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  • 751.
    Wiesinger, Birgitta
    et al.
    Umeå University and Västernorrland County Council.
    Häggman-Henriksson, Birgitta
    Umeå University and Malmö University.
    Wänman, Anders
    Umeå University.
    Lindqvist, Mikael
    Umeå University.
    Hellström, Fredrik
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Jaw-opening accuracy is not affected by masseter muscle vibration in healthy men2014Ingår i: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 232, nr 11, s. 3501-3508Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 752. Wiholm, C
    et al.
    Richter, Hans O
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Mathiassen, Svend-Erik
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Toomingas, A
    Associations between eyestrain and neck-shoulder symptoms among call centre operators2007Ingår i: Work With Display Unit, 2007Konferensbidrag (Övrig (populärvetenskap, debatt, mm))
  • 753. Wiholm, Clairy
    et al.
    Richter, Hans O.
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Mathiassen, Svend Erik
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Toomingas, Allan
    Associations between eyestrain and neck-shoulder symptoms among call centre operators2007Ingår i: Scandinavian Journal of Work, Environment & Health, ISSN 0356-6528, nr Suppl. 3, s. 54-59Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Few if any studies have investigated if eyestrain and shoulder-neck symptoms are correlated, although functional links could be expected on the basis of neurophysiological evidence. The present cross sectional study assessed correlations between self-reported eye strain and shoulder-neck symptoms among call centre workers, controlling for possible confounders for these ailments. A questionnaire concerning socioeconomic background, work conditions and symptoms was mailed to 1531 employees at 28 different call centers during the years 2001- 2003. Twenty-one percent of responding subjects (N = 1162) reported both eyestrain and neck shoulder symptoms, 46% reported neck/shoulder and 6 % eye symptoms. 46% were free from symptoms in these regions. A significant positive association was found between eyestrain and neck/shoulder symptoms. Significant covariates for shoulder-neck disorders were eyestrain (OR = 1.6 p = 0.007), gender (to be female) (OR 1.9, p < 0.001, irritation index (OR 1.2, p =0.03), and feeling stressed (OR 1.2, p = 0.001. In a multi-nominal regression analysis gender (female) (OR = 1.9, p = 0.002), feeling stressed (OR 1.3, p = 0.002), feelings of distress (OR = 1.7, p < 0.001), computer problems (OR 1.3, p = 0.002)) and social support (OR 0.6, p = 0.003) remained in the model for the eye/neck symptoms. The results from this study support an association between self-reported combined eyestrain and shoulder-neck symptoms. However no causal relations can be derived due to the cross-sectional design.

  • 754. Wiholm, Clairy
    et al.
    Richter, Hans O
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Mathiassen, Svend-Erik
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Toomingas, Allan
    Samband mellan ögon och nacke/skulder besvär bland professionella datoranvändare2007Ingår i: Svenska Läkaresällskapets Riksstämma, 2007Konferensbidrag (Övrigt vetenskapligt)
  • 755.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Balancing intrusive illness: the experiences of people with musculoskeletal problems2007Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The overall aim of the present thesis was to explore and describe the health experiences of men and women with musculoskeletal problems. The specific aims of the four papers were: (I) to explore the experience of illness and wellness among ambulance personnel with musculoskeletal symptoms; (II) to explore the experience of illness and wellness among female health care personnel with musculoskeletal symptoms; (III) to explore the experience of bodily illness among people with musculoskeletal problems in the neck-shoulder region, and; (IV) to investigate the symptoms described by people with non-specific neck-shoulder problems, to investigate the method of development of neck-shoulder questionnaires that assesses pain and other symptoms, to analyse the content and items of these questionnaires, and to compare the findings.

    The overall findings show that the occupationally active men and women with MSDs were “striving for balance” (I-II), that the disease course of chronic neck-shoulder disorders was characterised by “uncontrollable fluctuations” (III), and that most neck-shoulder questionnaires had a low correspondence to the variety of symptoms experienced during this course (IV). In the process of striving for balance (I-II), the informants’ health experiences were not a state of either wellness or illness, but of both, in varying degrees at different times. The balancing started when illness became too intrusive, and was a process of minimising the impact of illness by accepting and handling it, while attaining and maintaining wellness to feel well enough. When striving for balance, the interviewees kept on working to continue being nurtured at the same time as they made different efforts directed at minimising the impact of their illness. For both men and women, illness was characterised by disembodiment, vulnerability, and exhaustion. The illness experiences were counterbalanced by wellness, where some differences could be recognised between the men and the women. Study III further explored the experiences of bodily illness, focusing on people with chronic musculoskeletal disorders in the neck-shoulder region. The course of the disorder was described as characterised by uncontrollable fluctuations, and it usually developed from insidious symptoms to a state of constant discomfort. The participants experienced calmer periods during the course, but intermittent events of increasing illness were always lying in wait, with periodic moments of consuming intensity. In the interviews included in study IV a variety of symptoms were expressed, which indicated a bodily, mental, and emotional engagement, which included more general and more severe symptoms than are usually related to neck-shoulder disorders. Few of the questionnaires were developed using the experiences of the affected. Taken as a whole, did the questionnaires cover many of the symptoms of the interviewees, but each individual questionnaire only included a few. The fluctuations and nuances of symptoms were rarely considered. The correspondence between individual questionnaires and the experiences of those affected was most often low. This thesis reveals other aspects of health than just bodily experiences as important among occupationally active people with MSDs. It also provides a description of the disease course, and an indication of possibilities for improvement of neck-shoulder questionnaires

  • 756.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Health as balance: illness and wellness among persons with musculoskeletal disorders2006Ingår i: 5th Global Conference Making Sense Of: Health, Illness and Disease, 2006Konferensbidrag (Refereegranskat)
    Abstract [en]

    Musculoskeletal disorders is a condition mostly approached from an out-side perspective and with quantitative methodology. This paper presents health experiences of men with musculoskeletal problems, explored through narrative interviews and constant comparative analysis. As there is a need for further research concerning people with early musculoskeletal symptoms, we turned to persons still active in working life. Ten men working as ambulance personnel were interviewed about their health experiences.

    The analysis revealed a process of striving for balance between experiences of illness and wellness. The informants’ health experiences were not a state of either wellness or illness but both, in varying degrees at different times. The process of striving for balance started when the illness experience became too intrusive, and was a process of both minimising the impact of illness by accepting and handling it and attaining and maintaining enough wellness to strike a balance. The state of balance was the experience of feeling “well enough”.

    Illness was characterised by disembodiment, vulnerability, and exhaustion, as the illness experiences incorporated feelings of that the previously silent body made it self heard, of being vulnerable when suffering gets too close and of getting worn out. Those experiences were counterbalanced by wellness, which was nurtured by experiences of relatedness, usefulness, being some one, and by excitement, challenge, and freedom.

  • 757.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Well but ill: Lay perspectives on health among people with musculoskeletal disorders.2012Konferensbidrag (Refereegranskat)
    Abstract [en]

    This study departs from questions arisen in previous interview studies of health experiences with people with musculoskeletal disorders. During data collection about health experiences in this group a common comment to the question –“How do you experience your health”? was –“Well, but”…  This awoke our interest to further explore this topic. Thus the aim of present study was to investigate lay perspectives on health among people with musculoskeletal disorders. Semi-structured interviews were performed with 68 women and men with long term (>3 months) musculoskeletal disorders in neck, shoulder and/or low back. All informants were recruited as participants in previous studies on health experiences among people with MSDs (Wiitavaara et al., 2007a, b, 2008, 2009). The informants (39 women and 29 men), were 18-64 years old and most of them were occupationally active in a variety of different occupations. Analysis was performed using qualitative content analysis (Graneheim & Lundman, 2003). The lay perspective on health in this group of people with musculoskeletal problems was perceived as “Having resources and possibilities to lead the life one want”. This theme incorporated three main categories as the informants perceived health to include “A good enough physical and psychological functioning and balance”; “Freedom of action”; and “A positive state of emotion and an enriching social life”. The informants expressed a holistic view of health, encompassing physical, psychological, emotional, as well as social aspects, which can be interpreted from an action theoretical perspective (Nordenfelt, 2007).

