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  • 151.
    Elcadi, Guilherme H.
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    Tsaklis, Panagiotis
    Alexander Technological Institute of Thessaloniki, Thessaloniki, Greece.
    Blomqvist, Sven
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    Ervasti, Per-Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    W. Söderström, Mikael
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    Forsman, Mikael
    Karolinska Institute, Stockholm, Sweden.
    Richter, Hans
    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 Strong Correlation Between Dorsolateral Prefrontal Cortex And Vastus Lateralis Activity During Running To Fatigue2016In: Medicine and science in sports and exercise, ISSN 0195-9131, Vol. 48, no 5, p. 854-854Article in journal (Refereed)
    Abstract [en]

    Fatigue is a phenomenon of pronounced importance in sports. Recently, there is strong evidence of interplay between the prefrontal cortex and motor output during fatiguing contractions. The dorsolateral prefrontal cortex (DLPC) due to its large involvement in cognitive and motor activities is believed to be involved but this requires physiological clarification. AIM: We investigated the relationship between DLPC activity - responses in oxyhemoglobin (HbO2) and total hemoglobin (HbT) measured by near-infrared spectroscopy (NIRS), and the vastus lateralis muscle (VL) activity - quantified as root-mean-square (RMS) of the EMG signal, during a fatigue protocol.

    METHODS: Four male runners (32±12 yrs) with probes for NIRS over the DLPC and EMG over the VL performed a track running test at a constant speed to fatigue (exhaustion). The running speed was individually determined as the average speed of a 1200-m time trial performed ~3 days prior to testing. For NIRS changes in μmole/L of HbO2 and HbT were computed. The VL EMG-RMS of the contraction of each step was normalized as a percent of a submaximal reference contraction (%RMS), thus removing the non-activity between steps. Data of 10s epochs at 20, 40, 60, 80 and 100% of time for each lap were averaged for analyses. Regression analyses performed with HbO2 and with HbT as dependent variables and %RMS as the independent variable.

    RESULTS: Over time there was an increase in HbO2 and HbT in the DLPC, and in VL-%RMS. Both HbO2 and HbT correlated strongly with EMG-RMS during running to fatigue (see figures below); p<0.001 for both.

    CONCLUSION: The strong relationship between DLPC and VL activities during running to fatigue suggests the involvement of the DLPC in the central processing of fatigue.

  • 152.
    Elfving, Britt
    et al.
    Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
    Åsell, Malin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Bergsten, Charlotte Luning
    Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
    Alexanderson, Kristina
    Karolinska Inst, Div Insurance Med, Dept Clin Neurosci, Stockholm, Sweden.
    Exploring activity limitations and sick leave among patients with spinal pain participating in multidisciplinary rehabilitation2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 4, p. 292-299Article in journal (Refereed)
    Abstract [en]

    Purpose. To describe limitations in 12 activities at baseline, after multidisciplinary rehabilitation and at a 6-month follow-up for patients with spinal pain and, further, to investigate whether low limitation in any of the activities or in the mean score at baseline might predict increased working time at follow-up. Method. A prospective cohort study of 302 patients, 22- to 63-years old, who participated in multidisciplinary rehabilitation because of chronic neck, thoracic and/or lumbar pain. Data from the Disability Rating Index questionnaire were obtained at baseline, after the 4-week rehabilitation programme, and at the 6-month follow-up. Two subgroups are described: patients who at baseline (1) worked full-time or (2) were on part- or full-time sick leave. Results. The degree of limitation in the 12 activities (items) showed large variations in median scores (7-91). Both subgroups showed significant improvements in most activities after rehabilitation, which remained at the follow-up. Nevertheless, in the sick-leave group, patients who had increased their working time at follow-up (62%) were still very limited in running, heavy work, and lifting heavy objects. In logistic regressions, low limitation in standing bent over a sink at baseline was the only single activity that predicted increased working time at the follow-up: odds ratio (OR) 1.93 (95% CI 1.1-3.5). OR for the mean score was 1.8 (1.0-3.3). Conclusion. A profile of the separate activities demonstrates the large variation in the degree of limitation, which is concealed in a mean score. The single items can be useful when evaluabing interventions. However, to predict increased working time after rehabilitation, the mean score, as well as the activity standing bent over a sink, proved useful.

  • 153.
    Elfving, Britt
    et al.
    Section of Personal Injury Prevention, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Åsell, Malin
    University of Gävle, Centre for Musculoskeletal Research.
    Ropponen, Annina
    Section of Personal Injury Prevention, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Institute of Biomedicine, Department of Physiology/Ergonomics, University of Kuopio, Kuopio, Finland.
    Alexanderson, Kristina
    Section of Personal Injury Prevention, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    What factors predict full or partial return to work among sickness absentees with spinal pain participating in rehabilitation?2009In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, no 16, p. 1318-1327Article in journal (Refereed)
    Abstract [en]

    Purpose. To identify the factors that predict full or partial return to work among long-term (>= 90 days) sickness absentees due to spinal pain who begin a multidisciplinary rehabilitation programme. Method. In a prospective cohort study, 312 patients with neck, thoracic and/or lumbar pain, aged 20-64, participated in a 4-week multidisciplinary rehabilitation programme in Sweden. Questionnaire data at inclusion were used. Factors included in logistic regressions were as follows: age, gender, type of work, pain location, pain intensity (visual analogue scale), activity limitations [Disability Rating Index (DRI)], health-related quality of life (SF-36), pain-related fear of movement (Tampa Scale of Kinesiophobia), motivation (Self Motivation Inventory), sickness absence at baseline and number of sick-leave days during the previous 2 years. Outcome factor was increased versus not increased working time at follow-up 6 months later. Results. Most patients (68%) reported two or three pain locations. At baseline, 56% were full-time sickness absent and 23% at follow-up; 61% had increased their working time. Predictors for increased working time were age below 40 years, low activity limitation (DRI < 50), low SF-36 bodily pain (>30) and high SF-36 social functioning (>60). Number of sick-leave days during the previous 2 years (md 360; range 90-730) had no influence. Conclusions. Even patients with long previous sick leave can increase working time after a multidisciplinary rehabilitation programme, especially if they are younger, have lower levels of activity limitations and pain and better social functioning. To include information on part-time work is useful when evaluating work ability following rehabilitation programmes.

  • 154.
    Engström, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet; Lishui universitet.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Strömberg, Annika
    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.
    Hagerman, Heidi
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Staff working life and older persons' satisfaction with care: a multilevel, correlational design2020In: Journal of Nursing Care Quality, ISSN 1057-3631, E-ISSN 1550-5065Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The importance of staff working life for staff well-being has been demonstrated in several studies; less research has focused on staff working life and older persons' satisfaction with care.

    PURPOSE: The study aim was to study relationships between 1) staff assessments of their structural conditions/empowerment in elderly care, psychological empowerment, and job satisfaction and (2) older persons' satisfaction with care.

    METHODS: A multilevel, cross-sectional, and correlational design was applied using questionnaire data on working life (1021 staff members) and unit-level data (40 elderly care units) on older persons' satisfaction with care.

    RESULTS: Statistically significant relationships were found between all 3 working life variables and older persons' satisfaction with care. Furthermore, the results revealed an indirect/mediating effect of job satisfaction between structural empowerment and satisfaction with care, but not for psychological empowerment.

    CONCLUSIONS: Staff structural empowerment, psychological empowerment, and job satisfaction are linked to older persons' satisfaction with care.

  • 155.
    Ericsson, Pernilla
    et al.
    Work and Environmental Medicine, Umeå University Hospital, Umeå, Sweden.
    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.
    Wahlström, Jens
    Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
    Exposure assessment in different occupational groups at a hospital using Quick Exposure Check (QEC): a pilot study2012In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 41, no Suppl. 1, p. 5718-5720Article in journal (Refereed)
    Abstract [en]

    In order to test the feasibility and sensitivity of the ergonomic exposure assessment tool Quick Exposure Check (QEC), a pilot-study was conducted. The aim was to test QEC in different occupational groups to compare the exposure in the most common work task with the exposure in the work task perceived as the most strenuous for the neck/shoulder region, and to test intra-observer reliability. One experienced ergonomist observed 23 workers. The mean observation time was 45 minutes, waiting time and time for complementary questions included. The exposure scores varied between the different occupational groups as well as between workers within the occupational groups. Eighteen workers rated their most common work task as also being the most strenuous for the neck/shoulder region. For the remaining five workers, the mean exposure score were higher both for the neck and shoulder/arm in the most common work task. Intra-observer reliability shows agreement in 86% of the exposure interactions in the neck and in 71% in the shoulder/arm. QEC seems to fulfill the expectations of being a quick, sensible and practical exposure assessment tool that covers physical risk factors in the neck, upper extremities and low back.

