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  • 1.
    Björklund, Erika
    et al.
    University of Gävle, Faculty of Education and Business Studies, Department of Educational sciences, Educational science, Education.
    Nordlöf, Hasse
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Discourses about electricians in vocational education2018Conference paper (Refereed)
    Abstract [en]

    Students in vocational education to become electricians have an increased risk of developing musculoskeletal disorders (MSDs) once in the workforce compared to most other blue collar professions (Toomingas et al., 2014). This increased risk comes from having to work in awkward body positions, with heavy and sometimes poorly adapted tools and with time constraints. Many end up with chronic disabilities, forcing them to change careers or to go on sickness pension. Besides the significant and damaging consequences for the individual concerned, losing electricians from the workforce is a significant loss for the building industry in which electricians these days are scarce, and for society that not only loses tax-incomes but also possibly need to pay sickness pension for these people during quite a few years. It is therefore important to find ways to prevent MSDs and to promote good ergonomics in the building industry in general and among electricians specifically. Electricians’ knowledge and habits regarding MSDs are first formed and shaped in school, during vocational education to become an electrician. Drawing on the ideas of bio-power and governmentality, as introduced and developed by Foucault (1988, 1990, 2003) and developed by Rose (1999; Rabinow and Rose, 2006), discourses govern how it is possible to think and act. From this standpoint, then, talk and discourses are not perceived as innocent or ‘mere’ talk (Hall, 2001) but as governing the production, regulation and representation of both bodies and subjects through the acquisition of specific dispositions, tastes and abilities (Foucault, 1988; Rose, 1999). Thus, discourses drawn on in school about electricians and the profession govern how it is possible to think and act about oneself and others in relation to both ergonomics and MSD and, by extension, have material effects on electricians’ health. This means that, to foster healthy ergonomics one needs to consider how electricians and the profession are conceived and thought about in school, i.e. how electricians and the profession are discursively conceived. The purpose of this paper is thus to explore discursive constructions of electricians and the profession as these are expressed in discussions about MSDs in the vocational education and school context. Methods used are four focus group interviews: two with students, one with teachers and one with school management at one senior high school program for electricians. In the focus group interviews the participants were asked to discuss ideas about causes and reasons to why electricians develop MSDs, consequences and effects of MSDs and ideas about what could be done to prevent MSDs. The interviews were then transcribed and discursively analyzed with questions in mind about how each group conceived of electricians and the profession.

  • 2.
    Björklund, Martin
    et al.
    University of Gävle, Belastningsskadecentrum.
    Crenshaw, Albert
    University of Gävle, Belastningsskadecentrum.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Johansson, Håkan
    University of Gävle, Belastningsskadecentrum.
    Position sense acuity is diminished following repetitive low-intensity work to fatigue in a simulated occupational setting. A critical comment2003In: European Journal of Applied Physiology and Occupational Physiology, ISSN 0301-5548, E-ISSN 1432-1025, Vol. 88, no 4-5, p. 485-486Article in journal (Refereed)
  • 3.
    Björklund, Martin
    et al.
    Centre for Musculoskeletal Research, National Institute for Working Life, Umeå Sweden.
    Crenshaw, Albert G.
    Centre for Musculoskeletal Research, National Institute for Working Life, Umeå Sweden.
    Djupsjöbacka, Mats
    Centre for Musculoskeletal Research, National Institute for Working Life, Umeå Sweden.
    Johansson, Håkan
    Centre for Musculoskeletal Research, National Institute for Working Life, Umeå Sweden.
    Position sense acuity is diminished following repetitive low-intensity work to fatigue in a simulated occupational setting2000In: European Journal of Applied Physiology and Occupational Physiology, ISSN 0301-5548, E-ISSN 1432-1025, Vol. 81, p. 361-367Article in journal (Other academic)
    Abstract [en]

    Repetitive work to fatigue is soundly associated with work-related musculoskeletal disorders (WMSD), although the underlying mechanisms are poorly understood. In the present study, we tested the hypothesis that fatiguing work leads to proprioceptive deficits, which can be an initiating factor for the occurrence of WMSD. Thus, the position sense of the shoulder was determined for 13 males and 13 females before and after performing repetitive low-intensity arm work to fatigue in a simulated occupational setting. From a starting position of 45grader to the sagittal plane, position sense tests consisted of subjects attempting to actively reproduce target positions of horizontal move- ments to 15grader and 30grader (shoulder adduction) and to 60grader and 75grader (shoulder abduction). An analysis of variance revealed that the absolute error was significantly increased following fatigue for the subjects as a group (P < 0.001). Furthermore, females had an overall higher error than males (P < 0.01). No difference in error was detected for the shorter movements versus the longer movements. However, the overall absolute error for adduction was significantly higher than for abduc- tion (P < 0.001). The results of the present study support the hypothesis of diminished proprioceptive acuity following low-intensity work to fatigue. A reduction in position sense acuity could lead to impairment in motor control, which would further impact on position sense. Thus, a vicious cycle may be activated that might result in WMSD. The poorer position sense acuity observed for females may contribute to the explanation of why females may contribute to explanation of why females demonstrate a higher incidence of WMSD than males. Key Words: Fatigue, Glenohumeral joint, human, Occupational musculoskeletal problems,Proprioception.

  • 4.
    Björklund, Martin
    et al.
    Centre for Musculoskeletal Research, National Institute for Working Life, Umeå Sweden.
    Crenshaw, Albert G.
    Centre for Musculoskeletal Research, National Institute for Working Life, Umeå Sweden.
    Djupsjöbacka, Mats
    Centre for Musculoskeletal Research, National Institute for Working Life, Umeå Sweden.
    Johansson, Håkan
    Centre for Musculoskeletal Research, National Institute for Working Life, Umeå Sweden.
    Repetitive low-back-level arm activity to fatigue diminishes limb position sense1999Conference paper (Refereed)
    Abstract [en]

    Position sense awareness of the shoulder was determined for 9 males and 9 females before and after performing repetitive low-level arm activity to fatigue. The activity consisted of continuous horizontal internal and external rotations. Position sense awareness tests were performed with subjects blindfolded and seated with the arm in a motorized rig. The subjects were asked to actively reproduce test positions of 10°, 25°, 55° and 70° randomly assigned, while starting at 40° (relative to the sagittal plane). The tests were conducted immediately before and after the fatiguing activity. An ANOVA revealed that the absolute error, measured as test position minus reproduced position, was significantly increased following fatigue for the subjects as a group (p<0.001 ). Furthermore, females had overall higher error than males (p<0.05). The results indicate that repetitive low-level activity to fatigue leads to proprioceptive deficits. These deficits can create a non-optimized motor control, causing an increase in the co-activation of agonist and antagonist muscles and thus increasing the work-load. This could create an unfavorable cycle of events, which would further impact proprioception and thereby enhance the risks for muscle pain and injury. The higher incidence of injuries for female athletes compared to males may be attributed to gender differences in proprioception.

  • 5.
    Björklund, Martin
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Crenshaw, Albert G
    University of Gävle, Centre for Musculoskeletal Research.
    Acute muscle stretching and shoulder position sense2006In: Journal of athletic training, ISSN 1062-6050, E-ISSN 1938-162X, Vol. 41, no 3, p. 270-274Article in journal (Refereed)
    Abstract [en]

    Context: Stretching is common within sports as a potential maneuver for injury prevention. Stretching induced changes in muscle spindIe properties is a suggested mechanism. This may imply a reduction in proprioception following stretching, however, little is known of this association. Our finding showing no effect of acute stretching on shoulder position sense provides insight into this issue.

    Objectives: To evaluate if acute stretching of the shoulder muscles affects position sense.

    Design: A crossover design with subjects randomized to 3 groups, as regarded by the I sequence of 3 interventions.

    Setting: A university human research laboratory.

    Patients or Other participants: Nine female (age, 21 +2) and 9 male (24 + 3) healthy volunteers.

    lntervention(s): The interventions consisted of stretching of shoulder 1) agonists, 2) antagonists, and 3) non-stretching control.

    Main Outcome Measure(s): Position sense acuity of the right shoulder was determined before and arter the interventions by subjects at tempting to reproduce arm positions of 15° and 30° (shoulder adduction) while starting at 45° to the sagittal plane. The outcome variables were the response variability (variable error, VE) and overall accuracy (absolute error, AE).

    Results: A multivariate repeated measures analysis ofvariance revealed that the relative change in VE (i.e., VE after/VE before) was not significantly different between the interventions (p = 0.38). Similarly no change in AE was found (p = 0.76). Furthermore, there were no differences regarding test sequence or in the interaction 'intervention x sequence' for either VE (p = 0.73 and 0.53, respectively) or for AE (p = 0.71 and 0.67, respectively)

    Conclusions: The present study showed no effect on shoulder position sense after an acute bout of stretching either agonist or antagonist shoulder muscles.