  • 758.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Nursing, Umeå University, Umeå, Sweden.
    Barnekow-Bergkvist, Margareta
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Brulin, Christine
    Department of Nursing, Umeå University, Umeå, Sweden.
    Striving for balance: a grounded theory study of health experiences of nurses with musculoskeletal problems.2007Ingår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 44, nr 8, s. 1379-1390Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Musculoskeletal disorders (MSD) are one of the major causes of the high levels of long-term sickleave and early retirement, and healthcare personnel are among the occupational groups most affected. Only limited research in the area has focused on the experiences of those affected, and to increase the understanding of MSD, all dimensions of the health experiences need to be taken into consideration. OBJECTIVES: The aim of this paper was to explore the experiences of illness and wellness among female healthcare personnel with musculoskeletal symptoms. DESIGN: A qualitative grounded theory approach guided the study in data collection and analysis. SETTINGS: Medical and surgical ward units at three hospitals; one university hospital and two minor hospitals. PARTICIPANTS: Eight women, registered nurses and nursing aides, with neck, shoulder and/or back problems in early stages. METHODS: A grounded theory approach was used with narrative thematic interviews and parallel data analysis with constant comparisons. RESULTS: The analysis revealed a process of striving to reach a balance between illness and wellness, through accepting and handling illness. Illness appeared as a threat and an experience, while experiences of wellness were simultaneously nurtured. The informants were striving for balance through an inner reasoning leading to acceptance and by handling illness in various ways depending on the character of the illness. CONCLUSION: This paper indicates the diversity of the illness experience, the parallel importance of wellness, and the process of balancing these two in order to feel well enough. As previous research has shown that MSD has a multifactorial cause, a holistic view of health promotion, prevention and rehabilitation may provide a more effective tool than the bodily physical focus most frequently used today.

  • 759.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Bengs, Carita
    Sociologiska institutionen, Umeå universitet.
    Brulin, Christine
    Institutionen för omvårdnad, Umeå universitet.
    Lekmannaperspektiv på hälsa bland personer med muskuloskeletala besvär2015Ingår i: Best Practice : Smärta, Vol. 4, nr 10, s. 20-23Artikel i tidskrift (Övrigt vetenskapligt)
  • 760.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Bengs, Carita
    Sociologiska institutionen, Umeå universitet.
    Brulin, Christine
    Institutionen för omvårdnad, Umeå universitet.
    Well, I'm healthy, but...: lay perspectives on health among people with musculoskeletal disorders2016Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, nr 1, s. 71-80Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    urpose: The purpose was to investigate lay perspectives on health among people with musculoskeletal disorders. Method: Semi-structured interviews were performed with 39 women and 30 men, (aged 22–63 years) with long-term, non-specific musculoskeletal disorders in the neck, shoulder and/or low back. Data was analysed using qualitative content analysis. Results: These people experienced health as “having resources and opportunities to lead the life one wants”. Three categories, “a good enough physical and psychological functioning, freedom of action, and a positive state of emotion and an enriching life”, illustrate the different resources and opportunities that the informants described as important for them to perceive themselves as healthy. The informants also reflected on “being ill” and “being well” and what makes the difference. Five aspects influenced the dynamics of their health experiences: “body and soul, prognosis, character of symptoms, physical and social activity, and emotional state”. Consequently, the informants expressed a holistic view of health, where the focus lies on the opportunity and the ability to lead their lives the way they want. Conclusions: This study points at the value of taking lay perspectives on health into account, as it might increase the opportunity to design effective, personalized rehabilitation strategies.

  • 761.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Nursing, Ume̊ University, Umeå, Sweden.
    Björklund, Martin
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Alfta Research Foundation, Alfta, Sweden.
    Brulin, Christine
    Department of Nursing, Ume̊ University, Umeå, Sweden.
    Djupsjöbacka, Mats
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    How well do questionnaires on symptoms in neck-shoulder disorders capture the experiences of those who suffer from the disorders?: A content analysis of questionnaires and interviews2009Ingår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 10, nr 1, artikel-id 30Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Previous research has indicated neck-shoulder disorders to have a fluctuating course incorporating a variety of symptoms. These findings awoke our interest to make a comparison between symptoms experienced by people affected with the disorder and the content of questionnaires that assess pain and other symptoms in neck-shoulder disorders. Thus the aims of this study were: -to explore the symptoms experienced by people with non-specific neck-shoulder problems, as well as experiences of nuances and temporal variations (fluctuations) of symptoms; -to investigate which sources were used in the development of ten questionnaires for assessing pain and other symptoms in the neck-shoulder; -to analyse the item content of the questionnaires; -to analyse the correspondence between the item content of the questionnaires and the symptoms described by the informants. METHODS: Content analysis of interviews with 40 people with non-specific neck-shoulder pain, and 10 questionnaires used to assess pain and other symptoms in neck-shoulder disorders. RESULTS: The interviews revealed a variety of symptoms indicating a bodily, mental/cognitive, and emotional engagement, and more general and severe symptoms than are usually considered in neck-shoulder questionnaires. Taking all questionnaires together many of the symptoms were considered, but most questionnaires only included a few of them. The informants were able to distinguish fluctuation of symptoms, and a variety of different qualities which were not usually considered in the questionnaires. Only two questionnaires had made use of the opinions of affected people in the development. CONCLUSIONS: Few of the questionnaires had made use of the experiences of affected people in the development. The correspondence between the symptoms expressed by the affected and the content of the questionnaires was low. A variety of symptoms were expressed by the interviewees, and the participants were also able to distinguish nuances and fluctuations of symptoms. The present study points to the importance of other aspects than just pain and physical functioning as clinical trial outcome measures related to neck-shoulder disorders. To develop a condition-specific questionnaire, it is important to decide on the specific symptoms for the condition. Using the experiences of those affected, in combination with relevant research and professional knowledge, can enhance the validity of the questionnaires.

  • 762.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Nursing, Umeå University, Umeå, Sweden.
    Brulin, Christine
    Department of Nursing, Umeå University, Umeå, Sweden.
    Barnekow Bergqvist, Margareta
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    When the body makes itself heard: the experience of bodily illness among people with neck-shoulder problems2008Ingår i: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 10, nr 2, s. 85-94Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to explore the experience of bodily illness among people with musculoskeletal disorders (MSDs) in the neck/shoulder region. The study had a grounded theory approach, with constant comparisons and simultaneous data collection and analysis. Initially, parts of interviews about health experiences related to MSDs previously performed among men and women with musculoskeletal symptoms in the neck/shoulder and/or back were analysed. Next, complementary semi-structured interviews among men and women with neck/shoulder problems were performed, focusing on the experience of bodily illness, until saturation was reached. The results describe the experiences of bodily illness among people with MSDs in the neck/shoulder region as being characterized by uncontrollable fluctuations. The experiences are presented as a model of the disease course as experienced by the affected. The process usually developed from a beginning with insidious symptoms to a state of constant discomfort. Along the line of this development, periods of intermittent events of increasing illness occurred with peaks of consuming intensity. A variety of different symptoms was present during the process, which are presented in this paper. An increased knowledge of the disease course can be useful in prevention and treatment as communication about the disorder can be more specific.

  • 763.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Fahlström, Martin
    Institutionen för klinisk vetenskap, Umeå universitet.
    Djupsjöbacka, Mats
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Prevalence, diagnostics, and management of musculoskeletal disorders in primary health care in Sweden: an investigation of 2000 randomly selected patient records2017Ingår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 23, nr 2, s. 325-332Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. To improve the care of patients suffering from musculoskeletal disorders (MSD) further knowledge regarding the prevalence, diagnostics and management of different MSD in primary care is required. Thus the aims of this study were: -to investigate the prevalence of patients seeking care due to different MSD at primary health care centres (PHCs); -to chart different factors as symptoms, diagnosis, and actions prescribed for patients that visited the PHCs due to MSD; and -to make comparisons regarding differences due to gender, age, and rural or urban PHC.

    Methods. 2000 patient records for patients in working age were randomly selected equally distributed on one rural and one urban PHC. A 3-year period was reviewed retrospectively. For all patient records age, sex, occupation, occupational activity, date of visit, if it was a new or re-visit, cause to the visit, and diagnosis related to the visit were registered. For visits due to MSD the location of the patients symptoms, which symptoms were described in the patient record, the type of those symptoms, which actions were prescribed to resolve the patients problems, and also sickleave prior to and after the visit, were registered. Data was analysed using cross tabulation, multidimensional Chi-square (Pearson), and a probability level of p < .05.

    Results. The prevalence of MSD was high, almost 60 % of the patients had some sort of MSD symptoms, either at the day for visit or the reviewed 3 year period, and a bit higher among women than men. Upper and lower limb problems were most common. Symptoms were most prevalent in the young and middle age-groups. The patients got a variety of different diagnoses, and between 13-35 % of the patients did not receive a MSD-diagnose despite having MSD-symptoms. There was a great variation in how the cases were handled. Medication and sick leave certificates were most common while work-related rehabilitation was less common. Conclusion. The present study points out some weaknesses regarding diagnostics and management of MSD in primary care. Further studies to compare the results regarding diagnoses for musculoskeletal symptoms and measures taken to solve the patients’ problems would be of interest.

  • 764.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Content and psychometric evaluations of questionnaires for assessing physical function in people with low back disorders: a systematic review of the literature2018Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The purpose was to investigate how physical function is assessed in people with musculoskeletal disorders in the low back. Specifically:

    • Which questionnaires are used to assess physical function in people with musculoskeletal disorders in the low back?
    • What aspects of physical function do those questionnaires measure?
    • What are the measurement properties of the questionnaires?

