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  • 51.
    Nilsson, Michael
    et al.
    Football Research Group, Linköping, Sweden and Ängelholm Hospital, Sweden .
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ekstrand, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Waldén, Markus
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Head and Neck Injuries in Professional Soccer2013In: Clinical Journal of Sports Medicine, ISSN 1050-642X, E-ISSN 1536-3724, Vol. 23, no 4, p. 255-260Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the rate of and risk factors for head and neck injury in male soccer.

    Design: Prospective cohort study.

    Setting: Professional soccer.

    Participants: Twenty-six European teams between 2001/2002 and 2009/2010.

    Assessment of Risk Factors: Simple and multiple risk factor analyses were evaluated using Cox regression for player-related variables and logistic regression for match-related variables.

    Main Outcome Measures: Injury rate (number of time loss injuries per 1000 hours).

    Results: A total of 136 head and neck injuries were recorded (2.2% of all injuries). The head and neck injury rate was 0.17 (0.06 concussions) per 1000 hours. There was a 20-fold higher rate of head and neck injury during match play compared with training (rate ratio [RR], 20.2; 95% confidence interval [CI], 13.3-30.6) and a 78-fold higher rate of concussions (RR, 78.5; 95% CI, 24.4-252.5). Mean layoff for concussion was 10.5 days, but 27% of the concussed players returned to play within 5 days. Defender was the only significant player-related risk factor for head and neck injuries in the multiple analysis (RR, 1.8; 95% CI, 1.0-3.1), whereas no significant variables were identified for concussions.

    Conclusions: Head and neck injuries were relatively uncommon in professional soccer. Defender was the playing position most at risk. More than one-quarter of the concussed players returned to play before what is recommended in the consensus statements by the major sports governing bodies.

  • 52.
    Orchard, John W
    et al.
    School of Public Health, University of Sydney, NSW, Australia.
    Waldén, Markus
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Orchard, Jessica J
    School of Public Health, University of Sydney, NSW, Australia.
    Chivers, Ian
    Native Seeds, Cheltenham, VIC , Australia.
    Seward, Hugh
    Australian Football League Medical Officers Association, Melbourne, VIC , Australia.
    Ekstrand, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Comparison of injury incidences between football teams playing in different climatic regions2013In: Open Access Journal of Sports Medicine, ISSN 1179-1543, E-ISSN 1179-1543, Vol. 4, p. 251-260Article in journal (Refereed)
    Abstract [en]

    Australian Football League (AFL) teams in northern (warmer) areas generally have higher rates of injury than those in southern (cooler) areas. Conversely, in soccer (football) in Europe, teams in northern (cooler) areas have higher rates of injury than those in southern (warmer) areas, with an exception being knee anterior cruciate ligament (ACL) injuries, which are more common in the southern (warmer) parts of Europe. This study examined relative injury incidence in the AFL comparing 9,477 injuries over 229,827 player-weeks from 1999-2012. There was a slightly higher injury incidence for teams from warmer parts of Australia (relative risk [RR] 1.05, 95% confidence interval [CI] 1.01-1.10) with quadriceps strains (RR 1.32, 95% CI 1.10-1.58), knee cartilage injuries (RR 1.42, 95% CI 1.16-1.74), and ankle sprains (RR 1.17, 95% CI 1.00-1.37) all being more likely in warmer region teams. Achilles injuries followed a reverse pattern, tending to be more common in cooler region teams (RR 0.70, 95% CI 0.47-1.03). In conclusion, common findings from the AFL and European soccer are that ankle sprains and ACL injuries are generally more likely in teams playing in warmer climate zones, whereas Achilles tendinopathy may be more likely in teams playing in cooler zones. These injuries may have climate or surface risk factors (possibly related to types and structure of grass and shoe-surface traction) that are universal across different football codes.

