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  • 251.
    Hallman, David
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Lindberg, Lars Göran
    Linköping University, Sweden.
    Lyskov, Eugene
    University of Gävle, Centre for Musculoskeletal Research.
    Systemic and local responses to stress in subjects with chronic muscle pain and healthy controls2009In: Fifth international conference on work environment and cardiovascular diseases, Krakow, Poland: International Journal of Occupational Medicine and Environmental Health , 2009Conference paper (Refereed)
  • 252.
    Hallman, David
    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.
    Lindberg, Lars-Göran
    Dept of biomedical engineering, Linköping University.
    Arnetz, Bengt
    division of public health and caring sciences, Uppsala university.
    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.
    Effects of static contraction and cold stimulation on cardiovascular autonomic indices, trapezius blood flow and muscle activity in chronic neck-shoulder pain2011In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 111, no 8, p. 1725-1735Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate reactions in trapezius muscle blood flow (MBF), muscle activity, heart rate variability (HRV) and systemic blood pressure (BP) to autonomic tests in subjects with chronic neck-shoulder pain and healthy controls. Changes in muscle activity and blood flow due to stress and unfavourable muscle loads are known underlying factors of work-related muscle pain. Aberration of the autonomic nervous system (ANS) is considered a possible mechanism. In the present study, participants (n = 23 Pain, n = 22 Control) performed autonomic tests which included a resting condition, static hand grip test (HGT) at 30% of maximal voluntary contraction, a cold pressor test (CPT) and a deep breathing test (DBT). HRV was analysed in time and frequency domains. MBF and muscle activity were recorded from the upper trapezius muscles using photoplethysmography and electromyography (EMG). The pain group showed reduced low frequency-HRV (LF) and SDNN during rest, as well as a blunted BP response and increased LF-HRV during HGT (∆systolic 22 mm Hg; ∆LF(nu) 27%) compared with controls (∆systolic 27; ∆LF(nu) 6%). Locally, the pain group had attenuated trapezius MBF in response to HGT (Pain 122% Control 140%) with elevated trapezius EMG following HGT and during CPT. In conclusion, only HGT showed differences between groups in systemic BP and HRV and alterations in local trapezius MBF and EMG in the pain group. Findings support the hypothesis of ANS involvement at systemic and local levels in chronic neck-shoulder pain.

  • 253.
    Hallman, David
    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.
    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.
    Autonomic Regulation in Musculoskeletal Pain2012In: Pain in Perspective / [ed] Subhamay Ghosh, InTech, 2012, p. 35-62Chapter in book (Refereed)
  • 254.
    Hallman, David
    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.
    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.
    Autonomic regulation, physical activity and perceived stress in subjects with musculoskeletal pain: 24-hour ambulatory monitoring2012In: International Journal of Psychophysiology, ISSN 0167-8760, E-ISSN 1872-7697, Vol. 86, no 3, p. 276-282Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate autonomic nervous system regulation, physical activity (PA) and perceived stress and energy during daily activities in subjects with chronic muscle pain in the neck-shoulders (trapezius myalgia) (n = 23) and symptom-free controls (n = 22). Subjects underwent 24-h objective ambulatory monitoring of heart rate variability (HRV) and PA, and reported their perceived stress and energy in a diary. Standard HRV measures were extracted in time and frequency domains. The volume and pattern of different types of activities were quantified in terms of intensity and duration of walking, and time spent sitting, standing and lying during the 24-h measurement. Results showed shortened inter beat-intervals (higher heart rate) and reduced HRV in the pain group, most pronounced during sleep (p < 0.05). For overall PA, the pain group showed increased lying time, compared to controls (p < 0.05). A different activity pattern was found in the pain group, with reduced leisure time PA and increased PA during morning hours, in comparison with controls (p < 0.05). Both groups demonstrated low levels of perceived stress, whereas reduced energy was observed in the pain group (p < 0.05). In conclusion, monitoring of 24-h HRV demonstrated diminished HRV among persons with chronic neck-shoulder pain. This reflected aberration in autonomic regulation, suggesting reduced parasympathetic activation and increased sympathetic tone as an element in maintenance of chronic muscle pain.

  • 255.
    Hallman, David
    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.
    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.
    Different levels of physical activity and 24-hour heart rate variability in persons with neck-shoulder pain2011In:  , 2011, p. 117-117Conference paper (Refereed)
  • 256.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Lyskov, Eugene
    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.
    Monitoring of autonomic regulation and physical activity in workers with musculoskeletal pain2013Conference paper (Refereed)
    Abstract [en]

    Purposes

    Neck-shoulder pain (NSP) is a common work-related musculoskeletal disorder (1). The autonomic nervous system (ANS) is a potential element in the pathogenesis of regional muscle pain (2). Altered cardiovascular regulation has been observed in chronic NSP at rest and in response to stressors (3, 4). Importantly, the ANS control of the cardiovascular system is strongly influenced by daily physical activity. Thus, the observed aberrations in ANS regulation in chronic NSP may be due to pain-related changes in daily physical activity. The present study aimed at investigating ANS regulation and physical activity in workers with chronic NSP (N = 29) and symptom-free controls (N = 27) during work and leisure time.

     

    Methods

    Ambulatory monitoring of physical activity (seven days) and ANS cardiac activity (72-hours) were performed using accelerometry and electrocardiography, respectively. Time walking, sitting/lying and standing, as well as number of steps were calculated for each hour and averaged for work and leisure time. Heart rate variability indices were calculated in both time and frequency domains, and averaged over work, leisure time and sleep.

     

    Results

    The results indicated a reduced level of leisure time physical activity in NSP compared to controls (p<0.05), while no differences were observed for sedentary time. NSP demonstrated diminished HRV during sleep (p<0.05). Positive correlations were found between leisure time physical activity and HRV during sleep (p<0.05).

     

    Conclusions

    Reduced leisure time physical activity and diminished nocturnal HRV were seen in persons with chronic muscle pain. Correlations between leisure time physical activity and HRV may indicate that ANS regulation was partly modulated by physical activity in leisure time

  • 257.
    Hallman, David
    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.
    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.
    Monitoring of heart rate variability, physical activity and perceived stress and energy in daily life among persons suffering from neck-shoulder pain2010In: Nordic Conference 2010 - Interdisciplinary perspectives on health, participation and effects of sport and exercise, 2010Conference paper (Refereed)
  • 258.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Lyskov, Eugene
    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.
    Seven Days Activity Monitoring in Workers with Musculoskeletal Pain: Daily Patterns, Associations with Symptoms2013Conference paper (Refereed)
    Abstract [en]

    INTRODUCTION:

    Musculoskeletal pain is highly common among the working population. It has been assumed that chronic pain may reduce the activity level in daily life, which in turn may aggravate pain and associated symptoms. However, it is not known whether pain impacts on daily activities among workers. Commonly accepted and validated protocols are needed to gain objective information about possible deviations in physical activity patterns in subjects with chronic musculoskeletal pain.

     

    PURPOSE:

    The aim of this cross-sectional study was to investigate the volume and time-pattern of daily physical activity in workers with chronic musculoskeletal pain compared with healthy controls.

     

    METHODS:

    Twenty-seven workers with chronic muscle pain primarily in the neck-shoulder region, and 27 age- and gender- matched controls participated in the study. Both groups were recruited from the same global manufacturing company within the industrial sector at a site in Sweden. Physical activity and sedentary behaviour were monitored for seven days, both during work and leisure time, using a single tri-axial accelerometer (PAL Technologies Ltd, Glasgow). Time spent walking, standing and sitting/lying and steps were calculated for each hour. The mean metabolic equivalent (MET) was estimated and used as a measure of energy expenditure. The coefficient of variation (CV) between daytime hours was calculated as a measure of variation.

     

    RESULTS:

    For overall daily activity, the mean standing time was significantly higher in the pain group (263 min/day) compared with controls (209 min/day) (p=0.04), whereas no difference was found in energy expenditure or sedentary time. The analyses of time patterns revealed lower energy expenditure in the evening and morning hours among those with pain (mean 1.6 MET/h) compared with the control group (mean 1.8 MET/h) (p<0.05). The pain group showed on average a smaller CV in MET (9%) than the control group (11%) (p=0.02), which indicated a reduced variation in physical activity. There were no significant associations between pain intensity and physical activity.

     

    CONCLUSION:

    Despite a normal level of total physical activity, workers with chronic musculoskeletal pain had an altered activity pattern in terms of reduced variation and a lower activity level in leisure time.

