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  • 1.
    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.

  • 2.
    Crenshaw, Albert G
    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.
    Elcadi, Guilherme H
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. 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, CBF. 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, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Reliability of near infrared spectroscopy for measuring forearm and shoulder oxygenation in healthy males and females2012In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 112, p. 2703-2715Article in journal (Refereed)
    Abstract [en]

    This study determined the day-to-day reliability of NIRS-derived oxygenation responses (ΔStO 2%) for isometric contractions and for cuff occlusion. Twenty-four subjects (12 males and 12 females) were tested on two days (4-6 days interval). Variables generated were: (i) ΔStO 2% for isometric contractions (10%, 30%, 50% and 70% MVC) for descending trapezius (TD) and extensor carpi radialis (ECR) muscles; (ii) slope changes in total haemoglobin (HbTslope) and deoxyhaemoglobin (HHbslope) for the ECR using upper arm venous (VO, 50 mmHg) and arterial occlusion (AO, 250 mmHg); (iii) recovery slopes (Rslope) for oxygen saturation (StO2) following isometric contractions and AO. For each variable an intraclass correlation (ICC) was calculated to assess the ability to differentiate between subjects, and limits of agreement (LOA) were computed to assess day-to-day consistency of the measurement. ICCs for ΔStO2% were lowest at 10% MVC for both ECR (0.58) and TD (0.55), and highest at 30% MVC for ECR (0.95) and at 70% MVC for TD (0.79). For both muscles, LOA for ΔStO 2% was lowest at 10% and highest at 50% and 70% MVC. ICC for HbTslope was 0.17. For HHbslope ICC was higher for AO (0.83) than for VO (0.73), and LOA was lower for AO. For the ECR Rslope ICCs ranged 0.88–0.90 for contraction, but was lower for AO (0.33); LOA was lowest at 70% MVC. For trapezius Rslope ICCs ranged 0.63–0.73 and LOA was lowest at 30% MVC. For this study establishing reliability data for the ECR and TD, and including variables commonly reported, are expected to have meaning for future NIRS studies of work-related upper-extremity pain as well as for other NIRS research and clinical applications.

  • 3.
    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)
  • 4.
    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. Umeå universitet.
    Hellström, Fredrik
    University of Gävle, Centre for Musculoskeletal Research.
    Impact of time pressure and pauses on physiological responses to standardized computer mouse use: a review of three papers with focusing on mechanisms behind computer-related disorders2007In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, no 3, p. 68-75Article in journal (Refereed)
    Abstract [en]

    This paper reviews three computer mouse studies in our laboratory where our emphasis was on mechanisms behind computer related disorders. Our approach was sequentially (i) to determine validity of a laboratory model of computer mouse use (painting rectangles) for studying musculoskeletal disorders; to use this model (ii) to study time pressure and precision demands on position sense and muscular oxygenation; and (iii) to determine the effect of pauses (active vs passive) on these parameters. (i) Kinematic data for the painting model showed constrained movements of the wrist similar to CAD work; a support for its validity for a real life situation. (ii) Changes in forearm oxygenation were associated with time pressure and precision demands; a potential for insight into the underlying pathophysiological mechanisms. (iii) Increasing trends in oxygenation and blood volume were associated with pauses, especially active; possible explanation for the alleviating effect of discomfort experienced in real life situations when a pause is implemented.

  • 5.
    Flodgren, Gerd
    et al.
    University of Gävle, Belastningsskadecentrum.
    Crenshaw, Albert
    University of Gävle, Belastningsskadecentrum.
    Alfredson, Håkan
    Fahlström, Martin
    Hellström, Fredrik
    University of Gävle, Belastningsskadecentrum.
    Bronemo, Lars
    Johansson, Håkan
    University of Gävle, Belastningsskadecentrum.
    Interstitial PGE2 and glutamate levels in the trapezius muscle of females - determined by microdialysis (poster)2004In: Medicine & Science in Sports & Exercise: May 2004 - Volume 36 - Issue 5 - p S332, 2004Conference paper (Other (popular science, discussion, etc.))
  • 6.
    Flodgren, Gerd
    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.
    Crenshaw, Albert G.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. 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, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Fahlström, Martin
    Department of Community Medicine and Rehabilitation, Umeå University .
    Combining microdialysis and near infrared spectroscopy for studying effects of low-load repetitive work on the intramuscular chemistry in trapezius myalgia2010In: Journal of Biomedicine and Biotechnology, ISSN 1110-7243, E-ISSN 1110-7251, Vol. 2010, article id 513803Article in journal (Refereed)
    Abstract [en]

    Epidemiological research provides strong evidence for a link between repetitive work (RW) and the development of chronic trapezius myalgia (TM). The aims were to further elucidate if an accumulation of sensitising substances or impaired oxygenation is evident in painful muscles during RW. Females with TM (n=14) were studied during rest, 30 min RW and 60 min recovery. Microdialysate samples were obtained to determine changes in [glutamate], [PGE2], [lactate], and [pyruvate] relative to work. Muscle oxygenation (%StO2) was assessed using near-infrared spectroscopy. During work all investigated substances, except PGE2, increased significantly: [glutamate] (54%, P<0.0001), [lactate] (26%, P<0.005), [pyruvate] (19%, P<0.0001), while the %StO2 decreased (P<0.05). During recovery [PGE2] decreased (P<0.005), [lactate] remained increased (P<0.001), [pyruvate] increased progressively (P<0.0001), and %StO2 had returned to baseline. Changes in substance concentrations and oxygenation in response to work indicate normal increase in metabolism but no ongoing inflammation in subjects withTM.

