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  • 601.
    Richter, J M
    et al.
    Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands.
    Slijper, H P
    Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences. University of Gävle, Centre for Musculoskeletal Research.
    Over, E A B
    Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands.
    Frens, M A
    Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands.
    The ability of computer activity recordings to estimate mechanical exposures during office work2008In: Proceedings of the International Conference on Ambulatory Monitoring of Physical Activity and Movement. Rotterdam, 2008Conference paper (Other academic)
  • 602.
    Richter, Janneke
    et al.
    Department of Neuroscience, Erasmus MC Rotterdam, the Netherlands.
    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.
    Slijper, Harm
    Department of Neuroscience, Erasmus MC Rotterdam, the Netherlands.
    Frens, Maarten
    Department of Neuroscience, Erasmus MC Rotterdam, the Netherlands.
    Differences in muscle load between computer and non-computer work among office workers2010In: Proceedings of the Premus 2010 conference, 2010, p. 272-Conference paper (Refereed)
  • 603.
    Richter, Janneke
    et al.
    University of Gävle, Centre for Musculoskeletal Research. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences. Department of Neuroscience Erasmus MC, Rotterdam, Netherlands.
    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.
    Slijper, Harm P.
    Department of Neuroscience Erasmus MC, Rotterdam, Netherlands.
    Over, Eelco A. B.
    Department of Neuroscience Erasmus MC, Rotterdam, Netherlands.
    Frens, Maarten
    Department of Neuroscience Erasmus MC, Rotterdam, Netherlands.
    Differences in muscle load between computer and non-computer work among office workers2009In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 52, no 12, p. 1540-1555Article in journal (Refereed)
    Abstract [en]

    Introduction of more non-computer tasks has been suggested to increase exposure variation and thus reduce musculoskeletal complaints (MSC) in computer-intensive office work. This study investigated whether muscle activity did, indeed, differ between computer and non-computer activities. Whole-day logs of input device use in 30 office workers were used to identify computer and non-computer activities, using a range of classification thresholds (NCTs). Exposure during these activities was assessed by bilateral electromyography recordings from the upper trapezius and lower arm. Contrasts in muscle activity between computer and noncomputer activities were distinct but small, even at the individualized, optimal NCT. Using an average groupbased NCT resulted in less contrast, also if stratified by subgroups (job function, MSC). Computer activity logs should be used cautiously as proxies of biomechanical exposure. Conventional non-computer tasks may have a limited potential to increase exposure variation in computer-intensive office work.

  • 604. Order onlineBuy this publication >>
    Rissén, Dag
    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. Centrum för forskning och utveckling, Uppsala universitet/Landstinget Gävleborg.
    Psykosocial arbetsmiljö och (o)hälsa: ett biopsykosocialt stressperspektiv2014In: Hälsa, livsmiljö och arbetsliv: ur ett socialt arbete-perspektiv / [ed] Fereshteh Ahmadi & Sam Larsson, Gävle: Gävle University Press , 2014, p. 17-42Chapter in book (Other academic)
  • 605.
    Rissén, Dag
    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. Centre for Research & Development, Uppsala University/Region of Gävleborg, Gävle, Sweden.
    Fjellman-Wiklund, Annchristine
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Röijezon, Ulrik
    Department of Health Science, Luleå University of Technology.
    Prevalence, intensity, and playing related consequences of musculoskeletal pain, and associations with mood among professional orchestra musicians: a pilot study2015Conference paper (Refereed)
    Abstract [en]

    Title: Prevalence, intensity, and playing related consequences of musculoskeletal pain, and associations with mood among professional orchestra musicians – a pilot study

    Aim: The aim of this cross-sectional study was to examine the 7-day prevalence, intensity, and consequences of musculoskeletal pain in the upper part of the body among professional musicians. Additional aims were to examine subjective mood and associations between mood and pain.

    Methods: This study is part of an ongoing national survey on musculoskeletal health conditions among professional musicians in Swedish symphony and opera orchestras. The data of this report is collected from two orchestras. Seventy-eight musicians (80%) participated, aged 45 ±9.6 years and 41% women. Results: Eighty percent of the musicians reported pain during the last 7 days. Pain was most frequent in the neck (59%) and the right shoulder (36%). The intensity of pain (11-point scale) was highest in the neck (mean 2.7, SD 1.8) and in the right hand (mean 2.7, SD 1.9). Playing related consequences were particularly related to pain in the left (71%) and right (54%) hands, and pain located to the left upper extremity did relatively more often affect playing performance compared to right side pain. Mood ratings showed that the musicians to a higher degree experienced “positive mood” (stimulated, concentrated, happy) compared to “negative mood” (stressed, exhausted, tense, nervous/anxious). Significant positive correlations were found between neck pain and stressed (rho=0.501, p=.000); neck pain and exhausted (rho=0.318, p=0.033); neck pain and tense (rho=0.314, p=0.034); and neck pain and nervous/anxious (rho=0.346, p=0.019). Significant correlations were not found between mood and pain in any other body region, except for a positive correlation between right shoulder and exhausted (rho=0.384, p=0.048).

    Conclusion: These preliminary results show a high 7-day prevalence of pain among professional musicians, especially in the neck. Left upper extremity and left and right hand pain needs special clinical attention due to high impact on playing performance. The results concerning associations between perceived “negative mood” and neck pain are supported by earlier findings (1,2) but need further exploration.

  • 606.
    Ristiniemi, Heli
    et al.
    Stress Clinic, Stockholm, Sweden.
    Perski, Aleksander
    Stress Research Institute Stockholm University, Stockholm, Sweden.
    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.
    Emtner, Margareta
    Department of Medical Sciences and Neuroscience Uppsala University, Uppsala, Sweden.
    Hyperventilation and exhaustion syndrome2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 4, p. 657-664Article in journal (Refereed)
    Abstract [en]

    Chronic stress is among the most common diagnoses in Sweden, most commonly in the form of exhaustion syndrome (ICD-10 classification – F43.8). The majority of patients with this syndrome also have disturbed breathing (hyperventilation). The aim of this study was to investigate the association between hyperventilation and exhaustion syndrome. Thirty patients with exhaustion syndrome and 14 healthy subjects were evaluated with the Nijmegen Symptom Questionnaire (NQ). The participants completed questionnaires about exhaustion, mental state, sleep disturbance, pain and quality of life. The evaluation was repeated 4 weeks later, after half of the patients and healthy subjects had engaged in a therapy method called ‘Grounding’, a physical exercise inspired by African dance. The patients reported significantly higher levels of hyperventilation as compared to the healthy subjects. All patients’ average score on NQ was 26.57 ± 10.98, while that of the healthy subjects was 15.14 ± 7.89 (t = −3.48, df = 42, p < 0.001). The NQ scores correlated strongly with two measures of exhaustion (Karolinska Exhaustion Scale KES r = 0.772, p < 0.01; Shirom Melamed Burnout Measure SMBM r = 0.565, p < 0.01), mental status [Hospital Anxiety and Depression Score (HADS) depression r = 0.414, p < 0.01; HADS anxiety r = 0.627, p < 0.01], sleep disturbances (r = −0.514, p < 0.01), pain (r = −.370, p < 0.05) and poor well-being (Medical Outcomes Survey Short Form 36 questionnaire- SR Health r = −0.529, p < 0.05). In the logistic regression analysis, the variance in the scores from NQ were explained to a high degree (R2 = 0.752) by scores in KES and HADS. The brief Grounding training contributed to a near significant reduction in hyperventilation (F = 2.521, p < 0.124) and to significant reductions in exhaustion scores and scores of depression and anxiety. The conclusion is that hyperventilation is common in exhaustion syndrome patients and that it can be reduced by systematic physical therapy such as Grounding.

  • 607.
    Riva, Roberto
    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. Department of Psychology, Stockholm University, Stockholm, Sweden.
    Mork, Paul Jarle
    Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
    Westgaard, Rolf H
    Department of Industrial Economics and Technology Management, Norwegian University of Science and Technology, Trondheim, Norway.
    Lundberg, Ulf
    Department of Psychology, Stockholm University, Stockholm, Sweden; CHESS (Centre for Health Equity Studies), Stockholm University, Stockholm, Sweden.
    Comparison of the Cortisol Awakening Response in Women with Shoulder and Neck Pain and Women with Fibromyalgia2012In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 37, no 2, p. 299-306Article in journal (Refereed)
    Abstract [en]

    Shoulder and neck pain (SNP) and fibromyalgia syndrome (FMS), two musculoskeletal conditions of unknown pathogenesis, share some common features in terms of altered neuroendocrine responses, pain and stress perception. However, the pain distribution in SNP is localized, whereas in FMS is more widespread. Because regional musculoskeletal pain may represent an intermediate stage along a continuum towards widespread musculoskeletal pain we compared the cortisol awakening response (CAR) in women with SNP with the CAR in FMS patients and healthy controls (HC) in a controlled hospital-hotel setting. The aim of the study was to investigate whether SNP is related to a deviant regulation of the hypothalamic-pituitary-adrenal (HPA) axis. Eighteen women with SNP, 29 female FMS patients, and 27 female HC participated in the study. Cortisol samples were collected upon awakening, 30 and 60 min later. Questionnaires measuring pain levels, sleeping problems, perceived stress, and psychological characteristics were administered to the participants. Compared with HC, women with SNP had a tendency towards higher cortisol levels, whereas FMS had lower cortisol levels. Adjustment for potential confounders did not influence the results. Women with SNP and FMS patients reported more health complaints, pain, and perceived stress than the HC, but women with SNP were less affected than the FMS patients. Women with SNP showed a tendency towards an elevated HPA axis activity compared with HC. The current findings may indicate that the hypercortisolism in regional musculoskeletal pain represent an intermediate stage towards the development of a hypocortisolism in widespread musculoskeletal pain.

