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  • 1.
    Gerdle, Björn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Sandberg, Margaretha
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Akuta och kroniska nociceptiva smärtor. Den biopsykosociala helhetssynen och aspekter på de neurobiologiska mekanismerna2006In: 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

  • 2.
    Sandberg, Margareta
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Acupuncture - effects on muscle blood flow and aspects of treatment in the clinicla context2004Doctoral 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.

    List of papers
    1. Manual Acupuncture in Fibromyalgia: A Long-Term Pilot Study
    Open this publication in new window or tab >>Manual Acupuncture in Fibromyalgia: A Long-Term Pilot Study
    1999 (English)In: Journal of Musculoskeletal Pain, ISSN 1058-2452, Vol. 7, no 3, p. 39-58Article in journal (Refereed) Published
    Abstract [en]

    Objectives: The aim of this cross-over designed pilot study was to investigate the short-term and long-term effects on pain and other common symptoms present in fibromyalgia [FMS] of manual acupuncture with needles inserted into traditional Chinese acupuncture points.

    Methods: Nine out of 10 consecutive FMS patients completed the study. Acupuncture was given in 10-14 sessions over two to three months, followed by an observation period of six months. The control regime consisted of continuous medical management. The patients were evaluated immediately after the completion of the treatment and at 4, 8, 12, and 24 weeks. Pain, sleep, medication, muscle tension, psychological tension, general well-being, the number of tender points, and range of movement in shoulders and neck were assessed.

    Results: In general, significantly greater changes occurred for the variables under investigation during the acupuncture period than during the control period. Nine of the 11 outcome variables showed a significant improvement after acupuncture period. The number of tender points was significantly decreased and the sense of well-being significantly improved up to 12 week follow-up. A significant decrease in general pain persisted for eight weeks. Muscle tension and local pain in head, neck, and shoulder regions were significantly reduced throughout the whole 24 week follow-up period. According to the patients' evaluation of global treatment outcome, improvements remained significant until the four week follow-up. Base-line values of well-being and sleep patterns were the most important predictors of treatment outcome.

    Conclusion: We conclude that for some FMS patients 10-14 acupuncture sessions seem to give additional benefits over a limited period.

    Keywords
    Fibromyalgia, acupuncture, manual needle stimulation, traditional chinese points
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-12841 (URN)10.1300/J094v07n03_04 (DOI)
    Available from: 2008-01-09 Created: 2008-01-09 Last updated: 2009-08-20
    2. Effects of electro-acupuncture on psychological distress in postmenopausal women
    Open this publication in new window or tab >>Effects of electro-acupuncture on psychological distress in postmenopausal women
    Show others...
    2002 (English)In: Complementary Therapies in Medicine, ISSN 0965-2299, Vol. 10, no 3, p. 161-169Article in journal (Refereed) Published
    Abstract [en]

    Objectives: To evaluate effects of electro–acupuncture (EA) on general psychological distress and relate to experience of climacteric symptoms in 30 postmenopausal women.

    Design: A randomised single-blind controlled design was used to evaluate effects of EA and extremely superficial needle insertion, with the latter serving as a near-placebo control.

    Settings: The Linköping University Hospital in Sweden. Interventions: Fourteen treatments during 12 weeks with follow-ups at 3 and 6 months.

    Outcome measures: General psychological well-being, mood and experience of climacteric symptoms. Results: Mood Scale improved only in EA group and not until 12 weeks compared to baseline, from 110 to 129 (P=0.01), and to 120 at 3-month follow-up (P=0.04). Mood was significantly better than control at 8 (P=0.05) and 12 weeks (P=0.01). Visual analogue scale estimation of climacteric symptoms was decreased at 4 weeks in both groups, and lasted throughout the study period, in EA group from 5 to 2 (P=0.04) and in control group from 5 to 3 (P=0.02) at 6-month follow-up. Well-being was ameliorated from 4 weeks in EA and from 8 weeks in control group until end of study (P=0.01, P=0.03). No significant differences on climacteric symptoms or well-being existed between the groups.

    Conclusions: This study does not show that EA is better than superficial needle insertion for the amelioration of general psychological distress and experience of climacteric symptoms in women with vasomotor symptoms after menopause. However, the more pronounced effect on mood suggests that EA might have additional effects compared with superficial needle insertion.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-12842 (URN)10.1016/S0965229902000547 (DOI)
    Available from: 2008-01-09 Created: 2008-01-09 Last updated: 2009-08-20
    3. Non-invasive monitoring of muscle blood perfusion by photoplethysmography: Evaluation of a new application
    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
    4. Effects of acupuncture on skin and muscle blood flow in healthy subjects
    Open this publication in new window or tab >>Effects of acupuncture on skin and muscle blood flow in healthy subjects
    2003 (English)In: European Journal of Applied Physiology, ISSN 1439-6319, Vol. 90, no 1-2, p. 114-119Article in journal (Refereed) Published
    Abstract [en]