  • 53.
    Peolsson, Anneli
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Landén Ludvigsson, Maria
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Overmeer, Thomas
    Malardalen University, Sweden .
    Dedering, Asa
    Karolinska University Hospital, Sweden .
    Bernfort, Lars
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Allergy Center.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Peterson, Gunnel
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Effects of neck-specific exercise with or without a behavioural approach in addition to prescribed physical activity for individuals with chronic whiplash-associated disorders: a prospective randomised study2013In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 14, no 311Article in journal (Refereed)
    Abstract [en]

    Background: Up to 50% of chronic whiplash associated disorders (WAD) patients experience considerable pain and disability and remain on sick-leave. No evidence supports the use of physiotherapy treatment of chronic WAD, although exercise is recommended. Previous randomised controlled studies did not evaluate the value of adding a behavioural therapy intervention to neck-specific exercises, nor did they compare these treatments to prescription of general physical activity. Few exercise studies focus on patients with chronic WAD, and few have looked at patients ability to return to work and the cost-effectiveness of treatments. Thus, there is a great need to develop successful evidence-based rehabilitation models. The study aim is to investigate whether neck-specific exercise with or without a behavioural approach (facilitated by a single caregiver per patient) improves functioning compared to prescription of general physical activity for individuals with chronic WAD. less thanbrgreater than less thanbrgreater thanMethods/Design: The study is a prospective, randomised, controlled, multi-centre study with a 2-year follow-up that includes 216 patients with chronic WAD (andgt;6 months and andlt;3 years). The patients (aged 18 to 63) must be classified as WAD grade 2 or 3. Eligibility will be determined with a questionnaire, telephone interview and clinical examination. The participants will be randomised into one of three treatments: (A) neck-specific exercise followed by prescription of physical activity; (B) neck-specific exercise with a behavioural approach followed by prescription of physical activity; or (C) prescription of physical activity alone without neck-specific exercises. Treatments will be performed for 3 months. We will examine physical and psychological function, pain intensity, health care consumption, the ability to resume work and economic health benefits. An independent, blinded investigator will perform the measurements at baseline and 3, 6, 12 and 24 months after inclusion. The main study outcome will be improvement in neck-specific disability as measured with the Neck Disability Index. All treatments will be recorded in treatment diaries and medical records. less thanbrgreater than less thanbrgreater thanDiscussion: The study findings will help improve the treatment of patients with chronic WAD.

  • 54.
    Peolsson, Anneli
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. University of Queensland, Brisbane, Australia.
    Landén Ludvigsson, Maria
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Department of Rehabilitation in Motala.
    Wibault, Johanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Dedering, Åsa
    Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
    Peterson, Gunnel
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Uppsala University, Sweden.
    Function in Patients With Cervical Radiculopathy or Chronic Whiplash-Associated Disorders Compared With Healthy Volunteers2014In: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 37, no 4, p. 211-218Article in journal (Refereed)
    Abstract [en]

    Objective

    The purposes of this study were to examine whether any differences in function and health exist between patients with cervical radiculopathy (CR) due to disk disease scheduled for surgery and patients with chronic whiplash-associated disorders (WADs) and to compare measures of patients' physical function with those obtained from healthy volunteers.

    Methods

    This is a cross-sectional study of patients with CR (n = 198) and patients with chronic WAD (n = 215). Patient data were compared with raw data previously obtained from healthy people. Physical measures included cervical active range of motion, neck muscle endurance, and hand grip strength. Self-rated measures included pain intensity (visual analog scale), neck disability (Neck Disability Index), self-efficacy (Self-Efficacy Scale), and health-related quality of life (EuroQol 5-dimensional self-classifier).

    Results

    Patient groups exhibited significantly lower performance than the healthy group in all physical measures (P < .0005) except for neck muscle endurance in flexion for women (P > .09). There was a general trend toward worse results in the CR group than the WAD group, with significant differences in neck active range of motion, left hand strength for women, pain intensity, Neck Disability Index, EuroQol 5-dimensional self-classifier, and Self-Efficacy Scale (P < .0001).

    Conclusions

    Patients had worse values than healthy individuals in almost all physical measures. There was a trend toward worse results for CR than WAD patients.