  • 156.
    Ericsson, Pernilla
    et al.
    Occupational and Environmental Medicine, Umeå University and Hospital, Sweden .
    Lindberg, Per
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Oudin, Anna
    Occupational and Environmental Medicine, Umeå University and Hospital, Sweden .
    Wahlström, Jens
    Occupational and Environmental Medicine, Umeå University and Hospital, Sweden .
    Reliability testing of two ergonomic risk assessment tools2012Conference paper (Other academic)
    Abstract [en]

    INTRODUCTION

    Quick Exposure Check (QEC¹) and Rapid Upper Limb Assessment (RULA²) are two ergonomic risk assessment tools that have been designed to be useful for ergonomists assessing musculoskeletal risk factors in upper extremities at workplaces.

    AIM

    The aim was to describe the variation between and within ergonomists assessments using QEC and RULA, and to compare the two tools regarding within-observer agreement.

    SUBJECTS & METHODS

    Twenty ergonomists observed five different work tasks twice with three weeks in between, watching video clips. They made ergonomic risk assessments using both QEC and RULA.

    The observed work tasks were: Window replacement, nailing a wooden pallet, toilet cleaning, instrumentation in an operating theatre, and sorting post.

    For the statistical analyses, percent agreement and kappa value was used.

    RESULTS

    There was a variation in assessments between the ergonomists in all positions and movements both when using QEC and RULA, except from assessing armposition when observing window replacement using QEC, where all ergonomists assessed the same position (figure 1).

    The ergonomists had higher percent agreement between observation one and two using QEC compared with RULA (table 1).

    CONCLUSION

    There was a variation when assessing positions and movements in different worktasks both between ergonomists and within the same ergonomist using both QEC and RULA. However the agreement between two observations within observers was higher for QEC.

  • 157.
    Eriksson, Per Olof
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Zafar, H
    Temporomandibular disorders2006In: Conn's current therapy 2006 / [ed] Robert E. Rakel, Edward T. Bope, Philadelphia, PA: Saunders , 2006, p. 1197-1202Chapter in book (Other (popular science, discussion, etc.))
  • 158.
    Evstigneeva, M
    et al.
    Higher Nervous Activity and Psychophysiology, St.Petersburg State Univ.Russian federation.
    Alexandrov, A
    Higher Nervous Activity and Psychophysiology, St.Petersburg State Univ.Russian federation.
    Mathiassen, Svend Erik
    University of Gävle, Centre for Musculoskeletal Research.
    Lyskov, Eugene
    University of Gävle, Centre for Musculoskeletal Research.
    Muscle fatigue and cognitive task performance, mechanisms of interaction2009In: Society for Psychophysiological Research 49th Annual Meeting Program Addendum, Berlin, 2009Conference paper (Other academic)
  • 159.
    Evstigneeva, M D.
    et al.
    Higher Nervous Activity and Psychophysiology, St.Petersburg State Univ.Russian federation.
    Alexandrov, A A.
    Higher Nervous Activity and Psychophysiology, St.Petersburg State Univ.Russian federation.
    Mathiassen, Svend Erik
    University of Gävle, Centre for Musculoskeletal Research.
    Lyskov, Eugene
    University of Gävle, Centre for Musculoskeletal Research.
    Muscular work and preattentive cognitive processing: motor fatigue reduces MMN amplitude in healthy adults2009In: Neuroscience Meeting Planner, 2009Conference paper (Refereed)
  • 160.
    Evstigneeva, Maria
    et al.
    Saint Petersburg State University, Russia.
    Aleksandrov, Aleksandr
    Saint Petersburg State University, Russia.
    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.
    Lyskov, Eugene
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Concurrent cognitive task may improve motor work performance and reduce muscle fatigue2012In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 41, no Suppl. 1, p. 2893-2896Article in journal (Refereed)
    Abstract [en]

    Performance of certain cognitive tasks either during physical load or in rest pauses between boosts might lead to slowing of muscle fatigue and fatigue related decline in performance. Seventeen right-handed healthy volunteers (age 24±1.4, 8 males) participated in this study, aiming to investigate the effect of the level of the cognitive information processing – 1) passive perception of audio stimuli, 2) active stimuli discrimination, 3) active stimuli discrimination following motor response - on motor task performance (handgrip test 30% and 7% of MVC) and muscle fatigue development. Cognitive tasks show the following effects on motor work: i) Perceived fatigue during 30 % MVC (fatiguing) condition developed slower if participant pressed button in response to deviant acoustic stimuli, as compared to passive listening. Counting task, an active task without motor component, took the intermediate position and did not differ significantly from two other cognitive tasks. ii) MVC after 30% MVC (fatiguing) condition tended to decrease stronger when accompanied with passive listening in comparison with both active tasks. iii) Motor task performance during 30% MVC (fatiguing) condition was better for active cognitive task with motor component than for passive task. Active task without motor component took the intermediate position and did not differ significantly from both the other cognitive tasks.

  • 161.
    Evstigneeva, Maria
    et al.
    Saint Petersburg State University, Russia.
    Aleksandrov, Alexander
    Saint Petersburg State University, Russia.
    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.
    Lyskov, Eugene
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Concurrent cognitive task may improve motor work performance and reduce muscle fatigue2012Conference paper (Refereed)
  • 162.
    Evstigneeva, Maria
    et al.
    St. Petersbutg State University.
    Aleksandrov, Alexander
    St. Petersbutg State University.
    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.
    Lyskov, Eugene
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Interaction between cognitive task and muscle work: Concurrent cognitive task may improve motor work performance and reduce muscle fatigue2012In: International Journal of Psychophysiology, ISSN 0167-8760, E-ISSN 1872-7697, Vol. 85, no 3, p. 381-381Article in journal (Refereed)
  • 163.
    Evstigneeva, Maria D.
    et al.
    Department of Higher Nervous Activity and Psychophysiology, Saint Petersburg State University, Saint Petersburg, Russia.
    Alexandrov, Alexander A.
    Department of Higher Nervous Activity and Psychophysiology, Saint Petersburg State University, Saint Petersburg, Russia.
    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.
    Lyskov, Eugene
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Muscle contraction force and fatigue: Effects on mismatch negativity2010In: NeuroReport, ISSN 0959-4965, E-ISSN 1473-558X, Vol. 21, no 18, p. 1152-1156Article in journal (Refereed)
    Abstract [en]

    Muscle load can affect performance of concurrent cognitive task. This effect is often explained by limited resources in the voluntary attention system. To examine whether earlier stages of cognitive information processing might be affected, we recorded the Mismatch Negativity component (MMN) of the auditory event-related brain potential before, during and after sustained handgrip at 7% and 30% of maximal voluntary contraction. MMN is an index of automatic detection of a deviating auditory event. MMN was not affected by force level. However, its amplitude at fronto-central sites decreased during the fatiguing 30% contraction, while it tended to increase during the light 7% work. Thus, muscle fatigue may affect auditory information processing at preattentive and preconscious stages, which could modify cognitive performance

  • 164.
    Fahlström, M.
    et al.
    Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden.
    Fahlström, P. G.
    School of Education, Sport Science, Växjö University, Växjö, Sweden.
    Lorentzon, R.
    University of Gävle, Centre for Musculoskeletal Research. Department of Surgical and Perioperative Sciences, Sports Medicine, Umeå University, Umeå, Sweden.
    Henriksson-Larsen, K.
    Department of Surgical and Perioperative Sciences, Sports Medicine, Umeå University, Umeå, Sweden.
    Positive short-term subjective effect of sports drink supplementation during recovery2006In: Journal of Sports Medicine and Physical Fitness, ISSN 0022-4707, E-ISSN 1827-1928, Vol. 46, no 4, p. 578-584Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this study was to investigate the effects of a naturally composed sports drink containing proteins and carbohydrates used during recovery in competitive badminton players. The hypothesis was that the use of a recovery drink would lead to positive subjective effects, enhanced physical performance and less signs of overtraining. Methods. During an in-door season 18 badminton players were instructed to drink at least 250 mL of a given sports drink immediately after each training or playing session. The study design was prospective double blind crossover with one active drink and one placebo. The active drink was based on natural products containing whey and orange juice, and the placebo was made of diluted apple juice. Evaluation of effects was done with laboratory tests, self-registered values and field tests. Results. The players perceived statistically significant short-term subjective positive effects after using the active drink, compared with after using placebo. The blood hemoglobin concentration was also higher after the period with active drink. There were no other differences concerning other laboratory tests (leg strength, endurance, body fat percent, lean arm and leg masses), self-registered values (body weight, pulse, training amount and intensity) or field tests (speed, explosive effort, grip strength, endurance and POMS) between the periods with the different sports drinks. Conclusions. Supplementation with a sports drink during recovery showed a significant short-term subjective positive effect compared with placebo. However, no effects were seen on physical performance or signs of overtraining.