  • 259.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Lyskov, Eugene
    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.
    Stress och muskelsmärta - mekanismer och behandling2013In: Stress: Gen, Individ, Samhälle / [ed] Bengt Arnetz, Rolf Ekman, Stockholm: Liber, 2013, 3, p. 181-193Chapter in book (Other academic)
  • 260.
    Hallman, David
    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.
    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.
    Lindberg, Lars Göran
    Department of Biomedical Engineering, Linköping University, Sweden.
    Circulatory and electromyographic responses to physical effort an experimental pain in subjects with trapezius myalgia2010In: Proceedings of the Premus 2010 conference (Seventh International Conference on Prevention of Work-Related Musculoskeletal Disorders), Angers, France, 2010, p. 122-122Conference paper (Refereed)
  • 261.
    Hallman, David M.
    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.
    Birk Jørgensen, Marie
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark; University of Southern Denmark, Odense, Denmark.
    Objectively measured physical activity and 12-month trajectories of neck-shoulder pain in workers: a prospective study in DPHACTO2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 3, p. 288-298Article in journal (Refereed)
    Abstract [en]

    Aims: This study aimed to investigate the association between objectively measured physical activity at work and leisure and the intensity (mean level and time course) of neck–shoulder pain (NSP) over 12 months among male and female blue collar workers. Methods: Data were obtained from 625 blue collar workers from the Danish cohort DPHACTO. Physical activity was measured objectively at baseline using accelerometers. The percentage of time spent in physical activity (walking, climbing stairs, running and cycling) was calculated for both work and leisure time. Longitudinal data on the intensity of NSP (numerical rating scale 0–10) were collected using text messages every fourth week over 12 months. Linear mixed models were used to investigate the associations between occupational physical activity (OPA) and leisure time physical activity (LTPA) and the trajectories of the intensity of NSP, adjusted for individual, biomechanical and psychosocial factors, and baseline pain. Results: OPA was not associated with the mean intensity of NSP over 12 months. LTPA was negatively associated with the mean intensity of NSP both among men (B=−0.71, 95% CI −1.31 to −0.11) and women (B=−0.85, 95% CI −1.57 to −0.13). Sex interactions on the 12-month trajectories of NSP showed that higher physical activity was associated with a slower reduction in NSP among men for OPA only (B=0.03, 95% CI 0.01-0.05) and women for LTPA only (B=0.05, 95% CI 0.00-0.09). Conclusions: We found that more time in LTPA was associated with a lower overall intensity of NSP over 12 months among blue collar workers. However, depending on sex and domain, high physical activity had an unfavourable effect on the course of NSP over 12 months.

  • 262.
    Hallman, David M.
    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.
    Gupta, Nidhi
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Birk Jørgensen, Marie
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Temporal patterns of sitting at work are associated with neck-shoulder pain in blue-collar workers: a cross-sectional analysis of accelerometer data in the DPHACTO study2016In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 5, p. 823-833Article in journal (Refereed)
    Abstract [en]

    Background

    Our aim was to examine the extent to which temporal patterns of sitting during occupational work and during leisure-time, assessed using accelerometry, are associated with intense neck–shoulder pain (NSP) in blue-collar workers.

    Methods

    The population consisted of 659 Danish blue-collar workers. Accelerometers were attached to the thigh, hip, trunk and upper dominant arm to measure sitting time and physical activity across four consecutive days. Temporal sitting patterns were expressed separately for work and leisure by the proportion of total time spent sitting in brief bursts (0–5 min), moderate (>5–20 min) and prolonged (>20 min) periods. The peak NSP intensity during the previous 3 months was assessed using a numerical rating scale (range 0–10) and dichotomized into a lower (≤4) and higher (>4) NSP score. Logistic regression analyses with multiple adjustments for individual and occupational factors were performed to determine the association between brief, moderate and prolonged sitting periods, and NSP intensity.

    Results

    Time in brief bursts of occupational sitting was negatively associated with NSP intensity (adjusted OR 0.68, 95 % CI 0.48–0.98), while time in moderate periods of occupational sitting showed a positive association with NSP (adjusted OR 1.32, 95 % CI 1.04–1.69). Time in prolonged periods of occupational sitting was not associated with NSP (adjusted OR 0.78, 95 % CI 0.78–1.09). We found no significant association between brief, moderate or prolonged sitting periods during leisure, and NSP.

    Conclusion

    Our findings indicate that the association between occupational sitting time and intense NSP among blue-collar workers is sensitive to the temporal pattern of sitting.

  • 263.
    Hallman, David M.
    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.
    Lyskov, Eugene
    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.
    Long-term monitoring of physical behavior reveals different cardiac responses to physical activity among subjects with and without chronic neck pain2015In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, Vol. 2015, article id 907482Article in journal (Refereed)
    Abstract [en]

    Background We determined the extent to which heart rate variability (HRV) responses to daily physical activity differ between subjects with and without chronic neck pain.

    Method Twenty-nine subjects (13 women) with chronic neck pain and 27 age- and gender-matched healthy controls participated. Physical activity (accelerometry), HRV (heart rate monitor) and spatial location (Global Positioning System (GPS)) were recorded for 74 hours. GPS data were combined with a diary to identify periods of work, and of leisure at home and elsewhere. Time- and frequency-domain HRV indices were calculated, and stratified by period and activity type (lying/sitting, standing, or walking). ANCOVAs with multiple adjustments were used to disclose possible group differences in HRV.

    Results The pain group showed a reduced HRV response to physical activity compared with controls (p=.001), according to the sympathetic-baroreceptor HRV index (LF/HF, ratio between low and high frequency power), even after adjustment for leisure time physical activity, work stress, sleep quality, mental health, and aerobic capacity (p=.02). The parasympathetic response to physical activity did not differ between groups.

    Conclusions Relying on long-term monitoring of physical behavior and heart rate variability, we found an aberrant sympathetic-baroreceptor response to daily physical activity among subjects with chronic neck pain.

  • 264.
    Hallman, David M.
    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.
    Nørregaard Rasmussen, Charlotte D.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Jørgensen, Marie Birk
    National Research Centre for the Working Environment, 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.
    Time course of neck-shoulder pain among workers: A longitudinal latent class growth analysis.2018In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, no 1, p. 47-57, article id 3690Article in journal (Refereed)
    Abstract [en]

    Objectives

    The aims of this study were to (i) identify trajectories of neck-shoulder pain (NSP) over one year in an occupational population and (ii) determine whether these trajectories are predicted by NSP characteristics as well as personal and occupational factors at baseline.

    Methods

    This longitudinal study was conducted among Danish workers (N=748) from 2012-2014. Text messages were used to collect frequent data on NSP over one year (14 waves in total). Peak NSP intensity in the past month was rated on a 0-10 numeric scale. A baseline questionnaire covered NSP characteristics (pain intensity, duration, comorbidity, pain medication, and pain interference) as well as personal (age, gender, body mass index) and occupational (seniority, work type, physical strain at work) factors. Latent class growth analysis was used to distinguish trajectories of NSP. Multivariate regression models with odds ratios (OR) were constructed to predict trajectories of NSP.

    Results

    Six distinct trajectories of NSP were identified (asymptomatic 11%, very low NSP 10%, low recovering NSP 18%, moderate recovering NSP 28%, strong fluctuating NSP 24% and severe persistent NSP 9% of the workers). Female gender, age, physical strain at work, NSP intensity and duration, pain medication, and pain interference in daily work at baseline were positively associated with severe persistent NSP and strong fluctuating NSP (all P<0.05). Altogether, personal and occupational factors accounted for 14% of the variance, while NSP characteristics accounted for 54%.

    Conclusions

    In an occupational sample, six distinct trajectories of NSP were identified. Physical strain at work appears to be a pertinent occupational factor predicting strong fluctuating and severe persistent NSP.

  • 265.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Gupta, Nidhi
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Korshøj, Mette
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Differences between work and leisure in temporal patterns of objectively measured physical activity among blue-collar workers2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, no 1, article id 976Article in journal (Refereed)
    Abstract [en]

    Background

    Leisure time physical activity (LTPA) is generally associated with favorable cardiovascular health outcomes, while occupational physical activity (OPA) shows less clear, or even opposite, cardiovascular effects. This apparent paradox is not sufficiently understood, but differences in temporal patterns of OPA and LTPA have been suggested as one explanation. Our aim was to investigate the extent to which work and leisure (non-occupational time) differ in temporal activity patterns among blue-collar workers, and to assess the modification of these patterns by age and gender.

    Methods

    This study was conducted on a cross-sectional sample of male (n = 108) and female (n = 83) blue-collar workers, aged between 21 and 65 years. Physical activity and sedentary behavior were assessed using accelerometers (Actigraph GT3X+) worn on the thigh and trunk for four consecutive days. Temporal patterns of OPA and LTPA were retrieved using Exposure Variation Analysis (EVA), and expressed in terms of percentage of work and leisure time spent in uninterrupted periods of different durations (<1 min, 1–5 min, 5–10 min, 10–30 min, 30–60 min and > 60 min) of sitting, standing, and walking. Repeated measures ANOVA and linear regression analyses were used to test a) possible differences between OPA and LTPA in selected EVA derivatives, and b) the modification of these differences by age and gender.