  • 6.
    Björklund, Martin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Svedmark, Åsa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Häger, Charlotte
    Inst samhällsmedicin och rehabilitering, sjukgymnastik, Umeå univeristet.
    Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests. A study protocol of a randomized controlled trial2012In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 13, no 75Article in journal (Refereed)
    Abstract [en]

    Background

    A major problem with rehabilitation interventions for neck pain is that the condition may have multiple causes, thus a single treatment approach is seldom efficient. The present study protocol outlines a single blinded randomised controlled trial evaluating the effect of tailored treatment for neck-shoulder pain. The treatment is based on a decision model guided by standardized clinical assessment and functional tests with cut-off values. Our main hypothesis is that the tailored treatment has better short, intermediate and long-term effects than either non-tailored treatment or treatment-as-usual (TAU) on pain and function. We sub-sequentially hypothesize that tailored and non-tailored treatment both have better effect than TAU.

    Methods

    120 working women with minimum six weeks of nonspecific neck-shoulder pain aged 20-65, are allocated by minimisation with the factors age, duration of pain, pain intensity and disability in to the groups tailored treatment (T), non-tailored treatment (NT) or treatment-as-usual (TAU). Treatment is given to the groups T and NT for 11 weeks (27 sessions evenly distributed). An extensive presentation of the tests and treatment decision model is provided. The main treatment components are manual therapy, cranio-cervical flexion exercise and strength training, EMG-biofeedback training, treatment for cervicogenic headache, neck motor control training. A decision algorithm based on the baseline assessment determines the treatment components given to the each participant of T- and NT-groups. Primary outcome measures are physical functioning (Neck Disability Index) and average pain intensity last week (Numeric Rating Scale). Secondary outcomes are general improvement (Patient Global Impression of Change scale), symptoms (Profile Fitness Mapping neck questionnaire), capacity to work in the last 6 weeks (quality and quantity) and pressure pain threshold of m. trapezius. Primary and secondary outcomes will be reported for each group with effect size and its precision.

    Discussion

    We have chosen not to include women with psychological ill-health and focus on biomedical aspects of neck pain. Future studies should aim at including psychosocial aspects in a widened treatment decision model. No important adverse events or side-effects are expected. Trial registration: Current Controlled Trials registration ISRCTN49348025. Key words: Neck, trapezius, myalgia, neck-shoulder pain, RCT, individualized treatment, rehabilitation, physiotherapy, tailored

  • 7.
    Björklund, Martin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Svedmark, Åsa
    Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Häger, Charlotte
    Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Effects of tailored versus non-tailored treatment on pain and pressure pain threshold in women with nonspecific neck pain: a randomized controlled trial2014Conference paper (Refereed)
    Abstract [en]

    Aim of the investigation: The evidence for physiotherapy treatments of nonspecific neck pain is modest despite a large increase of intervention studies the last decade. One reason could be different underlying causes for pain in individuals with nonspecific neck pain, and that identification of sub-groups or individual needs is seldom accounted for in studies. In the absence of causal treatment options, a tailored treatment approach based on an explicit clinical decision model guided by assessment of function, clinical signs and symptoms, should be considered. Our aim was to evaluate tailored treatment based on such a decision model, targeting women with nonspecific neck pain. Our main hypothesis was that the tailored treatment (T) would have better short, intermediate and long-term effects on pain intensity and pressure pain threshold for the trapezius muscles than either non-tailored treatment (NT) (same treatment components but applied quasi-randomly) or treatment-as-usual (TAU) (no treatment from the study, no restrictions). We further hypothesized that T or NT has better effect than TAU. For details, cf. Current Controlled Trials registration ISRCTN49348025 and published study protocol.

    Methods: 120 working women with minimum six weeks duration of neck pain were randomized to the T, NT or TAU groups. All participants had more than “no disability” but less than “complete disability” according to the Neck Disability Index, and reported impaired capacity on the quality or quantity to work the preceding month. Main exclusion criteria were trauma-related neck pain, specific diagnoses and generalized pain or concomitant low back pain. The decision model for tailored treatment was based on tests and symptoms with defined cut-off levels comprising the following main categories: reduced cervical mobility, impaired neck-shoulder strength and motor control, trapezius myalgia, cervicogenic headache and impaired eye-head-neck control (cf. published study protocol). Assessment was performed one week before and after the 11-weeks intervention, with follow-ups 6-months (intermediate-term) and 12-months (long-term) after the intervention. Outcome variables were pain intensity (Numeric Rating Scale, NRS, 0 – 10) and pressure pain threshold (PPT) of the upper trapezius muscles (kPa). PPT was not measured at long-term follow-up.  Preliminary statistical analyses for the predefined hypotheses were performed with analysis of covariance (ANCOVA) with baseline outcome values as covariates. This was supplemented with pairwise Bonferroni-compensated comparisons in case of significance of factor group.

    Results: 86% of the participants completed the intervention, and the attrition was similar across groups. Preliminary results for the short term evaluation showed a reduction in NRS from an average of 4.4 and 4.5 to 2.5 in the T and NT groups, respectively, which was significantly greater compared to the TAU group (p=0.024 and p=0.014 for T and NT). For the PPT, there was no difference between T and NT groups at the short term evaluation, but close to a significantly increased threshold for the T compared to the TAU group (p=0,058). No differences were found between treatment groups on the intermediate and long-term evaluations for neither of the two outcome variables.

    Conclusions: The results indicate that tailored treatment for women with nonspecific neck pain may not be more effective, with respect to pain reduction, compared to non-tailored treatment. The hypothesis of superiority of tailored or non-tailored treatment over treatment-as-usual was partly supported for the short-term evaluation. However, the short-term results should be interpreted with caution since the impact of higher attention given to the participants in T and NT groups is not known. Reference:1. Björklund M, Djupsjöbacka M, Svedmark Å, Häger C. (2012) Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests. A study protocol of a randomized controlled trial. BMC Musculoskeletal Disorders. May 20;13(1):75

  • 8.
    Björklund, Martin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Wijk, Katarina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Sundelin, Gunnevi
    Institutionen för samhällsmedicin och rehabilitering.
    Gellerstedt, Sten
    LO.
    Minska värken: Åtgärder mot värk i nacke och rygg2010Report (Other (popular science, discussion, etc.))
    Abstract [sv]

    Denna skrift vänder sig till dig som har ständig värk i rygg eller nacke, eller som vid flera tillfällen haft en diffus smärta i rygg eller nacke. Här kan du läsa om vilka åtgärder forskare rekommenderar och vad du själv kan göra för att minska värken. Forskningen om vilka åtgärder som hjälper har gjort framsteg och även för dig som haft långvarig värk finns det goda möjligheter att minska smärtan.

  • 9.
    Borg, Tina
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi..
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Wänman, Anders
    Hellström, Fredrik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Perceived muscular tension in healthy subjects: a cross-sectional study2016In: PREMUS2016: Book of abstracts, 2016, p. 411-411Conference paper (Refereed)
    Abstract [en]

    Background. Perceived muscular tension (PMT) has been suggested to predict development of neck/shoulder pain. It has been hypothesized to be an early sign of musculoskeletal disorder and a possible mediator of stress on symptoms. However, the content of the concept of PMT is not clear. This study examined the association between PMT and physical and psychosocial factors and physical activity in a group of healthy students.

    Methods. This cross-sectional study was conducted on the baseline measurements of an ongoing longitudinal case-control study. A total of 63 healthy university students without complaints of neck/shoulder pain were included (21 males, 42 females, mean age 24 years). PMT was measured by asking the question “Have you, during the past month, experienced muscular tension (for example, wrinkled your forehead, ground your teeth, raised your shoulders)?” with the following response options: never, a few times, a few times per week, or one or several times per day. Self-reports on symptoms in the neck, anxiety, depression, stress, mental health, physical health, sleep and physical activity were collected with questionnaires, as well as by tenderness on palpation of neck muscles and trapezius pressure pain threshold. This produced a total of 15 variables. The relationship between these variables and PMT were analyzed using Spearman’s rank correlation coefficient.

    Results. Positive correlations were found between PMT and temporomandibular complaints (rho= .34, p < .001), neck crepitus (rho= .33, p < .001), anxiety (rho= .33, p < .001), depression (rho= .31, p < .05), tenderness on palpation (rho= .25, p < .05). There was a negative correlation between PMT and mental health (rho= -.26, p < .05). Frequent experience of PMT had weak to moderate correlations with frequency of symptoms and higher psychosocial strain, but not with stress. This suggests some covariance between PMT and both physical and psychosocial factors.

