Umeå University's logo

umu.sePublications
Change search
Link to record
Permanent link

Direct link
Alternative names
Publications (10 of 41) Show all publications
Cronström, A., Tengman, E. & Häger, C. (2024). Response to comment on: “return to sports: a risky business? a systematic review with meta-analysis of risk factors for graft rupture following acl reconstruction” [Letter to the editor]. Sports Medicine, 54, 779-780
Open this publication in new window or tab >>Response to comment on: “return to sports: a risky business? a systematic review with meta-analysis of risk factors for graft rupture following acl reconstruction”
2024 (English)In: Sports Medicine, ISSN 0112-1642, E-ISSN 1179-2035, Vol. 54, p. 779-780Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
Springer Nature, 2024
National Category
Sport and Fitness Sciences Physiotherapy
Identifiers
urn:nbn:se:umu:diva-217458 (URN)10.1007/s40279-023-01965-3 (DOI)37999881 (PubMedID)2-s2.0-85177690697 (Scopus ID)
Available from: 2023-12-05 Created: 2023-12-05 Last updated: 2024-05-07Bibliographically approved
Olofsson, E., Gustafson, Y., Mukka, S., Tengman, E., Lindgren, L. & Olofsson, B. (2023). Association of depressive disorders and dementia with mortality among older people with hip fracture. BMC Geriatrics, 23(1), Article ID 135.
Open this publication in new window or tab >>Association of depressive disorders and dementia with mortality among older people with hip fracture
Show others...
2023 (English)In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 23, no 1, article id 135Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Hip fracture (HF) is a significant cause of mortality among older people. Almost half of the patients with HF have dementia, which increases the mortality risk further. Cognitive impairment is associated with depressive disorders (DDs) and both dementia and DDs are independent risk factors for poor outcome after HF. However, most studies that evaluate mortality risk after HF separate these conditions.

AIMS: To investigate whether dementia with depressive disorders (DDwD) affects the mortality risk at 12, 24, and 36 months after HF among older people.

METHODS: Patients with acute HF (n = 404) were included in this retrospective analysis of two randomized controlled trials performed in orthopedic and geriatric departments. Depressive symptoms were assessed using the Geriatric Depression Scale and cognitive function was assessed using the Mini-Mental State Examination. A consultant geriatrician made final depressive disorder and dementia diagnoses using the Diagnostic and Statistical Manual of Mental Disorders criteria, with support from assessments and medical records. The 12-, 24- and 36-month mortality after HF was analyzed using logistic regression models adjusted for covariates.

RESULTS: In analyses adjusted for age, sex, comorbidity, pre-fracture walking ability, and fracture type, patients with DDwD had increased mortality risks at 12 [odds ratio (OR) 4.67, 95% confidence interval (CI) 1.75-12.51], 24 (OR 3.61, 95% CI 1.71-7.60), and 36 (OR 4.53, 95% CI 2.24-9.14) months. Similar results were obtained for patients with dementia, but not depressive disorders, alone.

CONCLUSION: DDwD is an important risk factor for increased mortality at 12, 24, and 36 months after HF among older people. Routinely assessments after HF for cognitive- and depressive disorders could identify patients at risk for increased mortality, and enable early interventions.

TRIAL REGISTRATION: RCT2: International Standard Randomized Controlled Trial Number Register, trial registration number: ISRCTN15738119.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Dementia, Depressive disorders, Hip fracture, Mortality, Older people
National Category
Orthopaedics Geriatrics
Identifiers
urn:nbn:se:umu:diva-205678 (URN)10.1186/s12877-023-03862-w (DOI)000945613200001 ()36890449 (PubMedID)2-s2.0-85149626612 (Scopus ID)
Funder
Vårdal FoundationVisare NorrThe Kempe FoundationsUmeå UniversityRegion VästerbottenSwedish Research Council, K2005‐27VX‐15357‐01A
Available from: 2023-03-14 Created: 2023-03-14 Last updated: 2024-07-04Bibliographically approved
Cronström, A., Tengman, E. & Häger, C. (2023). Return to sports: a risky business? a systematic review with meta-analysis of risk factors for graft rupture following acl reconstruction. Sports Medicine, 53(1), 91-110
Open this publication in new window or tab >>Return to sports: a risky business? a systematic review with meta-analysis of risk factors for graft rupture following acl reconstruction
2023 (English)In: Sports Medicine, ISSN 0112-1642, E-ISSN 1179-2035, Vol. 53, no 1, p. 91-110Article, review/survey (Refereed) Published
Abstract [en]

