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Lundberg, Gunnar
Publications (9 of 9) Show all publications
Lundberg, G. & Gerdle, B. (2017). Musculoskeletal signs in female homecare personnel: A longitudinal epidemiological study. Work: A journal of Prevention, Assesment and rehabilitation, 58(2), 135-147
Open this publication in new window or tab >>Musculoskeletal signs in female homecare personnel: A longitudinal epidemiological study
2017 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 58, no 2, p. 135-147Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In Sweden, homecare services take care of elderly and disabled people, work that often requires heavy lifting and forward bending, resulting in high prevalences of pain and work accidents. OBJECTIVE: Using an eight-year follow-up, this study determines the prognostic importance of certain musculoskeletal signs reported in earlier studies [1, 2] with respect to aspects of pain and perceived disability. METHODS: Baseline data has been reported in earlier studies of 607 women [1-3]. This study uses a postal questionnaire survey and reports the results of eight years post initial study. RESULTS: Segmental pain at L4-L5 and/or L5-S1 levels was associated with higher low back pain intensity and disability at the eight-year follow-up. A decrease in low back pain intensity over eight years was larger for those with segmental pain. The important signs in the longitudinal analyses of pain aspects and disability were lumbar spinal mobility and segmental pain at L4-L5 and L5-S1 levels, but the explained variations were low. CONCLUSION: Evaluation of low lumbar segmental pain provocation and mobility should be considered in routine clinical assessments, as this type of evaluation provides prognostic pain and disability information over time.

Place, publisher, year, edition, pages
IOS PRESS, 2017
Keywords
Segmental mobility; segmental pain; posture; joint mobility; risk
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-143007 (URN)10.3233/WOR-172609 (DOI)000413401600007 ()29036858 (PubMedID)
Available from: 2017-11-13 Created: 2017-11-13 Last updated: 2018-04-17
Lundberg, G. & Gerdle, B. (2016). The relationships between pain, disability, and health-related quality of life: an 8-year follow-up study of female home care personnel. Disability and Rehabilitation, 38(3), 235-244
Open this publication in new window or tab >>The relationships between pain, disability, and health-related quality of life: an 8-year follow-up study of female home care personnel
2016 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 3, p. 235-244Article in journal (Refereed) Published
Abstract [en]

Purpose: To investigate the development of pain conditions, disability, and health-related quality of life over an 8-year period in home care personnel. Method: In earlier studies of 607 women, we reported baseline data concerning home care personnel. This study reports the results from an 8-year follow-up using a postal questionnaire. Results: The questionnaire was completed by 87%. Prevalences of pain in upper back, lower back, and knees as well as pain intensity of the low back had decreased. Participants with the highest pain intensities of the low back at baseline had relatively lower pain intensities at follow-up. Anatomical spreading of pain was associated with higher average pain intensity. Disability had increased significantly during the time period. In the regression of disability at follow-up, average pain intensity together with disability rating index at baseline were the most important regressors; a similar pattern was found for quality of life. Conclusions: The development of disability differed from that of low-back pain intensity. Spreading of pain and pain intensity across the anatomical regions influenced disability and quality of life over 8 years. When assessing pain, it seems important to determine the spread of pain rather than just focusing on the area with intense pain.Implications for RehabilitationSpreading of pain and the average intensity of pain across the involved anatomical regions have importance for future pain and disability and quality of life.The clinical assessment of subjects with chronic pain prior to rehabilitation interventions has to determine the spreading of pain rather than just focusing on the area with the most intense pain.The different developments over time for pain intensity and disability indicate the need for applying a bio-psycho-social view of pain both when assessing the patient with pain and when discussing the prognosis and course of the actual pain condition with the patient.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2016
Keywords
Health related quality of life; home care; musculoskeletal; pain; spine; women
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-124083 (URN)10.3109/09638288.2015.1035459 (DOI)000367013100005 ()25864984 (PubMedID)
Available from: 2016-01-25 Created: 2016-01-19 Last updated: 2018-01-10
Lundberg, G., Anderberg, U. M. & Gerdle, B. (2009). Personality Features in Female Fibromyalgia Syndrome. JOURNAL OF MUSCULOSKELETAL PAIN, 17(2), 117-130
Open this publication in new window or tab >>Personality Features in Female Fibromyalgia Syndrome
2009 (English)In: JOURNAL OF MUSCULOSKELETAL PAIN, ISSN 1058-2452, Vol. 17, no 2, p. 117-130Article in journal (Refereed) Published
Abstract [en]