  • 608.
    Rolfer, Bengt
    et al.
    Rolfer media & kommunikation.
    Mathiassen, Svend ErikUniversity of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.Vingård, EvaArbets- och miljömedicin, Uppsala universitet.
    Forskning i fara?: Forskarna själva om dagens svenska arbetsmiljöforskning2012Collection (editor) (Other (popular science, discussion, etc.))
  • 609.
    Rolfer, Bengt
    et al.
    Rolfer media & kommunikation.
    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.
    Vingård, Eva
    Arbets- och miljömedicin, Uppsala universitet.
    Vart är Sveriges arbetsmiljöforskning på väg?2012In: Forskning i fara?: Forskarna själva om dagens svenska arbetsmiljöforskning / [ed] Bengt Rolfer, Svend Erik Mathiassen, Eva Vingård, Gävle: Gävle University Press , 2012Chapter in book (Other (popular science, discussion, etc.))
  • 610.
    Rolfö, L.
    et al.
    Department of Ergonomics, KTH Royal Institute of Technology, Huddinge, 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.
    Järvholm, L. S.
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Öhrn, M.
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Babapour, M.
    Department of Industrial and Materials Science, Chalmers University of Technology, Gothenburg, Sweden.
    Predictors of Preference for the Activity-based Flexible Office2019In: Human Systems Engineering and Design: Proceedings of the 1st International Conference on Human Systems Engineering and Design (IHSED2018) / [ed] Tareq Ahram, Waldemar Karwowski, and Redha Taiar, Cham: Springer, 2019, p. 547-553Conference paper (Refereed)
    Abstract [en]

    Activity-based Flexible Offices (A-FOs) are implemented with varying degree of success. Employees relocate from cell or open-plan offices, from different organizational backgrounds, varying design and implementation processes, and have different types of work tasks. This study aims at investigating whether preference for the A-FO correlate with these preconditions. The results from Chi-square tests and Spearman’s non-parametric correlation of post-relocation questionnaires distributed to 11 A-FO sites, showed that a high preference for the A-FO correlated strongest with an A-FO preference prior to relocation, being a former open-plan office occupier and with frequent performance of innovation. Low preference for the A-FO correlated with frequent performance of concentration demanding tasks. Working with tasks with high confidentiality did not predict the preference ratings.

  • 611.
    Rolfö, Linda
    et al.
    Unit of Ergonomics, School of Technology and Health, KTH, Stockholm, Sweden.
    Eklund, Jörgen
    Unit of Ergonomics, School of Technology and Health, KTH, Stockholm, 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.
    Perceptions of performance and satisfaction after relocation to an activity-based office2018In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 61, no 5, p. 644-657Article in journal (Refereed)
    Abstract [en]

    Many companies move from open-plan offices (OPO) to activity-based workplaces (ABWs). However, few studies examine the benefits and drawbacks following such a change. The aim of this study was to explore how physical conditions, office use, communication, privacy, territoriality, satisfaction and perceived performance change following a company's relocation from an OPO to an ABW. A mixed methods approach included pre- and post-relocation questionnaires and post-relocation focus groups, individual interviews and observations. The questionnaires enabled comparisons over time (n = 34) and broader analyses based on retrospective ratings of perceived change (n = 66). Results showed that satisfaction with auditory privacy, background noise, air quality, outdoor view and aesthetics increased significantly after relocation. Negative outcomes, such as lack of communication within teams, were perceived as being due to the high people-to-workstation ratio and lack of rules. Overall satisfaction with the physical work environment increased in the ABW compared to the OPO. Perceived performance did not change significantly. Practitioner Summary: Activity-based workplaces (ABWs) are commonly implemented although their effects on performance and well-being are unclear. This case study gives advice to stakeholders involved in office planning. Despite shortcomings with the people-to-workstation ratio and rules, employees showed improved satisfaction with auditory privacy and aesthetics in the ABW compared with the previous open-plan office.

  • 612.
    Ross, Alastair B
    et al.
    Department of Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Sweden; Nestlé Research Center, Lausanne, Switzerland.
    Johansson, Åsa
    Department of Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Sweden.
    Vavruch-Nilsson, Veronika
    Department of Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Sweden.
    Hassler, Sven
    Southern Lappland Research Department, Vilhelmina, Sweden.
    Sjölander, Per
    University of Gävle, Centre for Musculoskeletal Research. Southern Lappland Research Department, Vilhelmina, Sweden.
    Edin-Liljegren, Anette
    Southern Lappland Research Department, Vilhelmina, Sweden.
    Gyllensten, Ulf
    Department of Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Sweden.
    Adherence to a traditional lifestyle affects food and nutrient intake among modern Swedish Sami2009In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 68, no 4, p. 372-385Article in journal (Refereed)
    Abstract [en]

    Objectives. To compare the nutrient and food intake of Sami still engaged in reindeer herding (traditional lifestyle or reindeer-herding Sami [RS]) and Sami not involved in reindeer herding (industrialized lifestyle or non-reindeer-herding Sami [NRS]) with other northern Swedish populations. Study design. Cross-sectional analysis of data from a prospective cardiovascular intervention program in northern Sweden. Methods. Data were used from a prospective cardiovascular intervention program in northern Sweden. Sami recruited into this study were divided according to whether they were involved in reindeer herding (traditional lifestyle, RS) (66 females, 79 males) or not (NRS) (255 females, 195 males), and compared to non-Sami from the same area taking part in the same study (controls) (499 females, 501 males). Subjects completed a Food Frequency Questionnaire (FFQ) and clinical parameters were analysed. Results. RS had a higher overall intake of energy for both females (P<0.01) and males (P<0.05), but not total food intake compared to controls and NRS. The overall Sami diet was characterized by a higher proportion of energy from protein and fat. RS had a lower energy adjusted intake of vitamins A and E, and fibre, and a higher intake of sodium. RS and NRS both had a lower intake of vegetables and a higher intake of meat, and for RS, fish. Nutrient and food-intake patterns were similar for males and females. Conclusions. Classification of Sami into RS and NRS indicates that a traditional lifestyle defined by occupation is reflected in differences in food and nutrient intake.

  • 613.
    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. Umeå universitet, Sjukgymnastik.
    Sensorimotor control and cervical range of motion in women with chronic neck pain: Kinematic assessments and effects of neck coordination exercise2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: Neck pain is a common problem in society and is more prevalent among women. The consequences of neck pain for the individual often include activity and participation limitations, thus affecting many dimensions of life. There is still a lack of understanding of the underlying mechanisms of the disorder and likewise of efficient rehabilitation for people with neck pain. However, coordination exercises have shown promising short-term effects. To carry this line of research forward, there is a need to improve methods for objective characterization of impairments and to investigate novel methods of rehabilitation.

    Aims: To characterize impairments of active cervical range of motion of the upper and lower cervical levels in women with chronic neck pain with a novel method (Study I and II) and identify the influence of head posture and movement strategies (Study II). Further, to investigate the effects of a novel method for neck coordination exercise on sensorimotor function and neck pain (study III) and the consistencies of motor variability metrics in a goal directed arm movement task to aid the design of future clinical research (Study IV).

    Methods: All studies were laboratory based with kinematic assessments of neck movements (Study I-III), balance (Study III) and goal directed arm movements (Study III, IV). The studies had designs that were: cross-sectional (I and II), randomized controlled trial (III) or test-retest reliability study (IV). Participants in Study I (n=135) and II (n=160) were women with chronic non-specific neck pain and healthy controls. In Study III, women with chronic non-specific neck pain (n=108) were randomized into three different individually supervised 11 week interventions. Study IV included healthy women (n=14).

    Results: It was found that cervical range of motion impairments in women with non-specific neck pain were direction- and level-specific; impairments were greater in extension in the upper and flexion in the lower levels of the cervical spine. The magnitude of impairments in range of motion was associated to self-ratings of functioning and health. Possible group differences in natural head posture were rejected as a cause for the direction specific effects. Neither could the effects be explained by a strategy to minimize torque in the cervical spine during movement execution. The neck coordination training was not superior to strength training (best-available) and massage treatment (sham) in improving sensorimotor functions or pain according to short-term and 6 months follow ups. The results from the study of the goal directed movement task showed that between and within-subject sizes of most motor variability metrics were too large to make the test suitable for application in clinical research.

    Conclusions: Women with chronic non-specific neck pain have direction- and level-specific impairments in cervical sagittal range of motion. The underlying causes of these specific impairments remains unresolved, but the direction specific impairments are not related to natural head posture. The clinical validity of the method of characterization of cervical range of motion was supported and it can be useful in future clinical research. The novel method of neck coordination exercise showed no advantages on sensorimotor functions or pain compared with best-available treatment in women with chronic non-specific neck pain.