  • 7.
    Flodgren, Gerd
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Crenshaw, Albert
    University of Gävle, Centre for Musculoskeletal Research.
    Hellström, Fredrik
    University of Gävle, Centre for Musculoskeletal Research.
    Fahlström, Martin
    University of Gävle, Centre for Musculoskeletal Research.
    Effects of low-load repetitive work on sensitizing substances and metabolism in the trapezius muscle of female pain subjects and controls-determined with microdialysis and near infrared-spectroscopy2007In: Sixth International Scientific Conference on Prevention of Work-Related Musculoskeletal Disorders, 2007, p. 275-Conference paper (Other academic)
  • 8.
    Flodgren, Gerd
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Crenshaw, Albert
    University of Gävle, Centre for Musculoskeletal Research.
    Hellström, Fredrik
    University of Gävle, Centre for Musculoskeletal Research.
    Fahlström, Martin
    Effects of low-load work on sensitizing substances and muscle metabolism in trapezius myalgia2008Conference paper (Other academic)
  • 9.
    Flodgren, Gerd
    et al.
    University of Gävle, Centre for Musculoskeletal Research. Department of Surgical and Perioperative Sciences, Sports Medicine Unit, Umeå, Sweden.
    Hellström, Fredrik
    University of Gävle, Centre for Musculoskeletal Research.
    Fahlström, Martin
    Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
    Crenshaw, Albert
    University of Gävle, Centre for Musculoskeletal Research.
    Effects of 30 versus 60 min of low-load work on intramuscular lactate, pyruvate, glutamate, prostaglandin E(2) and oxygenation in the trapezius muscle of healthy females2006In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 97, no 5, p. 557-565Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the effects of duration of low-load repetitive work on intramuscular lactate, pyruvate, glutamate and prostaglandin E2 (PGE2), and oxygen saturation in the trapezius muscle. Twenty healthy females were studied during baseline rest, during low-load repetitive work for either 30 (REP 30) or 60 (REP 60) minutes, and 60 minutes recovery. Intramuscular microdialysate (IMMD) samples were obtained, and local muscle tissue oxygenation (StO2 %) assessed with near infrared spectroscopy (NIRS). Subjects rated their perceived exertion (Borg CR-10 scale) and capillary blood was sampled for lactate analysis. The results showed a significant increase in IMMD lactate in response to both REP 30 and REP 60 (P<0.05 and P<0.01 respectively) and glutamate (P<0.0001), but no progressive increase with increasing work duration. Both IMMD pyruvate and lactate tended to be significantly increased during the recovery period. No corresponding increase in blood-lactate was found. Local muscle StO2 % did not change significantly in response to work and was not correlated to the IMMD lactate concentration. The ratings of perceived exertion increased in response to work, and remained increased after recovery for REP 60.

    In conclusion, the results of this study show significantly increased IMMD lactate and, glutamate concentrations in the trapezius muscle of healthy females in response to low-load work, but no progressive increase with increased work duration. Further, they do not indicate that the increased IMMD lactate concentration was caused by a locally decreased or insufficient muscle tissue oxygenation.

  • 10.
    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).

  • 11.
    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.

  • 12.
    Gold, Judith
    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. Gold Standard Research Consulting, Bryn Mawr, PA, USA.
    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, Umeå 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.
    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.
    Barbe, Mary
    Department of Anatomy and Cell Biology, Temple University Medical School,.
    Ali, Sayed
    Department of Radiology, Temple University Medical School,.
    Systematic review of quantitative imaging biomarkers for neck and shoulder musculoskeletal disorders2017In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 18, article id 395Article, review/survey (Refereed)
    Abstract [en]

    Background

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

    Methods

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

    Results

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

    Conclusions

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

  • 13.
    Gold, Judith
    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.
    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.
    Barbe, Mary F.
    Department of Anatomy and Cell Biology, Temple University Medical School, Philadelphia.
    Biochemical biomarkers for MSDs: systematic review results2016Conference paper (Refereed)
    Abstract [en]

    Background. Although the potential for musculoskeletal disorder (MSD) biomarkers to detect subclinical disease and monitor MSD severity was discussed more than 20 years ago, only one review on biochemical biomarkers exclusive to humans has been published (Saxton 2000). The aim of this study was to systematically summarize biochemical biomarker research in neck and upper extremity MSDs that could appear in a work-related context. Two research questions guided the review: (1) Are there biochemical markers associated with neck and upper extremity MSDs? (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. 87 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.

    Discussion. 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.

  • 14.
    Hadrevi, Jenny
    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.
    Ghafouri, B
    Rehabilitation Medicine, Faculty of Health Sciences, Linköping University, Sweden.
    Gerdle, Björn
    Rehabilitation Medicine, Faculty of Health Sciences, Linköping University, Sweden.
    Larsson, B
    Rehabilitation Medicine, Faculty of Health Sciences, Linköping University, Sweden.
    Pedrosa-Domellöf, Fatima
    Integrative Medical Biology, Anatomy, Umeå University, Umeå, Sweden.
    Hellström, Fredrik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Comprehensive analysis of the painful trapezius muscle using a proteomic method (Poster)2010In: Proceedings of the Premus 2010 conference (Seventh International Conference on Prevention of Work-Related Musculoskeletal Disorders) August 29-September 2, 2010Conference paper (Refereed)
  • 15.
    Hadrevi, Jenny
    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.
    Ghafouri, Bijar
    Occupational and Environmental Medicine, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University.
    Larsson, Britt
    Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Linköping University.
    Gerdle, Björn
    Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Linköping University and Pain and Rehabilitation Centre, County Council of Östergötland.
    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.
    Multivariate modeling of proteins related to trapezius myalgia, a comparative study of female cleaners with or without pain2013In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 9, p. e73285-Article in journal (Refereed)
    Abstract [en]

