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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, ISSN 2044-6055, 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
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: 2019-08-16Bibliographically 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
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 1432-1246Article in journal (Refereed) Epub ahead of print
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
Identifiers
urn:nbn:se:hig:diva-29674 (URN)10.1007/s00420-019-01447-y (DOI)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: 2019-08-20Bibliographically 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
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, 2009-1403AFA Insurance, 090288
Available from: 2018-04-03 Created: 2018-04-03 Last updated: 2018-11-28Bibliographically approved
Tronarp, R., Nyberg, A., Hedlund, M., Häger, C. K., McDonough, S. & Björklund, M. (2018). Office-cycling: a promising way to raise pain thresholds and increase metabolism with minimal compromising of work performance. BioMed Research International, 2018, Article ID 5427201.
Open this publication in new window or tab >>Office-cycling: a promising way to raise pain thresholds and increase metabolism with minimal compromising of work performance
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2018 (English)In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, Vol. 2018, article id 5427201Article in journal (Refereed) Published
Abstract [en]

Sedentary behaviour constitutes a risk for lifestyle related diseases and musculoskeletal pain which does not seem to be compensated for by shorter bouts of high intensity physical activity. A way of tackling this may be long term light intensity physical activity while performing office work.

Aim: Establish the effects of low intensity cycling (LC), moderate intensity cycling (MC) and standing at a simulated office workstation on pain modulation, metabolic expenditure and work performance.

Methods: 36 healthy adults (21 females), mean age 26.8 (SD 7.6) years, partook in this randomized 3x3 cross-over trial with 75 minutes of LC on 20% of maximum aerobic power output (MAP), 30 minutes of MC on 50% of MAP and standing 30 minutes with 48 hours wash-out periods. Outcome measures were pain modulation (pressure- and thermal pain thresholds, (PPT and TPT)), work performance (transcription, mouse pointing and cognitive performance) and metabolic expenditure.

Results: PPTs increased in all conditions. Median increase in PPT trapezius was highest after LC; 39.3 kilopascal (kPa) (15.6;78.6) compared to MC; 17.0 kPa (2.8;49.9) and standing; 16.8 kPa (-5.6;39.4), p=0.015. TPT showed no change. Work performance; compared to standing, transcription was reduced during LC and MC, mouse pointing was faster in LC but had more errors while slower with more errors in MC. Performance in the cognitive task did not differ between conditions. Metabolic expenditure rates differed between all conditions (p<0.001) and were 1.4 (1.3;1.7), 3.3 (2.3;3.7) and 7.5 (5.8;8.7) kilocalories per minute during standing, LC and MC, respectively.

Conclusions: LC seem to be the preferred option since it raised PPTs, more than doubled metabolic expenditure, while minimally influencing work performance when compared to standing. Thus, LC is promising but requires corroboration in field studies.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2018
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:hig:diva-25938 (URN)10.1155/2018/5427201 (DOI)000423319500001 ()29607323 (PubMedID)2-s2.0-85041904614 (Scopus ID)
Available from: 2018-01-08 Created: 2018-01-08 Last updated: 2018-12-06Bibliographically approved
Hallman, D., Mathiassen, S. E., Heiden, M., Birk Jørgensen, M., Holtermann, A., Rudolfsson, T., . . . Wahlström, J. (2018). Symposium: Arbete, individ och nacksmärta: Forskning vid Forte-centret “Kroppen i arbete – från problem till potential”. In: Per Lindberg (Ed.), FALF KONFERENS 2018 Arbetet - problem eller potential för en hållbar livsmiljö? 10-12 juni 2018 i Gävle: Program och Abstracts. Paper presented at FALF KONFERENS 2018 'Arbetet - problem eller potential för en hållbar livsmiljö?', 10-12 Juni 2018, Gävle (pp. 102). Gävle: Gävle University Press
Open this publication in new window or tab >>Symposium: Arbete, individ och nacksmärta: Forskning vid Forte-centret “Kroppen i arbete – från problem till potential”
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2018 (Swedish)In: FALF KONFERENS 2018 Arbetet - problem eller potential för en hållbar livsmiljö? 10-12 juni 2018 i Gävle: Program och Abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, p. 102-Conference paper, Oral presentation with published abstract (Refereed)
Abstract [sv]

Besvär ifrån kroppens muskler och leder såsom nack- och ryggbesvär är fortfarande ett stort problem inom arbetslivet. Muskuloskeletal diagnos är den vanligaste orsaken till lång sjukfrånvaro inom privat sektor och näst vanligast inom kommuner och landsting. Orsakerna till dessa besvär kan vara relaterade till exponering både under arbete och på fritid, men även till individfaktorer. Vår forskargrupp har en bred ansats för att fylla kunskapsluckor inom detta område och kommer att presentera resultat från flera forskningsprojekt i symposiet Arbete, individ och nacksmärta.