    Materials and methods: A systematic review was performed to identify questionnaires and psychometric evaluations of them. The content of the questionnaires was categorised according to the International Classification of Function, Disability and Health, and the psychometric evaluations were categorised using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist.

    Results: The questionnaires measured disability or ability to cope in everyday life, rather than physical function as such. Different aspects of a person’s mobility and ability to attend to one’s personal care were most often included regarding activity and participation. For body functions, items about sleep and pain were most often included. The Oswestry Disability Index and the Quebec Back Pain Disability Scale showed adequate psychometric properties in most evaluations.

    Conclusions: The extent of psychometric evaluations differed substantially, as did the items included. Focus of measurement was predominantly on activities in daily life.

    • Implications for rehabilitation
    • Valid and reliable instruments that measure relevant aspects of low back disorders are needed to provide early diagnostics and effective treatment.
    • Most questionnaires need more psychometric evaluations to establish the quality.
    • The Oswestry Disability Index and the Quebec Back Pain Disability Scale showed adequate psychometric properties in most evaluations.
    • The results may be useful when making decisions about which measurement instruments to use when evaluating low back disorders.
  • 765.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Content and psychometric evaluations of questionnaires for assessing physical function in people with neck disorders –  A systematic review of the literature2018Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, nr 19, s. 2227-2235Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Purpose: The purpose was to investigate how physical function is assessed in people with musculoskeletal disorders (MSD) in the neck. Specifically, we aimed to determine: (1) Which questionnaires are used to assess physical function in people with MSD in the neck? (2) What do those questionnaires measure? (3) What are the measurement properties of the questionnaires?

    Materials and methods: A systematic review was performed to identify questionnaires and psychometric evaluations. The content of the questionnaires was categorized according to the International Classification of Function, Disability and Health, and the psychometric properties were quality-rated using the COnsensus-based Standards for the selection of health Measurement INstruments checklist.

    Results: Ten questionnaires and 32 articles evaluating measurement properties were analyzed. Most questionnaires covered only the components body functions and activity and participation, more often activity participation than body function. Internal consistency was adequate in most questionnaires, whereas responsiveness was generally low. Neck Disability Index was most evaluated, but the evaluations of all questionnaires tended to cover most properties in the checklist.

    Conclusions: The questionnaires differed substantially in items and extent to which their psychometric properties had been evaluated. Focus of measurement was on activities in daily life rather than physical function as such.

    • Implications for Rehabilitation
    • To provide early diagnostics and effective treatment for patients with neck disorders, valid and reliable instruments that measure relevant aspects of the disorders are needed.

    • This paper presents an overview of content and quality of questionnaires used to assess physical function in neck disorders, which may facilitate informed decisions about which measurement instruments to use when evaluating the course of neck disorders.

    • Most of the questionnaires need more testing to judge the quality, however the NDI was the most frequently tested questionnaire.

    • The COnsensus-based Standards for the selection of health Measurement INstruments checklist is a useful tool in relation to psychometric testing of questionnaires, but clear definitions of interpretation of the quality criteria in each study would enhance comparability of results.

  • 766.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Content and quality of questionnaires for assessment of physical functioning in neck disorders – A systematic review of the literature2017Ingår i: Joy at Work, NES, 2017, 2017Konferensbidrag (Refereegranskat)
    Abstract [en]

    Valid and reliable instruments are required in order to determine effective interventions in the treatment of musculoskeletal disorders (MSD). Today, there is a lack of consistency in use of self-report outcome measures in research and practice, which makes it difficult or impossible to compare treatment effects. The questionnaires differ widely, in content as well as quality. The focus of present study was on assessment of physical functioning among people with MSD in the neck. The aim was to investigate how physical function is assessed in people with MSD in the neck. Specifically we wanted to determine: - Which questionnaires are used to assess physical function in people with musculoskeletal disorders in the neck? - What do those questionnaires measure? - What are the measurement properties of the questionnaires?

    The study was performed as a systematic literature review in order to identify articles presenting the questionnaires and psychometric tests of them. Items included in the questionnaires were classified according to the "International Classification of Functioning, Disability and Health", ICF. Thereafter, all psychometric tests of the different questionnaires were analysed with respect to relevant quality indicators using the "Cosmin checklist".

    Included in the final analysis were 10 questionnaires and 32 articles presenting psychometric tests of them. The analysis revealed that questionnaires for measuring physical functioning in neck disorders differ substantially in items and extent to which their psychometric properties have been evaluated. Most questionnaires contained only the ICF-components body functions and activity and participation, more often activity and participation. The most psychometrically tested questionnaire was Neck Disability Index. Remaining questionnaires were tested in fewer studies and only some of the properties in the Cosmin checklist were tested for most of them.

    Questionnaires for assessment of physical function in people with neck disorders tend to focus more on the ability to engage in activities of daily life than on physical function as such. Furthermore, the measurement properties of the questionnaires have usually been evaluated in few studies. It is vital to measure aspects that are of importance for the individual wellbeing and ability to function in work and daily life when evaluating neck disorders. However, to increase the validity of the results in clinical and research studies, it is also important to include the most relevant aspects of physical function. We recommend more psychometric testing of the questionnaires, especially those that cover important aspects of the ICF categories. To ensure coverage of important aspects, validation of the questionnaires against patients and practitioners is needed.

    A review and analysis of this kind makes it easier for researchers and clinicians to select the most suitable questionnaire for their own purpose, based on the content and quality of the questionnaire.

  • 767.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    What do questionnaires for assessment of physical functioning in neck disorders really measure?: A systematic review of the literature2016Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background. In order to determine which interventions are effective in the treatment of musculoskeletal disorders, valid and reliable instruments are required. However, there is a lack of consistency in the use of outcome measures, both in research and in treatment, that makes comparisons difficult or impossible; the content and quality varies widely be-tween questionnaires. This study focuses on the measurements of the physical function-ing of people with MSDs. The aim of this systematic review is to investigate how physical function is measured in people with musculoskeletal disorders or chronic pain. Specifically we want to determine: (1) What instruments are used to measure physical function in people with musculoskeletal disorders or chronic pain? (2) What do those instruments measure? (3) What is the methodological quality of these instruments?

    Method. The study was performed as a systematic literature review in the data bases PubMed, Cinahl, Web of Science, and Scopus, using the same set of keywords and Bool-ean operators. The selection of relevant articles was performed by reviewing the title and abstract first, and the article text thereafter. Selected articles were classified according to the “ICF Classification of Functioning, Disability and Health.” Subsequently, articles will be examined with respect to relevant quality indicators using the “Cosmin checklist.”

    Results. 69 relevant questionnaires were found and were sorted into groups according to focus. As a first step, neck and arm-shoulder-hand questionnaires were analyzed. The ICF-classification revealed that the included items belonged to the components “body func-tions” and “activity/participation,” and the included domains varied significantly between the questionnaires. The quality of the instruments will be determined in the next step.

    Discussion. A review and analysis of this kind makes it possible for researchers and clini-cians to more easily select the most suitable questionnaire for their purpose based on the content and quality of the questionnaire.

  • 768.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Nursing, Umeå University, Umeå, Sweden.
    Lundman, B.
    Department of Nursing, Umeå University, Umeå, Sweden.
    Barnekow-Bergkvist, Margaretha
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Brulin, C.
    Department of Nursing, Umeå University, Umeå, Sweden.
    Striking a balance - health experiences of male ambulance personnel with musculoskeletal symptoms: a grounded theory2007Ingår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 44, nr 5, s. 770-779Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Musculoskeletal disorders (MSD) are a dominant cause to long-term sick leave and early retirement. Some occupational groups are more affected than others and ambulance personnel are among them. Despite a vast amount of research, only a small part focuses the experiences of the affected.

    Objectives: The aim of the study was to explore the experience of illness and wellness in ambulance personnel with musculoskeletal symptoms.

    Design: An emerging design was used in accordance with Grounded Theory.

    Participants: Informants in the study were ten men with musculoskeletal symptoms, working as ambulance personnel at an ambulance station located in a mid-sized city in Sweden.

    Methods: Narrative interviews were performed, parallel to a constant comparative analysis.

    Results: The study resulted in a model, which describes the experience of illness and wellness as characterised by an effort to strike a balance. Wellness through nurturing appeared parallel to encountering illness as an experience and a threat. Accepting and handling illness was of importance to maintaining wellness, and wellness through nurturing was the motivation for accepting and handling illness.

    Conclusions: Enhancing the understanding of wellness and illness makes it possible to avoid undermining the meaningfulness that support accepting and handling illness, and by understanding different aspects of illness prevention can become facilitated. This is of importance as other aspects than solely physical have shown to be similarly important in the development of MSD.