    The prevalence of chronic trapezius myalgia is high in women with high exposure to awkward working positions, repetitive movements and movements with high precision demands. The mechanisms behind chronic trapezius myalgia are not fully understood. The purpose of this study was to explore the differences in protein content between healthy and myalgic trapezius muscle using proteomics. Muscle biopsies from 12 female cleaners with work-related trapezius myalgia and 12 pain free female cleaners were obtained from the descending part of the trapezius. Proteins were separated with two-dimensional differential gel electrophoresis (2D-DIGE) and selected proteins were identified with mass spectrometry. In order to discriminate the two groups, quantified proteins were fitted to a multivariate analysis: partial least square discriminate analysis. The model separated 28 unique proteins which were related to glycolysis, the tricaboxylic acid cycle, to the contractile apparatus, the cytoskeleton and to acute response proteins. The results suggest altered metabolism, a higher abundance of proteins related to inflammation in myalgic cleaners compared to healthy, and a possible alteration of the contractile apparatus. This explorative proteomic screening of proteins related to chronic pain in the trapezius muscle provides new important aspects of the pathophysiology behind chronic trapezius myalgia.

  • 16.
    Hadrevi, Jenny
    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 University.
    Ghafouri, Bijar
    Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Linköping University .
    Sjörs, Anna
    Institute of Stress Medicine, Carl Skottsbergs gata 22B, SE 41319 Gothenburg, Sweden.
    Antti, Henrik
    Department of Chemistry, Faculty of Science and Technology, Umeå University.
    Larsson, Britt
    Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Linköping University .
    Crenshaw, Albert
    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.
    Gerdle, Björn
    Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Linköping University .
    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.
    Comparative metabolomics of muscle interstitium fluid in human trapezius myalgia: an in vivo microdialysis study2013In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 113, no 12, p. 2977-2989Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    The mechanisms behind trapezius myalgia are unclear. Many hypotheses have been presented suggesting an altered metabolism in the muscle. Here, muscle microdialysate from healthy and myalgic muscle is analysed using metabolomics. Metabolomics analyse a vast number of metabolites, enabling a comprehensive explorative screening of the cellular processes in the muscle.

    METHODS:

    Microdialysate samples were obtained from the shoulder muscle of healthy and myalgic subjects that performed a work and stress test. Samples from the baseline period and from the recovery period were analysed using gas chromatography-mass spectrometry (GC-MS) together with multivariate analysis to detect differences in extracellular content of metabolites between groups. Systematic differences in metabolites between groups were identified using multivariate analysis and orthogonal partial least square discriminate analysis (OPLS-DA). A complementary Mann-Whitney U test of group difference in individual metabolites was also performed.

    RESULTS:

    A large number of metabolites were detected and identified in this screening study. At baseline, no systematic differences between groups were observed according to the OPLS-DA. However, two metabolites, L-leucine and pyroglutamic acid, were significantly more abundant in the myalgic muscle compared to the healthy muscle. In the recovery period, systematic difference in metabolites between the groups was observed according to the OPLS-DA. The groups differed in amino acids, fatty acids and carbohydrates. Myristic acid and putrescine were significantly more abundant and beta-D-glucopyranose was significantly less abundant in the myalgic muscle.

    CONCLUSION:

    This study provides important information regarding the metabolite content, thereby presenting new clues regarding the pathophysiology of the myalgic muscle.

  • 17.
    Hadrevi, Jenny
    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.
    Hellström, Fredrik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Kieselbach, Thomas
    Umeå Universitet.
    Malm, Christer
    Umeå Universitet.
    Pedrosa-Domellöf, Fatima
    Umeå Universitet.
    Protein differences between human trapezius and vastus lateralis muscles determined with a proteomic approach2011In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 12, no 181Article in journal (Refereed)
    Abstract [en]

    Background

    The trapezius muscle is a neck muscle that is susceptible to chronic pain conditions associated with repetitive tasks, commonly referred to as chronic work-related myalgia, hence making the trapezius a muscle of clinical interest. To provide a basis for further investigations of the proteomic traits of the trapezius muscle in disease, two-dimensional difference gel electrophoresis (2D-DIGE) was performed on the healthy trapezius using vastus lateralis as a reference. To obtain as much information as possible from the vast proteomic data set, both one-way ANOVA, with and without false discovery rate (FDR) correlation, and partial least square projection to latent structures with discriminant analysis (PLS-DA) were combined to compare the outcome of the analysis.

    Results

    The trapezius and vastus lateralis showed significant differences in metabolic, contractile and regulatory proteins, with different results depending on choice of statistical approach and pre-processing technique. Using the standard method, FDR correlated one-way ANOVA, 42 protein spots differed significantly in abundance between the two muscles. Complementary analysis using immunohistochemistry and western blot confirmed the results from the 2D-DIGE analysis.

    Conclusions

    The proteomic approach used in the present study combining 2D-DIGE and multivariate modelling provided a more comprehensive comparison of the protein profiles of the human trapezius and vastus lateralis muscle, than previously possible to obtain with immunohistochemistry or SDS-PAGE alone. Although 2D-DIGE has inherent limitations it is particularly useful to comprehensively screen for important structural and metabolic proteins, and appears to be a promising tool for future studies of patients suffering from chronic work related myalgia or other muscle diseases.