    Results

    OPA showed a larger percentage time walking in brief (<5 min) periods [mean (SD): 33.4 % (12.2)], and less time in prolonged (>30 min) sitting [7.0 % (9.3)] than LTPA [walking 15.4 % (5.0); sitting 31.9 % (15.3)], even after adjustment for the difference between work and leisure in total time spent in each activity type. These marked differences in the temporal pattern of OPA and LTPA were modified by gender, but not age.

    Conclusion

    We found that the temporal patterns of OPA and LTPA among blue-collar workers were markedly different even after adjustment for total physical activity time, and that this difference was modified by gender. We recommend using EVA derivatives in future studies striving to disentangle the apparent paradoxical cardiovascular effect of physical activity at work and during leisure.

  • 266.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Hed-Ekman, Annika
    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.
    Lyskov, Eugene
    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.
    Physical activity patterns in workers with neck pain assessed using accelerometry and GPS2014Conference paper (Refereed)
    Abstract [en]

    Background:

    Decreased physical activity levels have been found among subjects with work-related musculoskeletal disorders (MSD). Still, little is known about the distribution of physical activity and sedentary behavior over a work day, and whether these patterns differ between work and leisure time. Our aim was to characterize and compare physical activity patterns at work and leisure time (spent at home or elsewhere) among office workers with MSD and asymptomatic controls.

    Methods:

    Seventeen office workers (11f, 6m; mean age 41(SD=11) years) with neck-shoulder pain, and 17 age- and gender-matched asymptomatic office workers participated. Physical activity and sedentary behavior were monitored continuously for seven days using a single tri-axial accelerometer (ActivPAL). During four consecutive work-days within this period, data from a geographical positioning system (GPS) detector installed on a smartphone was combined with a written diary to identify the location (work place, leisure "at home" and "elsewhere") of the participants. Differences between groups in mean physical activity levels (excluding sleep) stratified by location were analysed with ANOVA. Physical activity patterns were expressed using Exposure Variation Analysis (EVA), showing the percentage of time spent in periods of different durations (<1min, 1-5min, 5-10min, 10-30min, 30-60min, >60min) of sitting/lying, standing, and walking.

    Results:

    In both groups, the lowest activity levels were found at work. Leisure "elsewhere" showed less %time in long bouts (>30min) of sitting/lying and more %time in walking (5-10 and 10-30 min bouts) compared with "home". Workers with pain did not increase their leisure activity level "elsewhere" compared with "home" to the same extent as controls, which was mainly reflected in a larger %time in prolonged periods (>30 min) of sitting/lying among those with pain.

    Conclusion:

    The combination of accelerometry and GPS allowed a detailed characterization of physical activity patterns stratified by location among office workers. Some differences were found between workers with and without MSD, which need further investigation as to their effects on health and well-being.

  • 267.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Birk Jørgensen, Marie
    Holtermann, Andreas
    Rudolfsson, Thomas
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Svedmark, Åsa
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Hellström, Fredrik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Rönnlund Borg, Tina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Häger, Charlotte
    Sommar, Johan
    Wahlström, Jens
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Symposium: Arbete, individ och nacksmärta: Forskning vid Forte-centret “Kroppen i arbete – från problem till potential”2018In: FALF KONFERENS 2018 Arbetet - problem eller potential för en hållbar livsmiljö? 10-12 juni 2018 i Gävle: Program och Abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, p. 102-Conference paper (Refereed)
    Abstract [sv]

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

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

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

  • 268.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Jahncke, Helena
    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.
    Sitting patterns after relocation to activity-based offices: a controlled study of a natural intervention2018In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 111, p. 384-390Article in journal (Refereed)
    Abstract [en]

    This study determined the effect of relocating workers from traditional to activity-based offices on objectively measured sitting patterns. Office workers (n=493) from five office-sites within a large Swedish government agency were included in a controlled study of a natural intervention (2015-2017). At four sites, traditional offices were replaced by activity-based offices, while workers at one site with no relocation acted as controls. Sitting, standing and walking were measured objectively for 5-8days in a sub-sample (n=110) using accelerometry (Actigraph). Total sitting time (% of working time) and time spent in short (<5min), moderate (5-30min) and prolonged (>30min) uninterrupted periods in sitting were determined. Intervention effects were determined at 3- and 12-month follow-ups using linear mixed models adjusted for baseline age, gender and office type, and stratified by office-site (referencing controls). The relocation to activity-based offices did not result in an overall effect (across sites) on occupational sitting time (all p>0.05), while walking time had increased significantly by 1.4% of the working time at 12months compared with controls. Heterogeneous results were found across offices after 12months on total sitting time compared with controls (estimated change -18.3% time-1.4% time), prolonged sitting (change -18.3% to -3.8%), walking (change 0.5%-3.5%) and standing (change -1.4%-13.9%). In conclusion, relocation to activity-based offices had a limited overall effect on occupational sitting patterns in the studied organization, but differed considerably between office sites. Site-specific determinants of sitting behavior in activity-based offices need be identified.

  • 269.
    Hallman, David
    et al.
    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.
    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.
    van der Beek, Allard
    Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam.
    Jackson, Jennie
    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.
    Coenen, Pieter
    Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam.
    Calibration of self-reported time spent sitting, standing and walking among office workers: a compositional data analysis2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 17, article id 3111Article in journal (Refereed)
    Abstract [en]

    We developed and evaluated calibration models predicting objectively measured sitting, standing and walking time from self-reported data using a compositional data analysis (CoDA) approach. A total of 98 office workers (48 women) at the Swedish Transport Administration participated. At baseline and three-months follow-up, time spent sitting, standing and walking at work was assessed for five working days using a thigh-worn accelerometer (Actigraph), as well as by self-report (IPAQ). Individual compositions of time spent in the three behaviors were expressed by isometric log-ratios (ILR). Calibration models predicting objectively measured ILRs from self-reported ILRs were constructed using baseline data, and then validated using follow-up data. Un-calibrated self-reports were inaccurate; root-mean-square (RMS) errors of ILRs for sitting, standing and walking were 1.21, 1.24 and 1.03, respectively. Calibration reduced these errors to 36% (sitting), 40% (standing), and 24% (walking) of those prior to calibration. Calibration models remained effective for follow-up data, reducing RMS errors to 33% (sitting), 51% (standing), and 31% (walking). Thus, compositional calibration models were effective in reducing errors in self-reported physical behaviors during office work. Calibration of self-reports may present a cost-e_ective method for obtaining physical behavior data with satisfying accuracy in large-scale cohort and intervention studies.

  • 270.
    Hallman, David
    et al.
    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.
    Niklas, Krause
    Departments of Epidemiology and Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA.
    Jensen, Magnus Thorsten
    Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark.
    Gupta, Nidhi
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Birk Jørgensen, Marie
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Objectively measured sitting and standing in workers: Cross-sectional relationship with autonomic cardiac modulation2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 4, article id 650Article in journal (Refereed)
    Abstract [en]

    Excessive sitting and standing are proposed risk factors for cardiovascular diseases (CVDs), possibly due to autonomic imbalance. This study examines the association of objectively measured sitting and standing with nocturnal autonomic cardiac modulation. The cross-sectional study examined 490 blue-collar workers in three Danish occupational sectors. Sitting and standing during work and leisure were assessed during 1–5 days using accelerometers. Heart rate (HR) and heart rate variability (HRV) were obtained during nocturnal sleep as markers of resting autonomic modulation. The associations of sitting and standing still (h/day) with HR and HRV were assessed with linear regression models, adjusted for age, gender, body mass index, smoking, and physical activity. More sitting time during leisure was associated with elevated HR (p = 0.02), and showed a trend towards reduced HRV. More standing time at work was associated with lower HR (p = 0.02), and with increased parasympathetic indices of HRV (root mean squared successive differences of R-R intervals p = 0.05; high-frequency power p = 0.07). These findings, while cross-sectional and restricted to blue-collar workers, suggest that sitting at leisure is detrimental to autonomic cardiac modulation, but standing at work is beneficial. However, the small effect size is likely insufficient to mitigate the previously shown detrimental effects of prolonged standing on CVD.

  • 271.
    Hallman, David
    et al.
    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.
    Nørregaard Rasmussen, Charlotte
    National research centre for the working environment, Denmark.
    Holtermann, Andreas
    National research centre for the working environment, Denmark.
    Time-use composition of physical behaviors at work and sick-leave trajectories due to musculoskeletal pain2019Conference paper (Refereed)
    Abstract [en]

    Background

    There is limited knowledge on the influence of physical behaviors at work such as sitting, standing, low- (LIPA) and moderate-to-vigorous physical activity (MVPA) on sick leave due to pain. Studies addressing this relationship using valid objective measures of physical behaviors are scarce. The aim was to determine the prospective association between time-use compositions of physical behavior at work with sick leave trajectories due to musculoskeletal pain.