  • 10.
    Crenshaw, Albert
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Svedmark, Å
    University of Gävle, Centre for Musculoskeletal Research.
    Oxygenation, EMG and position sense during computer mouse work: impact of active versus passive pauses2006In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 97, no 1, p. 59-67Article in journal (Refereed)
    Abstract [en]

    We investigated the effects of active versus passive pauses implemented during computer mouse work on muscle oxygenation and EMG of the forearm extensor carpi radialis muscle, and on wrist position sense. Fifteen healthy female subjects (age: 19-24 years) performed a 60-min mouse-operated computer task, divided into three 20 min periods, on two occasions separated by 3-6 days. On one occasion a passive pause (subjects resting) was implemented at the end of each 20-min period, and on another occasion an active pause (subjects performed a number of high intensity extensions of the forearm) was implemented. Also at the end of each 20-min period, test contractions were conducted and subjective ratings of fatigue and stress were obtained. Another parameter of interest was total haemoglobin calculated as the summation of oxy-and deoxy-haemoglobin, since it reflects blood volume changes. The most interesting findings were an overall increasing trend in total haemoglobin throughout the mouse work (P<0.001), and that this trend was greater for the active pause as compared to the passive pause (P<0.01). These data were accompanied by an overall increase in oxygen saturation (P<0.001), with a tendency, albeit not significant, toward a higher increase for the active pause (P=0.13). EMG amplitude and median frequency tended to decrease (P=0.08 and 0.05, respectively) during the mouse work but was not different between pause types. Borg ratings of forearm fatigue showed an overall increase during the activity (P<0.001), but the perceptions of stress did not change. Position sense did not change due to the mouse work for either pause type. While increasing trends were found for both pause types, the present study lends support to the hypothesis of an enhancement in oxygenation and blood volume for computer mouse work implemented with active pauses. However, a presumption of an association between this enhancement and attenuated fatigue during the mouse work was not supported.

  • 11.
    Crenshaw, Albert G.
    et al.
    University of Gävle, Belastningsskadecentrum.
    Heiden, Marina
    University of Gävle, Belastningsskadecentrum.
    Svedmark, Åsa
    University of Gävle, Belastningsskadecentrum.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Reliability Of Oxygen Saturation Of Forearm Extensor And Trapezius Muscles Of Males And Females (Poster)2005Conference paper (Refereed)
  • 12.
    Crenshaw, Albert
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Centre for Musculoskeletal Research.
    Lyskov, Eugene
    University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Applying near infrared spectroscopy (NIRS) to assess muscular oxygenation during computer mouse use2007In: Sixth International Scientific Conference on Prevention of Work-Related Musculoskeletal Disorders, 2007, p. 253-Conference paper (Other academic)
    Abstract [en]

    Chronic trapezius myalgia was shown to be associated with a reduction in microcirculation (via direct measurements of bloodflow). In line with this, morphological data have indicated disturbances in oxidative metabolism. Therefore, data obtained on the muscle oxygenation status could help provide insight into the pathomechanisms behind work related muscle pain. Near-infrared spectroscopy (NIRS) allows for the noninvasive monitoring of continuous changes in skeletal muscle oxygenation (representing the dynamic balance between oxygen delivery and consumption), and for subsequent determinations of changes in blood volume.

  • 13.
    Crenshaw, Albert
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Lyskov, Eugene
    University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Centre for Musculoskeletal Research.
    Flodgren, Gerd
    University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Hellström, Fredrik
    University of Gävle, Centre for Musculoskeletal Research.
    Physiological responses to a standardized computer mouse task: implications for pathophysiological mechanisms behind computer related disorders2007In: Work With Computing Systems - WWCS 2007, Stockholm: abstracts WWCS 2007 : Computing systems for human benefits from the 8th International Conference on Work With Computing Systems : May 21st-24th 2007, Stockholm Sweden, Stockholm: Royal Institute of Technology , 2007, p. 47-47Conference paper (Other academic)
  • 14.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Effects of physical work exposure on proprioception2003In: Chronic work-related myalgia: neuromuscular mechanisms behind work-related chronic muscle pain syndromes, Gävle: Gävle University Press , 2003, p. 175-183Chapter in book (Other academic)
  • 15.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Ospecifika muskuloskeletala besvär: rehabilitering, behandling och träning av senmotorisk funktion2007In: Svensk Rehabilitering, ISSN 1403-4468, Vol. 8/9, no 4-1, p. 26-29Article in journal (Refereed)
    Abstract [en]

    Långvarig värk i nacke-skuldra och ländrygg tillhör de vanligaste orsakerna till sjukskrivning. Bakgrunden till dessa tillstånd är vanligen oklara, vilket gör att kausal behandling inte är aktuell. Senare års forskning visar dock att multimodal rehabilitering ger god effekt och är kostnadseffektiv. Forskningen ger även en god grund för att träning av sensomotorisk funktion kan vara effektiv vid dessa tillstånd.

  • 16.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Proprioception and neck/shoulder pain2008In: Fundamentals of musculoskeletal pain, Seattle: IASP Press , 2008, p. 385-399Chapter in book (Other academic)
    Abstract [en]

    Chronic neck/shoulder pain constitutes an extensive health problem. The point prevalence has been estimated to be as high as 18% in the general population (Guez et al., 2003). The symptoms usually involve pain and stiffness in the neck/shoulder area as well as impaired neck mobility. A history of neck or head trauma is rather common. Thus, in the population studied by Guez et al. (2003), more than one fourth of the cases had a history of such trauma. Nevertheless, due to a limited knowledge on the underlying pathomechanisms, the source of the symptoms can only rarely be established. This obviously poses a severe problem for efficient treatment and rehabilitation of this patient group.

    In order to improve treatment and rehabilitation it is thus important to develop sensitive and specific methods for characterization of patients with chronic neck/shoulder pain. This should obviously entail many different aspects of the patient characteristics. One such aspect that has received increasing attention is sensorimotor functions, for example muscle coordination and proprioception. The growing interest in this area is based on an increasing number of studies reporting atypical, or impaired, sensorimotor functioning in subjects with chronic neck/shoulder pain, along with the fact that several models on the pathophysiology behind musculoskeletal disorders involves various aspects of sensorimotor functioning.

    This chapter will deal with one of these sensorimotor functions: proprioception. First, a background to the topic and a review on the research on proprioception in relation to chronic neck/shoulder pain is given, along with a discussion on methodology. Lastly, implications for future research as well as clinical implications are discussed.

  • 17.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Proprioception in chronic neck pain patients2004In: International Congress on Chronic Pain and Dysfunction after Whiplash and other Traumatic Neck Injuries, 2004, p. 7-10Conference paper (Refereed)
  • 18.
    Djupsjöbacka, Mats
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Erika
    University of Gävle, Faculty of Education and Business Studies, Department of Educational sciences, Educational science, Education.
    Nordlöf, Hasse
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Utveckling av arbetsmiljöutbildning på yrkesgymnasium för förebyggande av belastningsbesvär och främjandet av ett hållbart arbetsliv för installationselektriker: En förberedande fallstudie2018In: FALF KONFERENS 2018. Arbetet - problem eller potential för en hållbar livsmiljö? Gävle 10-12 juni 2018: Program och Abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, p. 92-Conference paper (Refereed)
    Abstract [sv]

    Bakgrund och syfte

    Många yrkesprogram på gymnasiet utbildar för yrken där vi vet att anställda ofta drabbas av belastningsrelaterad ohälsa. Exempelvis visar data från Arbetsmiljöverket att 9–12% av alla installationselektriker och elmontörer rapporterar besvär orsakade av påfrestande arbetsställningar och att de rapporterar en ettårsprevalens på 6–10% för besvär i nacke, axlar, arm och rygg till följd av arbetet som varit så svåra att det påverkat arbetsförmågan. Forskning har även visat att elever på elteknikprogram löper särskilt hög risk att drabbas av arbetsskada relativt andra utbildningar. Redan under utbildningen bör åtgärder sättas in för att minska dessa risker.

    En genomgång av litteraturen visar dock att det finns tydliga brister i hur yrkesprogram förbereder eleverna för ett kommande arbetsliv vad gäller arbetsmiljökunskap och att orsakerna till dessa brister troligen finns inom undervisningens innehåll och utformning, lärares kompetens och samverkan med yrkeslivet under utbildningen. Vidare kan elever-nas attityder till arbetsmiljöundervisning utgöra ett hinder. Sammantaget förefaller hin-dren för en bra arbetsmiljöutbildning på yrkesprogram inom gymnasiet vara komplexa och multifaktoriella.

    Innan åtgärder sätts in för att utveckla undervisningen finns därför stort behov av att kartlägga de komplexa orsakssambanden bakom brister inom utbildningen och utifrån det utforma förbättringsåtgärder.

    I vår studie avser vi att svara på forskningsfrågan: Hur anser olika intressenter att olika faktorer inom såväl utbildningen som framtida yrkeskontext interagerar och bidrar till uppkomsten av belastningsbesvär hos installationselektriker?