  • 18.
    Hadrevi, Jenny
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Hellström, Fredrik
    University of Gävle, Centre for Musculoskeletal Research.
    Malm, Christer
    Department of Intergrative Medical Biology, Section for Anatomy, Umeå University, Sweden.
    Frängsmyr, Lars
    Department of Intergrative Medical Biology, Section for Anatomy, Umeå University, Sweden.
    Pedrosa-Domellöf, Fatima
    Department of Intergrative Medical Biology, Section for Anatomy, Umeå University, Sweden.
    Evaluation of trapezius using proteomic methods2007In: Sixth International Scientific Conference on Prevention of Work-Related Musculoskeletal Disorders, 2007, p. 274-Conference paper (Refereed)
  • 19.
    Hadrévi, Jenny
    et al.
    Department of Community Medicine and Rehabilitation, Sports Medicine Unit, 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, Sports Medicine Unit, Umeå University, Umeå, Sweden.
    Kosek, Eva
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Hällgren, Solveig
    Department of Clinical Sciences, Professional Development, Umeå University, Sweden.
    Antti, Henrik
    Department of Chemistry, Faculty of Science and Technology, Umeå University, Umeå, Sweden.
    Fahlström, Martin
    Department of Clinical Sciences, Professional Development, Umeå University, Sweden.
    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.
    Systemic differences in serum metabolome: a cross sectional comparison of women with localised and widespread pain and controls2015In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 5, article id 15925Article in journal (Refereed)
    Abstract [en]

    Chronic musculoskeletal pain exists either as localised to a single region or as widespread to multiple sites in several quadrants of the body. Prospective studies indicate that widespread pain could act as a far end of a continuum of musculoskeletal pain that started with chronic localised pain. The mechanism by which the transition from localised pain to widespread occurs is not clear, although many studies suggest it to be an altered metabolism. In this study, systemic metabolic differences between women with chronic localised neck-shoulder pain (NP), women with chronic widespread pain (CWP) and women who were healthy (CON) were assessed. Blood samples were analysed taking a metabolomics approach using gas chromatography mass spectrometry (GC-MS) and orthogonal partial least square discriminant analysis (OPLS-DA). The metabolomics analysis showed a clear systematic difference in the metabolic profiles between the subjects with NP and the CON but only a weak systematic difference between the subjects with CWP and the CON. This most likely reflects a difference in the portion of the metabolome influenced by the two pain conditions. In the NP group, the overall metabolic profile suggests that processes related to energy utilisation and lipid metabolism could be central aspects of mechanisms maintaining disorder.

  • 20.
    Hadrévi, Jenny
    et al.
    Department of Community Medicine and Rehabilitation, Sports Medicine Unit, Umeå University, Umeå, Sweden.
    Turkina, Maria
    Department of clinical and experimental medicine, Linköping University.
    Carlsson, Andreas
    Division of community medicine, Department of medical and health sciences, Linköping University; Pain and rehabilitation center, anesthetics, operations and specialty surgery center, Region Östergötland.
    Gerdle, Björn
    Division of community medicine, Department of medical and health sciences, Linköping University; Pain and rehabilitation center, anesthetics, operations and specialty surgery center, Region Östergötland.
    Larsson, Britt
    Division of community medicine, Department of medical and health sciences, Linköping University; Pain and rehabilitation center, anesthetics, operations and specialty surgery center, Region Östergötland.
    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.
    Ghafouri, Bijar
    Division of community medicine, Department of medical and health sciences, Linköping University; Pain and rehabilitation center, anesthetics, operations and specialty surgery center, Region Östergötland.
    Myosin light chain and calcium regulating protein differences in chronic musculoskeletal neck and shoulder pain2016In: Journal of Integrated OMICS, ISSN 2182-0287, Vol. 6, no 1, p. 1-8, article id 191Article in journal (Refereed)
    Abstract [en]

    Proteomic screening analysis has detected myosin light chain (MLC) as a protein implied to be involved in chronic musculoskeletal neck and shoulder pain. Several analyses of MLC proteins have stated a difference in phosphorylation being the determining factor for protein activation hence altered contrability of the muscle in i.e. senescence. In continuation of a previous publication, this study is an attempt to analyze the different MLC isoforms by mass spectrometry and immune-analyses in myalgic and healthy trapezius muscle. In the present study no differences in phosphorylation level between the corresponding individual proteins were detected using LC-MSMS and immunoblotting; instead we assigned different isoforms of regulatory MLCs. To further elucidate the contrability: calcium (Ca2+) regulatory proteins, sarco(endo)plasmic reticulum Ca2+ ATPase 1 (SERCA-1) and calsequestrine (CSQ) were analyzed by western blot. The analysis revealed a significantly increased abundance of SERCA-1 protein in the myalgic muscle and a significantly increased abundance of CSQ in healthy muscle. Myalgic muscle contraction patterns have in previous studies shown to differ from healthy muscle which may be connected to the Ca2+ availability in the muscle. Here we present the proteomic characterization of differences in Ca2+ regulating proteins and particularly regulatory MLCs in trapezius muscle of women with chronic musculoskeletal neck and shoulder pain.

  • 21.
    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.
    Symposium: 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.

  • 22.
    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.