  • 769.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Rissén, Dag
    Region Gävleborg.
    Högberg, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap.
    Nilsson, Annika
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Uppsala universitet.
    Psychometric testing of a short form questionnaire for measurement of health experiences among people with musculoskeletal disorders undergoing multimodal rehabilitation2019Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, nr 5, artikel-id e025103Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

    The aim of present study was to assess if a previously suggested short-form questionnaire tested among women with non-specific neck-shoulder pain is suitable also for use among men and women with non-specific musculoskeletal disorders in any part of the body, by testing its construct validity by a confirmatory factor analysis. If not, the secondary aim was to investigate the evolving factor structure when performing an explorative factor analysis of data in the expanded sample.

    Methods

    Questionnaire data was collected in three different contexts, in primary care via eight different multimodal rehabilitation teams, in specialised care via two different specialist care centres. The sample consisted of 116 participants, male (n=29) and female (n=87) with non-specific musculoskeletal disorders.

    Data was analysed using confirmatory and exploratory factor analysis and a visual comparison between the result of the Principal Component Analysis in present study, and the results attained in a previous study with a similar aim and design.

    Results

    The confirmatory factor analyses did not end up in a model with acceptable measures for validity. Three models were tested, none of them met the criterion for an acceptable model and the goodness-of-fit statistics were not fully acceptable. The exploratory factor analysis had an only partly comparable result, compared to previous study.

    Conclusion

    The results of present study did not prove the suggested short form questionnaire to be suitable for evaluation of symptoms among men and women with non-specific musculoskeletal disorders in any part of the body. Further studies including larger samples are recommended.

  • 770.
    Wiitavaara, Birgitta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Rissén, Dag
    CFUG, Centrum för forskning och utveckling, Uppsala universitet / Landstinget Gävleborg.
    Nilsson, Annika
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Vårdvetenskap. Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    Utvärdering av muskuloskeletala besvär: Utveckling av ett kliniskt användbart frågeformulär för personer med besvär från rörelseapparaten2013Övrigt (Övrigt vetenskapligt)
  • 771.
    Wijk, Katarina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Work values among male and female students2011Rapport (Övrigt vetenskapligt)
    Abstract [en]

    The aim was to provide an overview of the different values that make for an ideal work situation for people currently studying at different educational levels in Sweden, and between males and females (n=190). A questionnaire measuring eight Index of work values were used. Results show that social relations was the index having the highest mean rating for both males and females, followed by work and health, and working conditions. Significant difference between genders could be seen in the Index social relations, work and health, working conditions, and altruism. The single question that received the highest mean score was; to have a fair and understanding boss. The results can contribute to an understanding of how to design workplaces that attract young people and, thus, optimize well-being.

  • 772.
    Wijk, Katarina
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Work values among male and female students2009Ingår i: Proceedings of the 17th World Congress on Ergonomics, 2009Konferensbidrag (Refereegranskat)
  • 773.
    Wijk, Katarina
    et al.
    Centre for Research and Development, Region Gavleborg/Uppsala University, Gävle, Sweden.
    Bergsten, Eva L.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Hallman, David
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Perceptions of facilitating factors and barriers when implementing activity based workplaces before and after implementation, with particularly regard to Sense of Coherence2019Konferensbidrag (Refereegranskat)
  • 774.
    Wijk, Katarina
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Bergsten, Eva
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Mathiassen, Svend Erik
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Tigerfors, A-M
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Incentives for work environment improvements at manufacturing companies from a manager perspective2011Konferensbidrag (Refereegranskat)
  • 775. Wijk, Katarina
    et al.
    Lindberg, Per
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Divergences in descriptions of the internal work environment management, between employees and the management, a case study2013Rapport (Övrigt vetenskapligt)
    Abstract [en]

    The aim of the case study was to critically compare the descriptions of employees and managers of how the work environment is prioritised in a medium-sized Swedish retailer belonging to an international group. The study is based upon a questionnaire study of employees (n=55), and on interviews with people in leading positions with partial responsibility for the work environment at the company (n=6) as well as with the local safety delegate (n=1). The results show that the driving forces behind the work environment are, according to respondents, finances, legislation, trademarks and the attitudes of the upper management. The on-going work environment management is described differently in terms of its form and content by employees and persons in leading positions.

  • 776.
    Wijk, Katarina
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Mathiassen, Svend Erik
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Explicit and implicit change theories behind ergonomic interventions in working life2010Ingår i: Proceedings of the Premus 2010 conference (Seventh International Conference on Prevention of Work-Related Musculoskeletal Disorders) August 29-September 2, Angers, France, 2010, s. 240-Konferensbidrag (Refereegranskat)
  • 777.
    Wijk, Katarina
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Mathiassen, Svend Erik
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Explicit and implicit theories of change when designing and implementing preventive ergonomics interventions: a systematic literature review2011Ingår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 37, nr 5, s. 363-375Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective In contrast to several previous papers dealing with the structure and effects of ergonomics interventions, this systematic literature review focuses on the theories concerning change processes upon which these interventions – implicitly or explicitly – have been based.

    Methods In a systematic search of 13 literature databases, 30 peer-reviewed intervention studies published between 2000–2007 were identified that provided sufficient information for the change process theory to be identified.

    Results Thirteen studies referred to an explicit theory of change, the most common being participatory theory, while in 17 studies, the change theory could only be discerned indirectly from the described intervention strategy. Twenty-five studies explained the reason for choosing their strategy, with a clear reference to theory or previous research, whereas five provided only a weak background. Four categories of intervention strategies for change were identified: (i) changes targeting the individual, (ii) changes focusing on the work environment, (iii) changes relying on interactions between people, and (iv) structural and organizational changes.

    Conclusions A strikingly small proportion of ergonomics intervention studies have explained the theory behind the expected change process. A better awareness of the assumptions about change processes embedded in intervention strategies – whether implicit or explicit – may help in identifying and examining those ideas and processes that promote or restrict successful implementation. Such knowledge, in turn, can contribute to the development of interventions that are thoughtfully designed and effectively implemented.

  • 778.
    Wijk, Katarina
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Nordlöf, Hasse
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Lönsamhet i en god arbetsmiljö (poster)2009Ingår i: Arbetet i människors liv: Forum för arbetslivsforskning (FALF), Göteborg, 13-14 maj 2009, Göteborg, 2009Konferensbidrag (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

    Presentation av de övergripande frågeställningarna från delstudier i ett pågående tvärvetenskapligt forskningsprojekt vid Centrum för belastningsskadeforskning (CBF), Högskolan i Gävle. Inom projektet studeras bl.a. tillvägagångssätt för arbetsmiljöarbete, hur arbetsmiljön prioriteras samt arbetsmiljöarbete och lönsamhet/varumärke. Inom projektet har även Ergopriset tagits fram, för att årligen uppmärksamma ett företag som med ergonomiska principer strävat efter att förbättra lönsamheten.

    Utställare är forskningsledare fil dr Katarina Wijk och projektmedarbetare Hasse Nordlöf.

  • 779.
    Wijk, Katarina
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Uppsala university; Region Gävleborg.
    Åberg Jönsson, Fredrik
    Region Gävleborg.
    Lindberg, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Uppsala university; Region Gävleborg.
    Perceived enabling factors and barriers for the implementation of improvements in health care in order to achieve patient‐centred care: A case report from Sweden2019Ingår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale, aim, and objectives

    More knowledge is needed regarding the complex factors and perceptions that enable the implementation of change in health care. The study aimed to examine the enabling factors and barriers encountered in the implementation of improvements in health care in order to achieve patient‐centred care (PCC) and to study if there was a correlation in the extent the improvements were perceived to be implemented and the preconditions that were considered to affect them.

    Methods

    Using a mixed method design, data were gathered via a questionnaire and individual interviews with health care personnel, clinic managers, and first‐line managers. The data collection and analyses were based on the framework for Promoting Action on Research Implementation in Health Services (PARiHS). Correlations between PCC improvements and preconditions for improvements were performed.

    Results

    A high level of involvement, knowledge, and adequate resources were considered important to achieve an implementation of PCC with joint responsibility. Leadership and management need to be explicit and promote continuous follow‐up and feedback. Preconditions for improvement had a linear correlation with the perceived level of implementation. Knowledge‐related preconditions had greatest impact on implementation.

    Conclusions

    The PARiHS framework was appropriate to use since the three components of evidence, context, and facilitation present different important preconditions in the implementation process. Evidence was the highest rated contributor since evidence‐based practices in health care are necessary. It is vital that the important role of the context and facilitators is acknowledged in the implementation process to enable a successful implementation of change. There is a need to incorporate a clear strategy involving all levels in the organization. Furthermore, leaders play an important role in the implementation by facilitating communication and support and by having trust in facilitators and health care personnel. The results are applicable to other interventions implementing change in health care.