    Metod och resultat

    Studien har en fallstudiedesign där fokusgrupper och problemträdsanalys används. Pro-blemträdsanalys är en metod för att kartlägga komplexa orsakssamband och att klargöra grundläggande orsaker. Analysen kan därmed säkra att aktiviteter och insatser inte väljs och påbörjas utan att man först har kartlagt kärnproblemets ofta komplexa orsaker grundligt.

    Som underlag till problemträdsanalysen kommer fokusgruppsintervjuer att genomföras där personer från samma kategori intressenter separat samtalar om kärnproblemet. Vi kommer genomföra intervjuer separat med elever, lärare, skolledning och representanter från arbetslivet. Problemträdsanalysen genomförs sedan vid ett tillfälle där 2–3 personer från varje intressent; elever, lärare, skolledningen, representanter från arbetslivet och forskare från projektgruppen deltar. Inför sessionen kommer vi att delge deltagarna underlag baserat på resultaten från fokusgruppintervjuerna och vår litteratursökning så att de kan ta del avSession D:2Individuella presentationer: Fysiskt arbetsliv93vad andra intressegrupper/källor identifierat som möjliga orsaksfaktorer. Efter framtagande av problemträd kommer tänkbara lösningar att formuleras i samverkan med alla intressenter för att skapa ett lösningsträd, vilket kommer att utgöra grund för kommande utvecklingsarbete inom utbildningen.

    Datainsamling och analyser genomförs under våren 2018 och preliminära resultat kommer att presenteras på konferensen.

  • 19.
    Djupsjöbacka, Mats
    et al.
    University of Gävle, Belastningsskadecentrum.
    Domkin, Dmitry
    University of Gävle, Belastningsskadecentrum.
    Correlation analysis of proprioceptive acuity in ipsilateral position-matching and velocity-discrimination2005In: Somatosensory & motor research, ISSN 0899-0220, E-ISSN 1369-1651, Vol. 22, no 1-2, p. 85-93Article in journal (Refereed)
    Abstract [en]

    In order to plan and control movements the central nervous system (CNS) needs to continuously keep track of the state of the musculoskeletal system. Therefore the CNS constantly uses sensory input from mechanoreceptors in muscles, joints and skin to update information about body configuration on different levels of the CNS. On the conscious level, such representations constitute proprioception. Different tests for assessment of proprioceptive acuity have been described. However, it is unclear if the proprioceptive acuity measurements in these tests correlate within subjects. By using both uni- and multivariate analysis we compared proprioceptive acuity in different variants of ipsilateral active and passive limb position-matching and ipsilateral passive limb movement velocity-discrimination in a group of healthy subjects. The analysis of the position-matching data revealed a higher acuity of matching for active movements in comparison to passive ones. The acuity of matching was negatively correlated to movement extent. There was a lack of correlation between proprioceptive acuity measurements in position-matching and velocity-discrimination.

  • 20.
    Djupsjöbacka, Mats
    et al.
    University of Gävle, Belastningsskadecentrum.
    Gellerstedt, Sten
    Stenberg, Leif
    University of Gävle, Belastningsskadecentrum.
    Muskelvärk?: Långvarig muskelsmärta vid arbete - risker, uppkomst och åtgärder2004Book (Other (popular science, discussion, etc.))
  • 21.
    Djupsjöbacka, Mats
    et al.
    University of Gävle, Belastningsskadecentrum.
    Johansson, Bengt HUniversity of Gävle, Belastningsskadecentrum.Mathiassen, Svend ErikUniversity of Gävle, Belastningsskadecentrum.Sjölander, PerUniversity of Gävle, Belastningsskadecentrum.
    International Congress on Chronic Pain and Dysfunction after Whiplash and other Traumatic Neck Injuries: October 28-29, 2004.2004Conference proceedings (editor) (Other (popular science, discussion, etc.))
  • 22.
    Djupsjöbacka, Mats
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Röiijezon, Ulrik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Häger-Ross, Charlotte
    Ortopedkliniken, Norrlands universitetssjukhus, Umeå.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Sensomotorisk funktion hos personer med nackbesvär2010In: Fysioterapi, ISSN 1653-5804, no 6-7, p. 38-45Article, review/survey (Other academic)
    Abstract [en]

    Nackbesvär är vanligt förekommande och utgör en betydande orsak till ohälsa och inskränkt arbetsförmåga. Vanligen går det inte att klarlägga organisk orsak till långvariga nackbesvär men mycket tyder på att de oftast är ett komplext tillstånd där både biologiska och psykosociala faktorer är av betydelse. Forskning har visat på samband mellan långvariga nackbesvär och störningar i olika sensomotoriska funktioner och att graden av funktionspåverkan ofta är kopplad till graden av upplevda besvär. Undersökning av sensomotorisk funktion kan därför vara en viktig del i bedömningen av denna patientgrupp. Forskning har även visat att det finns evidens för positiva effekter av sensomotorisk träning vid nackbesvär på kort sikt, medan kunskap om långtidseffekter saknas. Vid träning av sensomotorisk funktion är det viktigt att beakta grundläggande kunskap inom motorisk inlärning för att öka möjligheterna till bestående träningseffekter och att dessa överförs till vardagliga situationer.

  • 23.
    Domkin, Dmitry
    et al.
    University of Gävle, Belastningsskadecentrum.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Johansson, Håkan
    University of Gävle, Belastningsskadecentrum.
    Outcomes of ipsilateral position matching and velocity discrimination are uncorrelated2003In: Sensorimotor Coordination, behavioural modes and neural mechanisms, Fraser Island, Australia, 2003Conference paper (Refereed)
    Abstract [en]

    The central nervous system processes sensory input from proprioceptors to form a state estimate of body configuration, which represents proprioception on theconscious level. Proprioception can be divided in two submodalities: sense of movement and sense of position. It is unclear whether tests, involving psychophysical methods and assessing proprioceptive acuity, can separate between perception of movement and position and thus, measure specific proprioception submodalities. In order to investigate if position matching and velocity discrimination tests can separate perception of position and perception of movement, correlations between outcomes of these tests were analyzed. Sixteen young healthy right-handed and gender balanced subjects performed movements in the right glenohumeral joint in all tests. In the ipsilateral position matching test subjects replicated an arm location, achieved in a criterion movement. Movements were performed from positions Q, 4Q and 80- degrees to target positions 16, 32, 48 and 64 degrees with respect to the body sagittal plane. Four conditions, different in terms of movement mode to the target position during criterion and replication movement, were used: passive-active, passive-passive, active-active, semipassive-semipassive. In the latter condition subjects slightly resisted the passive movement. In the ipsilateral velocity discrimination test subjects assessed if a latter comparison arm movement was faster or slower than a previous criterion movement. Criterion movements were performed at velocities of 3Q and 5Q deg/s. T wo conditions were used: passive-passive and semipassive-semipassive. Variable errors (VE) andjust noticeable differences (JND) were measures of proprioceptive acuity in the position matching and velocity discrimination, respectively. Hierarchical cluster analysis (H CA) and principal component analysis (PCA) were applied to study correlations between outcomes in conditions of both tests. In the H CA solution, the position matchi ng and velocity discrimination conditions were located in clusters on opposite poles of the cluster structure. The PCA results were interpreted for six significant components. The position matching and velocity discrimination conditions loaded mainly on components one to five and on component six, respectively. Both the H CA and the PCA separated all test conditions in t wo groups: one contained the position matching and another the velocity discrimination conditions. There were no clear differences between conditions within each group. The study showed that the outcomes VE and JND of the position matching and velocity discrimination, respectively, are mainly uncorrelated. This implies that these tests likely measure different proprioceptive perceptual components or their different combinations. The position matching and velocity discrimination tests could in general separate between perception of position and movement, although no direct evidence was obtained for ex act match of each test with specific proprioception submodality. Much clearer separation of the measured outcomes could be achieved in subjects, heterogeneous with respect to proprioceptive acuity, i.e. with larger variability of performance.