  • 614.
    Rudolfsson, Thomas
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Range of motion in the upper and lower cervical spine in people with chronic neck pain2012In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 17, no 1, p. 53-59Article in journal (Refereed)
    Abstract [en]

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

  • 615.
    Rudolfsson, Thomas
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Range of motion in the upper and lower cervical spine in people with chronic neck pain2010In: The XVIII Congress of the International Society of Electrophysiology and Kinesiology (ISEK), Aalborg, Denmark, 2010Conference paper (Refereed)
    Abstract [en]

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

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

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

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

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

  • 616.
    Rudolfsson, Thomas
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Svedmark, Åsa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Srinivasan, Divya
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Direction-specific impairments in cervical range of motion in women with chronic neck pain: influence of head posture and gravitationally induced torque2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 1, article id e0170274Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 617.
    Rudolfsson, Thomas
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Umeå universitet.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Häger, Charlotte
    Umeå universitet.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Umeå universitet, Alfta Research Foundation.
    Effects of neck coordination exercise on sensorimotor function in chronic neck pain: a randomized controlled trial2014In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 9, p. 908-914Article in journal (Refereed)
    Abstract [en]

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

  • 618.
    Rudolfsson, Thomas
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Domkin, Dmitry
    University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Is neck pain associated with altered body sway kinematics?2009In: Sjukgymnastdagarna, Stockholmsmässan i Älvsjö, Stockholm: Legitimerade Sjukgymnasters Riksförbund, Stockholm , 2009, p. -40Conference paper (Other academic)
    Abstract [en]

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

  • 619.
    Röijezon, Ulrik
    University of Gävle, Centre for Musculoskeletal Research.
    Sensorimotor function in chronic neck pain: objective assessments and a novel method for neck coordination exercise2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Chronic neck pain is a widespread problem that causes individual suffering as well as large costs for the society. The knowledge about the pathophysiology is poor and therefore specific diagnosis and causal treatment are rare. Important knowledge for characterization of the disorders has been gained from research on sensorimotor functions in people with neck pain. Moreover, rehabilitation regimes including sensorimotor exercises indicate promising results. The main objectives of this thesis were to extend the knowledge on sensorimotor dysfunctions in chronic neck pain, and to develop a new exercise method for improving sensorimotor functions of the neck. The studies focused on aspects of postural control and movements of the arm and neck. These are vital functions for many activities of daily living. People with chronic (>3 months) neck pain were compared to healthy controls (CON). Neck pain related to trauma was referred to as whiplash associated disorders (WAD), while neck pain without association to trauma was referred to as non-specific (NS). Arm-functioning was assessed in a pointing task. WAD and NS had reduced pointing precision compared to CON. The reduced precision was associated with self-rated difficulties performing neck movements, physical functioning, and in WAD, also pain and balance disturbances. Postural control was assessed in quiet standing on a force platform without vision. The center of pressure signal was decomposed into it’s slow and fast components. WAD and NS were compared to CON. The results revealed an effect of age on the magnitude of the fast sway component, but no effect of group. The magnitude of the slow component was elevated in both WAD and NS. This increase was associated with self-rated balance disturbance, arm-functioning, difficulties to run and sensory alterations in WAD, while in NS, the increase in the slow sway component was associated with concurrent low back pain. Neck movements were assessed in a cervical axial rotation test with maximal speed. In total 8 variables representing basic kinematics, including variables reflecting movement smoothness and conjunct motions were calculated. NS were compared to CON. Linear discriminant modelling indicated Peak Speed and conjunct motions as significant classification variables that together had a sensitivity of 76.3% and specificity of 77.6%. Retest reliability was good for Peak Speed but poor for the measure of conjunct motions. Peak Speed was slower in NS compared to CON, and even slower in a sub-group of NS with concurrent low back pain. Reduced Peak Speed was associated with self-rated difficulties performing neck movements, car driving, running, sleeping disturbances and pain. The clinical applicability of a novel method for neck coordination exercise was assessed in a pilot study on persons with NS. The results supported the applicability and indicated positive effects of the exercise: reduced postural sway in quiet standing and increased smoothness in cervical rotations. Indications on improvement in self-rated disability and fear of movement were seen at six months follow up. In conclusion, sensorimotor functions can be altered in chronic neck pain, particularly in neck disorders with concurrent low back pain and WAD. The discriminative ability and clinical validity displayed in pointing precision, postural sway and cervical axial rotation speed imply that such tests can be valuable tools in the assessment of chronic neck pain patients, and for selecting and evaluating treatment interventions. Indications of improvements seen in the pilot-study support a future RCT.

  • 620.
    Röijezon, Ulrik
    et al.
    Department of Health Science, Luleå University of Technology.
    Ardel, Dag
    Department of Community Medicine & Rehabilitation, Physiotherapy, Umeå University.
    Rissén, Dag
    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 & Development, Uppsala University/Region of Gävleborg, Gävle, Sweden.
    Juul-Kristensen, Birgit
    Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark.
    Generalised Joint Hypermobility and musculoskeletal pain among professional classical orchestra musicians in Sweden: a pilot study2015Conference paper (Refereed)
    Abstract [en]

    Aims: The aims were to 1) investigate the presence of Generalised Joint Hypermobility (GJH) and musculoskeletal pain among musicians in professional Swedish symphony and opera orchestras, and 2) investigate associations between GJH and musculoskeletal pain.

    Methods: A Swedish version of the 5-part questionnaire [1] and the standardised Nordic questionnaire for musculoskeletal pain disorders [2] were included in an ongoing national survey on musculoskeletal health conditions among professional orchestra musicians in Sweden. The data of this report is collected from two orchestras. Seventy-eight musicians (80%) participated, aged 45 ±9.6 years with 41% women.

    Results: At present, 77 participants completed the 5-part questionnaire, of which 19.5% (28% of the women and 13% of the men) scored two or more on the 5-part questionnaire, which is the criteria for GJH. Pain prevalence during the last 12 months was highest for the neck (73.7%) and lowest for the left and right elbows (15.6% and 16.9%, respectively) (Table 1). Binary logistic regressions revealed that hypermobility was associated with increased risk for pain conditions at the neck (Odds Ratio 5.64, p=0.005) and the left and the right hand (Odds Ratio 1.80, p=0.019 and Odds Ratio 1.68, p=0.032, respectively) (Table 1).

    Discussion/Conclusion: Previous studies have reported various results regarding hypermobility and association with musculoskeletal pain conditions, including both increased and reduced risk [3- 5]. Our study shows increased risk of pain located to the neck and both hands among musicians with GJH, while no significant increased or decreased risks were seen for the other body parts. However, larger groups of musicians should confirm the influence of GJH on musculoskeletal pain, and whether it differs between men and women and between groups of instruments. The current preliminary results may indicate that GHJ among musicians should be identified and preventive strategies be recommended, e.g., regarding pauses, posture and physical exercises.

  • 621.
    Röijezon, Ulrik
    et al.
    University of Gävle, Centre for Musculoskeletal Research. Department of Community Medicine and Rehabilitation, Physiotherapy, University of Umeå, Umeå, Sweden; Alfta Research Foundation, Alfta, Sweden.
    Björklund, Martin
    University of Gävle, Centre for Musculoskeletal Research. Alfta Research Foundation, Alfta, Sweden.
    Bergenheim, Mikael
    University of Gävle, Centre for Musculoskeletal Research. Department of Surgery, Central Hospital Karlstad, Karlstad, Sweden.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    A novel method for neck coordination exercise: a pilot study on persons with chronic non-specific neck pain2008In: Journal of NeuroEngineering and Rehabilitation, ISSN 1743-0003, E-ISSN 1743-0003, Vol. 5, article id 36Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Chronic neck pain is a common problem and is often associated with changes in sensorimotor functions, such as reduced proprioceptive acuity of the neck, altered coordination of the cervical muscles, and increased postural sway. In line with these findings there are studies supporting the efficacy of exercises targeting different aspects of sensorimotor function, for example training aimed at improving proprioception and muscle coordination. To further develop this type of exercises we have designed a novel device and method for neck coordination training. The aim of the study was to investigate the clinical applicability of the method and to obtain indications of preliminary effects on sensorimotor functions, symptoms and self-rated characteristics in non-specific chronic neck pain METHODS: The study was designed as an uncontrolled clinical trial including fourteen subjects with chronic non-specific neck pain. A new device was designed to allow for an open skills task with adjustable difficulty. With visual feedback, subjects had to control the movement of a metal ball on a flat surface with a rim strapped on the subjects' head. Eight training sessions were performed over a four week period. Skill acquisition was measured throughout the intervention period. After intervention subjects were interviewed about their experience of the exercise and pain and sensorimotor functions, including the fast and slow components of postural sway and jerkiness-, range-, position sense-, movement time- and velocity of cervical rotation, were measured. At six-month follow up, self-rated pain, health and functioning was collected. RESULTS: The subjects improved their skill to perform the exercise and were overall positive to the method. No residual negative side-effects due to the exercise were reported. After intervention the fast component of postural sway (p = 0.019) and jerkiness of cervical rotation (p = 0.032) were reduced. The follow up showed decreased disability (one out of three indices) and fear of movement, and increased general health (three out of eight dimensions). CONCLUSION: The results support the clinical applicability of the method. The improvements in sensorimotor functions may suggest transfer from the exercise to other, non-task specific motor functions and justifies a future randomized controlled trial.