  • 780.
    Wijk, Katarina
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Åberg Jönsson, Fredrik
    Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden.
    Lindberg, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för vårdvetenskap, Med-Vårdvetenskap. Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Perceived enabling factors and barriers for the implementation of improvements in health care in order to achieve patient-centred care: A case report from Sweden2019Ingår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Abstract Rationale, aim, and objectives More knowledge is needed regarding the complex factors and perceptions that enable the implementation of change in health care. The study aimed to examine the enabling factors and barriers encountered in the implementation of improvements in health care in order to achieve patient-centred care (PCC) and to study if there was a correlation in the extent the improvements were perceived to be implemented and the preconditions that were considered to affect them. Methods Using a mixed method design, data were gathered via a questionnaire and individual interviews with health care personnel, clinic managers, and first-line managers. The data collection and analyses were based on the framework for Promoting Action on Research Implementation in Health Services (PARiHS). Correlations between PCC improvements and preconditions for improvements were performed. Results A high level of involvement, knowledge, and adequate resources were considered important to achieve an implementation of PCC with joint responsibility. Leadership and management need to be explicit and promote continuous follow-up and feedback. Preconditions for improvement had a linear correlation with the perceived level of implementation. Knowledge-related preconditions had greatest impact on implementation. Conclusions The PARiHS framework was appropriate to use since the three components of evidence, context, and facilitation present different important preconditions in the implementation process. Evidence was the highest rated contributor since evidence-based practices in health care are necessary. It is vital that the important role of the context and facilitators is acknowledged in the implementation process to enable a successful implementation of change. There is a need to incorporate a clear strategy involving all levels in the organization. Furthermore, leaders play an important role in the implementation by facilitating communication and support and by having trust in facilitators and health care personnel. The results are applicable to other interventions implementing change in health care.

  • 781.
    Wikström, Per Arne
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Wijk, Katarina
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Perceptions about work environment and profitability among successful enterprises2009Ingår i: Proceedings at conference "Understanding small enterprises", Denmark, 2009Konferensbidrag (Övrigt vetenskapligt)
  • 782.
    Wilhelmus Johannes Andreas, G.
    et al.
    Karolinska Insitutet, Department of Neurobiology, Caring Sciences and Society, División of Physical Therapy, Sweden.
    Johansson, Elin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Observational Methods for Assessing Ergonomic Risks for Work-Related Musculoskeletal Disorders: A Scoping Review2018Ingår i: Revista Ciencias de la Salud, ISSN 1692-7273, Vol. 16, nr Special Issue, s. 8-38Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Work-related musculoskeletal disorders (wrmsds) are one of the most common causes of absence from work. Exposures in the work environment can cause or aggravate the impact of these musculoskeletal disorders and the identification of ergonomic exposures are essential in risk assessment. It is important to assess all three key indicators of these exposures (intensity, frequency and duration) for being able to estimate the risk level for the development of wrmsds. Aim: This paper aims to give an overview of some of the observational methods that can be used for assessment of ergonomic risks at the workplace. Methods: This study was conducted as a scoping review of the medical and ergonomic literature and official governmental webpages in Sweden, U.S.A. and the Netherlands. Results: In total, 19 different observational methods were identified. We summarize our findings based on the body parts that were studied and what key indicators were assessed: 1) intensity of the work load (posture and force production), 2) frequency of the work load (e.g. repetitive movements), and 3) the duration of the work load (e.g. static work). In an appendix we include a brief presentation of these methods together with the work sheet (if available) and the source reference of the observational method. Conclusion: For ergonomists that perform risk assessments, there is a large number of observational assessment tools available and it is important to understand that different methods can be used simultaneously to be able to estimate the objective risk levels for wrmsds. © 2018, Universidad del Rosario. All rights reserved.

  • 783.
    Wilén, Jonna
    et al.
    National Institute for Working Life, Umeå, Sweden.
    Johansson, Amanda
    National Institute for Working Life, Umeå, Sweden.
    Kalezic, Nebojsa
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Lyskov, Eugene
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Sandström, Monica
    National Institute for Working Life, Umeå, Sweden.
    Psychophysiological tests and provocation of subjects with mobile phone related symptoms2006Ingår i: Bioelectromagnetics, ISSN 0197-8462, E-ISSN 1521-186X, Vol. 27, nr 3, s. 204-214Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the present study was to investigate the effect of exposure to a mobile phone-like radiofrequency (RF) electromagnetic field on persons experiencing subjective symptoms when using mobile phones (MP). Twenty subjects with MP-related symptoms were recruited and matched with 20 controls without MP-related symptoms. Each subject participated in two experimental sessions, one with true exposure and one with sham exposure, in random order. In the true exposure condition, the test subjects were exposed for 30 min to an RF field generating a maximum SAR(1g) in the head of 1 W/kg through an indoor base station antenna attached to a 900 MHz GSM MP. The following physiological and cognitive parameters were measured during the experiment: heart rate and heart rate variability (HRV), respiration, local blood flow, electrodermal activity, critical flicker fusion threshold (CFFT), short-term memory, and reaction time. No significant differences related to RF exposure conditions were detected. Also no differences in baseline data were found between subject groups, except for the reaction time, which was significantly longer among the cases than among the controls the first time the test was performed. This difference disappeared when the test was repeated. However, the cases differed significantly from the controls with respect to HRV as measured in the frequency domain. The cases displayed a shift in low/high frequency ratio towards a sympathetic dominance in the autonomous nervous system during the CFFT and memory tests, regardless of exposure condition. This might be interpreted as a sign of differences in the autonomous nervous system regulation between persons with MP related subjective symptoms and persons with no such symptoms.

  • 784.
    Yermakova, Irena
    et al.
    International scientific training centre for information technologies and systems.
    Boiko, K
    Bortkiewicz, A
    Hallman, David
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Lyskov, Eugene
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heart rate, blood pressure and electromyogram in assessment of physical activity fatigue using neural network model2011Konferensbidrag (Refereegranskat)
  • 785.
    Yung, Marcus
    et al.
    Department of Kinesiology, University of Waterloo.
    Mathiassen, Svend Erik
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Wells, Richard
    Department of Kinesiology, University of Waterloo.
    Variation of Force Amplitude and its Effects on Local Fatigue2012Ingår i: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 112, nr 11, s. 3865-3879Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Trends in industry are leaning towards stereotyped jobs with low workloads. Physical variation is an intervention to reduce fatigue and potentially musculoskeletal disorders in such jobs. Controlled laboratory studies have provided insight into the effectiveness of physical variation but very few have been devoted to intermittent activity without muscular rest as a component. This study was undertaken to determine whether the inclusion of muscular rest would result in physiological responses beyond those composed of varying non-zero forces. Five isometric contraction patterns with the same mean amplitude (15% maximum voluntary contraction, MVC), cycle time (6 seconds), and duty cycle (50%) were compared using multiple biophysical approaches. In exercise, sustained (15%Sust) and intermittent contractions including zero force (0%-30%Int) differed significantly in 19 of 27 response variables. Contractions varying by half the mean force (7.5%-22.5%Int) led to 8 and 7 measured responses that were significantly different from 0%-30%Int and 15%Sus, respectively. A sinusoidal condition (0%-30%Sine) resulted in 2 variables that were significantly different from 0%-30%Int and 16 different from 15%Sus. Finally, 10 response variables suggested that varying forces with 1% as the lower contraction level was significantly less fatiguing than 15%Sus while no responses were significantly different from 0%-30%Int. Sustained contractions led to decreased twitch force 24 hours post-exercise whereas intermittent contractions recovered within 60 minutes. This suggests that time varying force may be a useful intervention to reduce local fatigue in workers performing low-load tasks and that rest per se did not seem to cause any extraordinary effects.

  • 786.
    Zafar, Hamayun
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Odontology, Clinical Oral Physiology, Umeå University, Umeå, Sweden.
    Nordh, E
    Department of Clinical Neurophysiology, Umeå University Hospital, Sweden.
    Eriksson, Per Olof
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Odontology, Clinical Oral Physiology, Umeå University, Umeå, Sweden.
    Impaired positioning of the gape in whiplash-associated disorders2006Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 30, nr 1, s. 9-15Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We have previously introduced anew concept for natural jaw function suggesting that "functional jaw movements" are the result of coordinated jaw and neck muscle activation, leading to simultaneous movements in the temporomandibular, atlanto-occipital and cervical spine joints. Thus, jaw function requires a healthy state of both the jaw and the neck motor systems. The aim of this study was to examine the positioning of the gape in space during maximal jaw opening at fast and slow speed in healthy as well as whiplash-associated disorders (WAD) individuals. A wireless optoelectronic technique for three-dimensional movement recording was used. Subjects were seated in an upright position,with back support up to the mid-scapular level without headrest. The position of the gape in space was defined as the vertical midpoint position of the gape at maximal jaw opening (MP). In healthy, the MP generally coincided with the reference position at the start of jaw opening. In the WAD group, the MID was significantly lower than the reference position. No sex or speed related differences were found. The results suggest that both the width and orientation of the gape in space relies on coordinated jaw and neck muscle activation and mandibular and head-neck movements. This study also suggests an association between neck pain and dysfunction following trauma, and reduced width and impaired positioning of the gape in space. Finally, the MP seems to be a useful marker in evaluation of the functional state of the jaw-neck motor system.