  • 55.
    Peolsson, Anneli
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. University of Queensland, Brisbane, Australia.
    Peolsson, Michael
    Umeå University, Sweden .
    Longitudinal changes in ventral and dorsal neck muscle layers during loading against gravity in healthy volunteers using speckle tracking2014In: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 37, no 4, p. 253-259Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    This study aimed to describe and compare the longitudinal mechanical activity, deformation, and deformation rate of the different layers of dorsal and ventral neck muscles in healthy volunteers during head lifts against gravity.

    METHODS:

    The cross-sectional study included 19 healthy volunteers (mean age, 28 years; SD, 7 years). Ultrasound with speckle-tracking analysis was used to investigate longitudinal mechanical activation, deformation, and deformation rate of dorsal and ventral neck muscles in real time during a head lift. Significance levels were set as P = .025 or P = .0125, depending on the number of comparisons.

    RESULTS:

    The dorsal neck muscles did not significantly differ in deformation (P > .04); however, the multifidus had a higher deformation rate than all other dorsal muscles (P < .003). The sternocleidomastoid had significantly higher deformation than the longus capitis (P = .005) and colli (P = .001) but a lower deformation rate than the longus colli (P = .02).

    CONCLUSION:

    The sternocleidomastoid deformed more than the deeper muscles, but it did significantly slower than the longus colli. Among the dorsal muscles, the deepest (the multifidus) had the highest deformation rate.

  • 56.
    Peolsson, Anneli
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. NHMRC CCRE (Spinal Pain, Injury and Health), The University of Queensland, Brisbane, Australia.
    Peolsson, Michael
    Computational Life Science Cluster and Department of Chemistry, Umeå University, Umeå.
    Jull, Gwendolen
    NHMRC CCRE (Spinal Pain, Injury and Health), The University of Queensland, Brisbane, Australia.
    O Leary, Shaun
    NHMRC CCRE (Spinal Pain, Injury and Health), The University of Queensland, Brisbane, Australia and Physiotherapy Department, Royal Brisbane and Womens Hospital, Queensland Health, Queensland, Australia.
    Is there a difference in the pattern of muscle activity when performing neck exercises with a guild board versus a pulley?2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 9, p. 900-905Article in journal (Refereed)
    Abstract [en]

    Objective: Guild boards and pulleys are apparatus commonly used to train cervical muscle function for their purported benefit in facilitating activity of the deeper muscle layers, although this effect has not been substantiated. The objective of this study was to compare the activity of the different layers of cervical muscles when performing exercise with these 2 types of apparatus. Subjects: A total of 19 healthy persons (mean age 28 years, (standard deviation 7 years). Design: Ultrasound measurements of muscle deformation and deformation rate were recorded from the dorsal and ventral neck muscle layers during extension and flexion exercises. Pulley exercises were performed in the upright sitting position against a standardized resistance (men 2 kg, women 1 kg) and guild board exercises at an angle of 45 degrees. Results: The dorsal muscles generally showed greater levels of deformation and deformation rate during exercise with the guild board compared with the pulley system (p<0.05), but with no significant differences in relative activity between the deep and superficial muscle layers (condition x muscle interaction (p>0.05)). No differences were observed for the ventral muscles between exercise methods (p>0.05). Conclusion: While both exercise methods appear to train cervical muscle function, neither appear to be more selective in facilitating deep cervical muscle activity, probably as they involve very similar cervical kinematics.

  • 57.
    Peolsson, Anneli
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Peolsson, Michael N.
    Umeå University, Sweden.
    Jull, Gwendolen A.
    University of Queensland, Australia.
    OLeary, Shaun P.
    University of Queensland, Australia.
    Cervical Muscle Activity During Loaded Arm Lifts in Patients 10 Years Postsurgery for Cervical Disc Disease2013In: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 36, no 5, p. 292-299Article in journal (Refereed)
    Abstract [en]

    Objective

    The purpose of this study was to compare the mechanical activity of the neck muscles during loaded arm lifting tasks in individuals with long-standing disability after anterior cervical decompression and fusion (ACDF) with that of healthy controls.