  • 622.
    Röijezon, Ulrik
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    A novel method of neck coordination exercise: effects on sensorimotor functions and self reported health and functioning2007In: 15th International WCPT Congress, World Physical Therapy, 2007Conference paper (Refereed)
    Abstract [en]

    INTRODUCTION: The efficacy of exercises targeting sensorimotor functions in treatment of neck pain is increasingly acknowledged. To further develop this type of exercises we have designed a novel device (patent pending) and method for neck coordination training. The purpose of this study was to obtain indications of the usability of the method and its effects on sensorimotor functions, pain and functioning in neck pain patients. METHODS: Subjects with non-traumatic chronic neck pain (n=14) participated in this uncontrolled clinical trial. The neck exercise was an open skills task with adjustable difficulty. With visual feedback, subjects had to control the movement of a metal ball on a flat surface with a rim which was strapped on the subjects’ head. Before and after the intervention (eight sessions), pain ratings, postural sway and jerkiness-, range-, position sense-, movement time- and velocity of cervical rotation were assessed. At six-month follow up self rated pain, health and functioning was collected. RESULTS: Patients were overall positive to the exercise. A significant reduction in postural sway and jerkiness of cervical rotation was revealed after the training. The six-month follow up showed decreased disability and fear of movement, as well as increased general health and well being. CONCLUSION: The results support the clinical applicability of the method. The improved sensorimotor functions suggest transfer from the exercise to more general, non-task specific motor functions. The follow up may indicate a long term beneficial effect.

  • 623.
    Röijezon, Ulrik
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    The slow and fast components of postural sway in chronic neck pain2011In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 16, no 3, p. 273-278Article in journal (Refereed)
    Abstract [en]

    Background: Several studies have reported altered postural control in people with neck pain. The aim of this study was to increase the understanding of the nature of altered postural control in neck pain by studying the slow and fast components of body sway. Methods: Subjects with whiplash associated disorders (WAD, n = 21) and chronic non-specific neck pain (NS, n = 24) were compared to healthy controls (CON, n = 21) in this cross-sectional study. The magnitudes of the slow and fast sway components were assessed in Rhomberg quiet stance for 30 s on a force plate with eyes closed. We also investigated associations between postural sway and symptoms, self-ratings of functioning and kinesiophobia. Results: Increased magnitude of the slow sway component was found in WAD, but not in NS. Greater magnitude of the slow component in WAD was associated with poorer physical functioning, including balance disturbances, and more severe sensory symptoms. Conclusions: Increased magnitude of the slow sway component implies an aberration in sensory feedback or processing of sensory information in WAD. The associations between postural sway and self-rated characteristics support the clinical validity of the test. Further investigation into NS, involving a longer test time is warranted. (C) 2010 Elsevier Ltd. All rights reserved.

  • 624.
    Röijezon, Ulrik
    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. Alfta Research Foundation, Alfta, Sweden.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research. Alfta Research Foundation, Alfta, Sweden.
    Häger-Ross, Charlotte
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Grip, Helena
    Department of Biomedical Engineering & Informatics, University Hospital of Umeå, Umeå, Sweden; Department of Biomedical Engineering and Informatics, University Hospital of Umeå, Umeå, Sweden .
    Liebermann, Dario G.
    Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel.
    Kinematics of fast cervical rotations in persons with chronic neck pain: a cross-sectional and reliability study2010In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 11, article id 222Article in journal (Refereed)
    Abstract [en]

    Background: Assessment of sensorimotor function is useful for classification and treatment evaluation of neck pain disorders. Several studies have investigated various aspects of cervical motor functions. Most of these have involved slow or self-paced movements, while few have investigated fast cervical movements. Moreover, the reliability of assessment of fast cervical axial rotation has, to our knowledge, not been evaluated before. Methods: Cervical kinematics was assessed during fast axial head rotations in 118 women with chronic nonspecific neck pain (NS) and compared to 49 healthy controls (CON). The relationship between cervical kinematics and symptoms, self-rated functioning and fear of movement was evaluated in the NS group. A sub-sample of 16 NS and 16 CON was re-tested after one week to assess the reliability of kinematic variables. Six cervical kinematic variables were calculated: peak speed, range of movement, conjunct movements and three variables related to the shape of the speed profile. Results: Together, peak speed and conjunct movements had a sensitivity of 76% and a specificity of 78% in discriminating between NS and CON, of which the major part could be attributed to peak speed (NS: 226 ± 88°/s and CON: 348 ± 92°/s, p < 0.01). Peak speed was slower in NS compared to healthy controls and even slower in NS with comorbidity of low-back pain. Associations were found between reduced peak speed and self-rated difficulties with running, performing head movements, car driving, sleeping and pain. Peak speed showed reasonably high reliability, while the reliability for conjunct movements was poor. Conclusions: Peak speed of fast cervical axial rotations is reduced in people with chronic neck pain, and even further reduced in subjects with concomitant low back pain. Fast cervical rotation test seems to be a reliable and valid tool for assessment of neck pain disorders on group level, while a rather large between subject variation and overlap between groups calls for caution in the interpretation of individual assessments.

  • 625.
    Samani, Afshin
    et al.
    Center for Sensory-Motor Interaction (SMI), Dept. of Health Science and Technology, Aalborg University.
    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.
    Madeleine, Pascal
    Center for Sensory-Motor Interaction (SMI), Dept. of Health Science and Technology, Aalborg University.
    Cluster-based EVA: an alternative approach for quantification of exposure variation2013In: Eighth International Conference on Prevention of Work-related Musculoskeletal Disorders; Abstracts, 2013, p. 219-Conference paper (Refereed)
  • 626.
    Samani, Afshin
    et al.
    Center for Sensory Motor Interaction, Department of Health Science and Technology, Aalborg University.
    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.
    Madeleine, Pascal
    Center for Sensory Motor Interaction, Department of Health Science and Technology, Aalborg University.
    Cluster-based exposure variation analysis2013In: BMC Medical Research Methodology, ISSN 1471-2288, E-ISSN 1471-2288, Vol. 13, p. 54-54Article in journal (Refereed)
    Abstract [en]

    Background: Static posture, repetitive movements and lack of physical variation are known risk factors for work-related musculoskeletal disorders, and thus needs to be properly assessed in occupational studies. The aims of this study were (i) to investigate the effectiveness of a conventional exposure variation analysis (EVA) in discriminating exposure time lines and (ii) to compare it with a new cluster-based method for analysis of exposure variation.

    Methods: For this purpose, we simulated a repeated cyclic exposure varying within each cycle between “low” and “high” exposure levels in a “near” or “far” range, and with  “low” or “high” velocities (exposure change rates). The duration of each cycle was also manipulated by selecting a “small” or “large” standard deviation of the cycle time. Theses parameters reflected three dimensions of exposure variation, i.e. range, frequency and temporal similarity. Each simulation trace included two realizations of 100 concatenated cycles with either low (r=0.1), medium (r=0.5) or high (r=0.9) correlation between the realizations. These traces were analyzed by conventional EVA, and a novel cluster-based EVA (C-EVA). Principal component analysis (PCA) was applied on the marginal distributions of 1) the EVA of each of the realizations (univariate approach), 2) a combination of the EVA of both realizations (multivariate approach) and 3) C-EVA. The least number of principal components describing more than 90% of variability in each case was selected and the projection of marginal distributions along the selected principal component was calculated. A linear classifier was then applied to these projections to discriminate between the simulated exposure patterns, and the accuracy of classified realizations was determined.

    Results: C-EVA classified exposures more correctly than uni 1 variate and multivariate EVA approaches; classification accuracy was 49%, 47% and 52% for EVA (univariate and multivariate), and C-EVA, respectively (p<0.001). All three methods performed poorly in discriminating exposure patterns differing with respect to the variability in cycle time duration.

    Conclusion: While C-EVA had a higher accuracy than conventional EVA, both failed to detect differences in temporal similarity. The data-driven optimality of data reduction and the capability of handling multiple exposure time lines in a single analysis are the advantages of the C-EVA.

  • 627.
    Samani, Afshin
    et al.
    Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Denmark.
    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.
    Madeleine, Pascal
    Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Denmark.
    Nonlinear metrics assessing motor variability in a standardized pipetting task: Between- and within-subject variance components2015In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 25, no 3, p. 557-564Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to estimate the between days test-retest reliability of nonlinear metrics used to quantify motor variability in a repetitive precision task. On three separate days, 14 healthy subjects performed pipetting as a general model of repetitive precision tasks. The task consisted of transferring liquid 20 times with a cycle time of 2.8 s from a pickup tube to eight target tubes placed on a table in front of the subjects. The motion of hand, arm and the pipet tip was tracked in 3D and the shoulder elevation and elbow flexion angle were obtained. Motor variability was assessed using nonlinear metrics based on information theory and recurrence quantification analysis. Between- and within- (between-days) subject variance components were computed using a one-way random effect model, and intra-class correlation coefficients (ICC) were calculated from the variance components as standardized measures of reliability. Most of the metrics displayed a considerable between-days variance component and therefore the ICC showed a slight to moderate reliability. The reported data on between- and within-subject variability can be used to design future studies using non-linear motor variability metrics on kinematics data.

  • 628.
    Samani, Afshin
    et al.
    Department of Health Science and Technology, Aalborg University.
    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.
    Madeleine, Pascal
    Department of Health Science and Technology, Aalborg University.
    Variability in patterns of muscular activity during a fatiguing repetitive task2016Conference paper (Refereed)
    Abstract [en]

    Background. Muscle fatigue develops at markedly different rates among individuals. The pattern of variation in muscle activity has been suggested as a determinant of the rate of fatigue development. This variation can occur between muscles or between compart-ments of a muscle. Thus, we investigated the pattern of muscular activity in shoulder and arm regions during a fatiguing repetitive work task.