  • 787.
    Zetterberg, Camilla
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Uppsala universitet, Arbets- och miljömedicin.
    The impact of visually demanding near work on neck/shoulder discomfort and trapezius muscle activity: Laboratory studies2016Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Introduktion: Muskelrelaterade besvär i nack- och skulderområdet är vanligt förekommande, framförallt hos individer som utför synkrävande datorarbete. En orsak till sådana besvär anses vara långvarig lågintensiv aktivitet i dessa muskler. Det är i dagsläget oklart om de belastningar som synsystemet utsätts för vid synkrävande arbete bidrar till ökad muskelaktivitet i nack/skulderregionen. Syfte: Syftet var att undersöka om experimentellt synkrävande närarbete påverkar muskelaktivitet och besvär i nack/skulderregionen, och att undersöka om aktivitet i trapezius muskeln (kappmuskeln) påverkas av ögats ackommodation, d.v.s. när linsens brytkraft förändras för att se skarpt på nära håll. Metod: De fyra delstudierna baseras på två laborativa experiment där försökspersoner (66 respektive 26 stycken) genomförde olika synkrävande uppgifter (fem och sju minuter långa). För att göra synuppgifterna mer eller mindre ansträngande för synsystemet användes linser med olika grad av brytkraft (dioptrier). Dessutom, eftersom monokulärt seende inte kräver aktiv konvergens, genomfördes tre av de fyra synuppgifterna i ena experimentet med ett öga för att undersöka den enskilda effekten av ackommodation. En autorefraktor mätte ögats ackommodation under synuppgifterna och aktiviteten i trapeziusmuskeln registreades kontinuerligt med elektromyografi (EMG). I samband med det ena experimentet skattade deltagarna sina upplevda ögon- och nack/skulderbesvär, både före experimentet (baslinje) och efter varje synuppgift. Resultat: Det synkrävande arbetet ökade både de självskattade nack/skulderbesvären och muskelaktiviteten i trapezius. De personer som upplevde en högre ökning av ögonbesvär (i förhållande till baslinjen), rapporterade också mer nack/skulderbesvär över tid. Det var varken någon signifikant skillnad i grad av muskelaktivitet mellan synuppgifterna, eller något signifikant samband mellan monokulär ackommodation och muskelaktivitet. Slutsats: Resultaten indikerar att ögats ackommodation, i sig, inte påverkar muskelaktiviteten i trapezius. Ökad muskelaktivitet i nack/skulderregionen i anslutning till synkrävande arbete kan istället bero på en kombination av höga krav på visuell uppmärksamhet och ett ökat behov av att stabilisera ögonen (huvudet) i förhållande till objektet i fokus (t.ex. texten på en bildskärm). Eftersom resultaten tyder på att synkrävande närarbete leder till ökade besvär i nack/skuldraregionen över tid, är det viktigt att utforma arbetsplatser och synkrävande arbetsuppgifter (t.ex. vid datorn) på ett sätt som främjar visuell hälsa.

  • 788.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Forsman, Mikael
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Richter, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Effects of visually demanding near work on trapezius muscle activity2013Ingår i: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 23, nr 5, s. 1190-1198Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Poor visual ergonomics is associated with visual and neck/shoulder discomfort, but the relation between visual demands and neck/shoulder muscle activity is unclear. The aims of this study were to investigate whether trapezius muscle activity was affected by: (i) eye-lens accommodation; (ii) incongruence between accommodation and convergence; and (iii) presence of neck/shoulder discomfort. Sixty-six participants (33 controls and 33 with neck pain) performed visually demanding near work under four different trial-lens conditions. Results showed that eye-lens accommodation per se did not affect trapezius muscle activity significantly. However, when incongruence between accommodation and convergence was present, a significant positive relationship between eye-lens accommodation and trapezius muscle activity was found. There were no significant group-differences. It was concluded that incongruence between accommodation and convergence is an important factor in the relation between visually demanding near work and trapezius muscle activity. The relatively low demands on accommodation and convergence in the present study imply that visually demanding near work may contribute to increased muscle activity, and over time to the development of near work related neck/shoulder discomfort.

  • 789.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Forsman, Mikael
    Karolinska Institutet.
    Richter, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, CBF. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Undermålig synergonomi kan påverka muskelaktivitet och nacksmärta2011Konferensbidrag (Refereegranskat)
    Abstract [sv]

    Bakgrund och syfte:Det är väl dokumenterat att kroppen kompenserar undermåliga synergonomiska förhållanden med ogynnsamma arbetsställningar. Det är däremot inte klarlagt om ökad belastning av ögats muskler påverkar muskelaktivitet och smärta i nackens muskulatur. Syftet med studien var att experimentellt fastställa om ökad belastning på ögats fokuseringsmuskler vid simulerat bildskärmsarbete ger ökad aktivitet i m. trapezius och ökad upplevd nacksmärta.Metoder:Sextiosex forskningspersoner (20-47 år, 54 kvinnor, 12 män) utförde en synuppgift under tre olika randomiserade synförhållanden (binokulärt -3.5D, monokulärt -3.5D och ±0D). Uppgiften var att fokusera blicken på ett mönster på en bildskärm, placerad på 1.5 m avstånd, under 7 minuter. Förhållanden med -3.5D gjorde mönstret oskarpt och personen instruerades att viljemässigt fokusera bort oskärpan. Belastning på ögats fokuseringsmuskel mättes indirekt med en kamera (Plusoptix, Nürnberg, Tyskland). Muskelaktivitet i m. trapezius mättes med EMG. Före och efter experimentet skattade personen sin upplevda nacksmärta med Borgs CR10-skala. Under experimentet satt försökspersonen lätt tillbakalutad i en kontorsstol med nackstöd. Personerna instruerades att sitta bekvämt och avslappnat och att upprätthålla kontakt med nackstödet.Resultat:Resultatet visade att personer med en högre grad av fokusering i binokulärt förhållande (-3.5D), hade högre amplitud EMG i m. trapezius. De två monokulära förhållandena visade inget samband mellan grad av fokuserig och EMG amplitud. Detta tyder på ett positivt samband mellan ögats fokusering (ackommodation och konvergens) och aktivering i trapezius muskulaturen. Resultatet visar också att personer skattar högre nacksmärta efter experimentet jämfört med före. Konklusion:Vid simulerat bildskärmsarbete med undermåliga synförhållanden, kan förhöjd aktivitet i m. trapezius och ökad upplevd nacksmärta uppkomma efter kort tid, även om arbetsställningen är god.

  • 790.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Uppsala universitet, Arbets- och miljömedicin.
    Forsman, Mikael
    Institutet för miljömedicin, Karolinska Institutet, Stockholm, Sverige.
    Richter, Hans O.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Neck/shoulder discomfort due to visually demanding near work is influenced by previous neck pain, task duration, astigmatism, eye discomfort and accommodation2017Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, nr 8, artikel-id e0182439Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Visually demanding near work can cause eye discomfort, and eye and neck/shoulder discomfort during, e.g., computer work are associated. Here, to investigate direct effects of experimental near work on eye and neck/shoulder discomfort, 33 individuals with chronic neck pain and 33 healthy control subjects performed four visual tasks, rating eye and neck/shoulder discomfort at baseline and after each task. The cumulative performance time (reflected in the temporal order of the tasks), astigmatism, concurrent eye discomfort, and extent of accommodation all aggravated neck/shoulder discomfort. There was an interaction effect between the temporal order and eye discomfort: participants with a greater mean increase in eye discomfort also developed more neck/shoulder discomfort with time. Since moderate musculoskeletal symptoms are a risk factor for more severe symptoms, it is important to ensure a good visual environment in occupations involving visually demanding near work.

  • 791.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Lindberg, Per
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Nylén, Per
    The Swedish Work Environment Authority, and The Royal Institute of Technology.
    Hemphälä, Hillevi
    Lund University.
    Intra-rater reliability of the Visual Ergonomics Risk Assessment Method (VERAM)2018Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction: Visually demanding near work can cause eye discomfort, and eye and neck/shoulder discomfort during, e.g., computer work are associated. Apart from visual demands and dryness a number of environmental factors including design of the work station, lighting, glare, and the quality of the computer screen might exert an impact on eye-related symptoms. To date, there is a lack of valid and reliable instruments assessing factors associated with eye- or visual symptoms. Therefore, a new method to assess visual ergonomics at workplaces was developed in Sweden between 2014 and 2016, the Visual Ergonomics Risk Assessment Method - VERAM. A first version of the method was drafted by the researchers mainly from existing checklists and instruments, and tested in the field by trained visual ergonomists. The method was then revised and used in the field to collect data for validity and reliability analyses. The final version of VERAM includes both a questionnaire for the employee, and an expert evaluation of the employee’s workplace. The questionnaire consists of subjective ratings in six domains: eye discomfort (frequency and intensity), musculoskeletal discomfort (frequency and intensity), ratings of visual symptoms (e.g. blurred and double vision) and ratings of the visual environment (e.g. illumination levels, glare and reflexes from a work object or a computer screen). The expert evaluation consists of both objective measurements and subjective assessments resulting in an overall expert risk assessment (no risk, low risk or high risk) of eight factors: daylight, lighting, illuminance, glare, flicker, work space, work object and work posture.

