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Stensdotter, Ann-Katrin
Alternative names
Publications (10 of 21) Show all publications
Stensdotter, A.-K., Tengman, E. & Häger, C. (2016). Altered postural control strategies in quiet standing more than 20 years after rupture of the anterior cruciate ligament. Gait & Posture, 46, 98-103
Open this publication in new window or tab >>Altered postural control strategies in quiet standing more than 20 years after rupture of the anterior cruciate ligament
2016 (English)In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 46, p. 98-103Article in journal (Refereed) Published
Abstract [en]

Aim: To explore long-term consequences of anterior cruciate ligament (ACL) rupture on postural sway and control strategies during bilateral quiet standing, in subjects treated with or without reconstructive surgery compared to uninjured controls. Method: 70 individuals who had unilateral ACL rupture 23 +/- 2.4 years ago (33 received ACL reconstructive surgery, ACL(R), and 37 had physiotherapy only, ACL(PT)) and 33 uninjured matched controls (CTRL) (mean age 46 +/- 5.3) stood quietly with eyes closed for 3 min on a firm and on a compliant surface, respectively. Center of pressure (CoP) was registered with a force plate and postural sway was calculated from center of mass (CoM) derived from 3D kinematics. Sway density (SD) analyses of CoP assessed distance and duration of stable phases. The torque controlling postural sway was estimated from CoP-CoM. Results: Comparisons across conditions to CTRL revealed larger CoP-CoM-area in ACLR (p = 0.017, Cl: 10.95, 143.10), but not in ACL(PT). Mean distance between SD-peaks was greater for ACLR (p < 0.001, Cl: 1.73, 5.31) than for ACLRT (p = 0.006, Cl: 0.56, 4.12) relative to CTRL. Duration of SD -peaks was smaller for both ACLR and ACLRT (p < 0.001, Cl: 4.04, 1.23 and 3.82, 1.03, respectively) compared to CTRL. CoM-area in the ACL-groups did not differ from CTRL. Conclusions: ACL-injured subjects demonstrated greater postural control efforts than CTRL but without significant differences in postural sway. Control efforts were thus not directly associated with sway and further research should be focused on variance in postural control strategies.

Keywords
Sway density, Center of pressure, Center of mass, Postural sway
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-121557 (URN)10.1016/j.gaitpost.2016.02.020 (DOI)000375468200018 ()27131185 (PubMedID)
Available from: 2016-06-30 Created: 2016-06-03 Last updated: 2018-06-07Bibliographically approved
Bjerke, J., Öhberg, F., Nilsson, K. G. & Stensdotter, A.-K. (2016). Walking on a compliant surface does not enhance kinematic gait asymmetries after unilateral total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 24(8), 2606-2613
Open this publication in new window or tab >>Walking on a compliant surface does not enhance kinematic gait asymmetries after unilateral total knee arthroplasty
2016 (English)In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 24, no 8, p. 2606-2613Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To investigate gait asymmetries and the effect of walking on compliant surfaces in individuals with unilateral total knee arthroplasty (TKA), hypothesizing that asymmetries would increase as an effect of the compliant surface.

METHODS: Individuals with unilateral TKA ~19 months post-operative (n = 23, median age 59 years) recruited from one orthopaedic clinic and age- and gender-matched healthy individuals without knee complaints (n = 23, median age 56 years) walked at comfortable speed on a hard surface and on a compliant surface. 3D kinematic analyses were made for knee and hip angles in sagittal and frontal planes, stance time, step length, and gait velocity.

RESULTS: Shorter stance time (p < 0.01) and less peak knee flexion (p < 0.001) at weight bearing acceptance was found in the prosthetic side compared with the contralateral side. Larger knee (p < 0.01) and hip (p < 0.001) adduction was found compared with healthy controls. Neither asymmetries between the prosthetic and the contralateral side nor differences compared with healthy controls were enhanced when walking on compliant surfaces compared with hard surfaces.

CONCLUSION: The TKA group adapted their gait to compliant surfaces similarly to healthy controls. Gait asymmetries in the TKA group observed on hard surface were not enhanced, and adduction in hip and knee joints did not increase further as an effect of walking on compliant surfaces. Thus, unfavourable knee joint loading did not increase when walking on a compliant surface. This implies that recommendations for walking on soft surfaces to reduce knee joint loading are not counteracted by increased gait asymmetries and unfavourable joint loading configurations.

LEVEL OF EVIDENCE: III.