  • 165.
    Fahlström, Martin
    et al.
    Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden.
    Yeap, Joo Seng
    International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia.
    Alfredson, Håkan
    University of Gävle, Centre for Musculoskeletal Research. Department of Surgical and Perioperative Sciences, Sports Medicine, Umeå University, Umeå, Sweden.
    Söderman, Kerstin
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Shoulder pain - a common problem in world-class badminton players2006In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 16, no 3, p. 168-173Article in journal (Refereed)
    Abstract [en]

    Badminton is a sport that requires a lot of over-shoulder motion, with the shoulder in abduction/external rotation. This questionnaire study on 188 international top-level badminton players during the World Mixed Team Championships showed that previous or present shoulder pain on the dominant side was reported by 52% of the players. Previous shoulder pain was reported by 37% of the players and on-going shoulder pain by 20% of the players. There were no significant differences in the prevalence of shoulder pain between men and women. The majority of the shoulder pain had started gradually. The pain was usually associated with shoulder activity, and stiffness was a common, associated symptom. Furthermore, the shoulder pain was associated with consequences such as sleeping disturbances, changes in training and competition habits, and it also affected activities of daily living. The majority of the players had sought medical advice and had been given different kinds of treatment. The study showed that shoulder pain is a common and significant problem in world-class badminton players, and the consequences are most likely of importance for their training and playing capacity.

  • 166.
    Fani, A
    et al.
    Department of Clinical Oral Physiology, Faculty of Medicine, Umeå University, Sweden.
    Tzemparilidis, N
    Department of Clinical Oral Physiology, Faculty of Medicine, Umeå University, Sweden.
    Utterström, K
    Department of Clinical Oral Physiology, Faculty of Medicine, Umeå University, Sweden.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Wanman, A
    Department of Clinical Oral Physiology, Faculty of Medicine, Umeå University, Sweden.
    Eriksson, P O
    Department of Clinical Oral Physiology, Faculty of Medicine, Umeå University, Sweden.
    Lyskov, Eugene
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Physical activity and cardiovascular regulation during clinical work in female students with and without musculoskeletal pain. Method study. (Poster)2010In: Proceedings of the Premus 2010 conference (Seventh International Conference on Prevention of Work-Related Musculoskeletal Disorders), 2010, p. 283-283Conference paper (Refereed)
  • 167. Faria, L
    et al.
    Lima Santos, N
    Taksic, V
    Räty, H
    Molander, Bo
    University of Gävle, Centre for Musculoskeletal Research.
    Holmström, Stefan
    University of Gävle, Centre for Musculoskeletal Research.
    Jansson, J
    Avsec, A
    Extreera, N
    Fernandez-Berrocal, P
    Toyota, H
    Cross-cultural validation of the Emotional Skills and Competence Questionnaire (ESCQ)2006In: Psicologia, ISSN 0874-2049, Vol. 20, no 2, p. 95-127Article in journal (Refereed)
  • 168.
    Ferreira, Mariana Candido
    et al.
    Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus. School of Medicine, Ribeirão Preto. University of São Paulo, São Paulo, Brasil .
    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.
    Dach, Fabiola
    Department of Neurosciences and Behavioral Sciences, School of Medicine, Ribeirão Preto, University of São Paulo, São Paulo, Brasil .
    Chaves, Thais Cristina
    Department of Neurosciences and Behavioral Sciences. School of Medicine, Ribeirão Preto University of São Paulo, São Paulo, Brasil .
    Cross-cultural adaptation of the profile fitness mapping neck questionnaire to brazilian Portuguese: internal consistency, reliability, and construct and structural validity2017In: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 40, no 3, p. 176-186Article in journal (Refereed)
    Abstract [en]

    Objective

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

    Methods

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

    Results

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

    Conclusion

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

  • 169.
    Flodgren, Gerd
    University of Gävle, Centre for Musculoskeletal Research.
    Effects of low-load repetitive work and mental load on sensitising substances and metabolism in the trapezius muscle2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Low-load repetitive work (LLRW) and mental load are important risk factors for the development of workrelated muscle pain. The link between these risk factors and the development of pain is still not understood, but stimulation of chemo-sensitive receptors in the muscle probably plays an important role. It has been suggested that sensitising substances may accumulate in the muscle during LLRW, especially when combined with mental load.

    The overall purpose of this thesis was to try to shed some light on the effects of LLRW on the concentration of sensitising substances (glutamate, prostaglandin E2 (PGE2), norepinephrine (NE)) and on metabolism (lactate, pyruvate and oxygenation) in the trapezius muscle of healthy controls (CON) and subjects with trapezius myalgia (TM).

    A first step was to investigate whether females with TM exhibit higher absolute concentrations of glutamate and PGE2 in the affected muscle during rest. Using Microdialysis (MD) females with TM and asymptomatic controls were studied during four hours of rest. [Glutamate] and [PGE2] during rest did not differ between groups.

    A second step was to investigate, in a simulated occupational setting, the effects of LLRW on the concentration of sensitising substances and metabolism in the trapezius muscle of TM and CON, and whether increased work duration resulted in a progressive effect. Asymptomatic females were studied during baseline rest, 30 versus 60 min work and recovery, using MD and near infrared spectroscopy (NIRS). Subjects with TM were studied during baseline rest, 30 min work and recovery. [Glutamate] and [lactate] increased in response to work, but not progressively with increased work duration. [Glutamate] was at all time points significantly lower in TM. [PGE2]and oxygenation remained unchanged during work for CON, while for TM oxygenation decreased significantly during work. In TM [pyruvate] increased during both work and recovery, and a significant interaction between groups was found for [pyruvate] during recovery; while moderately increased in CON it increased progressively in TM.

    The effects of LLRW with and without superimposed mental load on intramuscular [NE], muscle activity and oxygen saturation in the trapezius were also investigated and compared. Using MD, electromyography and NIRS, healthy females were studied on two occasions; during 30 min LLRW and during 30 min LLRW with superimposed mental load. During work [NE], and muscle activity, were increased, while oxygenation decreased, but no differences between occasions. However, recovery of [NE] to baseline was slower after LLRW with superimposed mental load. The findings of the present thesis suggest: (i) no inflammation, or increased interstitial [glutamate] in TM; (ii) LLRW causes an increased anaerobic metabolism in both TM and CON; (iii) no effect of work duration was found; (iv) a significant difference in the effects of LLRW on the interstitial milieu of the trapezius muscle in TM as compared to CON; (v) LLRW causes a significant increase in [NE], but superimposed mental load does not cause a further increase; (vi) LLRW with a superimposed mental load may result in a slower recovery to baseline [NE] as compared with LLRW alone.

  • 170.
    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.