Långvarigt sittande har blivit alltmer vanligt förekommande i många yrkesgrupper. Långvarigt sittande och låg fysisk aktivitet har också uppmärksammats som ett betydande hälsoproblem i dagens arbetsliv och även som en möjlig riskfaktor för smärta i nacke-skuldra. Men forskningen om betydelsen av långvarigt sittande för smärta i nacke-skuldra är fortfarande begränsad. Likaså är det oklart om huvudets hållning vid sittandet och nackens funktion, exempelvis nackens rörelsefunktion och styrka, har betydelse för besvärsutveckling. Statiskt arbete med nacken i vridna och böjda positioner misstänks vara en riskfaktor för nack-skuldersmärta i yrken såsom tandläkare, men det är oklart varför vissa exponerade individer drabbas medan andra inte får ont. För de med långvarig smärta krävs ofta rehabiliterande åtgärder, och hur väl dessa åtgärder lyckas kan även det vara beroende av individens fysiska och psykosociala arbetsmiljö. Individens arbetsmiljö påverkar således inte bara risken för om man får besvär utan kan också ha betydelse för hur rehabiliteringen av besvären lyckas.

Syftet med detta symposium är att presentera studier från Centrum för belastningsskadeforskning som handlar om nacksmärta i arbetslivet, sammanfatta kunskapsläget inom området och diskutera hur arbetet kan utformas för att bli hållbart och inkluderande. De forskningsexempel som presenteras berör stillasittande och hållning i arbetslivet och dess tänkbara konsekvenser för nacksmärta och hälsa, riskfaktorer för nacksmärta i tandläkaryrket och arbetsmiljöns betydelse för resultatet av rehabilitering vid nacksmärta. Symposiet avslutas med en frågestund och gemensam diskussion.

Place, publisher, year, edition, pages
Gävle: Gävle University Press, 2018
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:hig:diva-27196 (URN)978-91-88145-28-4 (ISBN)
Conference
FALF KONFERENS 2018 'Arbetet - problem eller potential för en hållbar livsmiljö?', 10-12 Juni 2018, Gävle
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareAFA Insurance
Note

Symposiet omfattade följande presentationer:

1. Stillasittande och nackbesvär i yrken med manuellt arbete. David Hallman, Svend Erik Mathiassen, Marina Heiden, Marie Birk Jørgensen, Andreas Holtermann

2. Har personer med nacksmärta dålig hållning – kan detta vara av betydelse för besvärsutvecklingen? Thomas Rudolfsson, Martin Björklund, Åsa Svedmark, Mats Djupsjöbacka

3. Riskfaktorer bakom nacksmärta i tandläkaryrket. Fredrik Hellström, Tina Rönnlund Borg, Mats Djupsjöbacka, Martin Björklund

4. Påverkar arbetsmiljön rehabiliteringsresultatet? En longitudinell uppföljning av kvinnor med nacksmärta. Martin Björklund, Åsa Svedmark, Charlotte Häger, Johan Sommar, Jens Wahlström

Available from: 2018-06-20 Created: 2018-06-20 Last updated: 2018-12-17Bibliographically approved
Ferreira, M. C., Björklund, M., Dach, F. & Chaves, T. C. (2017). Cross-cultural adaptation of the profile fitness mapping neck questionnaire to brazilian Portuguese: internal consistency, reliability, and construct and structural validity. Journal of Manipulative and Physiological Therapeutics, 40(3), 176-186
Open this publication in new window or tab >>Cross-cultural adaptation of the profile fitness mapping neck questionnaire to brazilian Portuguese: internal consistency, reliability, and construct and structural validity
2017 (English)In: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 40, no 3, p. 176-186Article in journal (Refereed) Published
Abstract [en]

Objective

The purpose of this study was to adapt and evaluate the psychometric properties of the ProFitMap-neck to Brazilian Portuguese.

Methods

The cross-cultural adaptation consisted of 5 stages, and 180 female patients with chronic neck pain participated in the study. A subsample (n = 30) answered the pretest, and another subsample (n = 100) answered the questionnaire a second time. Internal consistency, test-retest reliability, and construct validity (hypothesis testing and structural validity) were estimated. For construct validity, the scores of the questionnaire were correlated with the Neck Disability Index (NDI), and the Hospital Anxiety and Depression Scale (HADS), the Tampa Scale of Kinesiophobia (TSK), and the 36-item Short-Form Health Survey (SF-36).