    Methods. 21 healthy young women performed a repetitive pipetting task at 2.8 seconds/cycle. The session continued until the subject rate of perceived exertion reached 8 on Borg CR-10 scale. High density (HD) surface electromyogram (EMG) over upper trapezius, and bipolar EMG from extensor carpi radialis, flexor carpi radialis, biceps, triceps, deltoi-deus anterior, serratus anterior, upper and lower trapezius were collected to investigate intra- and inter-muscle variation patterns. EMG amplitude and mean power frequency (MPF) were obtained for all the recorded EMG signals. The barycenter of activity over the HD-EMG grid was also determined. Normalized mutual information (NMI) was determined for each pair of muscles. The extent of variability of the outcomes was also assessed.

    Results. As fatigue developed, EMG amplitude increased and the MPF decreased for all muscles except the MPF for upper trapezius and deltoideus. The activity of trapezius was higher on the lateral side of HD-EMG grid than on the medial side and the barycenter showed a lateral shift across time. NMI between the muscle pairs also increased with fatigue. The variability of the investigated outcomes was not associated with the time to the task ending.

    Discussion. Myo-electrical manifestations of muscle fatigue were observed but none of the outcomes had an association with the rate of fatigue development. Using multivariate approaches, synergistic pattern of muscular activity is yet to be investigated.

  • 629.
    Samani, Afshin
    et al.
    Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
    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.
    Madeleine, Pascal
    Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
    Variability in spatio-temporal pattern of trapezius activity and coordination of hand-arm muscles during a sustained repetitive dynamic task2017In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 235, no 2, p. 389-400Article in journal (Refereed)
    Abstract [en]

    The spatio-temporal distribution of muscle activity has been suggested to be a determinant of fatigue development. Pursuing this hypothesis, we investigated the pattern of muscular activity in the shoulder and arm during a repetitive dynamic task performed until participants' rating of perceived exertion reached 8 on Borg's CR-10 scale. We collected high density surface electromyogram (HD-EMG) over the upper trapezius, as well as bipolar EMG from biceps brachii, triceps brachii, deltoideus anterior, serratus anterior, upper and lower trapezius from 21 healthy women. Root mean square (RMS) and mean power frequency (MNF) were calculated for all EMG signals. The barycenter of RMS values over the HD-EMG grid was also determined, as well as normalized mutual information (NMI) for each pair of muscles. Cycle-to-cycle variability of these metrics was also assessed. With time, EMG RMS increased for most of the muscles, and MNF decreased. Trapezius activity became higher on the lateral side than on the medial side of the HD-EMG grid and the barycenter moved in a lateral direction. NMI between muscle pairs increased with time while its variability decreased. The variability of the metrics during the initial 10% of task performance was not associated with the time to task termination. Our results suggest that the considerable variability in force and posture contained in the dynamic task per se masks any possible effects of differences between subjects in initial motor variability on the rate of fatigue development.

  • 630.
    Sandberg, Camilla
    et al.
    Heart Center and Department of Public Health and Clinical Medicine, Umeå University.
    Crenshaw, Albert G.
    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.
    Elcadi, Guilherme
    Department of Medical Sciences, Cardiology, Uppsala University,.
    Christersson, Christina
    Department of Medical Sciences, Cardiology, Uppsala University.
    Hlebowicz, Joanna
    Department of Cardiology, Clinical Sciences, Lund University.
    Thilén, Ulf
    Department of Cardiology, Clinical Sciences, Lund University.
    Johansson, Bengt
    Heart Center and Department of Public Health and Clinical Medicine, Umeå University.
    Slower Skeletal Muscle Oxygenation Kinetics in Adults With Complex Congenital Heart Disease2019In: Canadian Journal of Cardiology, ISSN 0828-282X, E-ISSN 1916-7075Article in journal (Refereed)
    Abstract [en]

    Background: Adults with complex congenital heart disease (CHD) show reduced aerobic exercise capacity and impaired skeletal muscle function compared with healthy peers. Peripheral muscle factors are presumed to be important contributors to the aerobic capacity, but the mechanisms are poorly understood. The aim of the present study was to investigate differences between adults with CHD and controls in muscle oxygenation kinetics at rest, and during and after exercise.

    Methods: Seventy-four patients with complex CHD (mean age 35.6±14.3 years, female n=22) were recruited. Seventy-four age- and sex-matched subjects were recruited as controls. Muscle oxygenation was successfully determined on the anterior portion of the deltoid muscle using near-infrared spectroscopy in 65 patients and 71 controls. Measurements were made at rest, during isotonic shoulder flexions (0-90°) to exhaustion, and during recovery.

    Results: The patients with CHD performed fewer shoulder flexions (40±17 vs 69±40; P < 0.001), had lower muscle oxygen saturation (StO2) at rest (58±18% vs 69±18%; P < 0.001), slower desaturation rate at exercise onset (-9.7±5.9 vs -15.1±6.5% StO2 x 3.5 s-1, P <0.001), and slower resaturation rate post exercise (4.0±2.7 vs 5.4±3.6% StO2 x 3.5 s-1; P = 0.009) compared with the controls.

    Conclusions: Comparison with age- and sex-matched controls, adults with complex CHD had slower oxygenation kinetics. This altered skeletal muscle metabolism might contribute to the impaired skeletal muscle endurance capacity shown and thereby also to the reduced aerobic capacity in this population.

  • 631.
    Sandberg, Camilla
    et al.
    Department of Community Medicine and Rehabilitation, Umeå University.
    Crenshaw, Albert G.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Elcadi, Guilherme H.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Christensen, Christina
    Department of Medical Sciences, Uppsala University.
    Hlebowicz, Joanna
    Department of Cardiology, Lund University.
    Thilén, Ulf
    Department of Cardiology, Lund University.
    Johansson, Bengt
    Heart center and Department of Public Health and Clinical Medicine, Umeå University.
    Impaired skeletal muscle endurance in adults with complex congenital heart disease is associated with local muscle oxygenation2018In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754Article in journal (Refereed)
  • 632.
    Sandberg, Camilla
    et al.
    Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
    Crenshaw, Albert G.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Elcadi, Guilherme H.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Christersson, Christina
    Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Hlebowicz, Joanna
    Department of Cardiology, Lund University, Lund, Sweden.
    Thilén, Ulf
    Department of Cardiology, Lund University, Lund, Sweden.
    Johansson, Bengt
    Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
    Impaired Skeletal Muscle Endurance in Adults With Complex Congenital Heart Disease is Associated With Local Muscle Oxygenation Kinetics2018In: Circulation: Abstracts From the American Heart Association's 2018 Scientific Sessions, 2018, Vol. 138, p. A15914-, article id Suppl. 1Conference paper (Refereed)
    Abstract [en]

    Introduction: Adults with complex congenital heart disease show reduced aerobic exercise capacity and impaired skeletal muscle function compared to healthy peers. Peripheral muscle factors are presumed to be important contributors, but the mechanisms are poorly understood. Hypothesis: Muscle oxygenation is associated with reduced skeletal muscle endurance in adults with complex CHD. Methods: Sixty-four adults with complex congenital heart disease (mean age 36.9±14.8 years, females n=19) were recruited from centers specialized in congenital heart disease. Seventy-four age and gender matched healthy peers were recruited as controls. Muscle oxygen saturation was successfully determined on the anterior portion of the deltoid muscle using near-infrared spectroscopy for 57 patients and 71 controls. Measurements were made at baseline, during isotonic shoulder flexions (0-90°) to exhaustion and during 60 seconds of recovery. Results: The adults with complex CHD performed fewer shoulder flexions (38±15 vs. 69±40, p <0.001), had lower muscle oxygen saturation at rest (58±17% vs. 69±18%, p <0.001), a slower desaturation rate at exercise onset (-9.5±5.9%/sec vs. -15.1±6.5%/sec, p <0.001), and a slower resaturation rate post exercise (3.9±2.8%/sec vs. 5.4±3.6%/sec, p =0.008) compared to the controls. Conclusions: A distinct association was found between muscle oxygenation kinetics and early muscle fatigue for adults with complex CHD. Our findings may give insight to the underlying mechanisms for the reduced aerobic exercise capacity for these patients, and therefore provide implications for design of exercise training protocols in this population. [ABSTRACT FROM AUTHOR]

  • 633.
    Sandberg, Camilla
    et al.
    Heart Center and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Crenshaw, Albert G.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Elçadi, Guilherme H.
    Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; School of Health Sciences, Örebro University, Örebro, Sweden.
    Christersson, Christina
    Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.
    Hlebowicz, Joanna
    Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.
    Thilén, Ulf
    Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.
    Johansson, Bengt
    Heart Center and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Slower Skeletal Muscle Oxygenation Kinetics in Adults With Complex Congenital Heart Disease2019In: Canadian Journal of Cardiology, ISSN 0828-282X, E-ISSN 1916-7075Article in journal (Refereed)
    Abstract [en]

    Background: Adults with complex congenital heart disease (CHD) show reduced aerobic exercise capacity and impaired skeletal muscle function compared with healthy peers. Peripheral muscle factors are presumed to be important contributors to the aerobic capacity, but the mechanisms are poorly understood. The aim of the present study was to investigate differences between adults with CHD and controls in muscle oxygenation kinetics at rest, and during and after exercise.