Place, publisher, year, edition, pages
Springer, 2016
Keywords
Knee joint flexion, Knee joint adduction, Hip joint adduction, Prosthesis, Locomotion
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-120342 (URN)10.1007/s00167-015-3931-y (DOI)000380713600031 ()26708412 (PubMedID)
Note

First online: 26 December 2015

Available from: 2016-05-16 Created: 2016-05-16 Last updated: 2018-06-07Bibliographically approved
Tengman, E., Grip, H., Stensdotter, A.-K. & Häger, C. K. (2015). Anterior cruciate ligament injury about 20 years post-treatment: a kinematic analysis of one-leg hop. Scandinavian Journal of Medicine and Science in Sports, 25(6), 818-827
Open this publication in new window or tab >>Anterior cruciate ligament injury about 20 years post-treatment: a kinematic analysis of one-leg hop
2015 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 25, no 6, p. 818-827Article in journal (Refereed) Published
Abstract [en]

Reduced dynamic knee stability, often evaluated with one-leg hops (OLHs), is reported after anterior cruciate ligament (ACL) injury. This may lead to long-standing altered movement patterns, which are less investigated. 3D kinematics during OLH were explored in 70 persons 23 +/- 2 years after ACL injury; 33 were treated with physiotherapy in combination with ACL reconstruction (ACL(R)) and 37 with physiotherapy alone (ACL(PT)). Comparisons were made to 33 matched controls. We analyzed (a) maximal knee joint angles and range of motion (flexion, abduction, rotation); (b) medio-lateral position of the center of mass (COM) in relation to knee and ankle joint centers, during take-off and landing phases. Unlike controls, ACL-injured displayed leg asymmetries: less knee flexion and less internal rotation at take-off and landing and more lateral COM related to knee and ankle joint of the injured leg at landing. Compared to controls, ACL(R) had larger external rotation of the injured leg at landing. ACL(PT) showed less knee flexion and larger external rotation at take-off and landing, and larger knee abduction at Landing. COM was more medial in relation to the knee at take-off and less laterally placed relative to the ankle at landing. ACL injury results in long-term kinematic alterations during OLH, which are less evident for ACL(R).

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015
Keywords
biomechanics, long-term perspective, knee, jump performance
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:umu:diva-113723 (URN)10.1111/sms.12434 (DOI)000365452600024 ()25728035 (PubMedID)
Available from: 2015-12-30 Created: 2015-12-28 Last updated: 2018-06-07Bibliographically approved
Stensdotter, A.-K., Bjerke, J. & Djupsjobacka, M. (2015). Postural sway in single-limb and bilateral quiet standing after unilateral total knee arthroplasty. Gait & Posture, 41(3), 769-773
Open this publication in new window or tab >>Postural sway in single-limb and bilateral quiet standing after unilateral total knee arthroplasty
2015 (English)In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 41, no 3, p. 769-773Article in journal (Refereed) Published
Abstract [en]

Aim: To investigate whether total knee arthroplasty (TKA) was associated with stability in single-limb stance and whether reduced stability in single-limb stance was associated with increased postural sway in bilateral quiet standing.

Methods: 3D kinematics for center of mass was used to assess postural sway in 23 subjects with TKA and 23 controls. Tests included bilateral quiet standing with and without vision and on a compliant surface, and single-limb stance.

Results: 30% of the subjects in the TKA group were unable to maintain single-limb stance for 20 s on any leg. Of the 70% in the TKA group able to stand on one leg, mean sway velocity in the medio-lateral direction was marginally higher for the prosthetic side (p = .02), but no differences were found between the TKA and the control group in single-limb stance. Performance in bilateral quiet standing was similar in TKA-subjects, able as well as unable to stand on one leg, and controls. Reduced quadriceps strength in the contralateral leg, higher BMI, and older age predicted failure to maintain single-limb stance.

Conclusion: In subjects able to stand on one leg, performance was considered comparable between the prosthetic and contralateral side and between groups. Inability to stand on one leg did not affect postural sway in bilateral quiet standing. The results suggest that inability to maintain single-limb stance is explained by reduced physical capacity rather than the knee condition in itself. The present study emphasizes the importance of physical activity to improve strength and functional capacity.

