
Lund: Studenlitteratur, 2006 Edition: 1
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-36236 (URN)30685 (Local ID)91-44-04507-7 (ISBN)978-91-44-04507-8 (ISBN)30685 (Archive number)30685 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2013-09-19Bibliographically approved
Sandberg, M. (2006). Gott bemötande inte liktydligt med effektiv behandling. Dagens medicin
Open this publication in new window or tab >>Gott bemötande inte liktydligt med effektiv behandling
2006 (Swedish)In: Dagens medicin, ISSN 1104-7488Article in journal (Other (popular science, discussion, etc.)) Published
Abstract [sv]

2006-12-15REPLIK Legitimerad sjukvårdspersonals goda grundkunskaper gör en två veckor lång kurs tillräcklig som grundutbildning i akupunktur. Det framhåller Margareta Sandberg, som företrädare för en sektion inom Sjukgymnastförbundet i ett svar på ett inlägg av Lina Axelsson.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-21304 (URN)
Available from: 2009-10-01 Created: 2009-09-30 Last updated: 2009-10-01
Sandberg, M., Larsson, B., Lindberg, L.-G. & Gerdle, B. (2005). Different patterns of blood flow response in the trapezius muscle following needle stimulation (acupuncture) between healthy subjects and patients with fibromyalgia and work-related trapezius myalgia. European Journal of Pain, 9(5), 497-510
Open this publication in new window or tab >>Different patterns of blood flow response in the trapezius muscle following needle stimulation (acupuncture) between healthy subjects and patients with fibromyalgia and work-related trapezius myalgia
2005 (English)In: European Journal of Pain, ISSN 1090-3801, Vol. 9, no 5, p. 497-510Article in journal (Refereed) Published
Abstract [en]

Needle stimulation (acupuncture) has recently been shown to increase blood flow in the tibialis anterior muscle and overlying skin in healthy subjects (HS) and patients with fibromyalgia (FM). The aim of the present study was to examine the effect of needle stimulation on local blood flow in the trapezius muscle and overlying skin in HS and two groups of patients suffering from chronic pain in the trapezius muscle, i.e., FM and work-related trapezius myalgia (TM) patients. Two modes of needling, deep muscle stimulation (Deep) and subcutaneous needle insertion (SC), were performed at the upper part of the shoulder and blood flow was monitored for 60 min post-stimulation. Blood flow changes were measured non-invasively by using a new application of photoplethysmography. Increased blood flow in the trapezius muscle and overlying skin was found in all three groups following both Deep and SC. In HS, Deep was superior to SC in increasing skin and muscle blood flow, whereas in FM, SC was as effective as, or even more effective, than Deep. In the severely affected TM patients, no differences were found between the stimuli, and generally, a lesser blood flow response to the stimuli was found. At Deep, the muscle blood flow increase was significantly larger in HS, compared to the two patient groups. Positive correlations were found between muscle blood flow at Deep and pressure pain threshold in the trapezius muscle, neck movement and pain experienced at the stimulation, and negative correlations were found with spontaneous pain-related variables, symptom duration and age, pointing to less favorable results with worsening of symptoms, and to the importance of nociceptor activation in blood flow increase. It was hypothesized that the different patterns of muscle blood flow response to the needling may mirror a state of increased sympathetic activity and a generalized hypersensitivity in the patients. The intensity of stimulation should be taken into consideration when applying local needle stimulation (acupuncture) in order to increase the trapezius muscle blood flow in chronic pain conditions.

Keywords
Acupuncture; Fibromyalgia; Muscle blood flow; Non-invasive; Trapezius myalgia; Trapezius muscle
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-12846 (URN)10.1016/j.ejpain.2004.11.002 (DOI)
Available from: 2008-01-09 Created: 2008-01-09 Last updated: 2009-06-03
Sandberg, M. (2005). Förväntan, vänligt bemötande, lugn och ro och beröring lindrar - inte akupunktur. Läkartidningen, 102, 1353-1354
Open this publication in new window or tab >>Förväntan, vänligt bemötande, lugn och ro och beröring lindrar - inte akupunktur
2005 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, p. 1353-1354Article in journal (Other (popular science, discussion, etc.)) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-37115 (URN)33734 (Local ID)33734 (Archive number)33734 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Sandberg, M. (2005). Kontrollmetoden lika bra. Läkartidningen, 102, 1666-1667
Open this publication in new window or tab >>Kontrollmetoden lika bra
2005 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, p. 1666-1667Article in journal (Other (popular science, discussion, etc.)) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-37116 (URN)33735 (Local ID)33735 (Archive number)33735 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Sandberg, M., Zhang, Q., Styf, J., Gerdle, B. & Lindberg, L.-G. (2005). Non-invasive monitoring of muscle blood perfusion by photoplethysmography: Evaluation of a new application. Acta Physiologica Scandinavica, 183(4), 335-343
Open this publication in new window or tab >>Non-invasive monitoring of muscle blood perfusion by photoplethysmography: Evaluation of a new application
Show others...
2005 (English)In: Acta Physiologica Scandinavica, ISSN 0001-6772, E-ISSN 1365-201X, Vol. 183, no 4, p. 335-343Article in journal (Refereed) Published
Abstract [en]

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.