  • 171.
    Flodgren, Gerd
    et al.
    University of Gävle, Centre for Musculoskeletal Research. Department of Surgical and Perioperative Sciences, Sports Medicine Unit, Umeå University, Umeå, Sweden; Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
    Crenshaw, Albert
    University of Gävle, Centre for Musculoskeletal Research.
    Gref, Margareta
    Department of Surgical and Perioperative Sciences, Clinical Physiology Unit, Umeå University, Umeå, Sweden.
    Fahlström, Martin
    Department of Surgical and Perioperative Sciences, Sports Medicine Unit, Umeå University, Umeå, Sweden; Department of Community Medicine and Rehabilitation, Department of Rehabilitation Medicine, Umeå University, Umeå, Sweden.
    Changes in interstitial noradrenaline, trapezius muscle activity and oxygen saturation during low-load work and recovery2009In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 107, no 1, p. 31-42Article in journal (Refereed)
    Abstract [en]

    Both physical as well as mental demands result in an increased activity in the sympathetic nervous system (SNS) with changes in blood-pressure and heart-rate. Through local release of catecholamines, e.g. noradrenaline (NAd) SNS exerts various actions at the muscle level. The aims of this study were to investigate the effects of low-load repetitive work alone and in combination with mental demands on local muscle interstitial noradrenaline concentration [NAd](i), muscle activity and oxygenation, assessed with microdialysis(,) surface electromyography, and near-infrared spectroscopy, respectively. Healthy females (n = 15) were exposed to (1) 30 min repetitive work (RW) and (2) 30 min repetitive work with superimposed mental load (RWML) on two different occasions. Muscle [NAd](i) and muscle activity increased significantly in response to RW, but did not increase further during RWML. For RW, [NAd](i) was found to be inversely correlated to muscle activity. Oxygenation decreased significantly during work, independently of occasion. Our findings indicate that low-load work causes significantly increased trapezius muscle [NAd](i) in healthy females, and short periods of superimposed mental load do not add to this increase and further, that both muscle activity and oxygenation were unaffected by the superimposed mental load.

  • 172.
    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)
  • 173.
    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)
  • 174.
    Flodgren, Gerd
    et al.
    University of Gävle, Centre for Musculoskeletal Research. Department of Surgical and Perioperative Sciences, Sports Medicine Unit, Umeå, Sweden.
    Heiden, Marina
    University of Gävle, Centre for Musculoskeletal Research. Department of Public Health and Clinical Medicine, Occupational Medicine, Umeå, Sweden.
    Lyskov, Eugene
    University of Gävle, Centre for Musculoskeletal Research.
    Crenshaw, Albert G.
    University of Gävle, Centre for Musculoskeletal Research.
    Characterization of a laboratory model of computer mouse use: applications for studying risk factors for musculoskeletal disorders2007In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 38, no 2, p. 213-218Article in journal (Refereed)
    Abstract [en]

    In the present study, we assessed the wrist kinetics (range of motion, mean position, velocity and mean power frequency in radial/ulnar deviation, flexion/extension, and pronation/supination) associated with performing a mouse-operated computerized task involving painting rectangles on a computer screen. Furthermore, we evaluated the effects of the painting task on subjective perception of fatigue and wrist position sense. The results showed that the painting task required constrained wrist movements, and repetitive movements of about the same magnitude as those performed in mouse-operated design tasks. In addition, the painting task induced a perception of muscle fatigue in the upper extremity (Borg CR-scale: 3.5, p<0.001) and caused a reduction in the position sense accuracy of the wrist (error before: 4.6 degrees , error after: 5.6 degrees , p<0.05). This standardized painting task appears suitable for studying relevant risk factors, and therefore it offers a potential for investigating the pathophysiological mechanisms behind musculoskeletal disorders related to computer mouse use.

  • 175.
    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.

  • 176.
    Flykt, Anders
    et al.
    University of Gävle, Department of Education and Psychology, Ämnesavdelningen för psykologi.
    Bänziger, Tanja
    University of Gävle, Centre for Musculoskeletal Research.
    Lindeberg, Sofie
    University of Gävle, Department of Education and Psychology, Ämnesavdelningen för psykologi.
    Voice parameters, heart rate changes, and skin conductance responses in animal fear2009In: Psychophysiology, ISSN 0048-5772, E-ISSN 1469-8986, Vol. 46, no Special issue, p. S57-S57Article in journal (Other academic)
  • 177.
    Forsman, Mikael
    et al.
    IMM Institute of Environmental Medicine, Karolinska Institutet.
    Barkstedt, Vanda
    IMM Institute of Environmental Medicine, Karolinska Institutet.
    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.
    Can Borg’s RPE‐scale be used as an estimate of workday energy consumption in physicallydemanding work?2018Conference paper (Refereed)
  • 178.
    Forsman, Mikael
    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.
    Bernmark, Eva
    Department of Public Health Sciences, Division of Occupational and Environmental Medicine, Karolinska Institutet.
    Nilsson, Birgitta
    Innventia AB.
    Pousette, Sandra
    Innventia AB.
    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.
    Participative development of packages in the food industry – evaluation of ergonomics and productivity by objective measurements2012In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 41, p. 1751-1755Article in journal (Refereed)
    Abstract [en]

    Rationalizations generally have a negative effect on health and known risk factors for musculoskeletal disorders. These effects may be reduced by paying attention to modifiers as worker participation and a resonant management style. In this study a participatory approach was used in the food industry in order to improve ergonomics and productivity. The food industry shows a high prevalence of musculoskeletal disorders, and repetitive manual work occurs extensively. Prototypes of new packaging solutions were developed in three cases, and compared in a simulated production to the existing production system through direct measurements of working postures and muscle activity, ratings of physical load, and general productivity data. Measured and rated ergonomic exposures showed that workload was significantly lower for the prototypes, in all three cases. In two cases, the number of handling operations included in the packaging operations were greatly reduced with the prototype package, as were production costs. The impact on disorders of the obtained load reductions is difficult to assess, but we believe that in “critical” situations like this, even small improvements may have an effect. This study shows that workloads during manual handling of packages as well as production costs can be reduced by applying participative development of packages.

  • 179.
    Forsman, Mikael
    et al.
    IMM Institute of Environmental Medicine, Karolinska Institutet, Stockholm; Centre for Occupational and Environmental Medicine, Stockholm County Council .
    Eliasson, Kristina
    IMM Institute of Environmental Medicine, Karolinska Institutet, Stockholm; School of Technology and health, KTH Royal Institute of Technology, Huddinge.
    Rhen, Ida-Märta
    Centre for Occupational and Environmental Medicine, Stockholm County Council.
    Nyman, Teresia
    IMM Institute of Environmental Medicine, Karolinska Institutet, Stockholm; Centre for Occupational and Environmental Medicine, Stockholm County Council; School of Technology and health, KTH Royal Institute of Technology, Huddinge .
    Lindberg, Per
    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.
    Kjellberg, Katarina
    IMM Institute of Environmental Medicine, Karolinska Institutet, Stockholm; Centre for Occupational and Environmental Medicine, Stockholm County Council.
    Balliu, Natalja
    Centre for Occupational and Environmental Medicine, Stockholm County Council.
    Palm, Peter
    Department of Medical Sciences Occupational and Environmental Medicine, Uppsala University, Sweden.
    Inter-ergonomist Reliability in Rating Risk Level - without any Specific Method - in Ten Video Recorded Work Tasks2014Conference paper (Other academic)
    Abstract [en]

    1.  Introduction

    Recently, 30 observational methods for assessment of biomechanical exposures at work were evaluated through a literature review (Takala et al., 2010). It was found that several methods are insufficiently tested in terms of validity and reliability. In only in a few cases have estimates of the components of the methods been validated against technical measurements. Also comparisons between methods' resulting risk levels are rare. Swedish Work Environment Authority has recently increased the demands on ergonomic risk assessments. These assessments are usually made by ergonomists in occupational health services (OHS).

    This study is included in a larger on-going project, with the overall purpose to evaluate six observational methods for assessment of biomechanical exposures of repetitive work in respect of validity, reliability and usability, as well as provide information on which of the methods are best suited for practitioners in risk assessment of repetitive work. The methods' resulting risk levels are compared not only to each other, but also to ergonomists’ “own” risk estimates (i.e., done without any specific method). The specific aim of this sub-study was to investigate the inter-observer reliability of ergonomists’ own risk estimates.

    2.  Methods

    Nine OHS-ergonomists, all with more than 5 years of experience of general ergonomic risk assessments, made risk assessments of 10 different video-recorded (2-6 minutes) work-tasks (supermarket work, meat cutting and packing, engine assembly, cleaning, post sorting and hairdressing). Video sequences of two or three camera angles were synchronized and showed together. For each work-task, the ergonomists were given data of the work task length (see Table 1), pause- and rests schedules, weights of handled goods, physical factors, and the employees own ratings of discomfort, work demands and own control.

    The ergonomist could pause the playback as needed, the maximum allocated time per work-task assessment was 20 minutes. The risk of musculoskeletal disorders and need for improvements was rated into green (no risk), yellow (investigate further), and red (immediate risk) categories. Ratings were done for 8 specific body regions: neck, lower back, right and left shoulders, -arms/elbows, and -wrists/hands), and for one over-all risk level.