  • 23.
    Hellström, Fredrik
    University of Gävle, Centre for Musculoskeletal Research.
    Arbete med högrepetitiva rörelser2008In: Arbetslivsfysiologi / [ed] Allan Toomingas, Svend Erik Mathiassen, Ewa Wigaeus Tornqvist, Lund: Studentlitteratur AB , 2008, p. 161-190Chapter in book (Other academic)
  • 24.
    Hellström, Fredrik
    University of Gävle, Centre for Musculoskeletal Research.
    Visualising receptors of pain producing substances in muscles using PET/CT in patients with musculoskeletal disorders2007In: Sixth International Scientific Conference on Prevention of Work-Related Musculoskeletal Disorders, 2007, p. 278-Conference paper (Other academic)
  • 25.
    Hellström, Fredrik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Work with Highly Repetitive Movements2012In: Occupational Physiology / [ed] Allan Toomingas, Svend Erik Mathiassen, Ewa Wigaeus Tornqvist, Bosa Roca: Crc Press Inc , 2012, p. 117-139Chapter in book (Other academic)
  • 26.
    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)
  • 27.
    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)
  • 28.
    Hellström, Fredrik
    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.
    Gouveia-Figueira, Sandra
    Department of Chemistry, Umeå University, Umeå; Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå.
    Nording, Malin
    Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå.
    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, Umeå University, Umeå.
    Fowler, Christopher John
    Department of Community Medicine and Rehabilitation, Umeå universitet, Umeå.
    Association between plasma concentrations of linoleic acid-derived oxylipins and the perceived pain scores in an exploratory study in women with chronic neck pain2016In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 17, no 1, article id 103Article in journal (Refereed)
    Abstract [en]

    Background: Chronic musculoskeletal pain may be associated with changes in the balance of algogenic and anti-nociceptive compounds, and that such changes may be visible in plasma samples. We have undertaken an exploratory study to measure the levels of endocannabinoids, related N-acylethanolamines and oxylipins (primarily those derived from linoleic acid) in plasma samples from women with chronic neck pain (NP) and chronic widespread pain (CWP), and to investigate whether the observed levels are associated with the pain experienced by these women.

    Methods: Blood samples from 35 women with NP, 15 with CWP and 27 age-matched controls were analysed for the lipids using an ultra performance liquid chromatography coupled to tandem mass spectrometry method. Current pain ("NRSday") and the average pain during the last week ("NRSweek") were rated by the participants using a numerical rating scale.

    Results: There were no significant differences in the plasma concentrations of the fifteen lipids investigated between the pain subjects and the controls. However, significant correlations were seen for the NP group between the NRSday scores and the plasma concentrations of the linoleic acid derivatives 9- and 13- hydroxy-10E,12Zoctadecadienoic acid (Spearman's rho values 0.51 [P=0.0016]) and 0.53 [P=0.0011], respectively).

    Conclusions: The data obtained in this exploratory study are consistent with a model whereby the underlying inflammatory nature of the musculoskeletal disorders leads both to an increase in the NRSday scores and the hydroxy-10E,12Z-octadecadienoic acid levels, and these increases further influence the perceived pain of in the NP subjects.

  • 29.
    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.

  • 30.
    Hellström, Fredrik
    et al.
    Idrottsmedicin, Umeå universitet och Arbetslivsinstitutet.
    Roatta, Silvestro
    University of Turin., Italy.
    Johansson, Håkan
    Arbetslivsinstitutet.
    Passatore, Magda
    University of Turin, Italy.
    A technique for estimating activity in whole nerve trunks applied to the cervical sympathetic trunk, in the rabbit1999In: Neuroscience Letters, ISSN 0304-3940, E-ISSN 1872-7972, Vol. 277, no 2, p. 95-98Article in journal (Refereed)
    Abstract [en]

    The changes in sympathetic outflow may be evaluated from the amplitude of the antidromic compound action potential (ACAP) according to the collision technique described by Douglas and Ritchie (Douglas, W.W. and Ritchie J.M., A technique for recording functional activity in specific groups of medullated and non-medullated fibers in whole nerve trunks. J. Physiol., 138 (1957) 19-30). This technique was revised, taking into account the depressant action exerted by antidromic stimulation on sympathetic preganglionic neurones (SPNs). Cervical sympathetic nerve (CSN) of rabbits was used as experimental model. Stimulation frequencies of 0.2-0.5 Hz were found to be sufficiently low to avoid depressant actions on CSN spontaneous activity; they were employed to test the sensitivity of the technique during different experimental manoeuvres, such as changes in pulmonary-ventilation, baroreceptor unloading and arousal stimuli. In addition a procedure was devised to calibrate the ACAP amplitude: high frequency antidromic stimulation was used to induce a complete and transient inhibition of SPNs which allows to record the ACAP maximum amplitude. ACAPs recorded in various experimental conditions can then be expressed as percentage of this value.

  • 31.
    Lövgren, Anna
    et al.
    Clinical Oral Physiology, Department of Odontology Faculty of Medicine, University of Umeå, Umeå, Sweden.
    Österlund, Catharina
    Clinical Oral Physiology, Department of Odontology Faculty of Medicine, University of Umeå, Umeå, Sweden.
    Lampa, Ewa
    Clinical Oral Physiology, Department of Odontology Faculty of Medicine, University of Umeå, Umeå, Sweden.
    Ilgunas, Aurelija
    Clinical Oral Physiology, Department of Odontology Faculty of Medicine, University of Umeå, Umeå, Sweden.
    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.
    A high prevalence of TMD is related to somatic awareness and pain intensity among healthy dental students2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 6, p. 387-393Article in journal (Other academic)
    Abstract [en]

    Objective: Dental students have been identified as a group with high risks of developing both temporomandibular disorders (TMD) and psychosocial conditions. Our primary aim was to evaluate the cross-sectional prevalence of TMD diagnoses, as defined in the Diagnostic Criteria (DC)/TMD, among dental students. The secondary aim was to evaluate the prevalence and association of behavioural and psychosocial factors in relation to DC/TMD diagnoses.