    Aim: At the IEA conference 2018 the new VERAM method will be presented together with results from intra-rater reliability analyses.

    Results: Intra-rater reliability was evaluated with a re-test interval of minimum two and maximum three weeks. 99 employees were included in the analyses and 32 visual ergonomists performed the corresponding expert evaluations. The Intraclass Correlations (ICC) were between 0.70 and 0.87 for the six subjective domains, and there were no significant systematic differences between the first and second rating for any of the subjective domains (rmANOVA, p > 0.05, α = 0.008). For the eight environmental factors the expert estimated the risk equally during the first and the second assessment in 69-92% of the cases, and, as seen for the subjective domains, there were no significant systematic differences for any of the eight factors (Wilcoxon sign rank test, p > 0.014, α = 0.006). To control for multiple comparisons the Bonferroni method was used.

    Conclusion: The Visual Ergonomics Risk Assessment Method – VERAM showed good intra-rater reliability, both for the subjective questionnaire for the employee, and for the expert evaluation of the employee’s workplace when performed by a trained visual ergonomist.

  • 792.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Lindberg, Per
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Nylén, Per
    Swedish Work Environment Authority, Stockholm, Sweden.
    Hemphälä, Hillevi
    Division of Ergonomics and Aerosol Technology, Design Sciences, Lund University, Lund, Sweden.
    Reliability of a new risk assessment method for visual ergonomics2019Ingår i: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 72, s. 71-79Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction

    The Visual Ergonomics Risk Assessment Method (VERAM) is a newly developed and validated method to assess visual ergonomics at workplaces. VERAM consists of a questionnaire and an objective evaluation.

    Objective

    To evaluate reliability of VERAM by assessing test-retest reliability of the questionnaire, and intra- and inter-rater reliability of the objective evaluation.

    Methods

    Forty-eight trained evaluators used VERAM to evaluate visual ergonomics at 174 workstations. The time interval for test-retest and intra-rater evaluations was 2–3 weeks, and the time interval for inter-rater evaluations was 0–2 days. Test-retest reliability was assessed by intraclass correlation (ICC), the standard error of measurement (SEM) and the smallest detectable change (SDC). Intra- and inter-rater reliability were assessed with weighted kappa coefficients and absolute agreement. Systematic changes were analysed with repeated measures analyses of variance and Wilcoxon sign rank test.

    Results

    The ICC of the questionnaire indices ranged from 0.69 to 0.87, while SEM ranged from 7.21 to 10.19 on a scale from 1 to 100, and SDC from 14.42 to 20.37. Intra-rater reliability of objective evaluations ranged from 0.57 to 0.85 (kappa coefficients) and the agreement from 69 to 91%. Inter-rater reliability of objective evaluations ranged from 0.37 to 0.72 (kappa coefficients) and the agreement from 52 to 87%.

    Conclusion

    VERAM is a reliable instrument for assessing risks in visual work environments. However, the reliability might increase further by improving the quality of training for evaluators. Complementary evaluations of VERAM's sensitivity to changes in the visual environment are needed.

    Relevance to industry

    It is advantageous to set up a work environment for maximal visual comfort to avoid negative effects on work postures and movements and thus prevent visual- and musculoskeletal symptoms. This method, VERAM, satisfies the need of a valid and reliable tool for determining risks associated with the visual work environment.

  • 793.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Medical Sciences, Section of Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden..
    Hemphälä, Hillevi
    Ergonomics, Design Sciences, Lund University, Lund, Sweden.
    Nylén, Per
    The Swedish Work Environment Authority, and The Royal Institute of Technology.
    Lighting, visual ergonomics and health implications : A workshop2014Konferensbidrag (Refereegranskat)
    Abstract [en]

    Aim of the workshop:

    Deficient visual ergonomics is a problem across many occupations. Poor viewingand lighting conditions is associated with both visual and neck/shoulder discomfort,and can also impact productivity. According to the provision from the Swedish WorkEnvironment Authority on prevention of musculoskeletal disorders (AFS 2012:02), riskassessment of the visual conditions are mandatory. The aim of this workshop is toincrease knowledge about visual ergonomics among practitioners working with riskassessment, and to allow participants hands-on practice in assessing the visual environment.

    Format of the workshop:

    The first part of the workshop will involve a brief presentation of the subject visualergonomics and its implications on health and performance. The impact of progressiveglasses, too small or blurred font letters, or blurred vision on posture at e.g. computerwork will be demonstrated together with advice how to proceed to improve the conditions.The second part of the workshop will allow participants some hands-on practicein for example; how to measure light (luminance and illuminance); how different lightconditions impact pupil size and visual comfort; how to measure and quantify amountof flicker, light modulation and colour rendering in different light sources. Several usefulmobile phone applications concerning light and vision will be demonstrated.

  • 794.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Hemphälä, Hillevi
    Lund University.
    Nylén, Per
    The Swedish Work Environment Authority, and The Royal Institute of Technology.
    Workshop in visual ergonomics2013Konferensbidrag (Refereegranskat)
    Abstract [en]

    Increased use of computers is common across many work sectors. Prolonged near work at a computer screen is associated with both visual discomfort and neck/shoulder discomfort and pain. Inadequate visual ergonomics at a computer workstation can also influence both visual and neck/shoulder discomfort. The new provision from the Swedish Work Environment Authority on prevention of musculoskeletal disorders includes risk assessment of occupational visual conditions. These assessments require practitioners to have knowledge of the topic, as well as experience with practical assessment tools.

    The first part of the workshop proposed here will involve a presentation of the theories underlying visual ergonomic practices and a discussion of the most important factors to assess at a computer workstation. These factors include contrast, font size, resolution, glare, reflexion, non-visual flicker, and edge sharpness. The second part of the workshop, will allow participants hands-on practice in measuring and evaluating visual ergonomics at a computer workstation.

  • 795.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Medical Sciences, Section of Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden..
    Richter, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Forsman, Mikael
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Temporal co-variation between eye lens accommodation and trapezius muscle activity during a dynamic near-far visual task2015Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 5, artikel-id e0126578Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Near work is associated with increased activity in the neck and shoulder muscles, but the underlying mechanism is still unknown. This study was designed to determine whether a dynamic change in focus, alternating between a nearby and a more distant visual target, produces a direct parallel change in trapezius muscle activity. Fourteen healthy controls and 12 patients with a history of visual and neck/shoulder symptoms performed a Near-Far visual task under three different viewing conditions; one neutral condition with no trial lenses, one condition with negative trial lenses to create increased accommodation, and one condition with positive trial lenses to create decreased accommodation. Eye lens accommodation and trapezius muscle activity were continuously recorded. The trapezius muscle activity was significantly higher during Near than during Far focusing periods for both groups within the neutral viewing condition, and there was a significant co-variation in time between accommodation and trapezius muscle activity within the neutral and positive viewing conditions for the control group. In conclusion, these results reveal a connection between Near focusing and increased muscle activity during dynamic changes in focus between a nearby and a far target. A direct link, from the accommodation/vergence system to the trapezius muscles cannot be ruled out, but the connection may also be explained by an increased need for eye-neck (head) stabilization when focusing on a nearby target as compared to a more distant target.

  • 796.
    Zetterlund, Christina
    et al.
    Centre for Rehabilitation Research, Örebro University Hospital.
    Lundqvist, Lars-Olof
    Centre for Rehabilitation Research, Örebro University Hospital.
    Richter, Hans
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap.
    The relationship between low vision and musculoskeletal complaints: A case control study between age-related macular degeneration patients and age-matched controls with normal vision2009Ingår i: Journal of Optometry, ISSN 1888-4296, Vol. 2, nr 3, s. 127-133Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Age-related Macular Degeneration (AMD) patients often describe complaints from neck and scapula area muscles and a decreased postural control. In clinical assessment, these complaints are considered to be due to old age. Purpose: This study focuses on low vision patients with AMD, compared to age matched controls, without eye disease, in order to evaluate if a linkage between self-rated visual and muskuloskeletal complaints are more prominent when low vision is present. Methods: In a cross-sectional study, 24 AMD patients, aged 65-85 years, were compared to 24 controls of similar ages without visual problems. Visual acuity, the need for magnification plus other optical and visual data, were obtained. Visual, muskuloskeletal and balance/propriopceptive complaints were collected with a self-rating questionnaire. The Visual Functioning Questionnaire -Near Activities Subscale (VFQ-NAS) was used to evaluate visual function and related complaints. Results: The correlation coefficient between visual and musculoskeletal complaints yielded significant values when computed separately within each group as well as when calculated on the entire material (AMD ρ = 0.60, P = 0.002; control group ρ = 0.59, P = 0.004; both groups together ρ = 0.50 P < 0.001). Stepwise multiple regression analysis supported the hypothesized effect of vision (Visual complaints + Minimal readable typefaces) on musculoskeletal complaints, (R2 = 0.42, P < 0.05). Conclusions: The results in this study support the hypothesis of a relationship between visual and muskuloskeletal problems.