    The agreement of the ratings (in percent), and Light’s multi-observer kappa (i.e. Cohen’s pairwise kappa averaged over all pairs; Light, 1971; Cohen, 1960) were calculated per body region and for the over-all risk assessment.

    3.  Results

    For the 720 (9 ergonomists, 8 body regions, 10 work tasks) risk assessments of the separate body regions, 37% were green, 44% yellow and 19% red. For over-all risk assessments (Table 1), 14% were green, 50% yellow and 36% red.

    Table 1. Work tasks, hours per work task per work day, and the ergonomists ratings of over risk            

    As seen in Table 1, the consistency between the observers differed markedly.  For three of the work tasks all three categories were represented, only in one task all ergonomists rated the over-all risk equally. The average agreement of the ratings were 48% regarding the body regions, and 57% regarding the over-all risk assessments, Light’s kappa was 0.18 and 0.30, respectively.

    4.  Discussion

    The results showed fair inter-observer reliability according to Altman’s table for interpretation of kappa (kappa between 0.21 and 0.40; Altman, 1991). These kappa values will, in the major project, be compared to those of six systematic observation methods.

    5.  References

    Altman DG (1991) Practical statistics for medical research. London: Chapman and Hall.

    Cohen J. A coefficient of agreement for nominal scales. Educational and Psychological Measurement. 1960;20(1):37–46.

    Light RJ. Measures of response agreement for qualitative data: Some generalizations and alternatives. Psychological Bulletin. 1971;76(5):365–377.

    Takala EP et al. 2010. Systematic evaluation of observational methods assessing biomechanical exposures at work. Scand J Work E

  • 180.
    Forsman, Mikael
    et al.
    IMM Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden.
    Eliasson, Kristina
    IMM Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; School of Technology and health, KTH Royal Institute of Technology, Huddinge, Sweden.
    Rhén, Ida-Märta
    IMM Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden.
    Balliu, Natalya
    Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden.
    Nyman, Teresia
    IMM Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden; School of Technology and health, KTH Royal Institute of Technology, Huddinge, Sweden.
    Lindberg, Per
    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.
    Kjellberg, Katarina
    IMM Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden.
    Palm, Peter
    Department of Medical Sciences Occupational and Environmental Medicine, Uppsala, Sweden.
    Reliability in twelve ergonomists’ three-category risk ratings in ten video recorded work tasks.2015In: Proceedings 19th Triennial Congress of the IEA, Melbourne 9-14 August 2015, 2015Conference paper (Refereed)
    Abstract [en]

    The Swedish Work Environment Authority has recently increased the demands on ergonomic risk assessments. These assessments are usually made by ergonomists in occupational health services (OHS). Although they are many observational methods that may be used (Takala, Pehkonen et al. 2010), the ergonomists often do risk assessment by sole observation, based on his/her own knowledge and experience, without the use of any specific method.

    This study is included in a larger on-going OBS project, with the overall purpose to evaluate six observational methods for assessment of biomechanical exposures of repetitive work in respect of validity, reliability and usability, as well as provide information on which of the methods are best suited for practitioners in risk assessment of repetitive work. The methods' resulting risk levels will be compared not only to each other, but also to the ergonomists’ “own” assessments (without any specific method) of the risk of developing musculoskeletal disorders.

    The specific aim of this sub-study was to investigate the inter-observer reliability of ergonomists’ own risk assessments without any specific method

  • 181.
    Forsman, Mikael
    et al.
    Karolinska institute, Division of Occupational and Environmental Medicine, Department of Public Health Sciences.
    Lodin, Camilla
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Richter, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Co-variation in time between near-far accommodation of the lens and trapezius muscle activity2012In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 41, no Suppl. 1, p. 3393-3397Article in journal (Refereed)
    Abstract [en]

    Visual strain and discomfort may contribute to the generation of work-related musculoskeletal disorders among e.g. computer workers. A positive correlation on a group level between eye-lens accommodation and trapezius muscle activity has been reported. In this study we investigated the possibility of a direct, fast, connection between lens accommodation and trapezius muscles activity. The subjects focused alternately on Near and Far targets, with a mean switch time of 5 s, through four different lenses. The cross-correlation, R(tau) was computed, between the time signals of accommodation and electromyography (EMG) from 23 subjects. In the overall mean R(tau) of 736 curves, a small but significant correlation peak (0.019) with a delay (of the EMG signal) of about 0.3 s, revealed a small common component in the two signals. Among the lenses, the positive lens (3.5 D), showed the highest correlation peak (0.040). The correlation may be caused by a direct “hard-wired” connection between the ciliary and trapezius muscles. But it could also be caused indirectly by the subject’s need for a more stable head in a more demanding visual task. The latter is supported by the result that the correlation was the highest in the positive lens condition. The present correlation is however weak and it has probably a low practical importance.

  • 182.
    Forsman, Mikael
    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.
    Neumann, Patrick
    Ryerson University, Mechanical Engineering, Toronto.
    Palmerud, Gunnar
    Arbets- och miljömedicin, Göteborgs universitet.
    Winkel, Jörgen
    Institutionen för sociologi och arbetsvetenskap, Göteborgs universitet.
    Mechanical exposures in serial flow assembly - a proactive intervention research approach2013In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847Article in journal (Refereed)
    Abstract [en]

    The EU End of Life Vehicle (ELV) Directive 2000/53/EC has prompted rationalization initiatives to facilitate recycling of material and components from ELVs. In the present study, technical recordings were used to assess operators' mechanical exposures in a new serial flow system for full material recovery in car disassembly as compared with those of a previous study of traditional craft-type-parallel disassembly. Estimated task-specific mechanical exposures served as a base to simulate how further rationalisation may affect ergonomics in car disassembly. The time proportion of ‘direct work’ (deemed value-adding tasks) was about 30% in both systems, i.e. substantially lower than in modern forward factories. Movement velocities were higher in the new serial system, implying a higher risk for musculoskeletal disorders, while mixed results were found in the comparison of postures.

    Simulations revealed increased mechanical exposures, illustrated by increased time in high risk conditions, and decreased duration in low-exposure conditions, when indirect tasks and disturbances (deemed non-value-adding) were removed.

    This may illustrate the underlying mechanism of how rationalisations to eliminate "waste" can reduce valuable recovery time and increase employee injury risk over time.

  • 183.
    Forsman, Mikael
    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.
    Neumann, Patrick
    Department of Mechanical and Industrial Engineering, Ryerson University, Toronto.
    Palmerud, Gunnar
    Occupational and Environmental Medicine, University of Gothenburg.
    Winkel, Jörgen
    Department of Sociology and Work Science, University of Gothenburg.
    Simulating the effects of efficiency improvement efforts in car disassembly2012Conference paper (Refereed)
  • 184. Forsman, Mikael
    et al.
    Toomingas, Allan
    Veiersted, K B
    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.
    A risk index focusing the time pattern of work and recovery2010In: Proceedings of the Premus 2010 conference (Seventh International Conference on Prevention of Work-Related Musculoskeletal Disorders) August 29-September 2, 2010Conference paper (Refereed)
  • 185.
    Garza, Jennifer
    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.
    Reliability of using observations when assessing different posture variables2016Conference paper (Refereed)
    Abstract [en]

    Background. Working in extreme postures has been identified as a risk factor for musculoskeletal symptoms. Directly measuring work postures is considered to be the most accurate approach for assessing these exposures, but it is often not feasible to directly measure posture due to time or budget constraints. Alternatively, direct measurements of postures can be predicted based on observations of workers’ postures. Since observers are known to differ in posture ratings, it may, however, be necessary to develop calibration procedures for each specific observer.

    Methods. Arm and back postures of a random sample of 28 paper mill workers were measured via inclinometry and also were assessed by three observers from videos. Linear models with participant number and observer as random effects were resolved to assess whether or not observed postures were associated with the corresponding inclinometer values and if the effect of observer on slope and intercept was significant (p<0.05). The variance explained by these models was compared to the variance explained by corresponding linear models yet with observer entered as a fixed effect (i.e. allowing different slopes and intercepts for different observers).

    Results. For all postures, the variance explained was similar when using observer as a fixed compared to a random effect (R-squared ranging from 0.41 to 0.56 for observer as fixed or random effect). Throughout, participant was the major source of variance.