    In 14 healthy female subjects, the effects of needle stimulation (acupuncture) on skin and muscle blood flow were investigated using a non-invasive custom-designed probe and photoplethysmography (PPG). In randomised order, 2–7 days apart, three modes of needle stimulation were performed on the anterior aspect of the tibia: superficial insertion (SF), insertion into the anterior tibial muscle (Mu), and insertion into the muscle including manipulation of the needle in order to elicit a distinct sensation of distension, heaviness or numbness (DeQi). Before intervention, the subjects rested for 30 min. After the intervention, the needle was left in situ for 20 min. Blood flow recordings were performed intermittently from 10 min prior to the intervention to the end of the trial. In a fourth session, serving as control, corresponding measurements were performed without any needle stimulation. Area under curve was calculated for 5-min periods prior to and after stimulation, respectively, and for the remaining 15-min period after stimulation. Compared to the control situation, muscle blood flow increased following both Mu and DeQi for 20 min, with the latter being more pronounced for the initial 5 min. Skin blood flow increased for 5 min following DeQi. However, no increase was found following SF. The DeQi stimulation was preceded by higher visual analogue scale ratings of anxiety prior to stimulation, which might have influenced skin blood flow to some extent. The results indicate that the intensity of the needling is of importance, the DeQi stimulation resulting in the most pronounced increase in both skin and muscle blood flow.

    Keywords
    Axon reflex, Needle stimulation, Non-invasive, Photoplethysmography (PPG), Vasodilatation
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-12844 (URN)10.1007/s00421-003-0825-3 (DOI)
    Available from: 2008-01-09 Created: 2008-01-09 Last updated: 2009-08-20
    5. Peripheral effects of needle stimulation (acupuncture) on skin and muscle blood flow in fibromyalgia
    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
    6. 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
    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
  • 3.
    Sandberg, Margareta
    Linköping University, Department of Medicine and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Gott bemötande inte liktydligt med effektiv behandling2006In: Dagens medicin, ISSN 1104-7488Article in journal (Other (popular science, discussion, etc.))
    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.

  • 4.
    Sandberg, Margareta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences.
    Larsson, Britt
    Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
    Lindberg, Lars-Göran
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Gerdle, Björn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences.
    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 myalgia2005In: European Journal of Pain, ISSN 1090-3801, Vol. 9, no 5, p. 497-510Article in journal (Refereed)
    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.

  • 5.
    Sandberg, Margareta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Lindberg, Lars-Göran
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Gerdle, Björn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Peripheral effects of needle stimulation (acupuncture) on skin and muscle blood flow in fibromyalgia2004In: European Journal of Pain, ISSN 1090-3801, Vol. 8, no 2, p. 163-171Article in journal (Refereed)
    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.

  • 6.
    Sandberg, Margareta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Lundeberg, Thomas
    Division of Physiology II, Karolinska Institutet, Stockholm, Sweden.
    Gerdle, Björn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Manual Acupuncture in Fibromyalgia: A Long-Term Pilot Study1999In: Journal of Musculoskeletal Pain, ISSN 1058-2452, Vol. 7, no 3, p. 39-58Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this cross-over designed pilot study was to investigate the short-term and long-term effects on pain and other common symptoms present in fibromyalgia [FMS] of manual acupuncture with needles inserted into traditional Chinese acupuncture points.

    Methods: Nine out of 10 consecutive FMS patients completed the study. Acupuncture was given in 10-14 sessions over two to three months, followed by an observation period of six months. The control regime consisted of continuous medical management. The patients were evaluated immediately after the completion of the treatment and at 4, 8, 12, and 24 weeks. Pain, sleep, medication, muscle tension, psychological tension, general well-being, the number of tender points, and range of movement in shoulders and neck were assessed.

    Results: In general, significantly greater changes occurred for the variables under investigation during the acupuncture period than during the control period. Nine of the 11 outcome variables showed a significant improvement after acupuncture period. The number of tender points was significantly decreased and the sense of well-being significantly improved up to 12 week follow-up. A significant decrease in general pain persisted for eight weeks. Muscle tension and local pain in head, neck, and shoulder regions were significantly reduced throughout the whole 24 week follow-up period. According to the patients' evaluation of global treatment outcome, improvements remained significant until the four week follow-up. Base-line values of well-being and sleep patterns were the most important predictors of treatment outcome.

    Conclusion: We conclude that for some FMS patients 10-14 acupuncture sessions seem to give additional benefits over a limited period.