Keywords
blood flow, muscle blood perfusion, non-invasive, penetration depth, photoplethysmography, skin blood perfusion
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-12843 (URN)10.1111/j.1365-201X.2005.01412.x (DOI)
Available from: 2008-01-09 Created: 2008-01-09 Last updated: 2017-12-14
Sandberg, M. (2004). Acupuncture - effects on muscle blood flow and aspects of treatment in the clinicla context. (Doctoral dissertation). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Acupuncture - effects on muscle blood flow and aspects of treatment in the clinicla context
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to elucidate and investigate psychophysiological aspects and effects of acupuncture and needle stimulation. Within this framework emphasis was directed toward the effects of needle stimulation (acupuncture) on muscle blood flow in the tibialis anterior and trapezius muscles in healthy subjects and patients suffering from chronic muscle pain. This study also included evaluation of a new application of photoplethysmography in noninvasive monitoring of muscle blood flow. The evaluation was based on experiments known to provocate skin or muscle blood flow. The psychological aspects studied comprised the effects of manual acupuncture on pain in fibromyalgia patients and the effects of electro-acupuncture on psychological distress and vasomotor symptoms in postmenopausal women in the clinical context.

The results showed that photoplethysmography have potential to noninvasively monitor muscle blood flow and to discriminate between blood flow in skin and muscle, although some considerations still have to be accounted for. It was further shown that muscle blood flow change in response to needle stimulation differed between healthy subjects and patients. Deep needle stimulation in the muscle of healthy subjects consistently increased muscle blood flow more than subcutaneous needle stimulation. In the painful trapezius muscle of FMS patients, however, subcutaneous needling was equal or even more effective in increasing muscle blood flow than deep intramuscular stimulation. Generally, needle stimuli had weak effect on blood flow in the trapezius muscle of the severely affected trapezius myalgia patients, possibly depending on older age and lesser number of patients included in the study. The different patterns of blood flow response to needle stimulation between healthy subjects and patients with chronic muscle pain might be a manifestation of altered somatosensory processing in the patients.

The clinical studies showed that best pain relief of acupuncture in FMS patients was achieved in the neck-shoulder region, while the effect on the generalised symptoms was of short duration. Well-being and sleep was found to best predict treatment outcome. The results suggest that acupuncture treatment may be used for the alleviation of neck-shoulder pain, primarily, but it is not an alternative as the sole treatment. Electro-acupuncture, significantly decreased psychological distress and climacteric symptoms in postmenopausal women, but not better than a (near-) placebo control, implying pronounced non-specific effects.

Abstract [sv]

Akupunktur ingår som en del i traditionell kinesisk medicin (TCM) och har använts i över 2000 år för att lindra sjukdom och symptom. I Sverige blev akupunktur godkänd som smärtlindringsmetod inom Hälso- och Sjukvården 1984. Sedan nästan 10 år är akupunktur jämställd med övrig behandling i sjukvården vilket innebär, att akupunktur kan användas även för behandling av annat än smärta. Förutsättningen är emellertid, att det finns tillräckligt med vetenskapliga belägg, s.k. evidens, för detta. I de allra flesta fall saknas det idag. För att säkerställa att evidens föreligger krävs omfattande forskning om effekter av akupunktur.

Syftet med de olika studierna i avhandlingen var att belysa och studera psykologiska och fysiologiska aspekter och effekter av akupunktur och nålstimulering. Effekt på blodflöde i hud och muskel undersöktes på friska personer och på patienter med kronisk muskelsmärta. Normalt krävs ett mindre kirurgiskt ingrepp för att mäta blodflöde i muskel, men i dessa studier användes en mätmetod, som enkelt och utan ingrepp (icke-invasivt) i normala fall används för att mäta blodflöde i huden, s.k. fotopletysmografi (PPG, eng.). Med hjälp av ny teknik användes PPG i dessa studier för att mäta även muskelblodflöde. En studie för utvärdering av den nya PPG-tekniken ingick också i avhandlingen.