    Methods

    Data on 981 workers were analyzed in the DPHACTO cohort (2012-2014). Physical behaviors at work were assessed objectively at baseline using accelerometers, and the resulting time-line of exposure at work was classified as sitting, standing, low- (LIPA) and moderate-to-vigorous physical activity (MVPA). The number of days on sick leave due to musculoskeletal pain was reported using text messages at 4-week intervals across 1 year (14 waves in total). Latent class growth analysis was used to distinguish sub-groups with different trajectories of sick leave. Associations between time-use in physical behaviors and sick leave trajectories were determined using multinomial regression analysis with adjustment for age and gender. Compositional data analysis was used to account for the co-dependency of different behaviors.

    Results

    We identified four distinct trajectories of sick leave due to pain over one year as follows: no days (prevalence 76%), few days-increasing (19%), some days-decreasing (3%), and some days-increasing (2%). Spending more time in sitting relative to the other behaviors was associated with a reduced likelihood of few days-increasing sick leave (class 2 p<0.001), while time in LIPA was associated with an increased likelihood of some days-increasing sick leave (class 4 p=0.001).

    Conclusion

    We found that the time-use composition of physical behaviors at work was associated with sick leave trajectories due to pain over 1 year. Reducing time in occupational physical activities in favor of sitting may be useful for preventing sick leave due to musculoskeletal pain.

  • 272.
    Hallman, David
    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.
    Olsson, Erik
    Inst för Folkhälso och vårdvetenskap, Uppsala universitet.
    von Schéele, Bo
    School of Innovation, Design and Engineering, Mälardalen University.
    Melin, Lennart
    Department of Psychology, Uppsala University.
    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.
    Effects of heart rate variability biofeedback in subjects with stress-related chronic neck pain: a pilot study2011In: Applied Psychophysiology and Biofeedback, ISSN 1090-0586, E-ISSN 1573-3270, Vol. 36, no 2, p. 71-80Article in journal (Refereed)
    Abstract [en]

     

    Recent studies focusing on autonomic nervous system (ANS) dysfunctions, together with theoretical pathophysiological models of musculoskeletal disorders, indicate the involvement of ANS regulation in development and maintenance of chronic muscle pain. Research has demonstrated the effectiveness of heart rate variability (HRV) biofeedback (BF) in increasing HRV and reducing the symptoms of different disorders characterized by ANS aberration. The study investigated the effects of resonance frequency HRV BF on autonomic regulation and perceived health, pain, stress and disability in 24 subjects with stress-related chronic neck-shoulder pain. Twelve subjects participated in 10 weekly sessions of resonant HRV BF and were compared to a control group. Subjective reports and HRV measures during relaxation and in response to a standardized stress protocol were assessed for both groups pre- and post-intervention. Group X time interactions revealed a significantly stronger increase over time in perceived health (SF-36) for the treatment group, including vitality, bodily pain and social functioning. Interactions were also seen for HRV during relaxation and reactivity to stress. The present pilot study indicates improvement in perceived health over a 10 week intervention with HRV-biofeedback in subjects with chronic neck-pain. Increased resting HRV as well as enhanced reactivity to hand grip and cold pressor tests might reflect beneficial effects on ANS regulation, and suggest that this intervention protocol is suitable for a larger controlled trial.

  • 273.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Sato, Tatiana
    Physical Therapy Department, Federal University of São Carlos (UFSCar), São Paulo, Brazil.
    Kristiansen, Jesper
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Gupta, Nidhi
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Skotte, Jørgen
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Prolonged sitting is associated with attenuated heart rate variability during sleep in blue-collar workers2015In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 12, no 11, p. 14811-14827Article in journal (Refereed)
    Abstract [en]

    Prolonged sitting is associated with increased risk for cardiovascular diseases and mortality. However, research into the physiological determinants underlying this relationship is still in its infancy. The aim of the study was to determine the extent to which occupational and leisure-time sitting are associated with nocturnal heart rate variability (HRV) in blue-collar workers. The study included 138 blue-collar workers (mean age 45.5 (SD 9.4) years). Sitting-time was measured objectively for four days using tri-axial accelerometers (Actigraph GT3X+) worn on the thigh and trunk. During the same period, a heart rate monitor (Actiheart) was used to sample R-R intervals from the electrocardiogram. Time and frequency domain indices of HRV were only derived during nighttime sleep, and used as markers of cardiac autonomic modulation. Regression analyses with multiple adjustments (age, gender, body mass index, smoking, job-seniority, physical work-load, influence at work, and moderate-to-vigorous physical activity) were used to investigate the association between sitting time and nocturnal HRV. We found that occupational sitting-time was negatively associated (p < 0.05) with time and frequency domain HRV indices. Sitting-time explained up to 6% of the variance in HRV, independent of the covariates. Leisure-time sitting was not significantly associated with any HRV indices (p > 0.05). In conclusion, objectively measured occupational sitting-time was associated with reduced nocturnal HRV in blue-collar workers. This indicates an attenuated cardiac autonomic regulation with increasing sitting-time at work regardless of moderate-to-vigorous physical activity. The implications of this association for cardiovascular disease risk warrant further investigation via long-term prospective studies and intervention studies.

  • 274.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Srinivasan, Divya
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    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.
    Short- and long-term reliability of heart rate variability indices during repetitive low-force work2015In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 115, p. 803-812Article in journal (Refereed)
    Abstract [en]

    Purpose Heart rate variability (HRV) is often monitored in occupational studies as a measure of cardiac autonomic activation, but the reliability of commonly used HRV indices is poorly understood. In the present study, we determined the variability between and within subjects of common HRV indices during a repetitive low-force occupational task, i.e. pipetting, and interpreted the results in terms of necessary sample sizes in studies comparing HRV between conditions or groups.

    Methods Fourteen healthy female subjects performed a standardized pipetting task in the laboratory on three separate days within a short time-span (<2 weeks), and on one additional occasion six months later. A number of standard HRV indices were calculated in both time and frequency domains. For each HRV index, variance components were estimated between subjects, within subjects between occasions far apart in time, and within subjects between days within a two-week period.

    Results We found that the time interval between repeated measurements did not influence the extent of HRV variability, and that the reliability of most HRV indices was sufficient for even small study samples (30 subjects or less) to be able to detect, with satisfying power (>0.80), a significant 10% to 20% difference in HRV between groups, and between conditions within individuals.

    Conclusions We conclude that HRV can be used as a reliable and feasible marker of autonomic activity in occupational studies of repetitive low-force work.

  • 275.
    Hansson, Gert-Åke
    et al.
    Department of Occupational and Environmental Medicine, University Hospital, Lund, Sweden.
    Arvidsson, Inger
    Department of Occupational and Environmental Medicine, University Hospital, Lund, Sweden.
    Ohlsson, Kerstina
    Department of Occupational and Environmental Medicine, University Hospital, Lund, Sweden.
    Nordander, Catarina
    Department of Occupational and Environmental Medicine, University Hospital, Lund, Sweden.
    Mathiassen, Svend Erik
    University of Gävle, Centre for Musculoskeletal Research. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science.
    Skerfving, Staffan
    Department of Occupational and Environmental Medicine, University Hospital, Lund, Sweden.
    Balogh, Istvan
    Department of Occupational and Environmental Medicine, University Hospital, Lund, Sweden.
    Precision of measurements of physical workload during standardised manual handling: Part II : Inclinometry of head, upper back, neck and upper arms2006In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 16, no 2, p. 125-136Article in journal (Refereed)
    Abstract [en]

    For measuring the physical exposure/workload in studies of work-related musculoskeletal disorders, direct measurements are valuable. However, the between-days and between-subjects variability, as well as the precision of the method per se, are not well known. In a laboratory, six women performed three standardised assembly tasks, all of them repeated on three different days. Triaxial inclinometers were applied to the head, upper back and upper arms. Between-days (within subjects) and between-subjects (within tasks) variance components were derived for the 10th, 50th and 90th percentiles of the angular and the angular velocity distributions, and for the proportion of time spent in predefined angular sectors. For percentiles of the angular distributions, the average between-days variability was 3.4 degrees , and the between-subjects variability 4.0 degrees . For proportion of time spent in angular sectors, the variability depended on the percentage of time spent in the sector; the relative variability was scattered and large, on average 103% between days and 56% between subjects. For the angular velocity percentiles, the average between-days variability was 7.9%, and the average between-subjects variability was 22%. The contribution of the measurement procedure per se to the between-days variability, i.e., the imprecision of the method, was small: less than 2 degrees for angles and 3% for angular velocity.