Background: The risk of sustaining a graft rupture after anterior cruciate ligament reconstruction (ACLR) is high. Contributing risk factors are, however, still not clearly identified.

Objective: The aim of this systematic review was to identify and quantify risk factors for graft rupture after ACLR.

Methods: A systematic review with meta-analysis (PROSPERO CRD42020140129) based on PRISMA guidelines was performed. MEDLINE, CINAHL and EMBASE were searched from inception to September 2021. Prospective and retrospective studies addressing risk factors for graft rupture after ACLR in males/females of all ages were considered. Meta-analyses using a random effect model (effect measure: odds ratio [OR] with 95% confidence interval [CI]) were performed. The GRADE tool was used to assess evidence quality.

Results: Following full-text screening of 310 relevant papers, 117 were eventually included, incorporating up to 133,000 individuals in each meta-analysis. Higher Tegner activity level (≥ 7 vs < 7) at primary injury (OR 3.91, 95% CI 1.69–9.04), increased tibial slope (degrees) (OR 2.21, 95% CI 1.26–3.86), lower psychological readiness to return to sport (RTS) (OR 2.18, 95% CI 1.32–3.61), early surgery (< 12 vs ≥ 12 months) (OR 1.87, 95% CI 1.58–2.22), RTS (pre-injury level) (OR 1.87, 95% CI 1.21–2.91) and family history of ACL injury (OR 1.76, 95% CI 1.34–2.31) were all associated with increased odds of graft rupture. Higher age (OR 0.47, 95% CI 0.39–0.59), female sex (OR 0.88, 95% CI 0.79–0.98), fewer self-reported knee symptoms pre-reconstruction (OR 0.81, 95% CI 0.69–0.95) and concomitant cartilage injuries (OR 0.70, 95% CI 0.62–0.79) instead decreased the odds. Meta-analysis revealed no association between body mass index, smoking, joint laxity, RTS time, knee kinematics, muscle strength or hop performance and graft rupture.

Conclusion: Conspicuous risk factors for graft rupture were mainly sports and hereditary related. Few studies investigated function-related modifiable factors or included sports exposure data.

Place, publisher, year, edition, pages
Springer, 2023
National Category
Sport and Fitness Sciences Physiotherapy
Identifiers
urn:nbn:se:umu:diva-199211 (URN)10.1007/s40279-022-01747-3 (DOI)000844426700003 ()36001289 (PubMedID)2-s2.0-85136845913 (Scopus ID)
Available from: 2022-09-08 Created: 2022-09-08 Last updated: 2023-01-11Bibliographically approved
Markström, J., Tengman, E. & Häger, C. (2023). Side-hops challenge knee control in the frontal and transversal plane more than hops for distance or height among ACL-reconstructed individuals. Sports Biomechanics, 22(1), 142-159
Open this publication in new window or tab >>Side-hops challenge knee control in the frontal and transversal plane more than hops for distance or height among ACL-reconstructed individuals
2023 (English)In: Sports Biomechanics, ISSN 1476-3141, E-ISSN 1752-6116, Vol. 22, no 1, p. 142-159Article in journal (Refereed) Published
Abstract [en]