    Methods

    Ten individuals (mean age, 60 years; SD, 7.1) who underwent ACDF (10-13 years previously) for cervical disc disease and 10 healthy age- and sex-matched controls participated in the study. Ultrasonography was used to investigate the degree of deformation and deformation rate of ventral and dorsal neck muscles at the C4 segmental level during a single (1 × arm flexion to 120°) and repeated (10 × arm flexion to 90°) loaded arm elevation condition.

    Results

    The ACDF group showed greater deformation and deformation rate of the longus capitis (P = .02) and deformation rate of the sternocleidomastoid (P = .04) during the 120° arm lift. For repeated 90° arm lift, there was a significant group effect with higher deformation rate values observed in the longus capitis (P = .005-.01) and multifidus (P = .03) muscles in the ACDF group. Muscle behavior did not change the repeated arm lifts (no group × time interactions) for either the ventral or the dorsal muscles.

    Conclusions

    For study participants, greater muscle mechanical activity levels were observed in the ventral and multifidus muscles of patients with persistent symptoms after ACDF. These differences may indicate altered motor strategy in this patient group when performing the upper limb task and may need to be considered when prescribing exercise for postsurgical rehabilitation.

  • 58.
    Peolsson, Anneli
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Öberg, Birgitta
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Wibault, Johanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Dedering, Åsa
    Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
    Zsigmond, Peter
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Neurosurgery.
    Bernfort, Lars
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Allergy Center.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Futurum, County Council Jönköping, Sweden .
    Persson, Liselott
    Lunds University, Sweden.
    Löfgren, Håkan
    Ryhov Hospital, Jönköping, Sweden .
    Outcome of physiotherapy after surgery for cervical disc disease: a prospective randomised multi-centre trial2014In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 15, no 34Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Many patients with cervical disc disease require leave from work, due to long-lasting, complex symptoms, including chronic pain and reduced levels of physical and psychological function. Surgery on a few segmental levels might be expected to resolve disc-specific pain and reduce neurological deficits, but not the non-specific neck pain and the frequent illness. No study has investigated whether post-surgery physiotherapy might improve the outcome of surgery. The main purpose of this study was to evaluate whether a well-structured rehabilitation programme might add benefit to the customary post-surgical treatment for cervical disc disease, with respect to function, disability, work capability, and cost effectiveness.

    METHODS/DESIGN:

    This study was designed as a prospective, randomised, controlled, multi-centre study. An independent, blinded investigator will compare two alternatives of rehabilitation. We will include 200 patients of working age, with cervical disc disease confirmed by clinical findings and symptoms of cervical nerve root compression. After providing informed consent, study participants will be randomised to one of two alternative physiotherapy regimes; (A) customary treatment (information and advice on a specialist clinic); or (B) customary treatment plus active physiotherapy. Physiotherapy will follow a standardised, structured programme of neck-specific exercises combined with a behavioural approach. All patients will be evaluated both clinically and subjectively (with questionnaires) before surgery and at 6 weeks, 3 months, 6 months, 12 months, and 24 months after surgery. The main outcome variable will be neck-specific disability. Cost-effectiveness will also be calculated.

    DISCUSSION:

    We anticipate that the results of this study will provide evidence to support physiotherapeutic rehabilitation applied after surgery for cervical radiculopathy due to cervical disc disease.