    Methods: Seventy-four patients with complex CHD (mean age 35.6 ± 14.3 years, female n = 22) were recruited. Seventy-four age- and sex-matched subjects were recruited as controls. Muscle oxygenation was successfully determined on the anterior portion of the deltoid muscle using near-infrared spectroscopy in 65 patients and 71 controls. Measurements were made at rest, during isotonic shoulder flexions (0-90°) to exhaustion, and during recovery.

    Results: The patients with CHD performed fewer shoulder flexions (40 ± 17 vs 69 ± 40; P &lt; 0.001), had lower muscle oxygen saturation (StO2) at rest (58 ± 18% vs 69 ± 18%; P &lt; 0.001), slower desaturation rate at exercise onset (−9.7 ± 5.9 vs −15.1 ± 6.5% StO2 × 3.5 s−1, P &lt;0.001), and slower resaturation rate post exercise (4.0 ± 2.7 vs 5.4 ± 3.6% StO2 × 3.5 s−1; P = 0.009) compared with the controls. Conclusions: In comparison with age- and sex-matched controls, adults with complex CHD had slower oxygenation kinetics. This altered skeletal muscle metabolism might contribute to the impaired skeletal muscle endurance capacity shown and thereby also to the reduced aerobic capacity in this population. 

  • 634.
    Sandfeld, Jesper
    et al.
    Institute of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen.
    Larsen, Lisbeth Højkjær
    Institute of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen.
    Crenshaw, Albert
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Jensen, Bente Rona
    Institute of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen.
    Muscle oxygenation, EMG, and cardiovascular responses for cabin attendants vs. controls2013In: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 84, no 5, p. 478-485Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The goal was to investigate the effect of acute moderate hypobaric exposure on the physiological responses to sustained contractions (local) and light to moderate dynamic exercise (systemic) for cabin attendants (CAB) and a matched control group (CON).

    METHOD: There were 14 CAB and 13 CON who participated. The experimental protocol was designed as a 2 x 2 randomized crossover study for which subjects performed a forearm isometric test and a cycling test in normobaric (NORM) and hypobaric [HYPO; 574 mmHg approximately 8000 ft (2440 m) above sea level (ASL)] conditions. Oxygen saturation (StO2%) was measured in the extensor carpi radialis muscle at rest and during an isometric wrist extension (20% MVC). Heart rate (HR), ventilation (V(E)), and oxygen uptake (VO2) were measured at rest, during cycling exercise at intensities of 50 W and 100 W, and during recovery. Blood samples were collected and analyzed for hemoglobin concentrations.

    RESULTS: Local response: There was a significant effect of HYPO for both CAB and CON with a decrease in StO2% of 6.5% both at rest and during contraction. Systemic response: there was no general effect of HYPO on HR, VE, or VO2. No differences were found between groups in either the local or systemic response or in the blood parameters.

    CONCLUSION: This study shows an effect of moderate hypobaric exposure on local muscle oxygenation during rest and sustained contraction. Whether this has an impact on fatigue development during work among cabin attendants is discussed.

  • 635.
    Sandlund, Jonas
    University of Gävle, Centre for Musculoskeletal Research.
    Position-matching and goal-directed reaching acuity of the upper limb in chronic neck pain: associations to self-rated characteristics2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Neck-shoulder pain is common in the general population and causes individual suffering as well as large costs for the society. Despite substantial efforts, there is still a shortage of methods for objective diagnosis and effective rehabilitation of such disorders. Thus, there is a great need to develop and evaluate new methods for these purposes. From clinical observations and recent research it has become evident that sensorimotor control can be impaired in people with neck-shoulder pain and may play a role in the pathogenesis of these disorders. In this thesis, precision of goal-directed arm movements, a previously unstudied class of movements in neck-shoulder pain, was studied.

    The main aim of the thesis was to investigate if people with chronic neck-shoulder pain have a reduced acuity of goal-directed movements of the upper extremity. A second aim was to study associations between reduced movement acuity and symptoms and self-rated characteristics.

    Upper limb repositioning acuity was assessed in blindfolded subjects performing tests of active, ipsilateral position-matching of two target positions (long and short) in movements constrained to horizontal-adduction of the shoulder. Reduced repositioning acuity, suggesting impaired shoulder proprioception, was found for both subjects with whiplash associated disorders (WAD) and non-specific neck-shoulder pain (NS). The degree of reduced acuity was shown to correlate with self-ratings of various health concepts, functioning and pain. A conspicuous finding was that there was lack of correlation between short and long target errors, along with the fact that associations between repositioning acuity and symptoms and self-rated characteristics was primarily found for the short target position.

    To further investigate the possible mechanisms underlying the disassociation between long and short target movement control, the association pattern between the outcome of several variants of ipsilateral position matching and velocity-discrimination tests, were studied. It was found that the perception of limb position in position-matching of short target locations appears to be predominantly based on movement velocity, whereas perception of limb position in movements to longer target locations may rely on a location-based perception mechanism.

    To extend the research on reduced upper extremity proprioception in neck-shoulder pain to a more natural movement situation, acuity of goal-directed pointing including full vision and 3D multi-joint movements was investigated in WAD, NS and healthy controls subjects. The results revealed a reduced acuity for both neck-pain groups. Moreover, distinct associations between end-point acuity and neck movement problems, limitations of some physical functions and, in WAD; some aspects of pain, were revealed.

    The findings demonstrate that the precision of upper limb movements can be reduced in chronic neck-shoulder pain. Substantial associations with symptoms and self-rated functioning suggest a clinical relevance of acuity measures of goal-directed arm movements. The findings indicate that tests of sensorimotor control can provide objective measures that may be useful in biopsychosocial profiling and characterization of subgroups of patients with chronic neck-shoulder pain, and that training target control of goal-directed movements should be considered in rehabilitation programs of people with these disorders.

  • 636.
    Sandlund, Jonas
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Ryhed, Bengt
    Hamberg, Jern
    Björklund, Martin
    University of Gävle, Centre for Musculoskeletal Research.
    Predictive and discriminative value of shoulder proprioception tests for patients with whiplash-associated disorders2006In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 38, no 1, p. 44-49Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate whether patients suffering from whiplash-associated disorders have impaired shoulder proprioception and whether the acuity of shoulder proprioception is reflected in the patients' symptoms and self-rated function. DESIGN: A comparative group design, including a correlation design for the patient group. SUBJECTS: Patients with chronic whiplash-associated disorders (n=37) and healthy subjects (n=41). The groups were matched for age and gender. METHODS: All subjects underwent a shoulder proprioception test involving active ipsilateral arm position-matching. Group difference was evaluated by multiple analysis of variance and analysis of variance. The patient group completed questionnaires addressing functioning and health and performed pain ratings. Associations between proprioceptive acuity and self-rated functioning and symptoms were studied by correlation and regression analyses. RESULTS: The patient group showed significantly lower acuity of shoulder proprioception. Moderate correlations were found between proprioceptive acuity and questionnaire scores representing physical functioning, so that low proprioceptive acuity was associated with low self-rated physical functioning. Scores representing pain-intensity did not correlate with proprioceptive acuity. CONCLUSION: The results show that, at the group level, patients with whiplash-associated disorders have impaired shoulder proprioception. The clinical relevance of this finding is strongly supported by the association between shoulder proprioceptive acuity and self-rated functioning in the patient group.

  • 637.
    Sandlund, Jonas
    et al.
    University of Gävle, Centre for Musculoskeletal Research. Department of Surgery and Perioperative Sciences, Division of Sports Medicine, University of Umeå, Alfta, Sweden; Alfta Research Foundation, Alfta, Sweden.
    Röijezon, Ulrik
    University of Gävle, Centre for Musculoskeletal Research. Department of Community Medicine and Rehabilitation, Physiotherapy, University of Umeå, Umeå, Sweden; Alfta Research Foundation, Alfta, Swede.
    Björklund, Martin
    University of Gävle, Centre for Musculoskeletal Research. Alfta Research Foundation, Alfta, Swede.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Acuity of goal-directed arm movements to visible targets in chronic neck pain2008In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 40, no 5, p. 366-374Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate end-point acuity in goal-directed arm movements in subjects with chronic neck pain, while taking the trade-off between speed and accuracy into account, and to evaluate associations between reduced acuity and self-rated characteristics. DESIGN: Single-blinded, controlled, comparative group study. SUBJECTS: Forty-five subjects with chronic non-traumatic, non-specific neck pain (n = 24) and whiplash-associated disorders (n = 21). Healthy subjects served as controls (n = 22). The groups were age- and sex-matched. METHODS: Subjects performed fast and accurate pointing movements to a visual target. Group differences in end-point variability, controlled for peak velocity, were evaluated. Associations between end-point variability and self-rated symptoms, functioning, self-efficacy and kinesiophobia were analysed. RESULTS: End-point acuity, controlled for peak velocity, was reduced for both neck-pain groups. Similar spatial error patterns across all groups indicated no direction-specific reduction. For both neck-pain groups, associations were found between end-point acuity and neck movement deficits, physical functioning and, in whiplash, also balance and pain. CONCLUSION: Acuity of goal-directed arm movements can be reduced in chronic neck pain. Associations between acuity and self-rated characteristics support the clinical validity of the results and indicate that impaired neck function contributes to reduced end-point acuity. The results can be of importance for characterization and rehabilitation of neck disorders.