We compared knee landing mechanics with presumed relation to risk of anterior cruciate ligament (ACL) injury among three single-leg hop tests and between legs in individuals with unilateral ACL reconstruction. Thirty-four participants (>10 months' post-surgery, 23 females) performed the standardised rebound side hop (SRSH), maximal hop for distance (OLHD) and maximal vertical hop (OLVH). We calculated the following knee outcomes from motion capture and force plate data: finite helical axis inclination angles (approximates knee robustness), frontal and transversal plane angles at initial contact, peak angles of abduction and internal rotation during landing, and peak external moments of flexion, abduction and internal rotation during landing. Repeated-measures MANOVA analysis ('sex' as covariate) confirmed that SRSH induced greater angles and moments, particularly in the frontal plane, compared to OLHD and OLVH. There was between-leg asymmetry for peak knee flexion moment for males during OLHD and OLVH, and for females during SRSH. Our results advocate the SRSH over OLHD and OLVH for assessment of knee landing control to screen for movement patterns potentially related to ACL injury risk. However, clear differences in both knee kinematics and kinetics between OLHD and SRSH motivate the use of both tests to evaluate different aspects of landing control.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2023
Keywords
Biomechanics, hop landing, non-contact knee injury, sports
National Category
Physiotherapy Sport and Fitness Sciences
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-159146 (URN)10.1080/14763141.2020.1869296 (DOI)000618264000001 ()33586624 (PubMedID)2-s2.0-85100880478 (Scopus ID)
Funder
Swedish Research Council, 521-2013-2802Swedish Research Council, K2014-99X-21876-04-4Swedish Research Council, 2017-00892
Note

Previously included in thesis in manuscript form, with title: "One-leg lateral side-hops induce greater demands on knee landing control than hops in other directions as demonstrated in athletic and non-athletic females with or without injury of the anterior cruciate ligament"

Available from: 2019-05-20 Created: 2019-05-20 Last updated: 2022-12-30Bibliographically approved
Tengman, E., Schelin, L. & Häger, C. (2022). Angle-specific torque profiles of concentric and eccentric thigh muscle strength 20 years after anterior cruciate ligament injury. Sports Biomechanics
Open this publication in new window or tab >>Angle-specific torque profiles of concentric and eccentric thigh muscle strength 20 years after anterior cruciate ligament injury
2022 (English)In: Sports Biomechanics, ISSN 1476-3141, E-ISSN 1752-6116Article in journal (Refereed) Epub ahead of print
Abstract [en]

Thigh muscle weakness prevails following anterior cruciate ligament (ACL) injury, as usually evaluated by peak concentric quadriceps strength. Assessment throughout the range of motion (ROM), and for antagonists may provide more comprehensive information. We evaluated angle-specific torque profiles and ratios of isokinetic thigh muscle strength in 70 individuals 23 ± 2 years post-ACL injury (44males, 46.9 ± 5.4 years); 33 treated with ACL-reconstruction (ACL-R), and 37 treated only with physiotherapy (ACL-PT), and 33 controls. Quadriceps and hamstrings torques for concentric/eccentric contractions (90°/s) and ratios between hamstrings/quadriceps strength (HQ) were compared between and within groups using inferential functional data methods. The injured ACL-R leg had lower concentric and eccentric quadriceps strength compared to non-injured leg throughout the ROM, and lower concentric (interval 70–79°) and eccentric (64–67°) quadriceps strength compared to controls. The injured ACL-PT leg showed lower eccentric quadriceps strength (53–77°) than non-injured leg and lower concentric (41–79°) and eccentric (52–81°) quadriceps and eccentric hamstrings (30–77°) strength than controls. There were no group differences for HQ-ratios. The injured ACL-R leg had higher HQ-ratio (34–37°) than non-injured leg. Angle-specific torque profiles revealed strength deficits, masked if using only peak values, and seem valuable for ACL-injury rehabilitation.     