  • 797.
    Zetterlund, Christina
    et al.
    School of Health and Medicine, Örebro University, Örebro, Sweden.
    Lundqvist, Lars-Olov
    Centre for Rehabilitiation Research, Örebro County Council, Örebro, Sweden.
    Richter, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Visual, musculoskeletal and balance symptoms in individuals with visual impairment and with age-normal vision2019Ingår i: Clinical and experimental optometry, ISSN 0816-4622, E-ISSN 1444-0938, Vol. 102, nr 1, s. 63-69Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Visual impairment is globally among the most prevalent disabilities. Research concerning the health consequences of visual deficits is challenged by confounding effects of age, because visual impairment becomes more prevalent with age. This study investigates the influence of visual deficits on visual, musculoskeletal and balance symptoms in adults with and without visual impairment, while controlling for age effects.

    METHODS:

    Thirty-nine patients with visual impairment, aged 18-72 years, were compared to 37 age-matched controls with normal vision, allocated to two age groups: < 45 and ≥ 45 years. Self-reported symptoms were measured using the Visual, Musculoskeletal and Balance Symptoms Questionnaire and compared with demographic and optometric variables.

    RESULTS:

    In total, patients with visual impairment reported more symptoms than age-matched normally sighted controls. Younger adults in the control group were almost free from symptoms, whereas younger adults with visual impairment reported levels of symptoms equal to older adults with visual impairment. Multiple logistic regression modelling identified use of eyeglasses, magnifying aids and presence of anisometropia to be the most influential risk factors for reporting visual, musculoskeletal and balance symptoms, with accentuated influence on balance symptoms.

    CONCLUSIONS:

    People with visual impairments and people with age-related normal visual deficits are both predisposed to report visual, musculoskeletal and balance symptoms relative to people without visual defects or need for eye-wear correction. Age-related variations in symptoms were observed in the control groups but not in the visual impairment groups, with younger visual impairment patients reporting as many symptoms as older visual impairment patients. These findings indicate a need for a wider interdisciplinary perspective on eye care concerning people with visual impairment and people with need for habitual daily use of eye wear correction.

  • 798.
    Zetterlund, Christina
    et al.
    The Low Vision Centre, Region Örebro County, Örebro, Sweden; University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Richter, Hans O.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Lundqvist, Lars-Olov
    University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Visual, Musculoskeletal, and Balance Complaints in AMD: A Follow-Up Study2016Ingår i: Journal of Ophthalmology, ISSN 2090-004X, E-ISSN 2090-0058, Vol. 2016, artikel-id 2707102Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose. To investigate whether patients with age-related macular degeneration (AMD) run a potentially higher risk of developing visual, musculoskeletal, and balance complaints than age-matched controls with normal vision. Methods. Visual assessments, self-rated visual function, self-rated visual, musculoskeletal, and balance complaints, and perceived general health were obtained in 37 AMD patients and 18 controls, at baseline and after an average of 3.8 years later. Results. At follow-up both groups reported decreased visual acuity (VA) and visual function, but only AMD patients reported significantly increased visual, musculoskeletal, and balance complaints. Decreased VA, need for larger font size when reading, need for larger magnification, and decreased self-rated visual function were identified as risk markers for increased complaints in AMD patients. These complaints were also identified as risk markers for decreased health. For controls, decreased VA and self-reported visual function were associated with increased visual and balance complaints. Conclusions. Visual deterioration was a risk marker for increased visual, musculoskeletal, balance, and health complaints in AMD patients. Specifically, magnifying visual aids, such as CCTV, were a risk marker for increased complaints in AMD patients. This calls for early and coordinated actions to treat and prevent visual, musculoskeletal, balance, and health complaints in AMD patients.

  • 799.
    Åsell, Malin
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Svenska Rygginstitutet AB, Sundsvall, Sweden; Department of Odontology, Clinical Oral Physiology, Umeå University, Umeå, Sweden.
    Sjölander, Per
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Southern Lapland Research Department, Vilhelmina, Sweden.
    Kerschbaumer, Helmut
    Svenska Rygginstitutet AB, Sundsvall, Sweden.
    Djupsjöbacka, Mats
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Are lumbar repositioning errors larger among patients with chronic low back pain compared with asymptomatic subjects?2006Ingår i: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 87, nr 9, s. 1170-1176Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To resolve the debate over whether lumbar repositioning acuity is reduced in patients with chronic low back pain (CLBP) by using a study design and methodology to minimize the effects of potential confounders. DESIGN: A single-blinded, controlled, multigroup comparative study.

    SETTING: Vocational rehabilitation center.

    PARTICIPANTS: Ninety-two patients with CLBP, divided into subgroups based on severity of symptoms and diagnostic characteristics. An age- and sex-matched group (n=31) of healthy subjects were the control. I

    NTERVENTIONS: Not applicable.

    MAIN OUTCOME MEASURES: We measured repositioning errors (variable, constant) at 3 positions of the lumbar spine. Subjects were guided to a sitting target posture and asked to perform lumbar flexion before reproducing the target posture. Self-assessed pain, self-efficacy, and functional ability were addressed through questionnaires.

    RESULTS: There were no differences in repositioning errors between the patients with CLBP or the subgroups of patients and the control group. We found only weak correlations between the repositioning errors and the self-reported data on functional disability, self-efficacy, and pain.

    CONCLUSIONS: We suggest that sensorimotor dysfunctions in CLBP should be evaluated with methods other than repositioning tests in order to generate data relevant to the development of rational diagnostic methods and rehabilitation programs.

  • 800.
    Öhberg, Fredrik
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Biomechanical methods and error analysis related to chronic musculoskeletal pain2009Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    Background Spinal pain is one of humanity’s most frequent complaints with high costs for the individual and society, and is commonly related to spinal disorders. There are many origins behind these disorders e.g., trauma, disc hernia or of other organic origins. However, for many of the disorders, the origin is not known. Thus, more knowledge is needed about how pain affects the neck and neural function in pain affected regions. The purpose of this dissertation was to improve the medical examination of patients suffering from chronic whiplash-associated disorders or other pain related neck-disorders.

    Methods A new assessment tool for objective movement analysis was developed. In addition, basic aspects of proprioceptive information transmission, which can be of relevance for muscular tension and pain, are investigated by studying the coding of populations of different types of sensory afferents by using a new spike sorting method. Both experiments in animal models and humans were studied to accomplish the goals of this dissertation. Four cats where were studied in acute animal experiments. Mixed ensembles of afferents were recorded from L7-S1 dorsal root filaments when mechanical stimulating the innervated muscle. A real-time spike sorting method was developed to sort units in a multi-unit recording. The quantification of population coding was performed using a method based on principal component analysis. In the human studies, 3D neck movement data were collected from 59 subjects with whiplash-associated disorders (WAD) and 56 control subjects. Neck movement patterns were identified by processing movement data into parameters describing the rotation of the head for each subject. Classification of neck movement patterns was performed using a neural network using processed collected data as input. Finally, the effect of marker position error on the estimated rotation of the head was evaluated by computer simulations.

    Results Animal experiments showed that mixed ensembles of different types of afferents discriminated better between different muscle stimuli than ensembles of single types of these afferents. All kinds of ensembles showed an increase in discriminative ability with increased ensemble size. It is hypothesized that the main reason for the greater discriminative ability might be the variation in sensitivity tuning among the individual afferents of the mixed ensemble will be larger than that for ensembles of only one type of afferent. In the human studies, the neural networks had a predictivity of 0.89, a sensitivity of 0.90 and a specificity of 0.88 when discriminating between control and WAD subjects. Also, a systematic error along the radial axis of the rigid body added to a single marker had no affect on the estimated rotation of the head.

    Conclusion The developed spike sorting method, using neural networks, was suitable for sorting a multiunit recording into single units when performing neurophysiological experiments. Also, it was shown that neck movement analysis combined with a neural network could build the basis of a decision support system for classifying suspected WAD or other pain related neck-disorders.

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