  • 24.
    Domkin, Dmitry
    et al.
    University of Gävle, Belastningsskadecentrum.
    Laczko, Jozsef
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Jaric, Slobodan
    Latash, Mark L
    Joint angle variability in 3D bimanual pointing: uncontrolled manifold analysis2004In: Motor Control 2004, 2004Conference paper (Other (popular science, discussion, etc.))
  • 25.
    Domkin, Dmitry
    et al.
    University of Gävle, Belastningsskadecentrum.
    Laczko, Jozsef
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Jaric, Slobodan
    Latash, Mark L
    Joint angle variability in 3D bimanual pointing: uncontrolled manifold analysis.2005In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 163, no 1, p. 44-57Article in journal (Refereed)
    Abstract [en]

    The structure of joint angle variability and its changes with practice were investigated using the uncontrolled manifold (UCM) computational approach. Subjects performed fast and accurate bimanual pointing movements in 3D space, trying to match the tip of a pointer, held in the right hand, with the tip of one of three different targets, held in the left hand during a pre-test, several practice sessions and a post-test. The prediction of the UCM approach about the structuring of joint angle variance for selective stabilization of important task variables was tested with respect to selective stabilization of time series of the vectorial distance between the pointer and aimed target tips (bimanual control hypothesis) and with respect to selective stabilization of the endpoint trajectory of each arm (unimanual control hypothesis). The components of the total joint angle variance not affecting (V(COMP)) and affecting (V(UN)) the value of a selected task variable were computed for each 10% of the normalized movement time. The ratio of these two components R(V)=V(COMP)/V(UN) served as a quantitative index of selective stabilization. Both the bimanual and unimanual control hypotheses were supported, however the R(V) values for the bimanual hypothesis were significantly higher than those for the unimanual hypothesis applied to the left and right arm both prior to and after practice. This suggests that the CNS stabilizes the relative trajectory of one endpoint with respect to the other more than it stabilizes the trajectories of each of the endpoints in the external space. Practice-associated improvement in both movement speed and accuracy was accompanied by counter-intuitive lack of changes in R(V). Both V(COMP) and V(UN) variance components decreased such that their ratio remained constant prior to and after practice. We conclude that the UCM approach offers a unique and under-explored opportunity to track changes in the organization of multi-effector systems with practice and allows quantitative assessment of the degree of stabilization of selected performance variables.

  • 26.
    Flodgren, Gerd M
    et al.
    University of Gävle, Belastningsskadecentrum.
    Crenshaw, Albert G
    University of Gävle, Belastningsskadecentrum.
    Alfredson, Håkan
    Fahlström, Martin
    Hellström, Fredrik B
    University of Gävle, Belastningsskadecentrum.
    Bronemo, Lars
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Glutamate and prostaglandin E2 in the trapezius muscle of female subjects with chronic muscle pain and controls determined by microdialysis.2005In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 9, no 5, p. 511-515Article in journal (Refereed)
    Abstract [en]

    Much is still unknown concerning the mechanisms underlying the development of chronic muscle pain. The presence and magnitude of inflammatory substances and neurotransmitters in chronic painful conditions is not clear. The aims of the present study were to determine, with the use of microdialysis, the interstitial concentrations and the equilibration times for PGE(2) and glutamate in the trapezius muscles of nine female subjects with chronic muscle pain, and nine pain-free age-matched controls. A microdialysis probe was implanted in the upper part of the trapezius muscle and perfused with Ringer-acetate solution at a flow rate of 0.3 muL/min. Samples were obtained every 30 min, during a 4-h rest period. At equilibration, the mean concentrations (+/-SE) of PGE(2) were 0.71 (+/-0.11) ng/mL for the pain-group and 0.97 (+/-0.35) ng/mL for the controls. For glutamate the mean concentrations for the pain-group were 66.3 (+/-13.3) mumol/L and 60.6 (+/-22.9) mumol/L for the controls. For the pain group and the control group, respectively, equilibration for PGE(2) was reached at 180 and 150 min, and for glutamate at 150 and 120 min. The present study showed no differences between groups in the concentrations of PGE(2) and glutamate in the trapezius muscle. Further, it revealed that when using the slow-flow method, a period of at least 2.0-2.5 h is needed, after probe insertion, to reach steady state for glutamate and PGE(2).

  • 27.
    Gold, Judith E
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Hellström, Fredrik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umeå Sweden.
    Crenshaw, Albert G.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Piligian, George
    Department of Occupational Medicine, Epidemiology and Prevention, North Shore-Long Island Jewish Health System, Great Neck, NY, USA.
    Barbe, Mary F.
    Department of Anatomy and Cell Biology, Temple University Medical School, Philadelphia, PA, USA..
    Systematic review of biochemical biomarkers for neck and upper-extremity musculoskeletal disorders2016In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 42, no 2, p. 103-124Article, review/survey (Refereed)
    Abstract [en]

    Objective:  This study systematically summarizes biochemical biomarker research in non-traumatic musculoskeletal disorders (MSDs).  Two research questions guided the review:  1) Are there biochemical markers associated with neck and upper extremity MSDs? and, 2) Are there biochemical markers associated with the severity of neck and upper extremity MSDs? 

    Methods:  A literature search was conducted in PubMed and SCOPUS.  Eighty-seven studies met primary inclusion criteria.  Following a quality screen, data were extracted from 44 sufficient quality articles.

    Results:  Most of the 87 studies were cross-sectional and utilized convenience samples of patients as both cases and controls.  A response rate was explicitly stated in only 11 (13%) studies.  Less than half of the studies controlled for potential confounding through restriction or in the analysis.  Most sufficient quality studies were conducted in older populations (mean age in one or more analysis group > 50 yrs).

    In sufficient quality articles, 82% demonstrated at least one statistically significant association between the MSD(s) and biomarker(s) studied.  Evidence suggested that: a) the collagen repair marker TIMP-1 is decreased in fibroproliferative disorders, b) 5-HT (serotonin) is increased in trapezius myalgia, and c) triglycerides are increased in a variety of MSDs.  Only five studies showed an association between a biochemical marker and MSD severity.

    Conclusion: While some MSD biomarkers were identified, limitations in the articles examined included possible selection bias, confounding, spectrum effect (potentially heterogeneous biomarker associations in populations according to symptom severity or duration) and insufficient attention to co-morbid conditions. A list of recommendations for future studies is provided.

  • 28.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Birk Jørgensen, Marie
    Holtermann, Andreas
    Rudolfsson, Thomas
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Svedmark, Åsa
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Hellström, Fredrik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Rönnlund Borg, Tina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Häger, Charlotte
    Sommar, Johan
    Wahlström, Jens
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Arbete, individ och nacksmärta: Forskning vid Forte-centret “Kroppen i arbete – från problem till potential”2018In: 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 (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.

  • 29.
    Heiden, Marina
    et al.
    University of Gävle, Belastningsskadecentrum.
    Lyskov, Eugene
    University of Gävle, Belastningsskadecentrum.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Hellström, Fredrik
    University of Gävle, Belastningsskadecentrum.
    Crenshaw, Albert G
    Effects of time pressure and precision demands during computer mouse work on muscle oxygenation and position sense.2005In: European journal of applied physiology, ISSN 1439-6319, Vol. 94, no 1-2, p. 97-106Article in journal (Refereed)
    Abstract [en]

    The present study investigated the effects of time pressure and precision demands during computer mouse work on muscle oxygenation and position sense in the upper extremity. Twenty-four healthy subjects (12 males and 12 females) performed a 45-min standardized mouse operated computer task on two occasions. The task consisted of painting rectangles that were presented on the screen. On one occasion, time pressure and precision demands were imposed (more demanding task, MDT) whereas, on the other occasion, no such restraints were added (less demanding task, LDT). The order of the two task versions was randomized. Tissue oxygen saturation in the trapezius and extensor carpi radialis muscles was recorded throughout, and the position matching ability of the wrist was measured before and after the tasks. In addition, measurements of autonomic nervous system reactivity and subjective ratings of tenseness and physical fatigue were obtained. Performance was measured in terms of the number of rectangles that were painted during the task. During MDT, oxygen saturation in extensor carpi radialis decreased (p<0.05) compared to LDT. These data were paralleled by increased electrodermal activity (p<0.05), skin blood flow (p<0.05), ratings of tenseness and fatigue (p<0.01), and increased performance (p<0.01) during MDT. Females exhibited lower oxygen saturation than males, during rest as well as during the computer tasks (p<0.01). Wrist repositioning error increased following LDT as compared to MDT (p<0.05). In conclusion, computer mouse work under time pressure and precision demands caused a decrease in forearm muscle oxygenation, but did not affect wrist position sense accuracy. We attribute our changes in oxygenation more to increased oxygen consumption as a result of enhanced performance, than to vasoconstriction.