  • 7.
    Sandberg, Margareta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Lundeberg, Thomas
    Division of Physiology II, Karolinska Institutet, Stockholm, Sweden.
    Lindberg, Lars-Göran
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Gerdle, Björn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Effects of acupuncture on skin and muscle blood flow in healthy subjects2003In: European Journal of Applied Physiology, ISSN 1439-6319, Vol. 90, no 1-2, p. 114-119Article in journal (Refereed)
    Abstract [en]

    In 14 healthy female subjects, the effects of needle stimulation (acupuncture) on skin and muscle blood flow were investigated using a non-invasive custom-designed probe and photoplethysmography (PPG). In randomised order, 2–7 days apart, three modes of needle stimulation were performed on the anterior aspect of the tibia: superficial insertion (SF), insertion into the anterior tibial muscle (Mu), and insertion into the muscle including manipulation of the needle in order to elicit a distinct sensation of distension, heaviness or numbness (DeQi). Before intervention, the subjects rested for 30 min. After the intervention, the needle was left in situ for 20 min. Blood flow recordings were performed intermittently from 10 min prior to the intervention to the end of the trial. In a fourth session, serving as control, corresponding measurements were performed without any needle stimulation. Area under curve was calculated for 5-min periods prior to and after stimulation, respectively, and for the remaining 15-min period after stimulation. Compared to the control situation, muscle blood flow increased following both Mu and DeQi for 20 min, with the latter being more pronounced for the initial 5 min. Skin blood flow increased for 5 min following DeQi. However, no increase was found following SF. The DeQi stimulation was preceded by higher visual analogue scale ratings of anxiety prior to stimulation, which might have influenced skin blood flow to some extent. The results indicate that the intensity of the needling is of importance, the DeQi stimulation resulting in the most pronounced increase in both skin and muscle blood flow.

  • 8.
    Sandberg, Margareta
    et al.
    Linköping University, Department of Medicine and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Sandberg, Matilda
    Linköping University, Faculty of Health Sciences.
    Dahl, Johanna
    Linköping University, Faculty of Health Sciences.
    Blood flow changes in the trapezius muscle and overlying skin following transcutaneous electrical nerve stimulation2007In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 87, no 8, p. 1047-1055Article in journal (Refereed)
    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.

  • 9.
    Sandberg, Margareta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences.
    Wyon, Yvonne
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
    Nedstrand, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Hammar, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Effects of electro-acupuncture on psychological distress in postmenopausal women2002In: Complementary Therapies in Medicine, ISSN 0965-2299, Vol. 10, no 3, p. 161-169Article in journal (Refereed)
    Abstract [en]

    Objectives: To evaluate effects of electro–acupuncture (EA) on general psychological distress and relate to experience of climacteric symptoms in 30 postmenopausal women.

    Design: A randomised single-blind controlled design was used to evaluate effects of EA and extremely superficial needle insertion, with the latter serving as a near-placebo control.

    Settings: The Linköping University Hospital in Sweden. Interventions: Fourteen treatments during 12 weeks with follow-ups at 3 and 6 months.

    Outcome measures: General psychological well-being, mood and experience of climacteric symptoms. Results: Mood Scale improved only in EA group and not until 12 weeks compared to baseline, from 110 to 129 (P=0.01), and to 120 at 3-month follow-up (P=0.04). Mood was significantly better than control at 8 (P=0.05) and 12 weeks (P=0.01). Visual analogue scale estimation of climacteric symptoms was decreased at 4 weeks in both groups, and lasted throughout the study period, in EA group from 5 to 2 (P=0.04) and in control group from 5 to 3 (P=0.02) at 6-month follow-up. Well-being was ameliorated from 4 weeks in EA and from 8 weeks in control group until end of study (P=0.01, P=0.03). No significant differences on climacteric symptoms or well-being existed between the groups.

    Conclusions: This study does not show that EA is better than superficial needle insertion for the amelioration of general psychological distress and experience of climacteric symptoms in women with vasomotor symptoms after menopause. However, the more pronounced effect on mood suggests that EA might have additional effects compared with superficial needle insertion.

  • 10.
    Sandberg, Margareta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences.
    Zhang, Qiuxia
    Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Styf, Jorma
    Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Gerdle, Björn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences.
    Lindberg, Lars-Göran
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Non-invasive monitoring of muscle blood perfusion by photoplethysmography: Evaluation of a new application2005In: Acta Physiologica Scandinavica, ISSN 0001-6772, E-ISSN 1365-201X, Vol. 183, no 4, p. 335-343Article in journal (Refereed)
    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.

  • 11.
    Sandberg, Margaretha
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Acupuncture procedures must be accurately described [1]2006In: Acupuncture in Medicine, ISSN 0964-5284, Vol. 24, no 2, p. 92-94Article in journal (Other academic)
    Abstract [en]

    [No abstract available]

  • 12.
    Sandberg, Margaretha
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Förväntan, vänligt bemötande, lugn och ro och beröring lindrar - inte akupunktur2005In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, p. 1353-1354Article in journal (Other (popular science, discussion, etc.))
  • 13.
    Sandberg, Margaretha
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Kontrollmetoden lika bra2005In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, p. 1666-1667Article in journal (Other (popular science, discussion, etc.))
1 - 13 of 13
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