    Discussion. Our findings of similar amounts of variance explained when using observer as a fixed compared to a random effect for all postures indicates that calibration models developed for each individual observer may not necessarily perform better than a general calibration applying to any observer. Since posture observations explained only a small proportion of directly measured posture variance, observation may not be very useful in this setting

  • 186.
    Gilson, Nicholas
    et al.
    University of Queensland, Brisbane, Australia.
    Hall, Caitlin
    University of Queensland, Brisbane, Australia.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    van der Beek, Allard
    Department of Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
    Huysmans, Maaike
    Department of Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
    Mathiassen, Svend Erik
    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.
    Straker, Leon
    School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, Perth, Australia.
    Sedentary and physical activity behaviour in ‘blue-collar’ workers: A systematic review of accelerometer studies2019In: Journal of Physical Activity and Health, ISSN 1543-3080, E-ISSN 1543-5474, Vol. 16, no 11, p. 1060-1069Article in journal (Refereed)
    Abstract [en]

    Background: This systematic review assessed evidence on the accelerometer-measured sedentary and physical activity (PA) behavior of nonoffice workers in “blue-collar” industries.

    Methods: The databases CINAHL, Embase, MEDLINE, PubMed, and Scopus were searched up to April 6, 2018. Eligibility criteria were accelerometer-measured sedentary, sitting, and/or PA behaviors in “blue-collar” workers (≥10 participants; agricultural, construction, cleaning, manufacturing, mining, postal, or transport industries). Data on participants’ characteristics, study protocols, and measured behaviors during work and/or nonwork time were extracted. Methodologic quality was assessed using a 12-item checklist.

    Results: Twenty studies (representing 11 data sets), all from developed world economies, met inclusion criteria. The mean quality score for selected studies was 9.5 (SD 0.8) out of a maximum of 12. Data were analyzed using a range of analytical techniques (eg, accelerometer counts or pattern recognition algorithms). “Blue-collar” workers were more sedentary and less active during nonwork compared with work time (eg, sitting 5.7 vs 3.2 h/d; moderate to vigorous PA 0.5 vs 0.7 h/d). Drivers were the most sedentary (work time 5.1 h/d; nonwork time 8.2 h/d).

    Conclusions: High levels of sedentary time and insufficient PA to offset risk are health issues for “blue-collar” workers. To better inform interventions, research groups need to adopt common measurement and reporting methodologies.

  • 187.
    Gilson, Nicholas
    et al.
    The University of Queensland, Australia.
    Hall, Caitlin
    The University of Queensland, Australia.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    van der Beek, Allard
    VU University Medical Centre, Amsterdam, The Netherlands.
    Huysmans, Maaike
    VU University Medical Centre, Amsterdam, The Netherlands.
    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.
    Straker, Leon
    Curtin University, Perth, Australia.
    Sedentary behaviour and physical activity in blue collar workers: a systematic review of accelerometer studies2019Conference paper (Refereed)
  • 188.
    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.

  • 189.
    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. Gold Standard Research Consulting, Bryn Mawr, Pennsylvania, USA.
    Kurowski, Alicia
    Center for the Promotion of Health in the New England Workplace, University of Massachusetts Lowell, Massachusetts, USA.
    Gore, Rebecca
    Center for the Promotion of Health in the New England Workplace, University of Massachusetts Lowell, Massachusetts, USA.
    ProCare, Research team
    Center for the Promotion of Health in the New England Workplace, University of Massachusetts Lowell, Massachusetts, USA.
    Punnett, Laura
    Center for the Promotion of Health in the New England Workplace, University of Massachusetts Lowell, Massachusetts, USA.
    Knee pain in nursing home workers after implementation of a safe resident handling program2018In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 61, no 10, p. 849-860Article in journal (Refereed)
    Abstract [en]

    Purpose: Approximately 25-30% of nursing personnel experience knee pain (KP). We sought to identify physical and psychosocial work exposures, and personal factors related to prevalent, incident, and persistent KP 5-8 years after safe resident handing program (SRHP) implementation in nursing homes.

    Methods: Health and exposure information was obtained from worker surveys 5-6 years (“F5”) and 7-8 years (“F6”) post-SRHP implementation. Prevalent KP correlates were examined at F5; persistent and incident KP predictors were analyzed at F6, utilizing robust Poisson multivariable regression.

    Results: F5 KP prevalence (19.7%) was associated with combined physical exposures, and with either high job strain or low social support, in separate models. Two-year persistent KP was similarly associated with these psychosocial exposures. Being overweight was associated with KP in all analyses.

    Conclusions: The SRHP program did not eliminate knee physical loading, which should be reduced to prevent nursing home worker KP. Workplace psychosocial exposures (high job strain, low social support) also appeared germane.

  • 190.
    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.
    Lewis, Charlotte
    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.
    Elcadi, Guilherme H.
    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.
    Trapezius oxygenation and hemodynamics during work : a field study using EMG and Near Infrared Spectroscopy (NIRS)2016Conference paper (Refereed)
    Abstract [en]

    Background. Relative blood volume (RBV) and muscle oxygenation (TSI) can be measured using near infrared spectroscopy (NIRS), but no studies have used NIRS with workers performing their job in the field. The study aims were (1) to assess day-to-day within-subjects dispersion in NIRS measurements during work, and (2) to determine whether trapezius RBV and TSI differed between office and industrial workers. Electromyography (EMG) measured trapezius muscle activity.

    Methods. Portable NIRS and EMG instruments were adhered to the trapezius of healthy female industrial (n = 8) and office (n = 10) workers for approximately four hours on two separate days. Mean and standard deviation (SD) RBV, TSI and 50th percentile EMG were calculated for both days separately. Participants were videotaped to demarcate work and rest periods, and to qualitatively assess ergonomic exposures. Two-way mixed effects models were constructed to examine outcomes, with occupation (office/industrial) and work/rest as fixed effects and subject as a random effect.

    Results. Industrial workers appeared to have more variable arm postures and handled heavier loads than office workers. The between-days variability of RBV and TSI indicated that NIRS performed well in an occupational setting. Median trapezius EMG showed an effect of occupation (p < 0.0001), and an interaction between occupation and work/rest (p < 0.0001). As expected, industrial workers had higher median EMG overall and during work, but office workers had a higher EMG during rest. Similar results for EMG SD were found. Mean RBV and RBV SD were greater in industrial workers. No effects on mean TSI were found. However, TSI SD was higher in industrial workers, while TSI SD was greater in office workers during rest.

    Discussion. NIRS had a satisfying reliability and showed face validity with respect to expected responses to occupational work. NIRS shows promise as a method for measuring hemodynamics in the field.

  • 191.
    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.

  • 192.
    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.

  • 193.
    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.
    Kietrys, David
    University of Medicine and Dentistry of New Jersey, Stratford, NJ, USA.
    Gerg, Michael
    Temple University.
    Touch screen size affects neck and wrist posture and thumb usage during texting2013Conference paper (Refereed)
    Abstract [en]

    Purposes

    Mobile devices with various screen sizes are now popular.  Screen size may affect how persons choose to interact when typing with such devices.  Self-reported duration and frequency of text messaging has been associated with musculoskeletal disorder (MSD) symptoms, particularly in the shoulder, neck, and thumb (1, 2).  It is unknown which aspects of mobile device usage may increase MSD risk.  However, non-neutral neck and wrist postures are associated with MSDs in office workers engaging in keyboarding (3-8).  The study aim was to determine if mobile device screen size affects neck and/or wrist posture during self-determined texting positions.  Also, fingers used in texting were tabulated by screen size, as this may affect MSD risk.

     

    Methods

    Three touch screen mobile devices of different screen sizes – 3.5” (Apple iPod Touch MC544LL), 7” (Samsung Galaxy Tab GT-P1010) and 9.5” (Apple iPad 2) -- were randomly presented to asymptomatic college students (n = 20).  Each device was made ready for simulated texting by activating the “Notes” or a similar application.  Devices were placed screen down on a table 1 m away from the participant.  Participants retrieved the device, resumed sitting in a chair, and spent as much time as desired to determine how they wanted to text “hi how are you” repeatedly for 10 seconds.  Wrist and neck postures were measured through electrogoniometry and sagittal plane motion analysis, respectively.  Fingers used to text and whether the device was placed on the lap were noted.  Excel (Microsoft Corp., Redmond, WA) and SAS V9.3 (SAS Institute Inc., Cary, NC) were used in data analysis.  Outcome variable trends by screen size were determined using SAS PROC GLM for repeated measures, with p < 0.05 denoting statistical significance.