  • 638.
    Sandlund, Jonas
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Röijezon, Ulrik
    University of Gävle, Centre for Musculoskeletal Research.
    Björklund, Martin
    University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Acuity of goal-directed reaching movements to visible targets in chronic neck disorders2007In: Sixth International Scientific Conference on Prevention of Work-Related Musculoskeletal Disorders, 2007, p. 10-Conference paper (Other academic)
  • 639.
    Sandlund, Jonas
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    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.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Differences in motor variability among individuals performing a standardized short-cycle manual task2017In: Human Movement Science, ISSN 0167-9457, E-ISSN 1872-7646, Vol. 51, p. 17-26Article in journal (Refereed)
    Abstract [en]

    Motor variability (MV) has been suggested to be a determinant of the risk for developing musculoskeletal disorders in repetitive work. In this study we examined whether individuals consistently differed in the extent of motor variability when performing a standardized short-cycle manual task. On three separate days, arm kinematics was recorded in 14 healthy subjects performing a pipetting task, transferring liquid from a pick-up tube to eight target tubes with a cycle time of 2.8 s. Cycle-to-cycle standard deviations (SD) of a large selection of shoulder and elbow kinematic variables, were processed using principal component analysis (PCA). Thereafter, between-subjects and between-days (within-subject) variance components were calculated using a random effects model for each of four extracted principal components. The results showed that MV differed consistently between subjects (95% confidence intervals of the between-subjects variances did not include zero) and that subjects differed consistently in MV between days. Thus, our results support the notion that MV may be a consistent personal trait, even though further research is needed to verify whether individuals rank consistently in MV even across tasks. If so, MV may be a candidate determinant of the risk of developing fatigue and musculoskeletal disorders in repetitive occupational work.

  • 640.
    Sandlund, Jonas
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Department for Community Medicine and Rehabilitation, Umeå University.
    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.
    Consistency of individual motor variability patterns in repetitive precision work2015In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, no Suppl. 1, p. e1334-e1335Article in journal (Other academic)
    Abstract [en]

    Background:

    A longstanding hypothesis in physical therapy and occupational research is that workers repeating a task very stereotypically will be more prone to develop musculoskeletal disorders than workers that manage to vary postures and loads. Increased movement variability (MV), presumably, modify tissue loads, distribute stresses more equally, and thus reduce the cumulative load on any particular tissue. A handful of studies of MV have indicated less overuse injuries and faster recovery from musculoskeletal pain disorders. Even when repeating strictly controlled tasks individuals may differ in motor consistency, some showing higher levels of MV than others. However, whether the extent of MV is indeed a consistent individual trait across different tasks and different days is not known.

    Purpose:

    To investigate whether individual profiles of MV is stabile between days, the consistency of MV patterns from kinematic recordings, repeated across three days, was studied when performing repetitive upper-extremity precision work.

    Methods:

    A laboratory-based simulation of precision work; a 'pipetting' task paradigm, was developed in which liquid was repeatedly transferred from one tube to another, with a cycle time of 2.8s. Fourteen healthy female subjects, aged 20-45 years, right-handed and with experience in pipetting participated on 3 different days under identical conditions. Kinematic data were obtained using an electromagnetic motion capture system (FASTRAK). MV in shoulder elevation, elbow flexion and shoulder-elbow coordination were operationalized using cycle-to-cycle standard deviations across 20 pipetting cycles of kinematics parameters including joint range of motion, average and peak velocities, time to peak velocities, average angle and phase. Multivariate analysis was conducted using principal component analysis (PCA) (SIMCA+P, 12.0) to analyze relationships among variables and individual patterns in the data matrix of the recordings from day1. Thereafter, in order to confirm the observed structure of inter-individual MV patterns, classification of the data from day2 and day3 was performed using the parameters of the model from day1.

    Results:

    Four PCA components (Eigenvalues>1) accounted for 80 percent of the total variance in the model for day1. In the subsequent prediction model where data from day2 and 3 were projected into the model of day1, all subject observations except one could be predicted with 95% confidence (Hotelling T2). And individual data scores from all three days were clustered in relative proximity to each other, indicating consistency in MV between days.

    Conclusion(s):

    The findings indicate, even in this small and homogenous sample of young healthy females, that there may indeed be consistent individual traits in motor variability. A next step would be to answer whether these traits remain consistent if work factors such as work pace or precision are altered, and whether individual profiles of MV are associated with physiological responses related to risk for developing musculoskeletal disorders.

    Implications:

    Consistency of individual MV patterns substantiate previous notions that some people appear prone to repeat themselves while others tend to vary their motor behavior when performing the same task. Assessment of MV by physical therapists in research and practice could be valuable to further explore and address the relation of MV and musculoskeletal health.

  • 641.
    Sato, Tatiana
    et al.
    Physical Therapy Department, Federal University of São Carlos (UFSCar), Brazil.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Kristiansen, Jesper
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    The association between multisite musculoskeletal pain and cardiac autonomic modulation during work, leisure and sleep - a cross-sectional study2018In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 19, no 1, article id 405Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The prevention and rehabilitation of multisite musculoskeletal pain would benefit from studies aiming to understand its underlying mechanism. Autonomic imbalance is a suggested mechanism for multisite pain, but hardly been studied during normal daily living. Therefore, the aim of the study is to investigate the association between multisite musculoskeletal pain and cardiac autonomic modulation during work, leisure and sleep.

    METHODS:

    This study is based on data from the "Danish Physical activity cohort with objective measurements" among 568 blue-collar workers. Pain intensity scales were dichotomized according to the median of each scale, and the number of pain sites was calculated. No site was regarded as the pain-free, one site was considered as single-site musculoskeletal pain and pain in two or more sites was regarded as multisite musculoskeletal pain. Heart rate variability (HRV) was measured by an electrocardiogram system (ActiHeart) and physical activity using accelerometers (Actigraph). Crude and adjusted linear mixed models were applied to investigate the association between groups and cardiac autonomic regulation during work, leisure and sleep.

    RESULTS:

    There was no significant difference between groups and no significant interaction between groups and domains in the crude or adjusted models for any HRV index. Significant differences between domains were found in the crude and adjusted model for all indices, except SDNN; sleep time showed higher values than leisure and work time, except for LF and LF/HF, which were higher during work.

    CONCLUSION:

    This cross-sectional study showed that multisite musculoskeletal pain is not associated with imbalanced cardiac autonomic regulation during work, leisure and sleep time.

  • 642.
    Sato, Tatiana
    et al.
    Physical Therapy Department, Federal University of São Carlos (UFSCar), Brazil.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Kristiansen, Jesper
    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.
    Different autonomic responses to occupational and leisure time physical activities among blue-collar workers2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 3, p. 293-304Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    The differential effect of occupational and leisure time physical activity on cardiovascular health is termed the physical activity health paradox. Cardiac autonomic modulation could bring insights about the underlying mechanism behind this differential effect. The aim was to compare heart rate variability (HRV) during different activities (sitting, standing and moving) at work and leisure among blue-collar workers.

    METHODS:

    One hundred thirty-eight workers from the NOMAD cohort were included. Data from physical activity and HRV were obtained for 3-4 days using tri-axial accelerometers (Actigraph GT3X+) and a heart rate monitor (Actiheart). HRV indices were determined during sitting, standing and moving both at work and leisure. Linear mixed-models with two fixed factors (activities and domains) were applied to investigate differences in HRV indices adjusting for individual and occupational factors.

    RESULTS:

    The results showed significant effects of domain (p < 0.01), physical activity type (p < 0.01) and interaction between domain and activity type (p < 0.01) on HRV indices. Mean heart rate (IBI) and parasympathetic measures of HRV (RMSSD and HF) were lower for sitting (p < 0.01) and higher for moving (p < 0.01) during work compared with leisure, while no difference between domains was found for standing (p > 0.05). Sympathovagal balance (LF/HF) was higher during work for sitting and moving (p < 0.01), but showed no difference for standing (p = 0.62).

    CONCLUSIONS:

    Differences in cardiac autonomic modulation between work and leisure were found, indicating sympathetic predominance during work and parasympathetic predominance during leisure for sitting. Autonomic responses can be part of the mechanism that explains the differential effect of occupational and leisure time physical activity on health.

  • 643.
    Sato, Tatiana
    et al.
    Physical Therapy Department, Federal University of São Carlos, São Paulo, Brazil.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Kristiansen, Jesper
    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.
    Different autonomic responses to occupational and leisure time physical activity among blue-collar workers2016Conference paper (Refereed)
    Abstract [en]

    Introduction: There is a well-established relationship between high physical activity at leisure time and decreased mortality risk. On the other hand, high physical demands at work seem to increase this risk. However, the underlying mechanism behind this effect remains unknown. Heart rate variability (HRV) measurements may bring some insight into the mechanism. Thus, the aim of this study was to determine whether HRV differs between work and leisure time among blue-collar workers.

    Methods: This study was based on data from the cross-sectional NOMAD study among blue-collar workers from seven workplaces in Denmark. One hundred thirty-eight blue-collar workers, which had at least 7 recording hours during work and leisure time were included in the analysis. Data from physical activity and HRV were obtained for four days using tri-axial accelerometers (Actigraph GT3X+) and heart rate monitor (Actiheart), respectively. Parametric (paired t test) and nonparametric (Wilcoxon signed-ranks test) tests for pairwise comparisons were applied to compare mean HRV indices in time and frequency domains between work and leisure time.

