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Diarbakerli, E., Thoreson, O., Björklund, M., Dahlberg, L. E., Englund, M., Gerdhem, P., . . . Abbott, A. (2024). Swedish musculoskeletal researchers view on a collaborative network and future research priorities in Swedish healthcare. Musculoskeletal Care, 22(1), Article ID e1865.
Open this publication in new window or tab >>Swedish musculoskeletal researchers view on a collaborative network and future research priorities in Swedish healthcare
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2024 (English)In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 22, no 1, article id e1865Article in journal (Refereed) Published
Abstract [en]

Background

Musculoskeletal disorders (MSK) are a global burden causing significant suffering and economic impact. Systematic identification and targeting of research questions of highest interest for stakeholders can aid in improving MSK disorder knowledge and management.

Objective

To obtain Swedish MSK researchers' opinions and views on a collaborative Swedish MSK network (SweMSK) and identify future research areas of importance for Swedish MSK research.

Methods

A web-based survey was conducted July to September 2021 to collect data from 354 Swedish MSK researchers. The survey focused on the need, objectives, and structure of a SweMSK network and identified prioritised areas for future MSK research.

Results

The study included 141 respondents, of which 82 were associate professors or professors. The majority (68%) supported the creation of a new musculoskeletal network. The most supported element was increased collaboration regarding nationwide and multicenter studies. Respondents recommended the creation of a homepage and the establishment of national work groups with different specific interests as the primary elements of a new network.

Conclusion

The results demonstrated a need and desire for increased national research collaboration and the creation of a new musculoskeletal network. The high academic experience and active research participation of the respondents suggest the need for MSK disorder knowledge and management improvement in Sweden. Therefore, the SweMSK network may help facilitate effective collaboration and research efforts that can contribute to the advancement of MSK disorder management and care. This study may provide valuable insights for policymakers, clinicians, and researchers to improve MSK disorder care and management in Sweden.

Place, publisher, year, edition, pages
Wiley, 2024
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-43810 (URN)10.1002/msc.1865 (DOI)001158247800001 ()2-s2.0-85184404909 (Scopus ID)
Funder
Swedish Research Council, 2019‐06101
Available from: 2024-02-19 Created: 2024-02-19 Last updated: 2024-02-22Bibliographically approved
Diarbakerli, E., Thoreson, O., Björklund, M., Dahlberg, L. E., Englund, M., Gerdhem, P., . . . Abbott, A. (2022). Learning from the past to plan for the future: A scoping review of musculoskeletal clinical research in Sweden 2010–2020. Upsala Journal of Medical Sciences, 127, Article ID e8709.
Open this publication in new window or tab >>Learning from the past to plan for the future: A scoping review of musculoskeletal clinical research in Sweden 2010–2020
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2022 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 127, article id e8709Article in journal (Refereed) Published
Abstract [en]

Background: The aims of this study are to 1) determine the scope of musculoskeletal (MSK)-related clinical research in Sweden; 2) collate the amount of first-tier funding received; 3) discuss strategies and infrastructure supporting future MSK clinical trials in Sweden.

Methods: A systematic scoping review protocol was applied in PubMed, Scopus, and SweCRIS databases. The articles were examined, and data were extracted in multiple stages by three blinded authors.

Results: The search strategy resulted in 3,025 publications from 479 Swedish-affiliated authors. Primary health care was the basis for 14% of the publications, 84% from secondary health care, and 2% from occupational health care with a similar proportional distribution of first-tier research grant financing. Approximately one in six publications were randomized controlled trials (RCTs), while the majority were of observational cohort design. The majority of publications in primary and occupational health care were related to pain disorders (51 and 67%, respectively), especially diagnosis, prognosis, and healthcare organizational-related interventions (34%) and rehabilitation (15%) with similar proportional distribution of first-tier research grant financing. In secondary health care, rheumatic inflammatory disorder-related publications were most prevalent (30%), most frequently concerning diagnosis, prognosis, and healthcare organizational-related interventions (20%), attracting approximately half of all first-tier funding. Publications related to degenerative joint disorders (25%), fractures (16%), and joint, tendon, and muscle injuries (13%) frequently concerned surgical and other orthopedic-related interventions (16, 6, and 8%, respectively). Pain disorder-related publications (10%) as well as bone health and osteoporosis-related publications (4%) most frequently concerned diagnosis, prognosis, and healthcare organizational-related interventions (5 and 3%, respectively).