Place, publisher, year, edition, pages
Routledge, 2022
Keywords
Long-term perspective, isokinetic, functional data analysis, rehabilitation, strength assessment, cross-sectional study
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-194432 (URN)10.1080/14763141.2022.2054856 (DOI)000777927100001 ()35373714 (PubMedID)2-s2.0-85129195440 (Scopus ID)
Funder
Swedish Research Council, K2014-99X21876-04-4Swedish Research Council, 2017-00892Swedish Research Council, 2016-02763Swedish National Centre for Research in Sports, CIF 2017/8Swedish National Centre for Research in Sports, P2018-0104Region Västerbotten, RV-838421Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Available from: 2022-05-04 Created: 2022-05-04 Last updated: 2023-03-24
Karlström, J., Wiklund, M. & Tengman, E. (2022). Disrupted knee – disrupted me: a strenuous process of regaining balance in the aftermath of an anterior cruciate ligament injury. BMC Musculoskeletal Disorders, 23(1), Article ID 290.
Open this publication in new window or tab >>Disrupted knee – disrupted me: a strenuous process of regaining balance in the aftermath of an anterior cruciate ligament injury
2022 (English)In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 23, no 1, article id 290Article in journal (Refereed) Published
Abstract [en]

Background: Individuals describe both short and long term consequences after an anterior cruciate ligament (ACL) injury. Functional impairments are well documented while psychological, social and contextual factors need to be further investigated. By the use of a qualitative method incorporating a biopsychosocial lens, we aimed to explore individuals' experiences of living and coping with an ACL rupture with a specific focus on experiences significant to overall life, activity in daily living and physical activity more than one year after injury.

Methods: Twelve participants were chosen strategically by a purposive sampling. Four men and eight women (19–41 years) with an ACL rupture 2–25 years ago, were included. Semi-structured interviews were used and analysed with qualitative content analysis.

Results: The results consisted of one overarching theme: 'A strenuous process towards regaining balance' which built on three categories 'Disrupted knee', 'Disrupted me' and 'Moving forward with new insights'. The overarching theme captures the participants' experiences of a strenuous process towards regaining both physical and mental balance in the aftermath of an ACL injury. The results illuminate how participants were forced to cope with a physically 'disrupted knee', as well as facing mental challenges, identity challenges and a 'disrupted me'. By gradual acceptance and re-orientation they were moving forward with new insights – although still struggling with the consequences of the injury.

Conclusions: Individuals with an ACL injury experience both physical, psychological, and social challenges several years after injury. In addition to the functional impairments, diverse psychological, social and contextual 'disruptions' and struggles may also be present and influence the rehabilitation process. It is important that physiotherapists identify individuals who face such challenges and individually tailor the rehabilitation and support. A biopsychosocial approach is recommended in the clinical practice and future studies focusing on psychosocial processes in the context of ACL rehabilitation are warranted.

Place, publisher, year, edition, pages
BioMed Central, 2022
Keywords
ACL, Coping strategies, Fear of re-injury, Interviews, Physiotherapy, Psychological impairments, Qualitative Research, Rehabilitation
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-193701 (URN)10.1186/s12891-022-05252-6 (DOI)000773936300003 ()35346145 (PubMedID)2-s2.0-85127247809 (Scopus ID)
Available from: 2022-04-28 Created: 2022-04-28 Last updated: 2024-01-17Bibliographically approved
Strong, A., Arumugam, A., Tengman, E., Röijezon, U. & Häger, C. (2022). Properties of tests for knee joint threshold to detect passive motion following anterior cruciate ligament injury: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research, 17(1), Article ID 134.
Open this publication in new window or tab >>Properties of tests for knee joint threshold to detect passive motion following anterior cruciate ligament injury: a systematic review and meta-analysis
Show others...
2022 (English)In: Journal of Orthopaedic Surgery and Research, E-ISSN 1749-799X, Vol. 17, no 1, article id 134Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Threshold to detect passive motion (TTDPM) tests of the knee joint are commonly implemented among individuals with anterior cruciate ligament (ACL) injury to assess proprioceptive acuity. Their psychometric properties (PMPs), i.e. reliability, validity and responsiveness, are however unclear. This systematic review aimed to establish the PMPs of existing knee joint TTDPM tests among individuals with ACL injury.

METHODS: The databases PubMed, AMED, CINAHL, SPORTDiscus, Web of Science, Scopus, CENTRAL and ProQuest were searched to identify studies that assessed the properties of knee joint TTDPM tests in individuals with ACL injury. The risk of bias for each included study was assessed at the outcome level for each test. Overall quality and levels of evidence for each property were rated according to established criteria. Meta-analyses with mean differences were conducted using random-effects models when adequate data were available.