    Materials and methods: The study was conducted among undergraduate dental students during the second semester of their third year at the Department of Odontology, Medical Faculty, Umeå University, Sweden. Three consecutive cohorts were recruited during August in 2013, 2014, 2015. In total, 54 students were included and examined according the DC/TMD procedure.

    Results and conclusions: The prevalence of any DC/TMD diagnosis was 30%. The most prevalent TMD diagnosis was myalgia. Individuals with a TMD-pain diagnosis (i.e. myalgia or arthralgia) reported significantly higher pain intensity levels according to the Graded Chronic Pain Scale (GCPS) as compared to individuals without TMD-pain (Fisher’s exact test p < .001, two-sided). In addition, individuals with any TMD scored significantly higher jaw functional limitations according to the Jaw Functional Limitation Scale 20 (JFLS-20, p < .001) and oral parafunctions according to the Oral Behavior Checklist (OBC, p = .005) as compared to individuals without TMD. The psychosocial factors evaluated did not differ between individual with or without a TMD diagnosis. The majority of the dental students reported symptoms that are already identified as risk factors for developing TMD and pain conditions. However, longitudinal data are needed to evaluate how this evolves over time.

  • 32. Mel'nichouk, Alexander P
    et al.
    Bulgakova, Natalia V
    Tal'nov, Arkadij N
    Hellström, Fredrik
    University of Gävle, Centre for Musculoskeletal Research.
    Windhorst, Uwe
    Kostyukov, Alexander I
    Movement-dependent positioning errors in human elbow joint movements2007In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 176, no 2, p. 237-247Article in journal (Refereed)
    Abstract [en]

    Healthy adult humans performed elbow movements in a horizontal plane under a small external extending torque (2.1-3.3 Nm). Test movements (TMs) consisted of slow ramp-and-hold flexions in the absence of visual feedback, with the target joint angle to be remembered from a preceding conditioning movement (CM). The CM was produced by matching two beams on the monitor screen: (1) command representing the target position (a straight line); and (2) a signal from the sensor of the elbow joint angle. Two kinds of CM were applied, which had the same target position (50 degrees in most experiments) but differed in initial positions: (1) fully extended joint (0 degrees, P1 CMs); (2) flexed joint (100 degrees, P2 CMs). In a group of 25 subjects, the target in TMs was usually overshot, with the position errors depending on the CMs: 2.7 +/- 0.6 degree (mean +/- SEM) for P1 CMs, and 10.9 +/- 0.7 degree (P < 0.001) for P2 CMs. Vibration of the elbow flexors substantially diminished the difference between the position errors, amounting to--0.31 +/- 0.5 degree and 2.33 +/- 0.6 degrees, respectively. It is suggested that the observed position errors resulted from after-effects in the activity of muscle spindles in agonist and antagonist muscles, but influence of differences in dynamic components of the afferent signals during oppositely directed approaches to the target cannot be excluded.

  • 33. Passatore, Magda
    et al.
    Hellström, Fredrik
    University of Gävle, Centre for Musculoskeletal Research.
    Roatta, S.
    The role of the sympathetic nervous system in stress and pain2004In: International Congress on Chronic Pain and Dysfunction after Whiplash and other Traumatic Neck Injuries / [ed] Djupsjöbacka, M., Johansson, H B., Mathiassen, S E., Sjölander, P., Centre for Musculoskeletal Research, Gävle, Sweden: Gefle University Press , 2004, p. 16-26Chapter in book (Other academic)
  • 34.
    Passatore, Magda
    et al.
    University of Gävle, Belastningsskadecentrum.
    Hellström, Fredrik
    University of Gävle, Belastningsskadecentrum.
    Roatta, Silvestro
    The role of the sympathetic nervous system in stress and pain2004In: Proceedings of international Congress on Chronic Pain and Dysfunction after Whiplash and other Traumatic Neck Injuries / [ed] Djupsjöbacka M, Johansson B H, Mathiassen S E, Sjölander P, Gävle: Gefe University Press , 2004, p. 16-26Conference paper (Refereed)
  • 35.
    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)
  • 36. Pilyavskii, Alexander I
    et al.
    Maznychenko, Andrey V
    Maisky, Vladimir A
    Kostyukov, Alexander I
    Hellström, Fredrik
    University of Gävle, Belastningsskadecentrum.
    Windhorst, Uwe
    Capsaicin-induced effects on c-fos expression and NADPH-diaphorase activity in the feline spinal cord.2005In: European Journal of Pharmacology, ISSN 0014-2999, E-ISSN 1879-0712, Vol. 521, no 1-3, p. 70-78Article in journal (Refereed)
    Abstract [en]

    The distribution of c-fos expression and NADPH-diaphorase reactivity in the cervical and lumbar segments after stimulation of the vanilloid receptors in the dorsal neck muscles with capsaicin was studied in cats anaesthetized with alpha-chloralose. After the unilateral intramuscular injection of capsaicin, the mean number of Fos-immunoreactive neurons detected with an avidin-biotin-peroxidase technique was significantly increased in the superficial laminae (I), neck of the dorsal horn (V), and area around the central canal (VII) within both the cervical and lumbar spinal cord. Most Fos-immunoreactive neurons in the cervical spinal cord were giant and small cells. The widespread distribution of Fos-immunoreactive cells throughout the cervical cord within the intermediate zone (VII) coincided with the sites of localization of last-order premotor interneurons and cells of origin of inter-segmental crossed and uncrossed descending propriospinal pathways to the lumbar spinal cord. Fos-immunoreactive neurons were co-distributed with nitric oxide-generating cells at both levels of the spinal cord, although the double-labeled cells were not observed. In conclusion, the analysis of c-fos expression and NADPH-diaphorase reactivity shows that stimulation of vanilloid receptors in the neck muscles can initiate distinctive neuronal plasticity in the cervical (C1-C8) and lumbar (L1-L7) segments, and confirms the anatomical and functional coupling of both regions during processing of nociceptive signals from the dorsal neck muscles.