Conclusions: Swedish-affiliated MSK disorder research 2010–2020 was predominantly observational cohort rather than RCT based. There was skewed first-tier funding allocation considering prevalence/incidence and burden of disease. Use of infrastructure supporting register-based RCTs, placebo-controlled RCTs, and hybrid effectiveness-implementation studies on prevention and clinical intervention is important strategies for the future in all healthcare sectors.

Place, publisher, year, edition, pages
Upsala Medical Society, 2022
Keywords
Musculoskeletal disorders, clinical research, research design, research funding, primary health care, secondary health care, occupational health care, Sweden
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-40398 (URN)10.48101/ujms.v127.8709 (DOI)000879744700001 ()36337277 (PubMedID)2-s2.0-85141355356 (Scopus ID)
Funder
Swedish Research Council, DNR 2019-06101
Available from: 2022-11-11 Created: 2022-11-11 Last updated: 2022-12-01Bibliographically approved
Arumugam, A., Björklund, M., Mikko, S. & Häger, C. K. (2021). Effects of neuromuscular training on knee proprioception in individuals with anterior cruciate ligament injury: a systematic review and GRADE evidence synthesis. BMJ Open, 11(5), Article ID e049226.
Open this publication in new window or tab >>Effects of neuromuscular training on knee proprioception in individuals with anterior cruciate ligament injury: a systematic review and GRADE evidence synthesis
2021 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 5, article id e049226Article, review/survey (Refereed) Published
Abstract [en]

Objective To systematically review and summarise the evidence for the effects of neuromuscular training compared with any other therapy (conventional training/sham) on knee proprioception following anterior cruciate ligament (ACL) injury.Design Systematic Review.

Data sources PubMed, CINAHL, SPORTDiscus, AMED, Scopus and Physical Education Index were searched from inception to February 2020.

Eligibility criteria Randomised controlled trials (RCTs) and controlled clinical trials investigating the effects of neuromuscular training on knee-specific proprioception tests following a unilateral ACL injury were included.

Data extraction and synthesis Two reviewers independently screened and extracted data and assessed risk of bias of the eligible studies using the Cochrane risk of bias 2 tool. Overall certainty in evidence was determined using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool.Results Of 2706 articles retrieved, only 9 RCTs, comprising 327 individuals with an ACL reconstruction (ACLR), met the inclusion criteria. Neuromuscular training interventions varied across studies: whole body vibration therapy, Nintendo-Wii-Fit training, balance training, sport-specific exercises, backward walking, etc. Outcome measures included joint position sense (JPS; n=7), thresholds to detect passive motion (TTDPM; n=3) or quadriceps force control (QFC; n=1). Overall, between-group mean differences indicated inconsistent findings with an increase or decrease of errors associated with JPS by ≤2°, TTDPM by ≤1.5° and QFC by ≤6 Nm in the ACLR knee following neuromuscular training. Owing to serious concerns with three or more GRADE domains (risk of bias, inconsistency, indirectness or imprecision associated with the findings) for each outcome of interest across studies, the certainty of evidence was very low.

Conclusions The heterogeneity of interventions, methodological limitations, inconsistency of effects (on JPS/TTDPM/QFC) preclude recommendation of one optimal neuromuscular training intervention for improving proprioception following ACL injury in clinical practice. There is a need for methodologically robust RCTs with homogenous populations with ACL injury (managed conservatively or with reconstruction), novel/well-designed neuromuscular training and valid proprioception assessments, which also seem to be lacking.

PROSPERO registration number CRD42018107349.

Place, publisher, year, edition, pages
BMJ, 2021
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-37557 (URN)10.1136/bmjopen-2021-049226 (DOI)000729767000012 ()34006560 (PubMedID)2-s2.0-85106149490 (Scopus ID)
Funder
Swedish Research Council, 2017-00892Swedish National Centre for Research in Sports, CIF P2019 0068Region Västerbotten, ALF 7003575; VLL-358901; 7002795
Available from: 2021-12-26 Created: 2021-12-26 Last updated: 2023-08-28Bibliographically approved
Degerstedt, F., Björklund, M., Keisu, B.-I. & Enberg, B. (2021). Unequal physical activity among children with cerebral palsy in Sweden - A national registry study. Health Science Reports, 4(3), Article ID e342.
Open this publication in new window or tab >>Unequal physical activity among children with cerebral palsy in Sweden - A national registry study
2021 (English)In: Health Science Reports, E-ISSN 2398-8835, Vol. 4, no 3, article id e342Article in journal (Refereed) Published
Abstract [en]

Aim: To examine the extent to which sex, country of birth, and functional aspects influence participation in physical education and physical leisure activity among children with cerebral palsy (CP) in Sweden.