     

    Results

    Ninety percent of subjects using the 3.5” screen chose to text with both thumbs (table).  As screen size increased, more used the right index finger as more varied texting styles were chosen.  Additionally, more placed the entire device or its bottom edge on their lap.  Wrist extension and ulnar deviation, and cervical flexion increased with increasing screen size (test for trend, all p < 0.01, table).

     

    Conclusions

    Greater prevalence of non-neutral neck and wrist postures were found during texting with increasing touch screen size.  These factors may increase MSD risk.  However, decreased thumb usage occurs with greater screen size.  Such larger screens may be protective against thumb symptoms.  Further studies are warranted.

     

  • 194.
    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.
    Mohamed, Feroze
    Temple University.
    Ali, Sayed
    Temple University.
    Barbe, Mary
    Temple University.
    Serum and MRI biomarkers in mobile device texting: a pilot study2014In: Human Factors, ISSN 0018-7208, E-ISSN 1547-8181, Vol. 56, no 5, p. 864-872Article in journal (Refereed)
    Abstract [en]

    Objective: We aimed to determine if serum biochemical and MRI biomarkers differed between high volume (≥ 230 texts sent/day; n = 5) and low volume (≤ 25 texts sent/day; n = 5) texters.  A secondary aim was to ascertain what correlations between the biochemical and imaging biomarkers could tell us about the pathophysiology of early onset tendinopathies.

    Background: Text messaging has become widespread, particularly among college-aged young adults.  There is concern that high rates of texting may result in musculoskeletal disorders, including tendinopathies.  Pathophysiology of tendinopathies is largely unknown.

    Method: Ten females with a mean age of 20 were recruited. We examined serum for 20 biomarkers of inflammation, tissue degeneration and repair. We used conventional MRI and MRI mean intratendinous signal intensity (MISI) to assess thumb tendons.  Correlations between MISI and serum biomarkers were also examined.

    Results: Three high volume texters had MRI tendinopathy findings as did one low volume texter.  Increased serum TNF-R1 was found in high volume texters compared to low volume texters, as were non-significant increases in MISI in two thumb tendons.  Serum TNF-R1 and TNF-α correlated with MISI in these tendons, as did IL1-R1. 

    Conclusion: These results suggest that early onset tendinopathy with concurrent inflammation may be occurring in prolific texters. Further studies with larger sample sizes are needed for confirmation.

  • 195.
    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.
    Punnett, Laura
    Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA.
    Gore, Rebecca
    Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA.
    ProCare Research Team, .
    Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA.
    Predictors of low back pain in nursing home workers after implementation of a safe resident handling programme2017In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 74, no 6, p. 389-395Article in journal (Refereed)
    Abstract [en]

    Objectives. Healthcare workers have high rates of low back pain (LBP) related to handling patients. A large chain of nursing homes experienced reduced biomechanical load, compensation claims and costs following implementation of a safe resident handling programme (SRHP). The aim of this study was to examine whether LBP similarly declined and whether it was associated with relevant self-reported occupational exposures or personal health factors.

    Methods. Worker surveys were conducted on multiple occasions beginning with the week of first SRHP introduction (baseline). In each survey, the outcome was LBP during the prior 3 months with at least mild severity during the past week. Robust Poisson multivariable regression models were constructed to examine correlates of LBP cross-sectionally at 2 years (F3) and longitudinally at 5–6 years (F5) post-SRHP implementation among workers also in at least one prior survey.

    Results. LBP prevalence declined minimally between baseline and F3. The prevalence was 37% at F3 and cumulative incidence to F5 was 22%. LBP prevalence at F3 was positively associated with combined physical exposures, psychological job demands and prior back injury, while frequent lift device usage and ‘intense’ aerobic exercise frequency were protective. At F5, the multivariable model included frequent lift usage at F3 (relative risk (RR) 0.39 (0.18 to 0.84)) and F5 work– family imbalance (RR=1.82 (1.12 to 2.98)).

    Conclusions. In this observational study, resident lifting device usage predicted reduced LBP in nursing home workers. Other physical and psychosocial demands of nursing home work also contributed, while frequent intense aerobic exercise appeared to reduce LBP risk.

  • 196.
    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. Department of Public Health, Temple University, Philadelphia, United States ; West Virginia University, Injury Control Research Center, Morgantown, United States .
    Rauscher, Kimberly
    West Virginia University, Injury Control Research Center, Morgantown, United States; Department of Occupational and Environmental Health Sciences, West Virginia University, School of Public Health, Morgantown, United States .
    Zhu, Motao
    West Virginia University, Injury Control Research Center, Morgantown, United States ; Department of Epidemiology, West Virginia University, School of Public Health, Morgantown, United States .
    A validity study of self-reported daily texting frequency, cell phone characteristics, and texting styles among young adults2015In: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 8, article id 120Article in journal (Refereed)
    Abstract [en]

    Background

    Texting is associated with adverse health effects including musculoskeletal disorders, sleep disturbances, and traffic crashes. Many studies have relied on self-reported texting frequency, yet the validity of self-reports is unknown. Our objective was to provide some of the first data on the validity of self-reported texting frequency, cell phone characteristics including input device (e.g. touchscreen), key configuration (e.g., QWERTY), and texting styles including phone orientation (e.g., horizontal) and hands holding the phone while texting.

    Methods

    Data were collected using a self-administered questionnaire and observation of a texting task among college students ages 18 to 24. To gauge agreement between self-reported and phone bill-derived categorical number of daily text messages sent, we calculated percent of agreement, Spearman correlation coefficient, and a linear weighted kappa statistic. For agreement between self-reported and observed cell phone characteristics and texting styles we calculated percentages of agreement. We used chi-square tests to detect significant differences (α = 0.05) by gender and study protocol.

    Results

    There were 106 participants; 87 of which had complete data for texting frequency analyses. Among these 87, there was 26% (95% CI: 21–31) agreement between self-reported and phone bill-derived number of daily text messages sent with a Spearman’s rho of 0.48 and a weighted kappa of 0.17 (95% CI: 0.06-0.27). Among those who did not accurately report the number of daily texts sent, 81% overestimated this number. Among the full sample (n = 106), there was high agreement between self-reported and observed texting input device (96%, 95% CI: 91–99), key configuration (89%, 95% CI: 81–94), and phone orientation while texting (93%, 95% CI: 86–97). No differences were found by gender or study protocol among any items.

    Conclusions

    While young adults correctly reported their cell phone’s characteristics and phone orientation while texting, most incorrectly estimated the number of daily text messages they sent. This suggests that while self-reported texting frequency may be useful for studies where relative ordering is adequate, it should not be used in epidemiologic studies to identify a risk threshold. For these studies, it is recommended that a less biased measure, such as a cell phone bill, be utilized.

  • 197.
    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.
    Rauscher, Kimberly
    West Virginia University.
    Zhu, Motao
    West Virginia University.
    Validity of Self-reported Texting Frequency, Texting Styles, and Cell Phone Characteristics among College Students2013Conference paper (Refereed)
    Abstract [en]

    Purposes

    Self-reported duration and frequency of text messaging has been associated with musculoskeletal disorders (1, 2).  The only published study examining self-reported texting validity is among young adolescents (3).  Overestimation in lower volume and underestimation in higher volume texters occurred as compared with service provider information.  The corresponding validity in college students is unknown.  The current objective was to determine the validity of self-reported categorical number of daily texts sent.  Much as office workers have been found to overestimate their computer keyboard usage (4-6), it was hypothesized that texters would overestimate daily texts sent.  Since phone characteristics (e.g., keyboard type and phone orientation), and texting styles (number of hands holding phone, fingers used to text) may affect the risk of musculoskeletal disorders, we also assessed their self-reported validity.

     

    Methods

    College students (n = 108) filled out a questionnaire noting daily texts sent, phone characteristics, and texting styles.  Their phone bill was used for verification of daily texts sent, and they were observed texting a short message to verify phone characteristics and texting styles.  A linear weighted kappa statistic was used to gauge the agreement between categorical self-reported and phone-bill derived daily text messages sent.  Percentages of agreement were presented to ascertain concordance between self-reported and observed cell phone characteristics and texting styles.  Gender was examined as a potential confounder.

     

    Results

    Subjects overestimated their daily texts sent in all phone-bill verified texting volumes. The weighted kappa statistic was 0.18 (95% CI: 0.07-0.30) with 43.8% agreement.  There was little difference in recall by gender. 