Results

Internal consistency was determined by adequate Cronbach's α values (α > 0.70). Strong reliability was identified by high intraclass correlation coefficients (ICC > 0.75). Construct validity was identified by moderate and strong correlations of the Br-ProFitMap-neck with total NDI score (–0.56 < R < –0.71) and with the SF-36, HADS-anxiety, HADS-depression, and TSK (–0.32 < R < –0.82). Exploratory factor analysis revealed 2 factors for the Symptom scale: intensity index and the Function scale. Symptom scale–frequency index identified 1 factor. Structural validity was determined by percentage of cumulative variance >50%, Kaiser-Meyer-Olkin index > 0.50, eigenvalue > 1, and factor loadings > 0.2.

Conclusion

Br-ProFitMap-neck had adequate psychometric properties and can be used in clinical settings, as well as research, in patients with chronic neck pain.

Keywords
Neck Pain; Reproducibility of Results; Validity of Results; Patient Outcome Assessment
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:hig:diva-21407 (URN)10.1016/j.jmpt.2017.01.004 (DOI)000399212300006 ()28259493 (PubMedID)2-s2.0-85014066456 (Scopus ID)
Available from: 2016-04-18 Created: 2016-04-18 Last updated: 2018-12-03Bibliographically approved
Rudolfsson, T., Björklund, M., Svedmark, Å., Srinivasan, D. & Djupsjöbacka, M. (2017). Direction-specific impairments in cervical range of motion in women with chronic neck pain: influence of head posture and gravitationally induced torque. PLoS ONE, 12(1), Article ID e0170274.
Open this publication in new window or tab >>Direction-specific impairments in cervical range of motion in women with chronic neck pain: influence of head posture and gravitationally induced torque
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2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 1, article id e0170274Article in journal (Refereed) Published
Abstract [en]

Background: Cervical range of motion (ROM) is commonly assessed in clinical practice and research. In a previous study we decomposed active cervical sagittal ROM into contributions from lower and upper levels of the cervical spine and found level- and direction-specific impairments in women with chronic non-specific neck pain. The present study aimed to validate these results and investigate if the specific impairments can be explained by the neutral posture (defining zero flexion/extension) or a movement strategy to avoid large gravitationally induced torques on the cervical spine.

Methods: Kinematics of the head and thorax was assessed in sitting during maximal sagittal cervical flexion/extension (high torque condition) and maximal protraction (low torque condition) in 120 women with chronic non-specific neck pain and 40 controls. We derived the lower and upper cervical angles, and the head centre of mass (HCM), from a 3-segment kinematic model. Neutral head posture was assessed using a standardized procedure.

Findings: Previous findings of level- and direction-specific impairments in neck pain were confirmed. Neutral head posture was equal between groups and did not explain the direction-specific impairments. The relative magnitude of group difference in HCM migration did not differ between high and low torques conditions, lending no support for our hypothesis that impairments in sagittal ROM are due to torque avoidance behaviour.

Interpretation: The direction- and level-specific impairments in cervical sagittal ROM can be generalised to the population of women with non-specific neck pain. Further research is necessary to clarify if torque avoidance behaviour can explain the impairments.

Keywords
Neck Pain, Cervical Range of Motion, Kinematics, Musculoskeletal pain
National Category
Physiotherapy
Identifiers
urn:nbn:se:hig:diva-23215 (URN)10.1371/journal.pone.0170274 (DOI)000392380100068 ()28099504 (PubMedID)2-s2.0-85009874286 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-1403AFA Insurance, 090288
Note

Additional funding from Centre for Environmental Research in Umeå, Award Number 1152383 and University of Gävle.

Available from: 2017-01-05 Created: 2017-01-05 Last updated: 2018-03-13Bibliographically approved
Svedmark, Å., Björklund, M., Häger, C., Sommar, J. & Wahlström, J. (2017). Impact of physical and psychosocial workplace exposure and stress on neck pain rehabilitation in women: - a longitudinal study. International Archives of Occupational and Environmental Health
Open this publication in new window or tab >>Impact of physical and psychosocial workplace exposure and stress on neck pain rehabilitation in women: - a longitudinal study
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2017 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246Article in journal (Refereed) Submitted
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hig:diva-23648 (URN)
Available from: 2017-02-17 Created: 2017-02-17 Last updated: 2018-03-13Bibliographically approved
Björklund, M., Wiitavaara, B. & Heiden, M. (2017). Responsiveness and minimal important change for the ProFitMap-neck questionnaire and the Neck Disability Index in women with neck-shoulder pain. Quality of Life Research, 26(1), 161-170
Open this publication in new window or tab >>Responsiveness and minimal important change for the ProFitMap-neck questionnaire and the Neck Disability Index in women with neck-shoulder pain
2017 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 26, no 1, p. 161-170Article in journal (Refereed) Published
Abstract [en]

Purpose

The aim was to determine the responsiveness and minimal important change (MIC) of the questionnaire ProFitMap-neck that measures symptoms and functional limitations in people with neck pain. The same measurement properties were determined for Neck Disability Index (NDI) for comparison purposes.