Methods: This national cross-sectional registry study included children with CP aged 6 to 18 years who participated in the Swedish national quality registry, the Cerebral Palsy Follow-up Program, CPUP, in 2015. Comparisons and associations between sex, country of birth, and functional aspects and physical leisure/physical education were examined using chi-squared and multivariable logistic regression analysis.

Results: The study included 1935 children. Of them, 1625 (87%) reported participating in physical education and 989 (53%) reported participating in physical leisure activity. Children born in Sweden had higher odds of participating in physical education (OR: 1.99; 95% CI: 1.20-3.28) and physical leisure activity (OR: 2.51; 95% CI: 1.70-3.72) compared with children born outside Europe. Greater impairment of gross motor function was associated with lower participation levels. Boys participated slightly more frequently in leisure activities than girls.

Conclusion: Enhancing social inclusion with regard to disability, birth country, and sex are important and achievable goals for policymakers and practitioners for promoting participation in physical activity for children and adolescents with CP.

Place, publisher, year, edition, pages
Wiley, 2021
Keywords
inequality, leisure, norms, physical education, youth
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-36926 (URN)10.1002/hsr2.342 (DOI)000700814100054 ()34401523 (PubMedID)2-s2.0-85115821642 (Scopus ID)
Available from: 2021-08-20 Created: 2021-08-20 Last updated: 2022-04-28Bibliographically approved
Degerstedt, F., Enberg, B., Keisu, B.-I. & Björklund, M. (2020). Inequity in physiotherapeutic interventions for children with Cerebral Palsy in Sweden - a national registry study. Acta Paediatrica, 109(4), 774-782
Open this publication in new window or tab >>Inequity in physiotherapeutic interventions for children with Cerebral Palsy in Sweden - a national registry study
2020 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 109, no 4, p. 774-782Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study was to investigate the distribution of physiotherapeutic interventions for children with Cerebral Palsy in Sweden from an equity perspective, considering sex, country of birth and geographical region.

METHOD: This national cross-sectional registry study includes children with Cerebral Palsy aged 0-18 years who participated in 2015 in the Swedish national quality registry, the Cerebral Palsy follow-up program, CPUP. Comparisons and associations between physiotherapeutic interventions and sex, country of birth and geographical regions were conducted using Chi2 and logistic regression analysis, controlling for cognitive level, level of motor function, age group and dominating symptom.

RESULTS: Of the 2855 participants, 2201 (79%) had received physiotherapy. Children born in Sweden had 1.60 times higher odds (95% CI 1.10-2.33) of receiving physiotherapy compared with children born in foreign countries. Distribution of physiotherapeutic interventions differed significantly between geographical regions. No associations between sex and physiotherapeutic interventions were observed.

CONCLUSION: The results of this study indicate inequity in care in Sweden towards children with Cerebral Palsy born in other counties. Further, physiotherapeutic interventions were not equally distributed in different.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
CPUP, Adolescents, Cerebral Palsy, Inequity, Physiotherapy
National Category
Health Sciences
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-30627 (URN)10.1111/apa.14980 (DOI)000488167100001 ()31435959 (PubMedID)2-s2.0-85073965380 (Scopus ID)
Note

Funding agency:

Norrbacka-Eugenia foundation [grant number 811/15 2016].Umeå Center for Gender Studies, Umeå University.Strategic Research Area: Health Care Science (SFO-V), Umeå University.