Utvärderingen av mätmetoden visade goda möjligheter att mäta muskelblodflöde icke-invasivt med hjälp av PPG. Hos friska personer blev effekten på blodflödet störst vid djup stimulering i muskeln och där den s.k. DeQi-känslan framkallades (som vid klassisk akupunktur). Hos patienter med fibromyalgi var nålstimulering i huden lika, eller t.o.m. mer, effektiv att öka muskelblodflödet i skuldran än den djupa nålstimuleringen. De olika mönstren av blodflödesökning mellan de friska personerna och patienterna kan bero på ett förändrat reaktionssätt i nervsystemet som svar på smärtsam stimulering.

I två kliniska studier studerades den smärtlindrande effekten av manuell akupunktur vid fibromyalgi och effekten av elektroakupunktur på stress och klimakteriebesvär hos kvinnor i övergångsåldern. Akupunktur vid fibromyalgi visade sig ha bäst smärtlindrande effekt i nack-skulderområdet, medan effekten på de generella symptomen var kortvarig. Patienter som mådde och sov relativt bra erhöll bäst effekt. Efter en behandlingsserie, bestående av elektroakupunktur, minskade stress och klimakteriebesvär påtagligt hos kvinnorna i övergångsåldern, men inte mer än hos en grupp kvinnor, som fick en kontrollbehandling bestående av mycket ytligt placerade nålar i huden. Detta tyder på att en betydlig del av behandlingsresultatet utgjordes av ospecifika effekter eller, s.k. eller placeboeffekter.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2004. p. 83
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 867
Keywords
Acupuncture, muscle blood flow, non-invasive, photoplethysmography, fibromyalgia, pain, postmenopausal symptoms, psychological distress
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-10456 (URN)91-7373-841-7 (ISBN)
Public defence
2004-11-19, Berzeliussalen, Campus US Linköping University, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2008-01-09 Created: 2008-01-09 Last updated: 2012-01-25Bibliographically approved
Sandberg, M., Lindberg, L.-G. & Gerdle, B. (2004). Peripheral effects of needle stimulation (acupuncture) on skin and muscle blood flow in fibromyalgia. European Journal of Pain, 8(2), 163-171
Open this publication in new window or tab >>Peripheral effects of needle stimulation (acupuncture) on skin and muscle blood flow in fibromyalgia
2004 (English)In: European Journal of Pain, ISSN 1090-3801, Vol. 8, no 2, p. 163-171Article in journal (Refereed) Published
Abstract [en]

Acupuncture has become a widely used treatment modality in various musculoskeletal pain conditions. Acupuncture is also shown to enhance blood flow and recovery in surgical flaps. The mechanisms behind the effect on blood flow were suggested to rely on vasoactive substances, such as calcitonin gene-related peptide, released from nociceptors by the needle stimulation. In a previous study on healthy subjects, one needle stimulation into the anterior tibial muscle was shown to increase both skin and muscle blood flow. The aim of this study was to examine the effect of needle stimulation on local blood flow in the anterior tibial muscle and overlying skin in patients suffering from a widespread chronic pain condition. Fifteen patients with fibromyalgia (FM) participated in the study. Two modes of needling, deep muscle stimulation and subcutaneous needle insertion were performed at the upper anterior aspect of the tibia, i.e., in an area without focal pathology or ongoing pain in these patients. Blood flow changes were assessed non-invasively by photoplethysmography (PPG). The results of the present study were partly similar to those earlier found at a corresponding site in healthy female subjects, i.e., deep muscle stimulation resulted in larger increase in skin blood flow (mean (SE)): 62.4% (13.0) and muscle blood flow: 93.1% (18.6), compared to baseline, than did subcutaneous insertion (mean (SE) skin blood flow increase: 26.4% (6.2); muscle blood flow increase: 46.1% (10.2)). However, in FM patients subcutaneous needle insertion was followed by a significant increase in both skin and muscle blood flow, in contrast to findings in healthy subjects where no significant blood flow increase was found following the subcutaneous needling. The different results of subcutaneous needling between the groups (skin blood flow: p=0.008; muscle blood flow: p=0.027) may be related to a greater sensitivity to pain and other somatosensory input in FM.

Keywords
Acupuncture, Blood flow, Fibromyalgia, Hyperexcitability, Non-invasive
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-12845 (URN)10.1016/S1090-3801(03)00090-9 (DOI)
Available from: 2008-01-09 Created: 2008-01-09 Last updated: 2009-08-20
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