RESULTS: Fifty-one studies covering 108 TTDPM tests and 1632 individuals with unilateral ACL injury were included. A moderate-to-strong level of evidence indicated insufficient quality for all of the following: convergent validity, known-groups validity, discriminative validity, responsiveness between subgroups, and responsiveness to intervention. Subgroup meta-analyses for known-groups validity did however find that a starting angle of 15° resulted in significantly worse TTDPM for knees with ACL injury compared to those of asymptomatic persons (mean difference 0.28°; 95% CI 0.03 to 0.53; P = 0.03), albeit based on only three studies. Due to the lack of evidence, it was not possible to estimate the quality of reliability, measurement error, and criterion validity, nor responsiveness from a criterion and construct approach.

CONCLUSIONS: Among persons with ACL injury, existing tests of knee joint TTDPM lack either sufficient quality or evidence for their reliability, validity and responsiveness. Significantly worse thresholds for ACL-injured knees compared to those of asymptomatic controls from a 15° starting angle and trends towards significance for some validity measures nevertheless encourage the development of standardised tests. Further research investigating the influence of modifiable test components (e.g. starting angle and motion direction) on the PMPs of knee joint TTDPM tests following ACL injury is warranted.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2022
Keywords
Kinesthesia, Proprioception, Reliability, Responsiveness, Validity
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-193157 (URN)10.1186/s13018-022-03033-4 (DOI)000764709200007 ()35246192 (PubMedID)2-s2.0-85125868799 (Scopus ID)
Funder
Swedish Research Council, 2017-00892Region Västerbotten, 7003575Region Västerbotten, 7002795Swedish National Centre for Research in Sports, P2019-0068Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Available from: 2022-03-18 Created: 2022-03-18 Last updated: 2024-03-14Bibliographically approved
Cöster, M., Tengman, E., Brax Olofsson, L. & Montgomery, F. (2021). Enkel senförflyttning kan ge ökad funktion vid droppfot efter stroke. Läkartidningen, 118(34-35), Article ID 21071.
Open this publication in new window or tab >>Enkel senförflyttning kan ge ökad funktion vid droppfot efter stroke
2021 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 118, no 34-35, article id 21071Article in journal (Refereed) Published
Abstract [en]

Foot drop (FD) can be caused by a variety of diseases and injuries. FD leads to walking difficulties and reduced balance which also can lead to a higher risk of falling. Patient with a stroke often have an equinovarus deformity of the foot together with the DF. There is a need to optimize and standardize the treatment for patients with FD across different medical specialities. Surgical interventions, with goals of producing a balanced functional foot, have been shown to improve the function and quality of life and decrease the use of braces and walking aids in patients with FD after a CVI. In Sweden data regarding FD surgery is collected in the National Quality Registry for Foot and Ankle Surgery (Riksfot), but there is also an ongoing multicentre study, investigating the patient-reported and functional results of surgery due to FD caused by a CVI.

Place, publisher, year, edition, pages
Läkartidningen Förlag AB, 2021
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-188393 (URN)2-s2.0-85115963438 (Scopus ID)
Note

Alternative title: "Surgical interventions have been shown to improve the function in patients with foot drop after a stroke"