  • 276.
    Hartig, Terry
    et al.
    Institute for Housing and Urban Research and Department of Psychology, Uppsala University, Uppsala, Sweden.
    Jahncke, Helena
    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.
    Letter to the editor: Attention restoration in natural environments: Mixed mythical metaphors for meta-analysis2017In: Journal of toxicology and environmental health. Part B, Critical reviews, ISSN 1093-7404, E-ISSN 1521-6950, Vol. 20, no 5, p. 305-315Article in journal (Other academic)
  • 277. Hassler, Sven
    et al.
    Sjölander, Per
    University of Gävle, Centre for Musculoskeletal Research.
    Health promotive lifestyle among reindeer herding Sami in Sweden: an analysis of gender differences2007In: The 19th IUHPE World Conference on Health Promotion and Health Education, 2007Conference paper (Other academic)
    Abstract [en]

    Objectives: The Sami are the indigenous of Northern Scandinavia. Traditional indigenous life styles are increasingly being acknowledged for their health promotive aspects such as being community based and salutogenetic in perspective. A gender difference in health among reindeer herding Sami has been observed such as lower relative risk for cancer and cardiovascular diseases among reindeer herding men compared to the women. This has partly been interpreted in terms of access to a traditional health protective life style. The objective of this study is to analyze these gender differences in health among different groups of reindeer herding Sami in the light of health promotive aspects of indigenous life styles described in the recent scientific health litterature.

    Study Design: Prospective cohort study and a litterature review

    Methods: The study cohort constitutes of a total of 7 482 reindeer herders from which subgroups with different levels of influence of a traditional Sami life style were genealogically and geographically defined. Follow-up was from 1961 to 2003 and standard incidence ratios (SIR) for major life style related diseases such as CVD and cancer were calculated using a demographically matched control population as the standard of comparison.

    Results: Overall lower risk for cancer and CVD was observed for reindeer herding men living in the mountain region compared to the control population while the relative risk for CVD was significantly higher among reindeer herding women living in lowland regions.

    Conclusions: Different access to the health promotive factors in an active, more traditional Sami life style is suggested to partly explain the gender difference in health status observed in different subgroups of the reindeer herding commun

  • 278. Hassler, Sven
    et al.
    Sjölander, Per
    University of Gävle, Centre for Musculoskeletal Research.
    Edin-Liljegren, Anette
    Daerga, Laila
    Cancer in the Sami population of Sweden, 1961-2003: demographical aspects of different genetic and lifestyle exposure2006In: The 13th International Congress on Circumpolar Health, 2006Conference paper (Other academic)
    Abstract [en]

    Objectives: In previous Nordic studies it has been reported that the overall cancer incidence is lower among the Sami compared to the rest of the population living in the same area. But the relative risk varies among different Sami groups with a lower overall risk among reindeer herders compared to other Sami groups. Diet and lifestyle factors such as physical activity has been suggested to explain these differences together with genetical factors. The objective of this study is to describe the cancer incidence among different Sami groups in Sweden between 1961 and 2003 and to evaluate the effect of demographical changes on risk factors related to Sami lifestyle and heritage.

    Study Design: Prospective cohort study

    Methods: The study cohort constitutes of a total of 7 482 reindeer herders and 34 239 non-herders from which subgroups were genealogically defined, carrying with them assumptions of different levels of influence of a traditional Sami life style. Follow up was from 1961 to 2003 and standard incidence ratios (SIR) were calculated using a demographically matched control population as the standard of comparison.

    Results:Overall lower cancer risk was observed for reindeer herding men compared to the control population while the relative risk for non-herding women was significantly higher. Significantly lower rates of prostate was observed among reindeer herders and higher rates of stomach and ovary was observed among non-herding women.

    Conclusions: Protective factors in an active, more traditional life style in combination with genertical factors is suggested to explain the lower cancer rates among reindeer herding men. An assumption of declining protective influence of a traditional life style in different Sami groups is supported by an demographical and genealogical analysis of the constitution of different Sami groups. It is indicated that demographical changes resulting in various levels of integration and/or assimilation should be considered when analysing the health status of the Sami.

  • 279.
    Hassler, Sven
    et al.
    Southern Lapland Research Departement, Vilhelmina, Sweden; Department of Nursing, Health and Culture, University West, Trollhattan, Sweden.
    Sjölander, Per
    University of Gävle, Centre for Musculoskeletal Research.
    Grönberg, Henrik
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Johansson, Robert
    Department of Radiation Sciences/Oncology, University of Umeå, Umeå, Sweden.
    Damber, Lena
    Department of Radiation Sciences/Oncology, University of Umeå, Umeå, Sweden.
    Cancer in the Sami population of Sweden in relation to lifestyle and genetic factors2008In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 23, no 4, p. 273-280Article in journal (Refereed)
    Abstract [en]

    The reindeer herding Sami of Sweden have low incidences of cancer. The aim of the present study was to investigate the cancer risk in a large cohort of Swedish Sami, containing Sami with different lifestyle and genetic Sami heritage. A cohort of 41,721 Sami identified in official national registers between 1960 and 1997, was divided into two sub-populations - reindeer herding Sami (RS) and non-reindeer herding Sami (NRS). A demographically matched non-Sami reference population (NS) was used as standard when incidence and mortality ratios were calculated. Incidence and mortality data were obtained from the Swedish Cancer and Cause of Death Registers for the period 1961–2003. For Sami men, lower risks were found for cancers of the colon and prostate, and for malignant melanoma and non-Hodkins lymphoma, but higher for stomach cancer. The Sami women showed higher risks for cancers of the stomach and the ovaries, but lower risk for cancer of the bladder. The RS demonstrated lower relative cancer risks compared with the NRS. The lowest relative risk was found among the RS men, while the highest were observed among the NRS women. The RS men who had adopted a more westernized lifestyle showed a similar relative risk for prostate cancer as that of the NS living in the same region. Most of these differences in cancer risks could probably be ascribed to differences in lifestyle. It is concluded that the traditional Sami lifestyle contains elements, e.g. dietary contents and physical activity that may protect them from developing cancer.

  • 280. Hassler, Sven
    et al.
    Sjölander, Per
    University of Gävle, Centre for Musculoskeletal Research.
    Janlert, Urban
    Northern Fennoscandia2008In: Health transitions in arctic populations, Toronto: University of Toronto Press , 2008, p. 103-116Chapter in book (Other academic)
  • 281. Hassler, Sven
    et al.
    Soininen, Leena
    Sjölander, Per
    University of Gävle, Centre for Musculoskeletal Research.
    Pukkala, Eero
    Cancer among the Sami: a review on the Norwegian, Swedish and Finnish Sami populations2008In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 67, no 5, p. 421-432Article in journal (Refereed)
    Abstract [en]

    Objectives. The Sami are the Indigenous people of the northernmost parts of Sweden, Finland and Norway, and of the Kola Peninsula of Russia. The present review summarizes the main results from studies on cancer morbidity and mortality among the Sami and discusses these results in relation to exposure of known risk factors.

    Study Design. Literature review.

    Methods. A systematic search over the time period 1966–2008 for relevant articles was conducted on MEDLINE. Updates and recalculations of some of the results from the original data were also done.

    Results. Nine articles whose main focus is on cancer incidence or mortality among the Sami were identified. In all studies, the overall incidence of cancer or cancer mortality was lower among the Sami in comparison with the national populations. The differences were less striking in relation to regional reference populations, but the rates were still significantly lower for all populations of Sami, except for Swedish Sami women. Beyond the general trend of a lower cancer incidence among the Sami, there were some notable differences between the various Sami subpopulations.

    Conclusions. The risk of developing and dying from cancer is low among the Sami. A life-style that includes cancer-protective factors, such as certain dietary components and physical activity, is the most likely explanation for the lower incidence of cancer among the Sami.

  • 282.
    Heiden, Marina
    University of Gävle, Centre for Musculoskeletal Research.
    Beakta smärta vid stressrelaterade besvär2006In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, no 47, p. 3700-3700Article in journal (Other (popular science, discussion, etc.))
  • 283.
    Heiden, Marina
    University of Gävle, Centre for Musculoskeletal Research.
    Ensidig behandling räcker inte2007In: Vårdfacket, ISSN 0347-0911, no 1, p. 30-30Article in journal (Other (popular science, discussion, etc.))
  • 284.
    Heiden, Marina
    University of Gävle, Centre for Musculoskeletal Research.
    Psychophysiological reactions to experimental stress: relations to pain sensitivity, position sense and stress perception2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Stress and monotonous work contribute substantially to the development of chronic musculoskeletal disorders. Yet, the pathophysiological mechanisms underlying the process, particularly the involvement of autonomic regulation, remain unclear. It has been suggested that altered motor control resulting from distorted sensory information from fatigued muscles may be an important component in the development of musculoskeletal disorders. Animal studies have shown that sympathetic nervous system activation exerts actions in skeletal muscles, such as vasoconstriction and modulation of afferent information from muscle spindles. However, few attempts have been made to address this issue in humans. Therefore, the first aim of the thesis was to investigate the impact of repetitive computer work with and without additional stressors on muscle oxygenation and position sense in the upper extremity.

    Assuming an important role of stress in the development of chronic musculoskeletal symptoms, one may expect open or latent manifestations of such symptoms in patients with non-specific stress-related illnesses. It is possible that sympathetic activation may influence pain perception, and that treatments aimed at reducing stress may also affect the pain experience. Thus, the second aim of the thesis was to evaluate the effects of a cognitive-behavioral training program and a physical activity program for patients with stress-related illnesses on autonomic reactivity, pain, and perceived health.