  • 59.
    Persson, Jan
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Bernfort, Lars
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Wåhlin, Charlotte
    Institute of Environmental Medicine, Karolinska Institutet.
    Öberg, Birgitta
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Costs to society related to sickness absence due to musculoskeletal or mental disorders in Sweden - results from a cohort study2013Conference paper (Refereed)
  • 60.
    Silén, Charlotte
    et al.
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Wirell, Staffan
    Linköping University, Department of Medical and Health Sciences, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping. Linköping University, Faculty of Health Sciences.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Nylander, Eva
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Fyrénius, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Clinical Physiology.
    Smedby, Örjan
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping. Linköping University, Faculty of Health Sciences.
    Advanced 3D visualization in student-centred medical education2008In: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 30, no 5, p. e115-e124Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Healthcare students have difficulties achieving a conceptual understanding of 3D anatomy and misconceptions about physiological phenomena are persistent and hard to address. 3D visualization has improved the possibilities of facilitating understanding of complex phenomena. A project was carried out in which high quality 3D visualizations using high-resolution CT and MR images from clinical research were developed for educational use. Instead of standard stacks of slices (original or multiplanar reformatted) volume-rendering images in the quicktime VR format that enables students to interact intuitively were included. Based on learning theories underpinning problem based learning, 3D visualizations were implemented in the existing curricula of the medical and physiotherapy programs. The images/films were used in lectures, demonstrations and tutorial sessions. Self-study material was also developed. AIMS: To support learning efficacy by developing and using 3D datasets in regular health care curricula and enhancing the knowledge about possible educational value of 3D visualizations in learning anatomy and physiology. METHOD: Questionnaires were used to investigate the medical and physiotherapy students' opinions about the different formats of visualizations and their learning experiences. RESULTS: The 3D images/films stimulated the students will to understand more and helped them to get insights about biological variations and different organs size, space extent and relation to each other. The virtual dissections gave a clearer picture than ordinary dissections and the possibility to turn structures around was instructive. CONCLUSIONS: 3D visualizations based on authentic, viable material point out a new dimension of learning material in anatomy, physiology and probably also pathophysiology. It was successful to implement 3D images in already existing themes in the educational programs. The results show that deeper knowledge is required about students' interpretation of images/films in relation to learning outcomes. There is also a need for preparations and facilitation principles connected to the use of 3D visualizations.

  • 61.
    Sjödahl, Jenny
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Gutke, Annelie
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Öberg, Birgitta
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Predictors for long-term disability in women with persistent postpartum pelvic girdle pain2013In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 22, no 7, p. 1665-1673Article in journal (Refereed)
    Abstract [en]

    Purpose

    The majority of prognostic studies on postpartum lumbopelvic pain have investigated factors during pregnancy. Since the majority of women recover within the first few months of delivery, it is unknown if the same predictors are valid for long-term consequences. It is also important to investigate predictors within subgroups of patients with pregnancy-related lumbopelvic pain due to their different clinical courses. The aim of this study was to identify predictors for disability 15 months postpartum in women with persistent postpartum pelvic girdle pain (PGP).

    Methods

    Data were obtained by clinical tests and questionnaires 3 months postpartum. The outcome 15 months postpartum was disability measured with the Oswestry Disability Index.

    Results

    A multiple linear regression analysis identified two significant two-way interaction effects that were predictive of disability 15 months postpartum: (a) age + trunk flexor endurance, and (b) disability + hip extensor strength.

    Conclusions

    Age, muscle function and disability seem to influence the long-term outcome on disability in women with persistent postpartum PGP. It may be important to consider the possibility of different variables impact on each other when predicting long-term disability. In addition, further studies are needed to investigate the impact of interaction effects on long-term consequences in women with persistent postpartum PGP.

  • 62.
    Tagesson (Sonesson), Sofi
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Witvrouw, Erik
    Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Differences in Knee Joint Stabilization Between Children and Adults and Between the Sexes2013In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 41, no 3, p. 678-683Article in journal (Refereed)
    Abstract [en]

    Background: Differences in knee joint stabilization between children and adults and between the sexes are not fully understood. Purpose: To compare the knee laxity and the dynamic tibial translation between (1) children and adults, (2) girls and boys, and (3) women and men. Study Design: Controlled laboratory study.

    Methods: Sixty-seven children (aged 8-13 years) and 63 adults (aged 18-30 years) without previous knee injuries participated. Sagittal tibial translation was measured during the instrumented Lachman test at 90 N and 134 N (knee laxity) and during gait (dynamic translation). Tibial translation was recorded with an electrogoniometer.

    Results: Knee laxity was greater in children than in adults (Lachman test at 90 N: 9.1 +/- 2.9 vs 7.3 +/- 2.7, respectively; P less than .001). In contrast, dynamic tibial translation during gait did not differ between children and adults. Girls and boys did not differ in knee laxity or maximum anterior tibial translation during gait, and men and women did not differ in knee laxity. Women had greater dynamic tibial translation during gait than men (7.8 +/- 2.7 vs 5.7 +/- 3.0, respectively; P = .004).