Objectives: Using the Temperament and Character Inventory [TCI], this study investigates whether differences in temperament and character exist in fibromyalgia syndrome [FMS] patients compared with healthy normal controls [HNC] of the community and whether there might be subgroups among FMS patients. Methods: This study asked 191 female patients with FMS and 652 age-matched female HNC of the community to answer the TCI questionnaire. Results: The FMS was associated with high harm avoidance, persistence, self-transcendence, and low self-directedness. Three subgroups of FMS were identified [cluster 1: N = 72; cluster 2: N = 83; and cluster 3: N = 30] based on all scales and subscales of TCI. Conclusions: Both aspects of TCI, temperament and character, are different and changed in FMS compared with HNC, mainly high harm avoidance, high persistence, low self-directedness, and high self-transcendence. The established personality patterns may affect the FMS patients ability to cope with stress and pain in daily-life situations. In future studies it is important to also incorporate pain intensity, depression and anxiety variables, and other personality instruments when interpreting the results.

Keywords
Fibromyalgia syndrome, pain, personality
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-18147 (URN)10.1080/10582450902820531 (DOI)
Available from: 2009-05-09 Created: 2009-05-08 Last updated: 2009-08-19
Henriksson, C., Carlberg, U., Kjällman, M., Lundberg, G. & Henriksson, K.-G. (2004). Evaluation of four outpatient educational programmes for patients with longstanding fibromyalgia. Journal of Rehabilitation Medicine, 36(5), 211-219
Open this publication in new window or tab >>Evaluation of four outpatient educational programmes for patients with longstanding fibromyalgia
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2004 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 36, no 5, p. 211-219Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Four programmes based on educational and cognitive principles but with a variation in total length and number of staff/patient contact hours were compared in order to gain further insight into the importance of the format of the programme for the final outcome.

DESIGN: A prospective non-randomized intervention study with 191 persons with fibromyalgia. Data were collected before, after and at 1-year follow-up. Participants served as their own controls. Results within and between the programmes were calculated.

METHODS: Clinical investigations before and after intervention. Questionnaires were answered before, after and at 1-year follow-up.

RESULTS: Most instruments showed no significant improvements after the programme. However, some improvements were found in important variables such as attitudes, self-efficacy, vitality and "days feeling well". Results were unchanged at the 1-year follow-up and 16 persons had started working. Seven had ceased working. Participants reported frequent use of coping strategies in everyday life. No major differences could be found between the programmes. Conclusions: More comprehensive programmes did not produce better results at group level. Also short and less costly interventions based on educational and cognitive principles were valuable for persons with longstanding fibromyalgia. More attention must be given to evaluating the clinical effect of programmes.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-23590 (URN)10.1080/16501970410027494 (DOI)3077 (Local ID)3077 (Archive number)3077 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13
Trygg, T., Lundberg, G., Rosenlund, E., Timpka, T. & Gerdle, B. (2002). Personality characteristics of women with fibromyalgia and of women with chronic neck, shoulder, or low back complaints in terms of Minnesota Multiphasic Personality Inventory and defense mechanism technique modified. Journal of Musculoskeletal Pain, 10(3), 33-55
Open this publication in new window or tab >>Personality characteristics of women with fibromyalgia and of women with chronic neck, shoulder, or low back complaints in terms of Minnesota Multiphasic Personality Inventory and defense mechanism technique modified
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2002 (English)In: Journal of Musculoskeletal Pain, ISSN 1058-2452, E-ISSN 1540-7012, Vol. 10, no 3, p. 33-55Article in journal (Refereed) Published
Abstract [en]

Objectives: To compare personality features of fibro-myalgia patients with those of a disease control group with regional pain.

Methods: A group of 33 women with fibromyalgia [FMS-group] was compared on the Minnesota Multiphasic Personality Inventory [MMPI] and the Defense Mechanism Technique modified [DMTm] with 31 women [C-group] without this diagnosis who had localized chronic pain in their neck, shoulder, and/or low back areas and were very similar in chronological age, intelligence, and basic personality patterns.

Results: As hypothesized the FMS-group scored higher than the C-group on the MMPI-scales of Hypochondriasis, Depression, and Hysteria. They also scored higher on Admission of symptoms, Psych-asthenia, Anxiety, Schizophrenia, Social introversion, and a number of nonclinical subscales. The differences were not found to be due to differences in pain intensity. The only statistically significant difference in DMTm between the groups was that of FMS patients more often reporting the projected self to be positive and/or to be afraid, suggesting them to be more vulnerable than the comparison group to threatening experiences. Significant relationships between the disability level and the number of tender points, group membership, pain intensity, and various of the MMPI scales were found.