    First, a laboratory model of computer mouse use was characterized in terms of biomechanical exposure of the wrist, and wrist position sense was determined before and after 45 minutes of continuous mouse use. Then, the effects of performing the computer mouse work under time pressure and precision demands were determined. Autonomic activity and muscle oxygenation in the upper extremity were measured during the work, and wrist position sense was assessed before and after the work. When patients with stress-related illnesses were compared to healthy individuals in autonomic reactivity to functional tests, pressure-pain thresholds, and ratings of health, indications of a relation between autonomic reactivity and symptoms of pain was found. Hence, in a subsequent evaluation of a cognitive-behavioral training program and a physical activity program for patients with stress-related illnesses, post intervention effects on autonomic reactivity to functional tests, pressure-pain thresholds, ratings of health and return-to-work were studied during a period of 12 months after the intervention.

    The main findings were the following. 1) Wrist kinetics data obtained during the computer mouse work showed similarities to previously presented data for mouse-operated design tasks. 2) When time pressure and precision demands were added to the computer work, increased autonomic activity paralleled with decreased muscle oxygenation in the upper extremity was found. Wrist position sense accuracy, however, did not decrease after the work as it did when the work was performed without the additional demands. The result is intriguing, as it does not appear to be in concordance with previous animal studies. 3) Patients with stress-related illnesses showed higher autonomic reactivity to cognitive and physical laboratory tests than healthy control subjects. They also had substantially lower pressure-pain thresholds in the back, and rated poorer health and health-related behavior than the control subjects. 4) We found little difference in effect of cognitive-behavioral training and physical activity, compared to usual care, for patients with stress-related illnesses. Patients in the control group showed an improvement of about the same magnitude as in the treatment groups over the 12-month follow-up period.

    The present findings indicate a non-additive relation between autonomic activity during repetitive work and position sense inaccuracy. Furthermore, patients with stress-related illnesses often reported pain in the neck, shoulders, and lower back. This was associated with lower pressure-pain thresholds in the back and a modest increase in sympathetic reactivity to physical and mental tests, which might suggest a potential use of these methods in the clinical examination and rehabilitation of patients with stress-related illnesses

  • 285.
    Heiden, Marina
    University of Gävle, Centre for Musculoskeletal Research.
    Reactions to experimental stress in the laboratory2008In: 9th Physiatric Summer School: How stress influences musculoskeletal disorders, Helsinki: Rehabilitation ORTON, Invalid Foundation , 2008, p. 17-19Conference paper (Refereed)
  • 286.
    Heiden, Marina
    University of Gävle, Centre for Musculoskeletal Research.
    Stressrelaterad ohälsa och smärta2007Report (Other (popular science, discussion, etc.))
  • 287.
    Heiden, Marina
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Dahlgren, Gunilla
    University of Gävle, Centre for Musculoskeletal Research.
    Lyskov, Eugene
    University of Gävle, Centre for Musculoskeletal Research.
    Crenshaw, Albert
    University of Gävle, Centre for Musculoskeletal Research.
    Johansson, Håkan
    University of Gävle, Centre for Musculoskeletal Research.
    Effects of time pressure and precision demands during computer mouse work on muscle oxygenation and position sense2003In: Conference proceeding at the 49th NAM conference (Nordiska Arbetsmiljömötet), 2003Conference paper (Refereed)
    Abstract [en]

    Introduction

    As the number of employees involved in computer work increases, neck and upper extremity complaints grow more common. Tight deadlines lead to high time pressure, which, in combination with precision demands, may increase the risk of musculoskeletal disorders. The physiological manifestation of such demands, however, is not entirely clear. In the present study, we examined local tissue oxygen saturation in the upper extremity as well as subjective stress responses during computer mouse work with and without time pressure and precision demands, and investigated whether these working situations have different effects on wrist position sense.

    Material and methods

    Twenty-four healthy, right-handed subjects (12 females, 12 males; age 19-28 years) participated in the study. Except for one subject who reported using a computer for 480 minutes per day, their average daily computer use was 84 minutes (SD 65 minutes). Subjects performed a 45-min mouse operated computer task on two occasions, separated by 3-5 days. The task consisted of painting squares that were presented on the screen. On one occasion, time pressure and precision demands were imposed on the task by limiting the time available for painting a square and introducing a scoring system based on precision of painting. On the other occasion, no such restraints were added. The order of the two task versions was randomized. During the task, tissue oxygen saturation in trapezius and extensor carpi radialis on the right arm was measured non-invasively by near-infrared spectroscopy, NIRS (Inspectra, Hutchinson Technology). In addition, subjective ratings of tenseness and strain, painting performance measures, and skin temperature were recorded. The position matching ability of the wrist was measured before and after the computer task. In the position matching tests, subjects attempted to actively reproduce target positions of horizontal movements about the right wrist joint. From a starting position of 30° of extension, target positions were randomized between 0° and 30° of flexion. The absolute value of the difference between presented target and reproduced position (AE) was used as outcome measure. Skin fold thickness at the locations of the NIRS electrodes was measured with a caliper at the beginning of the experiment.

    Repeated measures analyses of variance were used to test for differences in oxygen saturation throughout the task, and for testing differences in position sense, as estimated by position matching ability, before and after the task. Subjective ratings during the task were analyzed by Wilcoxon’s non-parametric tests. Remaining parameters were tested for differences by t-tests or Wilcoxon’s non-parametric tests, depending on distribution of data. In all tests, p<0.05 was considered significant.

    Results

    A significant decline in oxygen saturation during mouse work under time pressure and precision demands was seen for extensor carpi radialis (F=4.68, p=0.036). This pattern was not present when mouse work was performed under more relaxed conditions. For trapezius, no difference in oxygen saturation between task versions was seen (F=0.01, p=0.932), although a general increase in saturation during work was found (F=10.35, p=0.002). Gender differences were apparent for extensor carpi radialis as well as for trapezius. Females showed an overall lower oxygen saturation in extensor carpi radialis than men (F=4.81, p=0.034). Furthermore, they showed a significantly different trend in trapezius oxygen saturation during work than men (F=6.27, p=0.016). Somewhat surprisingly, these gender differences could not be explained by differences in skin fold thickness at electrode positions (extensor carpi radialis: t=0.77, p=0.449; trapezius: t= 1.34, p=0.193). Subjects’ mean skin temperature changes during work was +0.41°C (SD 0.83°C).

    AE measured before the computer task did not significantly differ between occasions (paired t-test: t=0.08, p=0.940), indicating that the time period between occasions was long enough for effects of work to wash out. A significant increase in AE was seen following the task (F=15.59, p<0.001), irrespective of task version (F<0.01, p=0.968). No gender differences in AE were found (F=0.08, p=0.774). Subjects’ ratings of tenseness and strain were significantly higher during work under time pressure and precision demands (Wilcoxon’s signed-ranks test: Z>3.41, p<0.001), compared to work without such demands. This is in agreement with the fact that subjects increased their work pace (squares painted in work with demands: 119, without demands: 84, paired t-test: t=8.38, p<0.001), and made an effort to paint as accurate and precise as possible (no. of times outside the square in work with demands: 2, without demands: 4, paired t-test: t=3.68, p=0.001) during the more demanding task version. No gender differences in subjective ratings (Mann-Whitney U-test: Z<2.14, ns) or performance variables (t-test: t<1.71, ns) were found.

    Discussion

    Subjects’ showed diminished oxygen saturation in extensor carpi radialis when working under time pressure and precision demands. This could be attributed to an increased mental load and/or a higher work intensity associated with this working situation. In support of this, subjective ratings of tenseness and strain scored higher during the more demanding task. It was also shown that subjects painted squares at a higher rate during the task. The fact that no differences in trapezius oxygen saturation between task versions was found might suggest that the physical strain associated with the work, being more prominent in extensor carpi radialis, could be a major contributor to oxygen saturation changes. Subjects’ tenseness ratings, however, would argue against it. Position sense, although poorer following work, was not affected by work type. One may speculate that physiological mechanisms involved in our measurement of position sense are not affected by local tissue oxygen saturation in extensor carpi radialis. The present data show considerable gender differences in oxygen saturation during rest as well as computer mouse work, that does not seem to be caused by skin fold thickness or painting performance.

  • 288.
    Heiden, Marina
    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.
    Garza, Jennifer
    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.
    Trask, Catherine
    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.
    Cost-efficient assessment of variation in arm posture during paper mill work2016Conference paper (Refereed)
    Abstract [en]

    Background. Arm posture is a recognized risk factor for occupational upper extremity musculoskeletal disorders and thus often assessed in research and practice. Posture assessment methods differ in cost, feasibility and, perhaps, bias. An attractive approach could be to build statistical models for predicting results of expensive direct measurements of arm posture from cheaper or more accessible data, and apply them to large samples in which only the latter data are available. We aimed to build and assess the performance of such prediction models in a random sample of paper mill workers.