  • 37.
    Rasmussen, Charlotte
    et al.
    National research centre for the working Environment, Copenhagen, Denmark.
    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.
    Symposia: Musculoskeletal pain as an outcome - how can we get better insight into the time course of musculoskeletal pain?2018Conference paper (Refereed)
  • 38.
    Schomburg, Eike D.
    et al.
    Zentrum Physiologie und Pathophysiologie, Universität Göttingen, Göttingen, Germany.
    Steffens, Heinz
    Zentrum Physiologie und Pathophysiologie, Universität Göttingen, Göttingen, Germany.
    Maznychenko, Andrey V.
    Department of Movement Physiology, Bogomoletz Institute of Physiology, National Academy of Sciences, Kiev, Ukraine.
    Pilyavskii, Alexander I.
    Department of Movement Physiology, Bogomoletz Institute of Physiology, National Academy of Sciences, Kiev, Ukraine.
    Hellström, Fredrik
    University of Gävle, Centre for Musculoskeletal Research.
    Kostyukov, Alexander I.
    Department of Movement Physiology, Bogomoletz Institute of Physiology, National Academy of Sciences, Kiev, Ukraine.
    Maisky, Vladimir A.
    Department of Movement Physiology, Bogomoletz Institute of Physiology, National Academy of Sciences, Kiev, Ukraine.
    Acute muscle inflammation enhances the monosynaptic reflexes and c-fos expression in the feline spinal cord2007In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 11, no 5, p. 579-586Article in journal (Refereed)
    Abstract [en]

    The aim of this research was to study the changes of the motor reflex activity (monosynaptic reflex (MSR) of the flexor and extensor muscles) and Fos immunoreactivity in lumbo-sacral spinal cord after acute induced myositis of m. gastrocnemius-soleus (GS). The experiments were carried out on ischaemic decerebrated, spinalized in C1 cats. After infiltration of the GS muscle with carrageenan (2%) MSRs of flexors and extensors showed a significant increase in amplitude +127+/-24.5% and +155+/-28.5%, respectively, p<0.05. The exposed effect was initiated within 30 min and achieved a maximum 2.8h after the intramuscular injections of carrageenan. After analysis of dynamics of the MSRs, animals were perfused and c-fos expression in the spinal segments L6-S1 was evaluated. In comparison to sham-operated animals, the number of Fos-immunoreactive (Fos-ir) cells was noticeably increased in the lumbar cord of cats with carrageenan-induced myositis. The labeled cells were concentrated in the ipsilateral laminae I/II, neck of the dorsal horn (V/VI) and intermediate zone (VII), however, clear predominance of their concentration was found in the deep laminae. The effect of muscle inflammation was also expressed as a significant decline in the number of NADPH-d-reactive cells (p<0.05) in ipsilateral laminae I/II of L6/L7. The results show that the input from acutely inflamed muscles may induce an increase of the reflex responsiveness of flexors and extensors which is not mediated via the gamma-spindle-loop and which coincides with a significant increase in c-fos expression in the deep laminae of the lumbar spinal cord.

  • 39.
    Wiesinger, Birgitta
    et al.
    Department of Odontology, Clinical Oral Physiology, Umeå University, Umeå, Sweden; Department of Research and Development, Umeå University, Sundsvall, Sweden.
    Häggman-Henrikson, Birgitta
    Department of Odontology, Clinical Oral Physiology, Umeå University, Umeå, Sweden; Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.
    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.
    Englund, Erling
    Department of Research and Development, Umeå University, Sundsvall, Sweden.
    Wänman, Anders
    Department of Odontology, Clinical Oral Physiology, Umeå University, Umeå, Sweden.
    Does induced masseter muscle pain affect integrated jaw-neck movements similarly in men and women?2016In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 124, no 6, p. 546-553Article in journal (Refereed)
    Abstract [en]

    Normal jaw opening-closing involves simultaneous jaw and head-neck movements. We previously showed that, in men, integrated jaw-neck movements during jaw function are altered by induced masseter muscle pain. The aim of this study was to investigate possible sex-related differences in integrated jaw-neck movements following experimental masseter muscle pain. We evaluated head-neck and jaw movements in 22 healthy women and 16 healthy men in a jaw opening-closing task. The participants performed one control trial and one trial with masseter muscle pain induced by injection of hypertonic saline. Jaw and head movements were registered using a three-dimensional optoelectronic recording system. There were no significant sex-related differences in jaw and head movement amplitudes. Head movement amplitudes were significantly greater in the pain trials for both men and women. The proportional involvement of the neck motor system during jaw movements increased in pain trials for 13 of 16 men and for 18 of 22 women. Thus, acute pain may alter integrated jaw-neck movements, although, given the similarities between men and women, this interaction between acute pain and motor behaviour does not explain sex differences in musculoskeletal pain in the jaw and neck regions.