Conclusions: There were no signs on the MMPI of serious psychological disturbances in either group, and at the “deeper” psychological level, assessed in DMTm, there were no marked differences between the two groups, a proneness to somaticize psychological pain being found in both groups. Both the MMPI and the DMTm results were interpreted as suggesting that a cognitive coping strategy program be considered for rehabilitation. The fact that both different symptoms and signs had importance when regressing disability might indicate that univariate approaches is not sufficient when investigating factors of importance for disability.

Keywords
Defense Mechanism Technique modified, Disability, Fibromyalgia, Minnesota Multiphasic Personality Inventory, Pain
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-46803 (URN)10.1300/J094v10n03_03 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2018-10-08Bibliographically approved
Lundberg, G. (2002). Signs, symptoms, and disability related to the musculo-skeletal system: studies of home care personnel and patients with fibromyalgia. (Doctoral dissertation). Linköping: Linköpings universitet
Open this publication in new window or tab >>Signs, symptoms, and disability related to the musculo-skeletal system: studies of home care personnel and patients with fibromyalgia
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Low back pain (LBP) and neck/shoulder pain are the major reasons for sickness absence and disability pensions in Sweden. The working situation of home care personnel in Sweden frequently requires heavy lifting and forward bending and workers report high prevalences of work-related musculo-skeletal pain and high frequencies of work accidents, especially lower back injuries. Most back pain patients are treated with non-surgical methods such as physical therapy, which includes manipulation, training of posture and co-ordination, lifting techniques, etc. There is limited scientific evidence with respect to clinical signs used in physical medicine. The clinical relevance of these signs with respect to symptoms and disability is unclear.

In Nyköping, Sweden, 607 home care personnel women were examined regarding pain prevalence and intensity in 9 body regions, other common symptoms, and disability. A clinical examination (conducted by 3 physiotherapists) investigated the following conditions: posture and sagittal spinal mobility (using kyphometer); joint laxity (Beighton score); segmental mobility and segmental pain from T10 down to L5-S1; and tender point (TP) palpation on 60 sites including the 18 ACR-criteria spots. In addition, a reliability study of 150 subjects was performed by two of the physiotherapists.

The 7-day prevalence of LBP was 48%. The reliability of manually investigated segmental mobility and pain was good, especially in L4-S 1 (kappa ≈o. 7). There was a positive correlation between segmental and total sagittal mobility (kyphometry) indicating criterion validity of the former. Sagittal hypomobility, segmental pain, hyper- and hypomobility, and tender point score correlated positively to pain intensity and many disability parameters. Neck-shoulder pain was more often combined with pain in other body regions and more strongly correlated to tender point score. The prevalence of fibromyalgia (FS) was 2%. There are many causes of FS. Central sensitisation is very likely essential and psychological factors and stress are discussed.

The personality profile of 33 female FS patients (FS-group) and 31 female controls (C-group) with local but not widespread pain was investigated, using MMPI and the Defence Mechanism Technique modified (DMTm). We found no sigos of serious personality abermtions in either group. A higher vulnerability for threatening experiences was found in the FS-group. Both symptoms and TP-score correlated positively to disability in both groups. The results of MMPI and DMTm indicate that cognitive coping strategies are suitable for FS patients. Because symptoms and sigos correlated to disability, the overall conclusion was that a multidisciplinary approach is appropriate in future investigations of pain problems.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2002. p. 69
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 718
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-28057 (URN)12820 (Local ID)91-7373-160-9 (ISBN)12820 (Archive number)12820 (OAI)
Public defence
2002-03-01, Administrationsbyggnadens aula, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-09-17Bibliographically approved
Lundberg, G. & Gerdle, B. (2002). Tender point scores and their relations to signs of mobility, symptoms, and disability in female home care personnel and the prevalence of fibromyalgia syndrome. Journal of Rheumatology, 29(3), 603-613
Open this publication in new window or tab >>Tender point scores and their relations to signs of mobility, symptoms, and disability in female home care personnel and the prevalence of fibromyalgia syndrome
2002 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 29, no 3, p. 603-613Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: In this study of female home care personnel employed in a municipality (n = 643; participation rate 94%) we investigated (1) the prevalence of tender points and fibromyalgia (FM); (2) the relationships between tender point score and other signs and symptoms; (3) if subgroups based on the tender point score differed with respect to signs, symptoms, disability, and health related quality of life; and (4) signs that showed the strongest intercorrelations with disability and health.