Methods

Longitudinal data were derived from two randomized controlled trials, including 103 and 120 women with non-specific neck pain, with questionnaire measurements performed before and after interventions. Sensitivity and specificity to discriminate between improved and non-improved participants, based on categorization of a global rating of change scale (GRCS), were determined for the ProFitMap-neck indices and NDI by using area under receiver operator curves (AUC). Correlations between the GRCS anchor and change scores of the questionnaires were also used to assess responsiveness. The change score that showed the highest combination of sensitivity and specificity was set for MIC.

Results

The ProFitMap-neck indices showed similar responsiveness as NDI with AUC exceeding 0.70 (Range: ProFitMap-neck, 0.74 – 0.83; NDI, 0.75 – 0.86). The MIC in the two samples ranged between 6.6 – 13.6% for ProFitMap-neck indices and 5.2 and 6.3% for NDI. Both questionnaires had significant correlations with GRCS (Spearman’s rho 0.47 – 0.72).

Conclusions

Validity of change scores was demonstrated for the ProFitMap-neck indices with adequate ability to discriminate between improved and non-improved participants. Values of minimal important change were presented.

Keywords
Validity, anchor-based, physical function, discrimination, sensitivity, specificity
National Category
Physiotherapy
Identifiers
urn:nbn:se:hig:diva-20925 (URN)10.1007/s11136-016-1373-8 (DOI)000393571300015 ()27506524 (PubMedID)2-s2.0-84981289076 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-1403
Available from: 2015-12-23 Created: 2015-12-23 Last updated: 2018-06-28Bibliographically approved
Gold, J., Hallman, D., Hellström, F., Björklund, M., Crenshaw, A. G., Mathiassen, S. E., . . . Ali, S. (2017). Systematic review of quantitative imaging biomarkers for neck and shoulder musculoskeletal disorders. BMC Musculoskeletal Disorders, 18, Article ID 395.
Open this publication in new window or tab >>Systematic review of quantitative imaging biomarkers for neck and shoulder musculoskeletal disorders
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2017 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 18, article id 395Article, review/survey (Refereed) Published
Abstract [en]

Background

This study systematically summarizes quantitative imaging biomarker research in non-traumatic neck and shoulder musculoskeletal disorders (MSDs). There were two research questions: 1) Are there quantitative imaging biomarkers associated with the presence of neck and shoulder MSDs?, 2) Are there quantitative imaging biomarkers associated with the severity of neck and shoulder MSDs?

Methods

PubMed and SCOPUS were used for the literature search. One hundred and twenty-five studies met primary inclusion criteria. Data were extracted from 49 sufficient quality studies.

Results

Most of the 125 studies were cross-sectional and utilized convenience samples of patients as both cases and controls. Only half controlled for potential confounders via exclusion or in the analysis. Approximately one-third reported response rates. In sufficient quality articles, 82% demonstrated at least one statistically significant association between the MSD(s) and biomarker(s) studied. The literature synthesis suggested that neck muscle size may be decreased in neck pain, and trapezius myalgia and neck/shoulder pain may be associated with reduced vascularity in the trapezius and reduced trapezius oxygen saturation at rest and in response to upper extremity tasks. Reduced vascularity in the supraspinatus tendon may also be a feature in rotator cuff tears. Five of eight studies showed an association between a quantitative imaging marker and MSD severity.

Conclusions

Although research on quantitative imaging biomarkers is still in a nascent stage, some MSD biomarkers were identified. There are limitations in the articles examined, including possible selection bias and inattention to potentially confounding factors. Recommendations for future studies are provided.

Keywords
MRI, MSD, near-infrared spectroscopy, overuse, pain, PET/CT, thermography
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:hig:diva-20784 (URN)10.1186/s12891-017-1694-y (DOI)000410323900001 ()10.1186/s12891-017-1694-y (PubMedID)2-s2.0-85029322406 (Scopus ID)
Projects
ImagingBiorev
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-1761NIH (National Institute of Health), AR056019
Available from: 2015-12-04 Created: 2015-12-04 Last updated: 2018-11-26Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7543-4397

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