    Conclusion: Children had greater knee laxity than adults, whereas the dynamic tibial translation did not differ. In adults, knee laxity did not differ between the sexes, but dynamic tibial translation was greater in women. Clinical Relevance: Children and men had less dynamic tibial translation during gait in proportion to their maximum knee laxity. The observed less dynamic tibial translation in children and adult men might be related to their reduced risk of sustaining an anterior cruciate ligament injury.

  • 63.
    Tödt, Kristina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine.
    Skargren, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Kentson, Magnus
    Ryhov Hospital, Sweden .
    Theander, Kersti
    Karlstad University, Sweden .
    Jakobsson, Per
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Experience of fatigue, and its relationship to physical capacity and disease severity in men and women with COPD2014In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 9, p. 17-25Article in journal (Refereed)
    Abstract [en]

    Introduction: Several differences have been reported in the clinical characteristics of chronic obstructive pulmonary disease (COPD) between men and women. Differences have been found in the association between respiratory symptoms and lung function, and in the factors associated with dyspnea. This raises the question of whether there are differences between the sexes in the relationship between fatigue, the second most prevalent symptom, and the variables of physical capacity and disease severity. Objectives: To examine the experience of fatigue and its relationship to physical capacity and disease severity in men and women with COPD. Methods: In a cross-sectional study 121 patients with COPD (54 men and 67 women), the experience of fatigue (frequency, duration, and severity) and physical capacity (lung function, 6-minute walk distance [6MWD], grip strength, and timed-stand test) were assessed. Disease severity was graded according to the Body mass index, airway Obstruction, Dyspnoea and Exercise capacity (BODE) index. Two multiple logistic regression models were tested, both of which were performed separately in men and women, to examine the association between the experience of fatigue and variables of physical capacity and the BODE index. Results: Eighty-nine (73.6%) patients experienced fatigue, with similar proportions in men and women. The men with fatigue had worse physical capacity and more severe disease than did the men without fatigue: for men with and without fatigue, respectively, the percent of predicted forced expiratory volume in 1 second (FEV1) (mean [standard deviation]) was 47 (14) vs 64 (17); the 6MWD (mean [standard deviation]) was 398 (138) vs 539 (105) m; and the BODE index (median [quartile 1-3]) was 3 (2-5) vs 1 (0-1) (Pless than0.01). In women, only higher leg fatigue post-6MWD was seen among those experiencing fatigue compared with women without fatigue: for women with and without fatigue, respectively, leg fatigue (median [quartile 1-3]) was 4 (3-5) vs 2 (0-3) (Pless than0.001). The regression models showed that the 6MWD and the BODE index were associated with fatigue in both men and women, but in women, leg fatigue remained an independent associate in both models. Conclusion: Exercise capacity and disease severity were associated with fatigue in both men and women. In women, leg fatigue was strongly associated with fatigue, which warrants further investigation.

  • 64.
    van der Werff, Ross
    et al.
    University of Queensland, Brisbane, Australia.
    O'Leary, Shaun
    University of Queensland, Brisbane, Australia.
    Jull, Gwendolen
    University of Queensland, Brisbane. Australia.
    Peolsson, Michael
    Umeå University, Sweden.
    Trygg, Johan
    Umeå University, Sweden.
    Peolsson, Anneli
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    A speckle tracking application of ultrasound to evaluate activity of multilayered cervical muscles2014In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 7, p. 662-667Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the capacity of the ultrasound-based method of speckle tracking analysis to detect changes in multilayered dorsal neck muscle activity induced by performing a lifting task.

    Subjects: Twenty-one healthy individuals.

    Design: Participants performed a loaded lifting task in 3 different postural orientations of the neck (neutral, flexed and forward head posture). Ultrasound images were recorded and speckle tracking analysis was used to quantify muscle deformation and deformation rate over 3 equal time-periods during the lifting sequence (rest, mid-lift and end-lift).

    Results: Significant main effects of postural orientation for the deformation measure (p < 0.05) and time for the deformation rate measure (p < 0.05) were observed in all dorsal muscles examined. Significant time by postural interactions for the deformation measure were observed in the trapezius, semispinalis cervicis and multifidus (p < 0.05) and in the semispinalis cervicis (p < 0.05) for the deformation rate measure.