METHODS: The following variables were registered: (1) Signs: joint mobility, spinal posture and mobility, tender points, and segmental mobility and pain provocation at L4-S1 levels of the low back. (2) Symptoms: pain and pain intensity and other symptoms. (3) Disability (i.e., self-rated reduced capacity for everyday activities and employment) and health: 3 indices and sick leave.

RESULTS: The tender point score correlated with the number of pain regions and the pain intensities, and the amount of other symptoms, sick leave, and disability. Tender point score was the strongest regressor of the investigated signs in regression of the 2 disability indices. Segmental pain showed the strongest correlation with tender point score. Three subgroups identified by tender point score showed significant differences in segmental pain, prevalence and intensity of different symptoms, disability, and health related quality of life. The prevalence of FM was 2.0%.

CONCLUSION: Tender point score together with different symptoms showed relatively strong correlations with disability. A relatively high prevalence of FM was found in occupationally active female home care personnel.

Keywords
fibromyalgia, home care, musculoskeletal, pain, tender point, women
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-48946 (URN)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12Bibliographically approved
Lundberg, G. & Gerdle, B. (2000). Correlations between joint and spinal mobility, spinal sagittal configuration, segmental mobility, segmental pain, symptoms and disabilities in female homecare personnel. Scandinavian Journal of Rehabilitation Medicine, 32(3), 124-133
Open this publication in new window or tab >>Correlations between joint and spinal mobility, spinal sagittal configuration, segmental mobility, segmental pain, symptoms and disabilities in female homecare personnel
2000 (English)In: Scandinavian Journal of Rehabilitation Medicine, ISSN 0036-5505, E-ISSN 1940-2228, Vol. 32, no 3, p. 124-133Article in journal (Refereed) Published
Abstract [en]

The aim of a study comprising 607 women working as homecare personnel was to investigate general spinal, joint and segmental mobility, different symptoms (pain and strain) and their relation to various aspects of disability. Joint mobility (mainly peripheral) was estimated using the 'Beighton' score and spinal posture and mobility were measured by kyphometer. Passive segmental mobility and pain provocation were estimated manually. Pain intensity and strain during work and leisure were estimated using visual analogue scales for defined anatomical regions. Disability was rated using defined items and two indices. The 7-day prevalence of low back pain was 48%. Peripheral joint mobility, spinal sagittal posture and thoracic sagittal mobility showed low correlations with disability. Lumbar sagittal hypomobility was associated with higher disability. Manually estimated segmental mobility and segmental pain provocation of L4-L5 and L5-S1 correlated with disability; hypo- and hypermobility or positive pain provocation tests at these levels showed higher disability than normal mobility and negative pain provocation tests, respectively. Cluster analysis revealed that the combination of positive pain provocation tests and low lumbar sagittal mobility was associated with particularly high disability levels. In conclusion, positive pain provocation tests were clearly associated with high disability levels.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27775 (URN)11028797 (PubMedID)12522 (Local ID)12522 (Archive number)12522 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
Lundberg, G. & Gerdle, B. (1999). The relationships between spinal sagittal configuration, joint mobility, general low back mobility and segmental mobility in female homecare personnel. Scandinavian Journal of Rehabilitation Medicine, 31(4), 197-206
Open this publication in new window or tab >>The relationships between spinal sagittal configuration, joint mobility, general low back mobility and segmental mobility in female homecare personnel
1999 (English)In: Scandinavian Journal of Rehabilitation Medicine, ISSN 0036-5505, E-ISSN 1940-2228, Vol. 31, no 4, p. 197-206Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to investigate joint mobility, segmental and general spinal mobility and their interrelationship in 607 women working as homecare personnel. Joint mobility (mainly peripheral) was estimated using the "Beighton" score. Spinal posture and mobility were measured by Debrunner's kyphometer. Passive segmental mobility and pain provocation were estimated manually. Reliability tests between two physiotherapists of segmental mobility and pain provocation (n = 150 subjects) were performed. Positive correlations were found between joint mobility, sagittal thoraco-lumbar mobility and segmental mobility. Hyperlordosis (>39 degrees) was associated with greater lumbar mobility. The reliability of manual segmental mobility and segmental pain provocation was good, especially in the lowest back segments (kappa approximately 0.7). Joint mobility, general mobility and segmental spinal mobility intercorrelated. Segmental mobility manually estimated showed intertester reliability. The good positive correlation between sagittal lumbar mobility and manually tested segmental mobility indicates criterion validity for the latter.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-81489 (URN)10.1080/003655099444362 (DOI)10599896 (PubMedID)
Available from: 2012-09-17 Created: 2012-09-17 Last updated: 2017-12-07Bibliographically approved
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