Available from: 2019-09-04 Created: 2019-09-04 Last updated: 2021-05-21Bibliographically approved
Svedmark, Å., Häger, C. & Björklund, M. (2019). Associations between symptoms and physical test outcomes in women with non-specific neck pain: cross-sectional and longitudinal analyses. In: : . Paper presented at World Confederation for Physical Therapy Congress 2019, May 10-13, Geneva, Switzerland.
Open this publication in new window or tab >>Associations between symptoms and physical test outcomes in women with non-specific neck pain: cross-sectional and longitudinal analyses
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: Non-specific neck pain has a multifaceted symptom picture and the relationship is obscure between individual improvement on physical function and the neck patient's self-rated status.Purpose: The present aim was to determine the associations between physical test outcomes involving the neck and shoulder region, and self-reported neck symptoms before and after a treatment intervention in women with non-specific neck pain.Methods: Data were obtained for 120 women (aged 20-65) who had participated in a previous randomized controlled trial. Data were used from all participants at baseline for cross-sectional analysis and from 69 women for longitudinal analysis (Change-scores). Associations between self-reported neck problems (pain, disability and symptoms from the neck) and physical test outcomes (Neck-Strength, Cervical Axial-Range of Motion and Peak-Speed of cervical rotation) were estimated with linear regression analyses.Results: Self-rated neck pain was only significantly associated to the physical outcome measure Peak-Speed of cervical rotation, i.e., increased pain related to lower speed. This was true at baseline and for Change-scores at 9 months. Increased neck disability and frequency of symptoms were associated to lower Neck Strength and reduced Peak-Speed at baseline, and to reduced Peak-Speed and Cervical Axial-Range of Motion at 3 and 9 months, respectively. Peak-Speed and Cervical Axial-ROM were thus the physical test outcomes with associations to self-rated changes in neck symptoms. At the 9-month follow-up, 26% of the variance of frequency of symptom changes was explained by changes in Cervical Axial-ROM and Peak-Speed, which were also inter-correlated (r=0.55).Conclusion(s): The results indicate that changes in physical functioning, tested as cervical mobility and strength, have only a modest relation to the course of self-rated condition in neck disorders.Implications: The present study calls for reconsideration regarding acting mechanisms behind the apparent effect of, e.g., strength training on neck pain disorders. The specificity and usefulness of various assessments for decision-making, treatment and evaluation might be questioned.Key-Words: Neck pain, Neck strength, Range of motionFunding acknowledgements: Swedish Council for Working Life and Social Research (2009-1403), AFA Insurance (090288), The Centre for Environmental Research (1152383).Ethics approval: Did this work require ethics approval?:YesInstitution: Regional ethical review board in Uppsala SwedenEthics Committee: Regional ethical review board in Uppsala SwedenEthics number: No 2011/081

National Category
Other Health Sciences
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-31025 (URN)
Conference
World Confederation for Physical Therapy Congress 2019, May 10-13, Geneva, Switzerland
Funder
AFA Insurance, 090288Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-1403
Available from: 2019-11-21 Created: 2019-11-21 Last updated: 2020-11-23Bibliographically approved
Björklund, M., Svedmark, Å., Rudolfsson, T. & Djupsjöbacka, M. (2019). Cervico-thoracic and cranio-cervical strength differences between women with and without neck pain and the diagnostic performance of neck-strength tests. In: World Confederation for physical Therapy Congress 2019, Geneva 10-13 May: . Paper presented at World Confederation for physical Therapy Congress 2019, Geneva, 10-13 May.
Open this publication in new window or tab >>Cervico-thoracic and cranio-cervical strength differences between women with and without neck pain and the diagnostic performance of neck-strength tests
2019 (English)In: World Confederation for physical Therapy Congress 2019, Geneva 10-13 May, 2019Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Background: Cervical strength and stability is often addressed in rehabilitation of people with neck pain. These functions may be associated with emergence and retention of neck pain in cases where the neck strength does not meet daily demands. However, clear empiric support for these notions are lacking, partly due to a scarcity of well controlled dynamometry studies with large samples. First, clarification is needed whether neck strength is in fact reduced in people with neck pain and to resolve the diagnostic performance of neck strength tests.

Purpose: To compare neck muscle strength of women with non-specific long-term neck pain and healthy controls. Also, to assess the diagnostic performance of neck strength tests by assessing their discriminative ability to discern women with and without neck pain.