    Methods. 28 workers were recruited to the study, and their upper arm postures were measured during three full work shifts using inclinometers. Simultaneously, the workers were video filmed, and their arm posture and gross body posture were assessed by observing the video afterwards. Models for predicting the inclinometer-assessed duration (proportion of time) and frequency (number/min) of periods spent in neutral right arm posture (<20°) were fitted using subject and observer as random factors, measured shift (1, 2 or 3) as fixed factor, and either observed time in neutral right arm angle or observed gross body posture as predictor.

    Results. For the proportion of time spent in neutral arm posture, the best performance was achieved by using observed gross body posture as predictor (explained variance: R2=26%; standard error: SE=9.8). For the frequency of periods spent in neutral arm posture, the corresponding model fit was R2=60% and SE=5.6. Bootstrap resample validation of the latter model showed an expected performance in other samples of R2=59-60% and SE=5.5-5.6 (5th-95th percentile).

    Discussion. Surprisingly, we found that observed gross body posture was a better predictor of variation in arm posture than observed arm angles. The findings suggest that arm posture during paper mill work can be cost-efficiently assessed using simple observations.

  • 289.
    Heiden, Marina
    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.
    Garza, Jennifer
    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. Division of Occupational and Environmental Medicine, University of Connecticut Health Center, Farmington, USA.
    Trask, Catherine
    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. Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
    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.
    Predicting directly measured trunk and upper arm postures in paper mill work from administrative data, workers’ ratings and posture observations2017In: Annals of Work Exposures & Health, ISSN 2398-7308, Vol. 61, no 2, p. 207-217Article in journal (Refereed)
    Abstract [en]

    Introduction: A cost-efficient alternative to measuring working postures directly could be to build statistical models for predicting results of such measurements from cheaper data, and apply these models to samples in which only the latter data are available. The present study aimed to build and assess the performance of statistical models predicting inclinometer-assessed trunk and arm posture among paper mill workers. Separate models were built using administrative data, workers’ ratings of their exposure, and observations of the work from video recordings as predictors.

    Methods: Trunk and upper arm postures were measured using inclinometry on 28 paper mill workers during three work shifts each. Simultaneously, the workers were video filmed, and their postures were assessed by observation of the videos afterwards. Workers’ ratings of exposure, and administrative data on staff and production during the shifts were also collected. Linear mixed models were fitted for predicting inclinometer-assessed exposure variables (median trunk and upper arm angle, proportion of time with neutral trunk and upper arm posture, and frequency of periods in neutral trunk and upper arm inclination) from administrative data, workers’ ratings, and observations, respectively. Performance was evaluated in terms of Akaike information criterion, proportion of variance explained (R2), and standard error of the model estimate (SE). For models performing well, validity was assessed by bootstrap resampling.

    Results: Models based on administrative data performed poorly (R2≤15%) and would not be useful for assessing posture in this population. Models using workers’ ratings of exposure performed slightly better (8%≤R2≤27% for trunk posture; 14%≤R2≤36% for arm posture). The best model was obtained when using observational data for predicting frequency of periods with neutral arm inclination. It explained 56% of the variance in the postural exposure, and its SE was 5.6. Bootstrap validation of this model showed similar expected performance in other samples (5th-95th percentile: R2=45-63%; SE=5.1-6.2).

    Conclusions: Observational data had a better ability to predict inclinometer-assessed upper arm exposures than workers’ ratings or administrative data, but they are typically more expensive to obtain. The results encourage comparisons of the cost-efficiency of modeling based on administrative data, workers’ ratings, and observation.

  • 290.
    Heiden, Marina
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Lyskov, Eugene
    University of Gävle, Centre for Musculoskeletal Research.
    Nakata, Minori
    University of Gävle, Centre for Musculoskeletal Research.
    Sahlin, Karin
    Curomed Utbildning, Umeå, Sweden.
    Sahlin, Tore
    Curomed Utbildning, Umeå, Sweden.
    Barnekow-Bergkvist, Margareta
    University of Gävle, Centre for Musculoskeletal Research.
    Evaluation of cognitive behavioural training and physical activity for patients with stress-related illnesses: a randomized controlled study2007In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, no 5, p. 366-373Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the effects of a cognitive behavioural training programme and a physical activity programme for patients with stress-related illnesses. DESIGN: In a randomized controlled study, patients were allocated randomly to 1 of 3 groups, where group 1 participated in a cognitive behavioural training programme, group 2 participated in a physical activity programme, and group 3, the control group, was offered usual care for the course of the study. SUBJECTS: A total of 75 patients participated in the study. They had been on sick leave for at least 50% of the time for between 1 month and 2 years due to stress-related illnesses. METHODS: Measurements of autonomic activity, pressure-pain thresholds and subjective ratings of health and behaviour were made before and after a 10-week intervention period, and at 6 and 12 months after the intervention. RESULTS: Minor differences in autonomic activity and pressure-pain thresholds were found between the groups immediately after the intervention. At the 6- and 12-month follow-up assessments, the differences were no longer present. Patients in the cognitive behavioural training group improved their ratings of general health compared with the physical activity group throughout the study. CONCLUSION: The study showed little difference in the effect of cognitive behavioural training and physical activity, compared with usual care, for patients with stress-related illnesses.

  • 291.
    Heiden, Marina
    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.
    Prediction of trunk and upper arm postures in paper mill workers by statistical modelling: an empirical validation study2015In: Proceedings of the 19th Triennial Congress of the International Ergonomics Association, Melbourne 9-14 August 2015 / [ed] Gitte Lindgaard & Dave Moore, 2015Conference paper (Refereed)
  • 292.
    Heiden, Marina
    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.
    Garza, Jennifer
    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. Division of Occupational and Environmental Medicine, UConn Health, Farmington, CT, United States .
    Liv, 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. Centre for Research and Development, Uppsala University/County Council of Gävleborg.
    Wahlström, Jens
    Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
    A comparison of two strategies for building an exposure prediction model2016In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 60, no 1, p. 74-89Article in journal (Refereed)
    Abstract [en]

    Cost-efficient assessments of job exposures in large populations may be obtained from models in which “true” exposures assessed by expensive measurement methods are estimated from easily accessible and cheap predictors. Typically, the models are built on the basis of a validation study comprising “true” exposure data as well as an extensive collection of candidate predictors from questionnaires or company data, which cannot all be included in the models due to restrictions in the degrees of freedom available for modeling. In these situations, predictors need to be selected using procedures that can identify the best possible subset of predictors among the candidates. The present study compares two strategies for selecting a set of predictor variables. One strategy relies on stepwise hypothesis testing of associations between predictors and exposure, while the other uses cluster analysis to reduce the number of predictors without relying on empirical information about the measured exposure. Both strategies were applied to the same dataset on biomechanical exposure and candidate predictors among computer users, and they were compared in terms of identified predictors of exposure as well as the resulting model fit using bootstrapped resamples of the original data. The identified predictors were, to a large part, different between the two strategies, and the initial model fit was better for the stepwise testing strategy than for the clustering approach. Internal validation of the models using bootstrap resampling with fixed predictors revealed an equally reduced model fit in resampled datasets for both strategies. However, when predictor selection was incorporated in the validation procedure for the stepwise testing strategy, the model fit was reduced to the extent that both strategies showed similar model fit. Thus, the two strategies would both be expected to perform poorly with respect to predicting biomechanical exposure in other samples of computer users.

  • 293.
    Heiden, Marina
    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.
    Toomingas, Allan
    Karolinska Institutet, institut of Environmental Medicine, Stockholm, Sweden.
    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.
    Forsman, Mikael
    Karolinska Institutet, Institute of Public Health Sciences, Stockholm, Sweden.
    Determinants of variation in gross physical activity during customer contact centre work. (Poster)2010In: Premus 2010 (Seventh International Conference on Prevention of Work-Related Musculoskeletal Disorders), 2010Conference paper (Refereed)
  • 294.
    Heiden, Marina
    et al.
    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.
    Widar, Linda
    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.
    Wiitavaara, Birgitta
    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.
    Boman, Eva
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Psychology.
    Telecommuting in academia – associations with health and well-being among staff2019In: Higher Education, ISSN 0018-1560, E-ISSN 1573-174XArticle in journal (Refereed)
  • 295.
    Heiden, Marina
    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.
    Widar, Linda
    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.
    Wiitavaara, Birgitta
    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.
    Boman, Eva
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Psychology.
    Telecommuting in academia – Associations with staff’s health and well-being2018In: Proceedings of the 20th Congress of the International Ergonomics Association (IEA 2018): Volume IX: Aging, Gender and Work, Anthropometry, Ergonomics for Children and Educational Environments / [ed] Bagnara S., Tartaglia R., Albolino S., Alexander T., Fujita Y., Cham: Springer, 2018, p. 308-312Conference paper (Refereed)
    Abstract [en]

    The ability to telecommute has changed working life for staff at universities and colleges. Although the opportunity to work away from the office at any time gives workers more freedom to manage their work, it also imposes higher demands on workers to set limits to their work. The aim of this ongoing study is to determine if there is an optimal amount of telecommuting for male and female academics with respect to perceived health, work stress, recovery, work-life balance, and work motivation. A web-based survey is currently being conducted among lecturers and professors at Swedish universities and colleges. Results so far show that perceived fatigue and stress associated with indistinct organization and conflicts are higher among academics that telecommute to a larger extent. The results also show that female academics are more fatigued and stressed at work than male academics, but this does not seem to be related to the extent of telecommuting performed.