    Conclusion: Speckle tracking analysis ultrasound measurements can detect differences in multilayered muscle activity of the dorsal neck induced by postural variations during a lifting task. Findings for the deformation and the deformation rate measures suggest that they quantify a different, albeit related, mechanical event during muscle contraction in a functional task such as lifting.

  • 65.
    Waldén, Markus
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Hässleholm-Kristianstad-Ystad Hospitals, Hässleholm, Sweden .
    Atroshi, Isam
    Hässleholm-Kristianstad-Ystad Hospitals, Hässleholm and Lund University, Sweden .
    Magnusson, Henrik
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Wagner, Philippe
    Lund University, Sweden.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Republished research: Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial2012In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 46, no 13, p. 904-Article in journal (Refereed)
    Abstract [en]

    Study question Does a neuromuscular warm-up programme reduce the rate of anterior cruciate ligament injury in adolescent female football players? 

    Summary answer The neuromuscular warm-up programme reduced the overall rate of anterior cruciate ligament injury by 64%.

    What is known and what this paper adds Knee injuries are common in football regardless of the playing level, and adolescent female players are more susceptible to anterior cruciate ligament injury than their male counterparts. Almost two thirds of anterior cruciate ligament injuries in adolescent female football players can be prevented with a 15 minute neuromuscular warm-up programme.

  • 66.
    Waldén, Markus
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ekstrand, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Time-trends and circumstances surrounding ankle injuries in men's professional football: an 11-year follow-up of the UEFA Champions League injury study2013In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 47, no 12, p. 748-753Article in journal (Refereed)
    Abstract [en]

    Background Ankle injury is common in football, but the circumstances surrounding them are not well characterised.

    Aim To investigate the rates, especially time-trends, and circumstances of ankle injuries in male professional football.

    Methods 27 European clubs with 1743 players were followed prospectively between 2001/2002 and 2011/2012. Time loss injuries and individual-player exposure during training sessions and matches were recorded. Injury rate was defined as the number of injuries/1000 h.

    Results A total of 1080 ankle injuries were recorded (13% of all injuries) with lateral ligament ankle sprain being the most common injury subtype (51% of all ankle injuries). The rates of ankle injury and ankle sprain were 1/1000 h and 0.7/1000 h, respectively. The ankle sprain rate declined slightly over time during the 11-year study period (on average 3.1%/season) with a statistically significant seasonal trend (p=0.041). Foul play according to the referee was involved in 40% of the match-related ankle sprains. Syndesmotic sprains and ankle impingement were uncommon causes of time loss (3% each of all ankle injuries).

    Conclusions Lateral ligament ankle sprain constituted half of all ankle injuries in male professional football, whereas ankle impingement syndromes were uncommon. The ankle sprain rate decreased slightly over time, but many ankle sprains were associated with foul play. Our data extend the body of literature that provides football policy makers with a foundation to review existing rules and their enforcement.

  • 67.
    Waldén, Markus
    et al.
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Orchard, J
    University of Sydney, Australia.
    Kristenson, Karolina
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Ekstrand, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Regional differences in injury incidence in European professional football2013In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 23, no 4, p. 424-430Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to investigate regional differences in injury incidence in men's professional football in Europe. A nine-season prospective cohort study was carried out between 2001–2002 and 2009–2010 involving 1357 players in 25 teams from nine countries. Teams were categorized into different regions according to the Köppen–Geiger climate classification system. Teams from the northern parts of Europe (n = 20) had higher incidences of injury overall [rate ratio 1.12, 95% confidence interval (CI) 1.06 to 1.20], training injury (rate ratio 1.16, 95% CI 1.05 to 1.27), and severe injury (rate ratio 1.29, 95% CI 1.10 to 1.52), all statistically significant, compared to teams from more southern parts (n  = 5). In contrast, the anterior cruciate ligament injury incidence was lower in the northern European teams with a statistically significant difference (rate ratio 0.43, 95% CI 0.25 to 0.77), especially for noncontact anterior cruciate ligament injury (rate ratio 0.19, 95% CI 0.09 to 0.39). In conclusion, this study suggests that there are regional differences in injury incidence of European professional football. However, further studies are needed to identify the underlying causes.