  • 30.
    Hellström, Fredrik
    et al.
    University of Gävle, Belastningsskadecentrum.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    How to explain the pain: the Brussels model2005In: 6th Physiatric Summer School. Fibromyalgia / [ed] Karl-August Lindgren, Helsinki: Rehabilitation ORTON Invalid Foundation , 2005Conference paper (Other academic)
  • 31.
    Hellström, Fredrik
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Metabolic profiles and inflammatory cytokines in people with generalized or local muscle pain2012Conference paper (Refereed)
  • 32.
    Hellström, Fredrik
    et al.
    University of Gävle, Belastningsskadecentrum.
    Roatta, S
    Thunberg, Johan
    University of Gävle, Belastningsskadecentrum.
    Passatore, Magda
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Responses of muscle spindles in feline dorsal neck muscles to electrical stimulation of the cervical sympathetic nerve.2005In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 165, no 3, p. 328-42Article in journal (Refereed)
    Abstract [en]

    Previous studies performed in jaw muscles of rabbits and rats have demonstrated that sympathetic outflow may affect the activity of muscle spindle afferents (MSAs). The resulting impairment of MSA information has been suggested to be involved in the genesis and spread of chronic muscle pain. The present study was designed to investigate sympathetic influences on muscle spindles in feline trapezius and splenius muscles (TrSp), as these muscles are commonly affected by chronic pain in humans. Experiments were carried out in cats anesthetized with alpha-chloralose. The effect of electrical stimulation (10 Hz for 90 s or 3 Hz for 5 min) of the peripheral stump of the cervical sympathetic nerve (CSN) was investigated on the discharge of TrSp MSAs (units classified as Ia-like and II-like) and on their responses to sinusoidal stretching of these muscles. In some of the experiments, the local microcirculation of the muscles was monitored by laser Doppler flowmetry. In total, 46 MSAs were recorded. Stimulation of the CSN at 10 Hz powerfully depressed the mean discharge rate of the majority of the tested MSAs (73%) and also affected the sensitivity of MSAs to sinusoidal changes of muscle length, which were evaluated in terms of amplitude and phase of the sinusoidal fitting of unitary activity. The amplitude was significantly reduced in Ia-like units and variably affected in II-like units, while in general the phase was affected little and not changed significantly in either group. The discharge of a smaller percentage of tested units was also modulated by 3-Hz CSN stimulation. Blockade of the neuromuscular junctions by pancuronium did not induce any changes in MSA responses to CSN stimulation, showing that these responses were not secondary to changes in extrafusal or fusimotor activity. Further data showed that the sympathetically induced modulation of MSA discharge was not secondary to the concomitant reduction of muscle blood flow induced by the stimulation. Hence, changes in sympathetic outflow can modulate the afferent signals from muscle spindles through an action exerted directly on the spindles, independent of changes in blood flow. It is suggested that such an action may be one of the mechanisms mediating the onset of chronic muscle pain in these muscles in humans.

  • 33.
    Johansson, Håkan
    et al.
    University of Gävle, Belastningsskadecentrum.
    Windhorst, UweUniversity of Gävle, Belastningsskadecentrum.Djupsjöbacka, MatsUniversity of Gävle, Belastningsskadecentrum.Passatore, MagdaUniversity of Gävle, Belastningsskadecentrum.
    Chronic Work-Related Myalgia: Neuromuscular Mechanisms behind Work-Related Chronic Muscle Pain Syndromes2003Collection (editor) (Other academic)
  • 34.
    Johansson, Håkan
    et al.
    University of Gävle, Belastningsskadecentrum.
    Windhorst, Uwe
    University of Gävle, Belastningsskadecentrum.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Passatore, Magda
    University of Gävle, Belastningsskadecentrum.
    Kronisk arbetsrelaterad muskelsmärta: Neuromuskulära mekanismer bakom arbetsrelaterade kroniska muskulära smärtsyndrom2004Report (Other academic)
  • 35.
    Kalezic, Nebojsa
    et al.
    University of Gävle, Belastningsskadecentrum.
    Åsell, Malin
    Sandlund, Jonas
    Lyskov, Eugene
    University of Gävle, Belastningsskadecentrum.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Physiological Reactivity to Laboratory Stressors in Patients With Low Back Pain and Whiplash Associated Disorder2004In: Proceedings of the 44th Annual Meeting of The Society for Psychophysiological Research, 2004, p. S75-Conference paper (Other academic)
  • 36. Kostyukov, Alexander I
    et al.
    Bugaychenko, Larisa A
    Kalezic, Ivana
    University of Gävle, Belastningsskadecentrum.
    Pilyavskii, Alexander I
    Windhorst, Uwe
    University of Gävle, Belastningsskadecentrum.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Effects in feline gastrocnemius-soleus motoneurones induced by muscle fatigue.2005In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 163, no 3, p. 284-94Article in journal (Refereed)
    Abstract [en]

    Responses of gastrocnemius-soleus (G-S) motoneurones to stretches of the homonymous muscles were recorded intracellularly in decerebrate cats before, during and after fatiguing stimulation (FST) of G-S muscles. Ventral roots (VR) L7 and S1 were cut, and FST was applied to VR S1, a single FST session including 4 to 5 repetitions of 12-s periods of regular 40 s(-1) stimulation. Muscle stretches consisted of several phases of slow sinusoidal shortening-lengthening cycles and intermediate constant lengths. The maximal stretch of the muscles was 8.8 mm above the rest length. Effects of FST on excitatory postsynaptic potentials (EPSPs) and spikes evoked by the muscle stretches were studied in 12 motoneurones from ten experiments. Stretch-evoked EPSPs and firing were predominantly suppressed after FST, with the exception of a post-contraction increase of the first EPSP after FST, which was most likely due to after-effects in the activity of muscle spindle afferents. The post-fatigue suppression of EPSPs and spike activity was followed by restoration within 60-100 s. Additional bouts of FST augmented the intensity of post-fatigue suppression of EPSPs, with the spike activity sometimes disappearing completely. FST itself elicited EPSPs at latencies suggesting activation of muscle spindle group Ia afferents via stimulation of beta-fibres. The suppression of the stretch-evoked responses most likely resulted from fatigue-evoked activity of group III and IV muscle afferents. Presynaptic inhibition could be one of the mechanisms involved, but homosynaptic depression in the FST-activated group Ia afferents may also have contributed.

  • 37.
    Michaelson, Peter
    et al.
    University of Gävle, Belastningsskadecentrum.
    Michaelson, M
    Jaric, Slobodan
    University of Gävle, Belastningsskadecentrum.
    Latash, M L
    Sjölander, Per
    University of Gävle, Belastningsskadecentrum.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Head stability and vertical posture in patients with whiplash associated disorders and work related neck pain2004In: Proceedings of the 8th International Federation of Orthopaedic Manipulative Therapists' Conference, 2004Conference paper (Other (popular science, discussion, etc.))
  • 38.
    Monnier, Andreas
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden; Swedish Armed Forces, Regional Medical Service Mälardalen, Berga, Sweden.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science.
    Larsson, Helena
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden; Swedish Armed Forces, Headquarters, Medical Services, Stockholm, Sweden.
    Norman, Kjell
    Swedish Armed Forces, 1st Marine Regiment, 2nd Amphibious Battalion, Berga, Sweden.
    Äng, Björn O.
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden; Centre for Clinical Research Dalarna, Falun, Sweden; Karolinska University Hospital, Stockholm, Sweden.
    Risk factors for back pain in marines; A prospective cohort study2016In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 17, no 1, article id 319Article in journal (Refereed)
    Abstract [en]

    Background: It is recognised that back pain (BP) is a debilitating medical problem in the soldier community, which limits operational readiness as well as work ability. As such, identification of risk factors is a necessity for effective preventive actions, but also regarded as important from a safety perspective. The aim of this prospective cohort study was therefore to identify risk factors for back pain and BP limiting work ability in active duty marines within a 6 and 12-month period. Methods: Demographic characteristics, health-related factors and occupational exposure information, as gathered from questionnaires, as well as clinical test of movement control among 137 Swedish marines were regressed with multivariable logistic regressions, and strength of associations was presented as odds ratio (OR) with 95 % confidence intervals (CI). BP within 6 and 12 months were used as primary outcomes, whereas BP limiting work ability within 6 and 12 months served as secondary outcomes. Results: Previous BP and tall body height (≥1.86 m) emerged as risk factors for back pain within 6 months (OR 2.99, 95 % CI 1.22-7.30; OR 2.81, 95 % CI 1.16- 6.84, respectively), and 12 months (OR 6.75, 95 % CI 2.30-19.80; 2.75, 95 % CI 1.21-6.29, respectively). Previous BP was also identified as risk factor for BP limiting work ability within 12 months (OR 6.64, 95 % CI 1.78-24.78), and tall body height emerged as a risk within both six (OR 4.30, 95 % CI 1.31-14.13) and 12 months (OR 4.55, 95 % CI 1.53-13.57) from baseline. Conclusions: Marines with a history of BP are at risk of further BP episodes, which, thus, emphasise the importance of early BP preventive actions. Tall body height also emerged as an important risk which may reflect that personal equipment and work tasks are not adapted for the tallest marines. While this should be considered when introducing new work equipment, further studies are warranted to clarify the underlying mechanism of this association.

  • 39.
    Monnier, Andreas
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Stockholm ; Swedish Armed Forces, Regional Medical Service Mälardalen, Berga.
    Larsson, Helena
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Stockholm ; Swedish Armed Forces, HR Centre, Stockholm.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Brodin, Lars-Åke
    Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Huddinge.
    Äng, Björn O
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Stockholm ; Centre for Clinical Research Dalarna, Falun ; Karolinska University Hospital, Stockholm.
    Musculoskeletal pain and limitations in work ability in Swedish marines: a cross-sectional survey of prevalence and associated factors2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 10, article id e007943Article in journal (Refereed)
    Abstract [en]

    Objectives To estimate the prevalence of self-rated musculoskeletal pain and pain limiting work ability in Swedish Armed Forces (SAF) marines, and to study factors potentially associated with pain limiting work ability for the most prevalent pain regions reported.