  • 296.
    Heiden, Marina
    et al.
    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.
    Zetterberg, Camilla
    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.
    Lindberg, Per
    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.
    Nylén, Per
    Swedish Work Environment Authority, Stockholm, Sweden.
    Hemphälä, Hillevi
    Division of Ergonomics and Aerosoltechnology, Design Sciences, Lund University, Lund, Sweden.
    Validity of a computer-based risk assessment method for visual ergonomics2019In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 72, p. 180-187Article in journal (Refereed)
    Abstract [en]

    Objective

    To describe the development of a computer-based risk assessment method for visual ergonomics, and assess its face validity, content validity, and internal consistency.

    Methods

    The risk assessment method contained a questionnaire for the worker, an evaluation form for the evaluator, a section of follow-up questions based on the worker's responses, and a section for recommended changes, including an overall risk assessment with respect to daylight, lighting, illuminance, glare, flicker, work space, work object and work postures, respectively. Forty-eight trained evaluators used the method to perform 224 workplace evaluations. Content validity of the method was assessed by the completeness and distribution of responses, and internal consistency was assessed by Cronbach's alpha, Spearman's rank correlation between items and indices, and exploratory factor analysis.

    Results

    The proportion of missing values in items was generally low (questionnaire: 0–2.3%; evaluation form: 1.4–4.1%). In the questionnaire, items about double vision, migraine and corrective lenses had limited information content. Cronbach's alpha and item-index correlations for the indices frequency of eyestrain, intensity of eyestrain, visual symptoms, lighting conditions, frequency of musculoskeletal discomfort and intensity of musculoskeletal discomfort were satisfactory. Based on the factor analysis, suggestions for improving some of the indices were made.

    Conclusion

    Our findings suggest that this computer-based method is a valid instrument for assessing risks in the visual work environment. By incorporating subjective ratings by the worker as well as objective measurements of the work environment, it provides a good basis for recommendations with respect to daylight, lighting, work surfaces/material, and work object.

    Relevance to industry

    Visual environment factors, such as glare, can cause eyestrain, headache and musculoskeletal discomfort. This method satisfies the need of a valid tool for determining risks associated with the visual work environment. It contains both worker's ratings and objective measurements, and is designed to be used in different types of work.

  • 297.
    Heiden, Marina
    et al.
    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.
    Zetterberg, Camilla
    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.
    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.
    Trunk and upper arm postures in paper mill work2019In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 70, p. 90-96Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to assess postures andmovements of the trunk and upper arm during paper mill work, and to determinethe extent to which they differ depending on method of assessment. For each oftwenty-eight paper mill workers, postures and movements were assessed duringthree full shifts using inclinometer registration and observation from video. Summary metrics for each shift, e.g.,10th, 50th, and 90th posture percentile, were averagedacross shifts and across workers. In addition, the standard deviation between workers,and the standard deviation between shifts within worker were computed. The resultsshowed that trunk and arm postures during paper mill work were similar to otheroccupations involving manual materials handling, but the velocity of armmovements were lower. While postures determined by inclinometry and observationwere similar on a group level, substantial differences were found betweenresults obtained by the two methods for individual workers, particularly for extremepostures. Thus, measurements by either method on individuals or small groupsshould be interpreted with caution.

  • 298.
    Helgadottir, Bjorg
    et al.
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Berze Liusvag 3, S-17177 Stockholm, Sweden..
    Narusyte, Jurgita
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Berze Liusvag 3, S-17177 Stockholm, Sweden..
    Ropponen, Annina
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Berze Liusvag 3, S-17177 Stockholm, Sweden.;Finnish Inst Occupat Hlth, Helsinki, Finland..
    Bergström, Gunnar
    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. Karolinska Inst, Inst Environm Med, Intervent & Implementat Res Worker Hlth Unit, Stockholm, Sweden.;Univ Gavle, Ctr Musculoskeletal Res, Dept Occupat & Publ Hlth Sci, Gavle, Sweden..
    Mather, Lisa
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Berze Liusvag 3, S-17177 Stockholm, Sweden..
    Blom, Victoria
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Berze Liusvag 3, S-17177 Stockholm, Sweden.;Swedish Sch Sport & Hlth Sci, Stockholm, Sweden..
    Svedberg, Pia
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Berze Liusvag 3, S-17177 Stockholm, Sweden..
    The role of occupational class on the association between sickness absence and disability pension: A Swedish register-based twin study2019In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 6, p. 622-630Article in journal (Refereed)
    Abstract [en]

    Objectives The aim of this study was to examine the association between long-term sickness absence (LTSA) due to mental disorders and musculoskeletal disorders and all-cause disability pension (DP) among blue- and white-collar workers. A secondary objective was to examine the influence of familial factors on the associations. Methods This was a prospective twin cohort study of 42 984 individuals (21-64 years at baseline), 3017 of whom had a new LTSA spell (>14 days) due to mental or musculoskeletal disorders in 2005-2006. Average follow-up time was 5.4 years. Survey data on occupational class and register data on LTSA and DP were used. Cox proportional hazards regression was applied to calculate hazards ratios (HR) with 95% confidence intervals (CI). Results During follow-up, 989 participants went on disability. LTSA due to mental disorders and musculoskeletal disorders led to similar HR for DP among both white- and blue-collar workers when compared to white-collar workers not on LTSA (reference group). LTSA >= 6 months due to musculoskeletal disorders was associated with a higher risk of DP for white-collar (HR 31.50, 95% CI 20.45-48.52) than blue-collar (HR 17.64, 95% CI 13.08-23.78) workers when compared to the reference group. HR were lower in the discordant twin pair models for LTSA due to mental disorders than in the whole cohort. Conclusions White-collar workers on LTSA due to musculoskeletal disorders are especially vulnerable to all-cause DP. This pattern was not present for LTSA due to mental disorders. Familial factors seem to influence the association between LTSA due to mental disorders and all-cause DP.

  • 299.
    Helgadóttir, Björg
    et al.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Svedberg, Pia
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Mather, Lisa
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Lindfors, Petra
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Bergström, Gunnar
    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. Unit of Intervention and Implementation Research for Worker Health, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Blom, Victoria
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    The association between part-time and temporary employment and sickness absence: a prospective Swedish twin study2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, no 1, p. 147-153Article in journal (Refereed)
    Abstract [en]

    Background: Sickness absence (SA) is becoming a major economic problem in many countries. Our aim was to investigate whether type of employment, including temporary employment or part-time employment, is associated with SA while controlling for familial factors (genetic and shared environment). Differences between men and women and across employment sectors were explored.

    Methods: This is a prospective twin study based on 21 105 twins born in Sweden 1959-85. The participants completed a survey in 2005 with follow-up of SA (≥15 days), using register data, until end of 2013. The data were analyzed with logistic regression, with results presented as odds ratios (OR) with 95% confidence intervals (CI).

    Results: Temporary employment involved higher odds of SA (OR=1.21 95% CI=1.04-1.40) compared to full-time employment. Both part-time workers (OR=0.84 95% CI=0.74-0.95) and the self-employed (OR=0.77 95%CI=0.62-0.94) had lower odds of SA. Stratifying by sex showed lower odds for part-timers (OR=0.82 95% CI=0.73-0.94) and self-employed women (OR=0.65 95% CI=0.47-0.90), but higher odds for men in temporary employment (OR=1.33 95% CI=1.03-1.72). Temporary employees in county councils (OR=1.73 95% CI=1.01-2.99) and municipalities (OR=1.41 95% CI=1.02-1.96) had higher odds while part-timers employed in the private sector had lower odds (OR=0.77 95% CI=0.64-0.93). Familial factors did not confound the association between employment type and SA.

    Conclusions: Employment type is associated with SA, with temporary employment involving a higher risk compared to permanent full-time employment while both part-time employment and self-employment involved a lower risk. The associations vary between women and men and across sectors.

  • 300.
    Hellström, Fredrik
    University of Gävle, Centre for Musculoskeletal Research.
    Arbete med högrepetitiva rörelser2008In: Arbetslivsfysiologi / [ed] Allan Toomingas, Svend Erik Mathiassen, Ewa Wigaeus Tornqvist, Lund: Studentlitteratur AB , 2008, p. 161-190Chapter in book (Other academic)
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