    Results: The mean age of the workers was 45.2 years, 51% were females, 42% were smokers, 18% reported lifetime occurrence of hypertension and 45% reported to perform lifting and carrying for more than half of the work time. A significant higher overall HRV was found during leisure time compared to work. Leisure time showed higher parasympathetic nervous system (PNS) measures of HRV (p<.05), while sympathetic nervous system (SNS) related indices (p<.05) were reduced in comparison to work.

    Conclusions: Leisure time showed high HRV and PNS indices and work time showed high SNS-related indices. The higher SNS modulation during work can be related to a greater risk of developing heart diseases among blue-collar workers.

  • 644.
    Schomburg, Eike D.
    et al.
    Zentrum Physiologie und Pathophysiologie, Universität Göttingen, Göttingen, Germany.
    Steffens, Heinz
    Zentrum Physiologie und Pathophysiologie, Universität Göttingen, Göttingen, Germany.
    Maznychenko, Andrey V.
    Department of Movement Physiology, Bogomoletz Institute of Physiology, National Academy of Sciences, Kiev, Ukraine.
    Pilyavskii, Alexander I.
    Department of Movement Physiology, Bogomoletz Institute of Physiology, National Academy of Sciences, Kiev, Ukraine.
    Hellström, Fredrik
    University of Gävle, Centre for Musculoskeletal Research.
    Kostyukov, Alexander I.
    Department of Movement Physiology, Bogomoletz Institute of Physiology, National Academy of Sciences, Kiev, Ukraine.
    Maisky, Vladimir A.
    Department of Movement Physiology, Bogomoletz Institute of Physiology, National Academy of Sciences, Kiev, Ukraine.
    Acute muscle inflammation enhances the monosynaptic reflexes and c-fos expression in the feline spinal cord2007In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 11, no 5, p. 579-586Article in journal (Refereed)
    Abstract [en]

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

  • 645.
    Sjölander, Per
    University of Gävle, Centre for Musculoskeletal Research.
    Samernas hälsa och livssituation2009In: Omvårdnad i mångkulturell rum: frågor om kultur, etik och reflektion / [ed] Björngren Cuadra, Carin, Lund: Studentlitteratur , 2009, p. 181-212Chapter in book (Refereed)
  • 646.
    Sjölander, Per
    et al.
    University of Gävle, Centre for Musculoskeletal Research. Southern Lapland Research Department, Postgatan 7, SE-912 32 Vilhelmina, Sweden.
    Daerga, Laila
    University of Gävle, Centre for Musculoskeletal Research. Southern Lapland Research Department, Vilhelmina, Sweden.
    Edin-Liljegren, Anette
    Southern Lapland Research Department, Vilhelmina, Sweden.
    Jacobsson, L.
    Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden.
    Musculoskeletal symptoms and perceived work strain among reindeer herders in Sweden2008In: Occupational Medicine, ISSN 0962-7480, E-ISSN 1471-8405, Vol. 58, no 8, p. 572-579Article in journal (Refereed)
    Abstract [en]

    Background There is a shortage of knowledge on the extent of musculoskeletal symptoms in reindeer husbandry.

    Aims To investigate the prevalence and relative risk for musculoskeletal symptoms and perceived psychosocial work strain among reindeer herders.

    Methods The prevalence of self-reported musculoskeletal symptoms during the last week and last year, respectively, were obtained from male reindeer herders (n574) of northern Sweden. Prevalence ratios (PRs) were calculated using two reference groups—women of reindeer-herding families (n5 53) and men in blue-collar occupations (n 5 194). Comparisons were made of perceived job strain between the study and reference groups. Associations between job strain factors and the occurrence of musculoskeletal symptoms from different body regions were analysed with regression statistics.

    Results The PRs for musculoskeletal symptoms from the hand/wrist (PR 3.48, 95% CI 1.86–6.50) and lower back (PR 1.44, 95% CI 1.06–1.95) were significantly higher among the reindeer herders in comparison with men working with other blue-collar occupations. The reindeer herders reported significantly higher work demands and decision latitude compared with both reference groups (P , 0.05). Significant associations were observed between demands and prevalence of symptoms from the lower back (OR 1.42, 95% CI 1.01–2.01) and from at least one body region (OR 1.58, 95% CI 1.07–2.32).

    Conclusions The relative risk for musculoskeletal symptoms, particularly from the hands/wrists and lower back, was high among reindeer herders. It is suggested that musculoskeletal symptoms constitute a considerable health problem in modern reindeer husbandry, which calls for implementation of preventive measures addressing psychosocial, physical and socio-economic risk factors.

  • 647.
    Sjölander, Per
    et al.
    University of Gävle, Centre for Musculoskeletal Research. Southern Lapland Research Department, Vilhelmina, Sweden.
    Hassler, Sven
    Southern Lapland Research Department, Vilhelmina, Sweden; Department of Nursing, Health and Culture, University West, Trollhättan, Sweden.
    Janlert, Urban
    epartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Stroke and acute myocardial infarction in the Swedish Sami population: incidence and mortality in relation to income and level of education2008In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 36, no 1, p. 84-91Article in journal (Refereed)
    Abstract [en]

    Background: Gender differences in cardiovascular diseases (CVD) among the Sami have been reported previously. The aim of the present study was to investigate the incidence of and mortality from stroke, subarachnoid haemorrhage (SAH) and acute myocardial infarction (AMI) in the Swedish Sami population between 1985 and 2002, and to analyse the potential impact of income and level of education on the cardiovascular morbidity and mortality.

    Methods: A Sami cohort of 15,914 persons (4,465 reindeer herding and 11,449 non-herding Sami) were followed from 1985 to 2002 with respect to incidence and mortality rates of AMI, stroke and SAH. Incidence and mortality ratios were calculated using a demographically matched non-Sami control population (DMC) as the standard (71,550 persons).

    Results: There was no elevated risk for developing AMI among the Sami compared with the DMC. However, the mortality ratio of AMI was significantly higher for Sami women. Higher incidence rates of stroke and SAH for both Sami men and women was observed, but no differences in mortality rates. Apart from the reindeer herding men who demonstrated lower levels of income and education, the income and education levels among Sami were similar to the DMC.

    Conclusions: High mortality rates from AMI rather than stroke explain the excess mortality for CVD previously shown among Sami women. The results suggest that the differences in incidence of stroke between herding and non-herding Sami men, and between Sami women and non-Sami women, are caused by behavioural and psychosocial risk factors rather than by traditional socioeconomic ones.

  • 648.
    Sjölander, Per
    et al.
    University of Gävle, Centre for Musculoskeletal Research. Southern Lapland Research Department, Vilhelmina, Sweden.
    Michaelson, Peter
    University of Gävle, Centre for Musculoskeletal Research. Department of Surgery and Perioperative Sciences, Division of Sports Medicine, University of Umeå, Sweden; Department of Health Science, Physiotherapy Unit, Luleå University of Technology, Luleå, Sweden.
    Jaric, Slobodan
    University of Gävle, Centre for Musculoskeletal Research. Human Performance Laboratory, University of Delaware, DE, USA.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Sensorimotor disturbances in chronic neck pain: range of motion, peak velocity, smoothness of movement, and repositioning acuity2008In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 13, no 2, p. 122-131Article in journal (Refereed)
    Abstract [en]

    The purpose of this pilot study was to evaluate sensorimotor functions in patients with chronic neck pain with objective and quantitative methods. A group of 16 patients with chronic idiopathic neck pain of insidious onset or whiplash associated disorders (WAD) was compared to an equally sized group of healthy subjects. Kinematics were investigated during voluntary head rotations by measuring range of motion, variability of range of motion (ROM-Variability), peak velocity, and smoothness of movement (jerk index). Repositioning acuity after cervical rotations was evaluated by analysing constant and variable error (VE). In comparison to the healthy subjects, the patients showed significantly larger jerk index, ROM-Variability and VE. No statistically significant differences were found between insidious neck pain and WAD. It is concluded that jerky and irregular cervical movements and poor position sense acuity are characteristic sensorimotor symptoms in chronic neck pain. The observed individuality in sensorimotor disturbances emphasizes the importance of developing specific rehabilitation programs for specific dysfunctions, and of using objective and quantitative methods for evaluation of rehabilitation.

  • 649. Slijper, H P
    et al.
    Mathiassen, Svend Erik
    University of Gävle, Centre for Musculoskeletal Research.
    Hoozemans, M
    Over, E A B
    Richter, J
    Time aspects of computer use across one year of exposure: metrics and empirical findings2008In: Proceedings of the International Conference on Ambulatory Monitoring of Physical Activity and Movement, 2008Conference paper (Other academic)
  • 650.
    Slijper, Harm
    et al.
    Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Over, E.
    Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands.
    Richter, Janneke
    Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands.
    Frens, Maarten
    Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands.
    Measuring computer use behavior: patterns of variability, within and across days and between different users2008In: Proceedings of Measuring Behavior 2008; 6th International Conference on Methods and Techniques in Behavioral Research / [ed] A.J. Spink, M.R. Ballintijn, N.D. Bogers, F. Grieco, L.W.S. Loijens, L.P.J.J. Noldus, G. Smit, and P.H. Zimmerman, Wageningen: Noldus , 2008, p. 111-112Conference paper (Refereed)
10111213141516 601 - 650 of 790
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