     

    High agreement (> 92%) was achieved between self-reported and observed input device, phone manufacturer, and phone orientation when texting (figure).  However, there was low agreement between self-reported and observed texting styles.  There was little difference in validity by gender.

     

    Conclusions

    College students consistently overestimated the number of daily texts sent.  This occurred in all frequencies of text messaging, suggesting that risk underestimation will occur in epidemiology studies where self-reported texting is an exposure variable.  Hence, any such studies should rely on a more valid measure, i.e., a phone bill.  Validity of self-reported texting style was low.  However, texting style as observed during a short trial executed under experimental conditions may not be reflective of the more diverse texting style(s) that would be observed during extended periods and in real-world settings for the students.  Further research is needed to confirm the study findings in other age groups.

  • 198.
    Grooten, Wilhelmus Johannes Andreas
    et al.
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden; Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden.
    Sandberg, Lisa
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden.
    Ressman, John
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden; Sports medicine clinic, Bosön, Swedish Sports Confederation Centre, Lidingö, Sweden.
    Diamantoglou, Nicolas
    Ryggkirurgiskt Centrum, Stockholm, AB, Sweden.
    Johansson, Elin
    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. Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden; Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden.
    Rasmussen-Barr, Eva
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden.
    Reliability and validity of a novel Kinect-based software program for measuring posture, balance and side-bending2018In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 19, no 1, article id 6Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Clinical examinations are subjective and often show a low validity and reliability. Objective and highly reliable quantitative assessments are available in laboratory settings using 3D motion analysis, but these systems are too expensive to use for simple clinical examinations. Qinematic™ is an interactive movement analyses system based on the Kinect camera and is an easy-to-use clinical measurement system for assessing posture, balance and side-bending. The aim of the study was to test the test-retest the reliability and construct validity of Qinematic™ in a healthy population, and to calculate the minimal clinical differences for the variables of interest. A further aim was to identify the discriminative validity of Qinematic™ in people with low-back pain (LBP).

    METHODS: We performed a test-retest reliability study (n = 37) with around 1 week between the occasions, a construct validity study (n = 30) in which Qinematic™ was tested against a 3D motion capture system, and a discriminative validity study, in which a group of people with LBP (n = 20) was compared to healthy controls (n = 17). We tested a large range of psychometric properties of 18 variables in three sections: posture (head and pelvic position, weight distribution), balance (sway area and velocity in single- and double-leg stance), and side-bending.

    RESULTS: The majority of the variables in the posture and balance sections, showed poor/fair reliability (ICC < 0.4) and poor/fair validity (Spearman <0.4), with significant differences between occasions, between Qinematic™ and the 3D-motion capture system. In the clinical study, Qinematic™ did not differ between people with LPB and healthy for these variables. For one variable, side-bending to the left, there was excellent reliability (ICC =0.898), excellent validity (r = 0.943), and Qinematic™ could differentiate between LPB and healthy individuals (p = 0.012).

    CONCLUSION: This paper shows that a novel software program (Qinematic™) based on the Kinect camera for measuring balance, posture and side-bending has poor psychometric properties, indicating that the variables on balance and posture should not be used for monitoring individual changes over time or in research. Future research on the dynamic tasks of Qinematic™ is warranted.

  • 199.
    Gupta, Nidhi
    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 Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Dumuid, Dorothea
    Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, SA, Australia.
    Vij, Akshay
    Institute for Choice, University of South Australia, Adelaide, Australia.
    Lund Rasmussen, Charlotte
    National Research Centre for the Working Environment, Copenhagen, Denmark; Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
    Birk Jørgensen, Marie
    Department of Forensic Science, University of Copenhagen, Copenhagen, Denmark.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
    Movement behavior profiles and obesity: a latent profile analysis of 24-h time-use composition among Danish workers2020In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 44, no 2, p. 409-417Article in journal (Refereed)
    Abstract [en]

    Background/objectives

    An element of obesity prevention is increasing total physical activity energy expenditure. However, this approach does not incorporate the balance of various movement behaviors—physical activity, sedentary behaviors and sleep - across domains of the day. We aimed to identify time-use profiles over work and leisure, termed ‘movement behavior profiles’ and to investigate their association with obesity.

    Subjects/methods

    Eight-hundred-and-seven workers completed (a) thigh accelerometry and diaries to determine their 24-h composition of behaviors (sedentary and standing, light physical activity and moderate-to-vigorous physical activity at work and leisure, and time in bed) and (b) obesity measurements. Movement behavior profiles were determined using latent profile analyses of isometric log-ratios of the 24-h composition, and labeled according to animal movement behavior traits. Linear models were applied to determine the association between profiles and obesity.

    Results

    Four profiles were identified, labeled as “Chimpanzees” (n = 226), “Lions” (n = 179), “Ants” (n = 244), and “Koalas” (n = 158). “Chimpanzees” work time was evenly distributed between behaviors while their leisure time was predominantly active. Compared to Chimpanzees, “Lions” were more active at work and sedentary during leisure and spent more time in bed; “Ants” were more active at work and during leisure; “Koalas” were more sedentary at work and leisure and spent similar time in bed. With “Chimpanzees” as reference, “Lions” had least favorable obesity indicators: +2.0 (95% confidence interval [CI] 0.6, 3.4) %body fat, +4.3 cm (1.4, 7.3) waist circumference and +1.0 (2.0, 0.0) Body Mass Index (BMI), followed by “Koalas” +2.0 (0.4, 3.7) %body fat, +3.1 cm (0.1, 6.0) waist circumference, and +0.8 (−0.30, 1.94) BMI. No significant differences were found between “Chimpanzees” and “Ants”.

    Conclusions

    Movement behavior profiles across work and leisure time-use compositions are associated with obesity. Achieving adequate balance between work and leisure movement behaviors should be further investigated as a potential obesity prevention strategy.

  • 200.
    Gupta, Nidhi
    et al.
    The National Research Centre for the Working Environment, Denmark.
    Hallman, David
    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.
    Dumuid, Dorothea
    Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
    Vij, Akshay
    Institute for Choice, University of South Australia, North Sydney, Australia.
    Lund Rasmussen, Charlotte
    The National Research Centre for the Working Environment, Denmark.
    Birk Jørgensen, Marie
    The National Research Centre for the Working Environment, Denmark.
    Korshøj, Mette
    The National Research Centre for the Working Environment, Denmark.
    Holtermann, Andreas
    The National Research Centre for the Working Environment, Denmark.
    Physical-behavior profiles and aerobic capacity: A latent profile analysis of 24-hour time-use composition among Danish workers2019In: ICAMPAM 2019: Oral Abstracts, Maastricht: ICAMPAM , 2019, article id O.11.4Conference paper (Refereed)
    Abstract [en]

    Introduction Obtaining a balance between exercise and recovery is an established approach in Exercise Science to improve aerobic capacity. However, it is unknown how different 24-h time-use profiles depicting a balance between physical behaviors (i.e. physical activities, sedentary behavior and sleep) across main domains of the day are associated with aerobic capacity. We aimed to identify such 'physical-behavior (PB) profiles' and to investigate their association with aerobic capacity. Methods Workers (n=807) participated in thigh-accelerometry to determine 24-h time-use composition of physical activity, sedentary and standing during work and leisure, as well as time in bed. Åstrand submaximal cycle ergometer test was used to estimate aerobic capacity. The PB profiles were determined using latent profile analysis of isometric log-ratios representing the 24-hour composition. Linear models were applied to determine the cross-sectional association between physical-behavior profiles and aerobic capacity. Results Four PB profiles were identified that were labeled based on animal traits; Chimpanzees (n=226), Lions (n=179), Ants (n=244), and Koalas (n=158). Compared to Chimpanzees (at work, in mins; sedentary=197, standing=145, physical activity=117; and at leisure in mins; physical activity=114, standing=121, time in bed= 440); Lions were more active at work, sedentary at leisure and spent more time in bed; Ants had more physical activity at work and similar physical activity and time in bed at leisure; Koalas were more sedentary at work and leisure and spent more time in bed. Compared to Chimpanzees, Koalas had lower aerobic capacity (mlO2/kg/min): -3.7 (95%CI -6.0,-1.5), followed by Lions -3.6 (-5.5,-1.7) and Ants -1.8 (-3.7,- 0.1). Conclusions Physical-behavior profiles based on 24-h time-use composition are associated with aerobic capacity. Obtaining a balance between physical behaviors at work and leisure may be a promising approach for improving aerobic capacity.

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