Methods: The study had a cross-sectional design with data on cervical strength derived from the baseline measurement of a randomized controlled trial (RCT). 80 women with long-term non-specific neck pain (NP) were compared with 40 healthy women (CON). The NP group was a subsample from the RCT selected so that there were no group differences (NP-CON) for body weight and physical activity. Cervical strength assessment included dynamometry of cervico-thoracic extension (CTE) and flexion (CTF) in sitting and cranio-cervical flexion (CCF) in standing, all performed with isometric maximum voluntary contraction (iMVC). Independent samples Mann-Whitney U test and T-test were used to assess group differences for iMVC of the tests. Diagnostic accuracy was further assessed with a receiver operating characteristic (ROC) curve by plotting the true positive rate (sensitivity) as a function of the false positive rate (1 - specificity). The area under the ROC curve (AUC) with 95% confidence interval was used to determine discriminative ability of the tests. The optimal cut-off value to discern NP from CON with corresponding sensitivity and specificity was also determined.

Results: Women with neck pain produced significant lower iMVC in CTE (28%), CTF (26%) and CCF (33%) (all p< 0.001). The ability of CTE, CTF and CCF to discriminate between NP and CON showed moderate accuracy (AUC 0.83, 0.78 and 0.73, respectively). The cut-off value of 165.7 N in CTE had a sensitivity of 0.725 and a specificity of 0.8. The corresponding values for CTF and CCF were 85.8 N (sensitivity 0.8; specificity 0.692) and 4.2 Nm (sensitivity 0.575; specificity 0.9).

Conclusion(s): The neck pain group had less neck muscle strength than controls in all tests. The diagnostic performance of the neck strength tests, judged as discriminative ability to discern neck pain from control participants, were moderate. These results support earlier findings of reduced neck strength in people with neck pain. Also, neck strength tests may have a complementary value in the assessment of neck pain persons.

Implications: The results highlights that impaired neck strength, both in global cervico-thoracic and deep cranio-cervical muscles, is most likely a characteristic of people with long-term neck pain. The study also shows that strength tests could be used with fairly good discriminative precision and may thereby be valuable assessment tools.

National Category
Health Sciences
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-31024 (URN)
Conference
World Confederation for physical Therapy Congress 2019, Geneva, 10-13 May
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-1403AFA Insurance, 090288
Available from: 2019-11-21 Created: 2019-11-21 Last updated: 2020-11-23Bibliographically approved
Bohman, T., Bottai, M. & Björklund, M. (2019). Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain: a longitudinal cohort study. BMJ Open, 9(4), Article ID e024557.
Open this publication in new window or tab >>Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain: a longitudinal cohort study
2019 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 9, no 4, article id e024557Article in journal (Refereed) Published
Abstract [en]

Objectives To develop predictive models for short-term and long-term clinically important improvement in women with non-specific chronic disabling neck pain during the clinical course of physiotherapy. Design Longitudinal cohort study based on data from a randomised controlled trial evaluating short-term and long-term effects on sensorimotor function over 11 weeks of physiotherapy. Participants and settings Eighty-nine women aged 31-65 years with non-specific chronic disabling neck pain from Gavle, Sweden. Measures The outcome, clinically important improvement, was measured with the Patient Global Impression of Change Scale (PGICS) and the Neck Disability Index (NDI), assessed by self-administered questionnaires at 3, 9 and 15 months from the start of the interventions (baseline). Twelve baseline prognostic factors were considered in the analyses. The predictive models were built using random-effects logistic regression. The predictive ability of the models was measured by the area under the receiver operating characteristic curve (AUC). Internal validity was assessed with cross-validation using the bootstrap resampling technique. Results Factors included in the final PGICS model were neck disability and age, and in the NDI model, neck disability, depression and catastrophising. In both models, the odds for short-term and long-term improvement increased with higher baseline neck disability, while the odds decreased with increasing age (PGICS model), and with increasing level of depression (NDI model). In the NDI model, higher baseline levels of catastrophising indicated increased odds for short-term improvement and decreased odds for long-term improvement. Both models showed acceptable predictive validity with an AUC of 0.64 (95% CI 0.55 to 0.73) and 0.67 (95% CI 0.59 to 0.75), respectively. Conclusion Age, neck disability and psychological factors seem to be important predictors of improvement, and may inform clinical decisions about physiotherapy in women with chronic neck pain. Before using the developed predictive models in clinical practice, however, they should be validated in other populations and tested in clinical settings.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Occupational Health and Environmental Health
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-30510 (URN)10.1136/bmjopen-2018-024557 (DOI)000471157200062 ()31023751 (PubMedID)2-s2.0-85065220930 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2006-1162Länsförsäkringar AB, 51-1010/06Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-1761
Note