    Design Population-based, cross-sectional survey.

    Participants There were 272 SAF marines from the main marine battalion in Sweden included in the study.

    Outcomes Self-assessed musculoskeletal pain and pain limiting the marines' work ability within a 6-month period, as obtained from structured questionnaires. The association of individual, health and work-related factors with musculoskeletal pain limiting work ability was systematically regressed with multiple logistic models, estimating OR and 95% CI.

    Results Musculoskeletal pain and pain limiting work ability were most common in the back, at 46% and 20%, and lower extremities at 51% and 29%, respectively. Physical training ≤1 day/week (OR 5.3, 95% CI 1.7 to 16.8); body height ≤1.80 m (OR 5.0, 95% CI 1.6 to 15.1) and ≥1.86 m (OR 4.4, 95% CI 1.4 to 14.1); computer work 1/4 of the working day (OR 3.2, 95% CI 1.0 to 10.0) and ≥1/2 (OR 3.3, 95% CI 1.1 to 10.1) of the working day were independently associated with back pain limiting work ability. None of the studied variables emerged significantly associated with such pain for the lower extremities.

    Conclusions Our findings show that musculoskeletal pain and resultant limitations in work ability are common in SAF marines. Low frequency of physical training emerged independently associated with back pain limiting work ability. This suggests that marines performing physical training 1 day per week or less are suitable candidates for further medical evaluation and secondary preventive actions. While also associated, body height and computer work need further exploration as underlying mechanisms for back pain limiting work ability. Further prospective studies are necessary to clarify the direction of causality.

  • 40. Passatore, Magda
    et al.
    Windhorst, Uwe
    University of Gävle, Belastningsskadecentrum.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Lytvynenko, S
    University of Gävle, Belastningsskadecentrum.
    Roatta, Silvestro
    Effects of sympathetic stimulation on the rhythmic jaw movements produced by electrical stimulation of the rabbit cortical masticatory areas: Possible implication in chronic muscle pain2004In: 4th Forum of European Neuroscience, Lisbon, Portugal, 2004Conference paper (Other academic)
    Abstract [en]

    The somatomotor and sympathetic nervous systems are intimately linked. One example is the influence of peripheral sympathetic fibers on the discharge characteristics of muscle spindles. Since muscle spindles play important roles in various motor behaviors, including rhythmic movements, changes in sympathetic outflow to muscle spindles should change rhythmic movement patterns. We set out to test this hypothesis in the masticatory system of rabbits. Cortically evoked rhythmic jaw movements (CRJMs) and electromyograms (EMGs), induced by long-lasting electrical cortical stimulation, were powerfully modulated by electrical stimulation of the peripheral stump of the cervical sympathetic nerve (CSN). This modulation was characterized by a consistent and marked reduction in the excursion of the mandibular movements (26±10%, mean±STD), often preceded by a transient modest enhancement, which could be mainly attributed to corresponding changes in masseter muscle activity (49±26%). These changes outlasted the duration of CSN stimulation. In some of the CRJMs, changes in masticatory frequency were also observed. When the jaw-closing muscles were subjected to repetitive ramp-and-hold force pulses, the CRMJs changed characteristics. Masseter EMG activity was strongly enhanced (+144±96%) and digastric EMG slightly decreased. This change was considerably depressed during CSN stimulation (to +96±57%). These effects of CSN are similar in sign and time course to the depression exerted by sympathetic activity on the jaw-closing muscle spindle discharge (Roatta et al. 2002). It is suggested that the change in proprioceptive information induced by an increase in sympathetic outflow (i) has important implications for the control of motor function in states of high sympathetic activity, and (ii) is one of the mechanisms responsible for motor impairment under certain pathological conditions such as chronic musculoskeletal head-neck disorders, associated with stress conditions.

  • 41.
    Pedersen, Jonas
    et al.
    Arbetslivsinstitutet.
    Lönn, Johan
    Arbetslivsintitutet.
    Hellström, Fredrik
    Idrottsmedicin, Umeå universitet och Arbetslivsinstitutet.
    Djupsjöbacka, Mats
    Arbetslivsinstitutet.
    Johansson, Håkan
    Arbetslivsinstitutet.
    The effects of localized muscle fatigue on the movement sense in the dominant human shoulder1998In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315Article in journal (Refereed)
  • 42.
    Raudsepp, Jaanus
    et al.
    University of Gävle, Belastningsskadecentrum.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Handgrip maximum force and the visual horizontal-vertical illusion.2005In: Perception, ISSN 0301-0066, E-ISSN 1468-4233, Vol. 34, no 4, p. 421-8Article in journal (Refereed)
    Abstract [en]

    The visual horizontal-vertical illusion (HVI) refers to the tendency to overestimate vertical distances relative to horizontals in both 2-D and 3-D presentations. Although the HVI is evident across a wide range of different stimuli, no general theoretical account fully explains the illusion. Some recent authors have proposed the 'effort' account of HVI, contending that vertical overestimation is mediated by effort assessment of gravitational challenges offered by the stimulus. The theory has been supported by a set of studies showing that the height overestimation of large-scale 3-D objects is inversely related to perceivers' fitness and strength. We explored if the large-scale HVI/strength dependence extends to the evaluation of small-scale 2-D line stimuli, traditionally used in HVI studies. We measured the maximum handgrip strength, and assessed the HVI with a computerised line-adjustment task in thirty-two individuals. Compatible with earlier findings in the context of large-scale 3-D stimuli, a significant negative correlation was found between the strength of the dominant hand and amount of HVI. In addition, the variability of HVI was negatively correlated with maximum grip strength of both hands. The results are discussed with reference to the 'effort' account of HVI.

  • 43.
    Richter, Hans O
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Crenshaw, Albert
    University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Kjellberg, Anders
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Lyskov, Eugene
    University of Gävle, Centre for Musculoskeletal Research.
    Accommodative/vergence eye-movements in response to optical blur and musculoskeletal discomfort2007In: Work with computing systems - WWCS 2007, Stockholm: Computing systems for human benefits from the 8th International Conference on Work With Computing Systems : May 21st-24th 2007, Stockholm Sweden, Stockholm: Royal institute of technology , 2007, p. 125-125Conference paper (Refereed)
  • 44.
    Richter, Hans O.
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Röijezon, Ulrik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Long-term adaptation to neck/shoulder pain and perceptual performance in a hand laterality motor imagery test2010In: Perception, ISSN 0301-0066, E-ISSN 1468-4233, Vol. 39, no 1, p. 119-130Article in journal (Refereed)
    Abstract [en]

    The effect of neck/shoulder pain on the performance in a hand laterality motor imagery test was studied. Responses to the Cooper and Shepard (1975, Journal of Experimental Psychology: Human Perception and Performance 104 48 ^ 56) hand laterality test were explored in twenty-four individuals with chronic non-specific neck pain and twenty-one subjects with chronic neck pain of traumatic origin (whiplash-associated disorder). Twenty-two controls were also included in the study. Digitalised right- or left-hand stimuli were presented at five different stimulus angles (08, 458 laterally, 908 laterally, 1358 laterally, and 1808). The experimental task was to decide the laterality as fast and accurately as possible. The performance, both reaction time (RT) and accuracy, of the two experimental groups was contrasted with that of the control group. The main results revealed that the subjects afflicted with whiplash injury on the average exhibited a faster response pattern than symptom-free healthy controls. Despite their  usculoskeletal deficits and experience of pain these volunteers also exhibited a preserved speed ^ accuracy tradeoff. Longer duration of time with symptoms of neck pain was, moreover, associated with progressively faster RTs. These results point to perceptual learning and may reflect different stages of adaptation to neck pain.