  • 40.
    Wiesinger, Birgitta
    et al.
    Dept. of Odontology, Clinical Oral Physiology, Umeå University.
    Häggman-Henrikson, Birgitta
    Dept. of Odontology, Clinical Oral Physiology, Umeå University.
    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.
    Wänman, Anders
    Dept. of Odontology, Clinical Oral Physiology, Umeå University.
    Experimental masseter muscle pain alters jaw-neck motor strategy2013In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 17, no 7, p. 995-1004Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    A functional integration between the jaw and neck regions has been demonstrated during normal jaw function. The effect of masseter muscle pain on this integrated motor behaviour in man is unknown. The aim of this study was to investigate the effect of induced masseter muscle pain on jaw-neck movements during a continuous jaw opening-closing task.

    METHODS:

    Sixteen healthy men performed continuous jaw opening-closing movements to a target position, defined as 75% of the maximum jaw opening. Each subject performed two trials without pain (controls) and two trials with masseter muscle pain, induced with hypertonic saline as a single injection. Simultaneous movements of the mandible and the head were registered with a wireless optoelectronic three-dimensional recording system. Differences in movement amplitudes between trials were analysed with Friedman's test and corrected Wilcoxon matched pairs test.

    RESULTS:

    The head movement amplitudes were significantly larger during masseter muscle pain trials compared with control. Jaw movement amplitudes did not differ significantly between any of the trials after corrected Wilcoxon tests. The ratio between head and jaw movement amplitudes was significantly larger during the first pain trial compared with control.

    CONCLUSIONS:

    Experimental masseter muscle pain in humans affected integrated jaw-neck movements by increasing the neck component during continuous jaw opening-closing tasks. The findings indicate that pain can alter the strategy for jaw-neck motor control, which further underlines the functional integration between the jaw and neck regions. This altered strategy may have consequences for development of musculoskeletal pain in the jaw and neck regions.

  • 41.
    Wiesinger, Birgitta
    et al.
    Umeå University and Västernorrland County Council.
    Häggman-Henriksson, Birgitta
    Umeå University and Malmö University.
    Wänman, Anders
    Umeå University.
    Lindqvist, Mikael
    Umeå University.
    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.
    Jaw-opening accuracy is not affected by masseter muscle vibration in healthy men2014In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 232, no 11, p. 3501-3508Article in journal (Refereed)
    Abstract [en]

    There is a functional integration between the jaw and neck regions with head extension–flexion movements during jaw-opening/closing tasks. We recently reported that trigeminal nociceptive input by injection of hypertonic saline into the masseter muscle altered this integrated jaw–neck function during jaw-opening/closing tasks. Thus, in jaw-opening to a predefined position, the head–neck component increased during pain. Previous studies have indicated that muscle spindle stimulation by vibration of the masseter muscle may influence jaw movement amplitudes, but the possible effect on the integrated jaw–neck function is unknown. The aim of this study was to investigate the effect of masseter muscle vibration on jaw–head movements during a continuous jaw-opening/closing task to a target position. Sixteen healthy men performed two trials without vibration (Control) and two trials with bilateral masseter muscle vibration (Vibration). Movements of the mandible and the head were registered with a wireless three-dimensional optoelectronic recording system. Differences in jaw-opening and head movement amplitudes between Control and Vibration, as well as achievement of the predefined jaw-opening target position, were analysed with Wilcoxon’s matched pairs test. No significant group effects from vibration were found for jaw or head movement amplitudes, or in the achievement of the target jaw-opening position. A covariation between the jaw and head movement amplitudes was observed. The results imply a high stability for the jaw motor system in a target jaw-opening task and that this task was achieved with the head–neck and jaw working as an integrated system.

  • 42.
    Österlund, Catharina
    et al.
    University of Umeå, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology, Umeå, Sweden.
    Nilsson, Evelina
    University of Umeå, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology, Umeå, Sweden.
    Hellström, Fredrik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Häger, Charlotte K.
    University of Umeå, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Umeå, Sweden.
    Häggman-Henrikson, Birgitta
    University of Malmö, Faculty of Odontology, Orofacial Pain and Jaw Function, Malmö, Sweden.; Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Sweden.
    Jaw-Neck Movement Integration in 6-year old Children Differs from that of Adults2019In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842Article in journal (Refereed)
    Abstract [en]

    Background: A functional integration between the jaw and neck regions during purposive jaw movements is well described in adults, but there is a lack of knowledge of such integration during jaw function in children.; Objectives: To determine the movement integration between the jaw and neck during jaw motor tasks in 6-year-olds, whether there is a difference between children and adults.; Methods: Jaw and neck movements were recorded with an optoelectronic 3D system in 25 healthy 6-year-olds (12 girls, 13 boys) and 24 healthy adults (12 women, 12 men) during paced jaw opening-closing and self-paced gum chewing. Jaw and neck movement amplitudes, intra-individual variation in movement amplitude, ratio between neck-jaw movement amplitudes, and movement cycle time were analysed. Differences between children and adults were evaluated with Mann-Whitney U test for independent samples.; Results: Compared to adults, 6-year old children showed larger neck movement amplitudes (P=0.008) during chewing, higher intra-individual variability in amplitudes of jaw (P=0.008) and neck (P=0.001) movements, higher ratio between neck-jaw movement amplitudes for jaw opening-closing (P=0.026) and chewing (P=0.003), and longer jaw movement cycle time (P≤0.0001) during the jaw opening-closing task.; Conclusion: Despite integrated jaw-neck movements in 6-year old children, the movement pattern differs from that of adults and may be interpreted as an immature programming of jaw-neck motor behavior. The well-integrated movements observed in adults most likely develop over years, perhaps into adolescence, and needs further research including well controlled longitudinal studies to map this development in order to provide appropriate age-related clinical treatment for functional disorders. This article is protected by copyright. All rights reserved.; This article is protected by copyright. All rights reserved.

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