  • 68.
    Wibault, Johanna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Vaillant, Jacques
    Centre Hospital University of Grenoble, France.
    Vuillerme, Nicolas
    CNRS UJF UPMF EPHE, France.
    Dedering, Åsa
    Karolinska University Hospital, Sweden.
    Peolsson, Anneli
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Using the cervical range of motion (CROM) device to assess head repositioning accuracy in individuals with cervical radiculopathy in comparison to neck- healthy individuals2013In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 18, no 5, p. 403-409Article in journal (Refereed)
    Abstract [en]

    This study had two purposes: to compare head repositioning accuracy (HRA) using the cervical range of motion (CROM) device between individuals with cervical radiculopathy caused by disc disease (CDD; n = 71) and neck- healthy individuals (n = 173); and to evaluate the test–retest reliability of the CROM device in individuals with CDD, and criterion validity between the CROM device and a laser in neck-healthy individuals, with quantification of measurement errors. Parameters of reliability and validity were expressed with intra- class- correlation coefficients (ICCs), and measurement errors with standard error of measurement (SEM) and Bland Altman limits of agreement. HRA (Mdn, IQR) differed significantly between individuals with CDD and neck- healthy individuals after rotation right 2.7° (6.0), 1.7° (2.7); and rotation left 2.7° (3.3), 1.3° (2.7) (p < = 0.021); 31% of individuals with CDD were classified as having impairment in HRA. The test–retest reliability of the CROM device in individuals with CDD showed ICCs of 0.79- 0.85, and SEMs of 1.4°- 2°. The criterion validity between the CROM device and the laser in neck-healthy individuals showed ICCs of 0.43- 0.91 and SEMs of 0.8°- 1.3°. The results support the use of the CROM device for quantifying HRA impairment in individuals with CDD in clinical practice; however, criterion validity between the CROM device and a laser in neck-healthy individuals was questionable. HRA impairment in individuals with CDD may be important to consider during rehabilitation and evaluated with the criterion established with the CROM device in neck-healthy individuals.

  • 69.
    Wibault, Johanna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Öberg, Birgitta
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Dedring, Åsa
    Karolinska University Hospital, Stockholm, Sweden .
    Löfgren, Håkan
    Ryhov Hospital, Jönköping, Sweden .
    Zsigmond, Peter
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Neurosurgery.
    Persson, Liselotte
    Lunds University, Sweden .
    Peolsson, Anneli
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. University of Queensland, Brisbane, Australia.
    Individual factors associated with neck disability in patients with cervical radiculopathy scheduled for surgery: a study on physical impairments, psychosocial factors, and life style habits2014In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 23, no 3, p. 599-605Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    The influence of individual factors on patient-reported outcomes is important in the interpretation of disability and treatment effectiveness. The purpose of this study was to assess how physical impairments, psychosocial factors, and life style habits were associated with neck disability based on the Neck Disability Index (NDI), in patients with cervical radiculopathy scheduled for surgery.

    METHODS:

    This cross-sectional study included 201 patients (105 men, 96 women; mean age 50 years). Data included self-reported measures and a clinical examination. Multiple linear regressions were performed to identify significant influencing factors.

    RESULTS:

    Pain, physical impairments in the cervical active range of motion, low self-efficacy, depression, and sickness-related absences explained 73 % of the variance in NDI scores (p < 0.001).

    CONCLUSION:

    Assessments of physical impairments and psychosocial factors in patients with cervical radiculopathy could improve the description of neck disability and the interpretation of treatment outcomes in longitudinal studies.

  • 70.
    Öberg, Birgitta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Wåhlin, Charlotte
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Persson, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, The Institute of Technology.
    Bernfort, Lars
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    A prospective cohort study on newly sick-listed patients with musculoskeletal disorders and sustainable return to work2013Conference paper (Other academic)
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