  • 45. Roatta, Silvestro
    et al.
    Windhorst, Uwe
    University of Gävle, Belastningsskadecentrum.
    Djupsjöbacka, Mats
    University of Gävle, Belastningsskadecentrum.
    Lytvynenko, S
    Passatore, Magda
    Effects of sympathetic stimulation on the rhythmical jaw movements produced by electrical stimulation of the cortical masticatory areas of rabbits.2005In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 162, no 1, p. 14-22Article in journal (Refereed)
    Abstract [en]

    The somatomotor and sympathetic nervous systems are intimately linked. One example is the influence of peripheral sympathetic fibers on the discharge characteristics of muscle spindles. Since muscle spindles play important roles in various motor behaviors, including rhythmic movements, the working hypothesis of this research was that changes in sympathetic outflow to muscle spindles can change rhythmic movement patterns. We tested this hypothesis in the masticatory system of rabbits. Rhythmic jaw movements and EMG activity induced by long-lasting electrical cortical stimulation were powerfully modulated by electrical stimulation of the peripheral stump of the cervical sympathetic nerve (CSN). This modulation manifested itself as a consistent and marked reduction in the excursion of the mandibular movements (often preceded by a transient modest enhancement), which could be attributed mainly to corresponding changes in masseter muscle activity. These changes outlasted the duration of CSN stimulation. In some of the cortically evoked rhythmic jaw movements (CRJMs) changes in masticatory frequency were also observed. When the jaw-closing muscles were subjected to repetitive ramp-and-hold force pulses, the CRMJs changed characteristics. Masseter EMG activity was strongly enhanced and digastric EMG slightly decreased. This change was considerably depressed during CSN stimulation. These effects of CSN stimulation are similar in sign and time course to the depression exerted by sympathetic activity on the jaw-closing muscle spindle discharge. It is suggested that the change in proprioceptive information induced by an increase in sympathetic outflow (a) has important implications even under normal conditions for the control of motor function in states of high sympathetic activity, and (b) is one of the mechanisms responsible for motor impairment under certain pathological conditions such as chronic musculoskeletal head-neck disorders, associated with stress conditions.

  • 46.
    Rudolfsson, Thomas
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Range of motion in the upper and lower cervical spine in people with chronic neck pain2012In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 17, no 1, p. 53-59Article in journal (Refereed)
    Abstract [en]

    Reduced cervical range of motion (ROM) is a common finding in people with neck pain. With few exceptions, only the angle between head and thorax has been measured. Our aim was to use an extended model to compare active cervical flexion and extension, separate for upper and lower cervical levels, between people with chronic non-traumatic neck pain and controls. We also investigated associations between ROM measures, symptoms and self-rated functioning. In this cross-sectional study, 102 subjects with neck pain and 33 healthy controls participated. An electromagnetic tracker system was used to measure the kinematics to construct a three-segment model including the thorax, cervical spine and head. Neutral flexion/extension were defined at subjects’ self-selected seated posture. We found that in the neck pain group, extension in the upper cervical levels and predominately flexion for the lower levels were reduced. The ratio between ROM for the upper and lower levels was altered in the neck pain group so that the lower levels contributed to a lesser extent to the total sagittal ROM compared to controls. These findings could not be explained by a greater forward head posture but must have other origins. For the neck pain group, ROM measures were weakly associated to pain and self-rated functioning. Altogether, this implies that using a three-segment model for assessment of ROM can be a valuable improvement for characterisation of patients and treatment evaluation.

  • 47.
    Rudolfsson, Thomas
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Range of motion in the upper and lower cervical spine in people with chronic neck pain2010In: The XVIII Congress of the International Society of Electrophysiology and Kinesiology (ISEK), Aalborg, Denmark, 2010Conference paper (Refereed)
    Abstract [en]

    AIM: Several studies have reported reduced cervical range of motion (ROM) in people with neck pain. Different methodologies have been used, but with a few exception they measure only head-trunk relationship and do not discriminate between upper and lower cervical motion. Recent strategies for treatment of neck pain condition include retraining the function of the deep cervical flexors that act in cranio-cervical movements. Thus objective measures of cervical ROM in flexion-extension that includes determination of cervical level can be valuable for treatment evaluation.

    The aim of the present study was to compare cervical flexion and extension, separate for upper and lower cervical levels, between people with chronic neck pain and controls. Also, the association between upper and lower cervical ROM and self rated characteristics was studied.

    METHODS: In a cross-sectional study design, 135 subjects (non-traumatic neck pain: n = 102, controls: n = 33) performed three trials of maximum active cervical flexion and extension. Subjects were seated in a chair with belts crossed over the chest. An electromagnetic tracker system was used to register the kinematics to construct a three-segment model including the trunk, cervical spine and head. The angle for the upper cervical level was defined as the angle between the head and the cervical spine segments. The angle for the lower cervical level was defined as the angle between the cervical spine and the trunk segments. Pressure pain thresholds, pain ratings as well as self ratings of functioning and physical activity were assessed.

    RESULTS: Total ROM was reduced in the neck pain group for both the lower (controls: mean = 26.5, SD=6.7, neck pain: mean=19.0, SD =6.5 degrees) and the upper cervical levels (controls: mean = 84.7, SD = 7.9, neck pain: mean = 73.0, SD = 11.2 degrees). This reduction was direction specific: in the upper cervical level only extension was reduced and in the lower cervical level the reduction was predominately in flexion. Multivariate regression analysis revealed that lower level of physical activity, greater impairments of physical functioning, self reported problems with head movements and lower pressure pain thresholds were related to a greater reduction in ROM in the neck pain group.

    CONCLUSION: Reduction of ROM is present for both the upper and lower levels of the cervical spine in people with non-traumatic neck pain. For the upper cervical level this reduction is direction specific so that only extension is reduced. The limited extension range of the upper cervical spine in the neck pain group could reflect a habituated sitting posture that includes a more extended upper cervical spine. Alternatively it could reflect an impaired functioning of the deep cervical flexors. For the lower cervical level the reduction was mainly limited to flexion. This could be a reflection of a ‘head forward posture’ that has previously been reported in people with neck pain. The associations between self rated characteristics and range of motion variables supports the validity of this methodology in research on neck pain conditions.

  • 48.
    Rudolfsson, Thomas
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Svedmark, Åsa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Srinivasan, Divya
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Direction-specific impairments in cervical range of motion in women with chronic neck pain: influence of head posture and gravitationally induced torque2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 1, article id e0170274Article in journal (Refereed)
    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.

  • 49.
    Rudolfsson, Thomas
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Umeå universitet.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Häger, Charlotte
    Umeå universitet.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Umeå universitet, Alfta Research Foundation.
    Effects of neck coordination exercise on sensorimotor function in chronic neck pain: a randomized controlled trial2014In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 9, p. 908-914Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the effect of neck coordination exercise on sensorimotor function in women with neck pain compared with best-available treatment and sham treatment. Design: Observer-blinded randomized controlled trial with short-term and 6-month follow-ups. Subjects: Women with chronic non-specific neck pain were randomized to 3 groups: neck coordinationexercise with a novel training device; strength training for the neck and shoulders; or massage. Each group had 36 participants. Methods: The intervention period was 11 weeks with 22 individually supervised sessions. Primary outcomes were postural sway measures and precision of goal-directed arm movements. Secondary outcomes were range of motion for the neck, peak speed of axial rotation, and neck pain. A repeated measures multivariate analysis of variance (MANOVA) was conducted separately on the primary outcomes for the short-term and 6-month evaluations and on the sensorimotor secondary outcomes for the 6-month effect. The 6-month effect on pain was analysed with a repeated measures analysis ofvariance (ANOVA). Results: No significant treatment effects in favour of neck coordination exercise were found for short-term or 6-month evaluations. Conclusion: Neck coordination exercise is no better than strength training and massage in improvingsensorimotor function. Further research should investigate the use of cutoffs for sensorimotordysfunctions prior to proprioceptive or coordinative training.

  • 50.
    Rudolfsson, Thomas
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Domkin, Dmitry
    University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Is neck pain associated with altered body sway kinematics?2009In: Sjukgymnastdagarna, Stockholmsmässan i Älvsjö, Stockholm: Legitimerade Sjukgymnasters Riksförbund, Stockholm , 2009, p. -40Conference paper (Other academic)
    Abstract [en]

    Introduction:Several studies have reported impaired postural control in people with neck pain. Many of these studies have analysed centre of pressure data from a force plate in quiet standing but to our knowledge none has investigated the kinematics of postural sway in people with neck pain. From studies on healthy controls there are two well established strategies of maintaining upright stance: hip and ankle strategies. Recent work has shown that these co-exist simultaneously. The purpose of this study is to investigate these kinematic strategies in people with neck pain. This could give a greater understanding of the mechanisms behind the postural control impairments and give implications for specific rehabilitation interventions.Methods:Seventy subjects (neck pain n=44, controls n=26) stood with their feet together, arms crossed and their eyes closed for 180 s. An electromagnetic tracker was used to record the kinematics for a two segment model (leg, trunk). An in-phase pattern between these segments corresponds to ankle strategy and an anti-phase pattern to hip-strategy. The strength of the in-phase pattern was quantified using coherence analysis.Results:Preliminary results indicate that people with neck pain rely less on ankle strategy in quiet standing than healthy controls. There were no differences in variability of the segment angles between groups. However people with neck pain tended to stand with a greater degree of extension in the hip.Conclusion:It’s generally considered that hip-strategy is used more when the difficulty of the task is higher. One speculative interpretation to the weaker ankle strategy in the neck pain group is that they perceived the task as more demanding. The method of coherence analysis used in this study can be a valuable tool in future studies for understanding postural sway in people with spinal pain.

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