Funding: Alfta Research Foundation

Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2023-08-28Bibliographically approved
Hallman, D., Holtermann, A., Björklund, M., Gupta, N. & Nørregaard Rasmussen, C. D. (2019). Sick leave due to musculoskeletal pain : determinants of distinct trajectories over 1 year. International Archives of Occupational and Environmental Health, 92(8), 1099-1108
Open this publication in new window or tab >>Sick leave due to musculoskeletal pain : determinants of distinct trajectories over 1 year
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2019 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 92, no 8, p. 1099-1108Article in journal (Refereed) Published
Abstract [en]

Purpose

This study aimed to identify sub-groups of workers with different trajectories of sick leave due to musculoskeletalpain over 1 year, and to investigate the extent to which the identified trajectories are associated with personal, occupational,lifestyle, and pain-related factors at baseline.

Methods

Data on 981 blue- and white-collar workers were analyzed in the DPHACTO cohort (2012–2014). The numberof days on sick leave due to pain was reported using text messages at 4-week intervals across 1 year. Latent class growthanalysis was used to distinguish sub-groups with different trajectories of sick leave. A web-based questionnaire at baselinewas used to assess personal, occupational (physical and psychosocial), lifestyle, and pain-related factors. Multinomial regressionmodels were constructed to determine associations between baseline factors and trajectories of sick leave (referencingno sick leave), with adjustment for potential confounders.

Results

Four distinct sub-groups were identified, with trajectories of sick leave due to pain ranging from no sick leave(prevalence 76%; average 0.5 days/year) to some days and increasing sick leave due to pain over 1 year (2%; 89 days/year).The increasing trajectory of sick leave was associated with higher perceived physical exertion, more time in manual work,less social community and influence at work, less leisure-time physical activity, smoking, and more severe symptoms (e.g.,multisite pain, low back pain intensity, and pain interference).

Conclusions

We identified four distinct trajectories of sick leave due to musculoskeletal pain. The sub-group with increasingsick leave due to pain was associated with several modifiable physical and psychosocial factors at work and outside work,which may have implications for prevention.

Keywords
Longitudinal, Risk factors, Sickness absence, Workers
National Category
Occupational Health and Environmental Health
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-29674 (URN)10.1007/s00420-019-01447-y (DOI)000492593000003 ()31165308 (PubMedID)2-s2.0-85067077539 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-01761
Note

Danish Working Environment Research Fund Grant no. 01-2015-09

Available from: 2019-06-05 Created: 2019-06-05 Last updated: 2021-04-01Bibliographically approved
Svedmark, Å., Björklund, M., Häger, C. K., Nilsson Sommar, J. & Wahlström, J. (2018). Impact of Workplace Exposure and Stress on Neck Pain and Disabilities in Women: A Longitudinal Follow-up After a Rehabilitation Intervention. Annals of Work Exposures and Health, 62(5), 591-603
Open this publication in new window or tab >>Impact of Workplace Exposure and Stress on Neck Pain and Disabilities in Women: A Longitudinal Follow-up After a Rehabilitation Intervention
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2018 (English)In: Annals of Work Exposures and Health, ISSN 2398-7316, Vol. 62, no 5, p. 591-603Article in journal (Refereed) Published
Abstract [en]

Introduction: The aim was to evaluate if pain, disability, and work productivity are influenced by physical and psychosocial work exposures as well as by stress, up to 1 year after a randomized controlled trial treatment intervention, and to determine whether any such association differed between treatment and control groups.

Methods: Ninety-seven working women suffering non-specific neck pain (n = 67 treatment group, n = 30 control group) were followed from end of treatment intervention and at 9- and 15-month follow-ups, respectively. Physical and psychosocial exposures, as well as perceived stress, were assessed after the treatment intervention. Pain, neck disability, and work productivity were assessed at baseline, after intervention 3 months later and at 9- and 15-month follow-ups. Longitudinal assessment was conducted using the exposure level at 3 months as predictor of pain, disability, and work productivity at 3, 9, and 15 months, respectively. Mixed models were used to estimate longitudinal associations, accounting for within-individual correlation of repeated outcome measures by incorporation of a random intercept. Age and duration of neck pain were adjusted for in all models. To evaluate group differences, interactions between exposures and treatment groups were estimated.