Publicerad på Lakartidningen.se 2021-08-24

Available from: 2021-10-07 Created: 2021-10-07 Last updated: 2021-10-07Bibliographically approved
Arumugam, A., Strong, A., Tengman, E., Röjezon, U. & Häger, C. (2021). Knee proprioception deficits following an ACL injury: a myth or a reality. In: : . Paper presented at 10th National I.S.Mu.L.T (Italian Society of Muscles, Ligaments and Tendons), Rome, Italy, April 8-9, 2021.
Open this publication in new window or tab >>Knee proprioception deficits following an ACL injury: a myth or a reality
Show others...
2021 (English)Conference paper, Oral presentation only (Refereed)
National Category
Medical and Health Sciences
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-223315 (URN)
Conference
10th National I.S.Mu.L.T (Italian Society of Muscles, Ligaments and Tendons), Rome, Italy, April 8-9, 2021
Available from: 2024-04-12 Created: 2024-04-12 Last updated: 2024-04-15Bibliographically approved
Strong, A., Arumugam, A., Tengman, E., Röijezon, U. & Häger, C. K. (2021). Properties of knee joint position sense tests after anterior cruciate ligament injury: A systematic review and meta-analysis. The Orthopaedic Journal of Sports Medicine, 9(8), Article ID 23259671211007878.
Open this publication in new window or tab >>Properties of knee joint position sense tests after anterior cruciate ligament injury: A systematic review and meta-analysis
Show others...
2021 (English)In: The Orthopaedic Journal of Sports Medicine, ISSN 2325-9671, Vol. 9, no 8, article id 23259671211007878Article, review/survey (Refereed) Published
Abstract [en]

Background: Knee proprioception is believed to be deficient after anterior cruciate ligament (ACL) injury. Tests of joint position sense (JPS) are commonly used to assess knee proprioception, but their psychometric properties (PMPs) are largely unknown.

Purpose: To evaluate the PMPs (reliability, validity, and responsiveness) of existing knee JPS tests targeting individuals with ACL injury.

Study design: Systematic review; Level of evidence, 4.

Methods: PubMed, Allied and Complementary Medicine, CINAHL, SPORTDiscus, Web of Science, Scopus, CENTRAL, and ProQuest databases were searched to identify studies that assessed PMPs of knee JPS tests in individuals with ACL injury. The risk of bias for each included study was assessed and rated at the outcome level for each knee JPS test. Overall quality and levels of evidence for each PMP were rated according to established criteria. Meta-analyses with mean differences were conducted using random effects models when adequate data were available.

Results: Included were 80 studies covering 119 versions of knee JPS tests. Meta-analyses indicated sufficient quality for known-groups and discriminative validity (ACL-injured knees vs knees of asymptomatic controls and contralateral noninjured knees, respectively), owing to significantly greater absolute errors for ACL-injured knees based on a strong level of evidence. A meta-analysis showed insufficient quality for responsiveness, which was attributed to a lack of significant change over time after diverse interventions with a moderate level of evidence. Statistical heterogeneity (I 2 > 40%) was evident in the majority of meta-analyses. All remaining PMPs (reliability, measurement error, criterion validity, convergent validity, and other PMPs related to responsiveness) were assessed qualitatively, and they failed to achieve a sufficient quality rating. This was a result of either the study outcomes not agreeing with the statistical cutoff values/hypotheses or the level of evidence being rated as conflicting/unknown or based on only a single study.

Conclusion: Knee JPS tests appear to have sufficient validity in differentiating ACL-injured knees from asymptomatic knees. Further evidence of high methodologic quality is required to ascertain the reliability, responsiveness, and other types of validity assessed here. We recommend investigations that compare the modifiable methodologic components of knee JPS tests on their PMPs to develop standardized evidence-based tests.

Place, publisher, year, edition, pages
Sage Publications, 2021
Keywords
proprioception, reliability, validity
National Category
Physiotherapy
Research subject
Physiotherapy; physiotherapy
Identifiers
urn:nbn:se:umu:diva-174977 (URN)10.1177/23259671211007878 (DOI)000691348300001 ()34350298 (PubMedID)2-s2.0-85109867193 (Scopus ID)
Funder
Swedish National Centre for Research in Sports, P2019-0068Swedish Research Council, 2017-00892Region Västerbotten, 7003575Region Västerbotten, VLL-838421Region Västerbotten, VLL-358901Region Västerbotten, 7002795
Note

Originally included in thesis in manuscript form with title "Properties of knee joint position sense tests after anterior cruciate ligament injury: A systematic review and meta-analysis".

Available from: 2020-09-14 Created: 2020-09-14 Last updated: 2022-01-13Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-5859-4284

Search in DiVA

Show all publications