Results: High perceived stress was associated with more neck pain, more neck disability, and decreased work productivity in both cross-sectional and longitudinal analyses. High 'control of decision' was associated with less neck pain, less neck disability, and higher work productivity in cross-sectional analyses but only to less disability and higher productivity in longitudinal analyses. Shoulder/arm load was the only physical exposure variable that was significantly associated with work productivity in the univariate analyses. Only small differences were observed between treatment and control groups.

Conclusion: High perceived stress and low 'control of decision' were associated with more neck pain, increased neck disability, and decreased work productivity. Treatment interventions for individuals with neck pain should take into account psychosocial workplace exposures and stress to improve intermediate and long-term results.

Place, publisher, year, edition, pages
Oxford University Press, 2018
Keywords
non-specific neck pain, physiotherapy, shoulder pain, work productivity
National Category
Occupational Health and Environmental Health
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-26396 (URN)10.1093/annweh/wxy018 (DOI)000449420200007 ()29562318 (PubMedID)2-s2.0-85050676120 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-01403AFA Insurance, 090288
Available from: 2018-04-03 Created: 2018-04-03 Last updated: 2020-11-23Bibliographically approved
Projects
Forte-centre Working Life: The Body at Work - from problem to potential [2009-01761_Forte]; University of Gävle; Publications
Jackson, J., Sund, M., Barlari Lobos, G., Melin, L. & Mathiassen, S. E. (2023). Assessing the efficacy of a job rotation for improving occupational physical and psychosocial work environment, musculoskeletal health, social equality, production quality, and resilience at a commercial laundromat: Protocol for a longitudinal case study. BMJ Open, 13(5), Article ID e067633. Jackson, J., Srinivasan, D. & Mathiassen, S. E. (2020). Consistent individual motor variability traits demonstrated by females performing a long-cycle assembly task under conditions differing in temporal organisation. Applied Ergonomics, 85, Article ID 103046. Jahncke, H. & Hallman, D. (2020). Objective measures of cognitive performance in activity based workplaces and traditional office types. Journal of Environmental Psychology, 72, Article ID 101503. Hallman, D., Holtermann, A., Dencker-Larsen, S., Birk Jorgensen, M. & Nørregaard Rasmussen, C. (2019). Are trajectories of neck-shoulder pain associated with sick leave and work ability in workers? A 1-year prospective study. BMJ Open, 9, Article ID e022006. Hallman, D., Mathiassen, S. E., van der Beek, A., Jackson, J. & Coenen, P. (2019). Calibration of self-reported time spent sitting, standing and walking among office workers: a compositional data analysis. International Journal of Environmental Research and Public Health, 16(17), Article ID 3111. Domkin, D., Forsman, M. & Richter, H. O. (2019). Effect of ciliary-muscle contraction force on trapezius muscle activity during computer mouse work. European Journal of Applied Physiology, 119(2), 389-397Bohman, T., Bottai, M. & Björklund, M. (2019). Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain: a longitudinal cohort study. BMJ Open, 9(4), Article ID e024557. Holtermann, A., Mathiassen, S. E. & Straker, L. (2019). Promoting health and physical capacity during productive work: the Goldilocks Principle. Scandinavian Journal of Work, Environment and Health, 45(1), 90-97Hallman, D., Holtermann, A., Björklund, M., Gupta, N. & Nørregaard Rasmussen, C. D. (2019). Sick leave due to musculoskeletal pain : determinants of distinct trajectories over 1 year. International Archives of Occupational and Environmental Health, 92(8), 1099-1108Gupta, N., Heiden, M., Mathiassen, S. E. & Holtermann, A. (2018). Is self-reported time spent sedentary and in physical activity differentially biased by age, gender, body mass index and low-back pain?. Scandinavian Journal of Work, Environment and Health, 44(2), 163-170
Rehabilitation of people with neck pain. Effects of individualized treatment based on prognostic indicators and tests of functioning [2009-01403_Forte]; University of Gävle; Publications
Svedmark, Å., Björklund, M., Häger, C. K., Nilsson Sommar, J. & Wahlström, J. (2018). Impact of Workplace Exposure and Stress on Neck Pain and Disabilities in Women: A Longitudinal Follow-up After a Rehabilitation Intervention. Annals of Work Exposures and Health, 62(5), 591-603
Rehabilitering för personer med nackbesvär: Effekter av individanpassad rehabilitering baserad på prognostiska indikatorer och funktionstest [090288]; University of Gävle
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7543-4397

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