Keywords
Postural control, Prosthesis, Romberg, Quadriceps strength, Joint position sense
National Category
Medical Materials
Identifiers
urn:nbn:se:umu:diva-103225 (URN)10.1016/j.gaitpost.2015.02.005 (DOI)000353209200005 ()25755019 (PubMedID)
Available from: 2015-05-19 Created: 2015-05-18 Last updated: 2018-06-07Bibliographically approved
Tengman, E., Brax Olofsson, L., Stensdotter, A.-K., Nilsson, K. G. & Häger, C. (2014). Anterior cruciate ligament injury after more than 20 years: II. Concentric and eccentric knee muscle strength. Scandinavian Journal of Medicine and Science in Sports, 24(6), e501-e509
Open this publication in new window or tab >>Anterior cruciate ligament injury after more than 20 years: II. Concentric and eccentric knee muscle strength
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2014 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 24, no 6, p. e501-e509Article in journal (Refereed) Published
Abstract [en]

The long-term consequences on knee muscle strength some decades after rupture of the anterior cruciate ligament (ACL) are not established. The aims of our study were to examine peak torque more than 20 years after ACL injury and to compare their knee muscle strength to that of healthy controls. We tested 70 individuals with unilateral ACL injury 23 ± 2 years after injury, whereof 33 (21 men) were treated with physiotherapy in combination with ACL reconstruction (ACLR) and 37 (23 men) with physiotherapy alone (ACLPT). These were compared with 33 age- and gender-matched controls (21 men). A Kin-Com® dynamometer (90°/s) was used to measure peak torque in knee flexion and extension in both concentric and eccentric contractions. Knee extension peak torque, concentric and eccentric, was ∼10% lower for the injured leg compared with the non-injured leg for both ACLR (P < 0.001; P < 0.001) and ACLPT (P = 0.007; P = 0.002). The ACLPT group also showed reduced eccentric knee flexion torque of the injured leg (P = 0.008). The strength of the non-injured leg in both ACL groups was equal to that of controls. No difference was seen for those with no-or-low degree of knee osteoarthritis compared to those with moderate-to-high degree of osteoarthritis. ACL injury may lead to a persistent reduction of peak torque in the injured leg, which needs to be considered across the lifespan.

Keywords
Isokinetic, peak torque, long-term consequences, cross-sectional design
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-86713 (URN)10.1111/sms.12215 (DOI)000345703300011 ()24684507 (PubMedID)2-s2.0-84912048217 (Scopus ID)
Funder
Swedish Research Council, K2008-70X-20845-01-3Swedish Research Council, K2011-69X-21876-01-3Swedish National Centre for Research in Sports, P2012-0008
Available from: 2014-03-05 Created: 2014-03-05 Last updated: 2018-06-08Bibliographically approved
Bjerke, J., Öhberg, F., Nilsson, K. G. & Stensdotter, A.-K. (2014). Compensatory strategies for muscle weakness during stair ascent in subjects with total knee arthroplasty. The Journal of Arthroplasty, 29(7), 1499-1502
Open this publication in new window or tab >>Compensatory strategies for muscle weakness during stair ascent in subjects with total knee arthroplasty
2014 (English)In: The Journal of Arthroplasty, ISSN 0883-5403, E-ISSN 1532-8406, Vol. 29, no 7, p. 1499-1502Article in journal (Refereed) Published
Abstract [en]

Subjects with total knee arthroplasty (TKA) exhibit decreased quadriceps and hamstring strength. This may bring about greater relative effort or compensatory strategies to reduce knee joint moments in daily activities. To study gait and map out the resource capacity, knee muscle strength was assessed by maximal voluntary concentric contractions, and whole body kinematics and root mean square (RMS) electromyography (EMG) of vastus lateralis and semitendinosus were recorded during stair ascent in 23 unilateral TKA-subjects ~19months post-operation, and in 23 healthy controls. Muscle strength and gait velocity were lower in the TKA group, but no significant group differences were found in RMS EMG or forward trunk lean. The results suggest that reduced walking velocity sufficiently compensated for reduced knee muscle strength.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
muscular utilization. electromyography. maximal voluntary contraction. kinematics. stairs
National Category
Physiotherapy Orthopaedics
Identifiers
urn:nbn:se:umu:diva-89607 (URN)10.1016/j.arth.2014.01.033 (DOI)000338941600033 ()24612738 (PubMedID)
Available from: 2014-06-05 Created: 2014-06-05 Last updated: 2018-06-07Bibliographically approved
Bjerke, J., Öhberg, F., Nilsson, K. G., Foss, O. A. & Stensdotter, A.-K. (2014). Peak knee flexion angles during stair descent in TKA patients. The Journal of Arthroplasty, 29(4), 707-711
Open this publication in new window or tab >>Peak knee flexion angles during stair descent in TKA patients
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2014 (English)In: The Journal of Arthroplasty, ISSN 0883-5403, E-ISSN 1532-8406, Vol. 29, no 4, p. 707-711Article in journal (Refereed) Published
Abstract [en]

Reduced peak knee flexion during stair descent (PKSD) is demonstrated in subjects with total knee arthroplasty (TKA), but the underlying factors are not well studied. 3D gait patterns during stair descent, peak passive knee flexion (PPKF), quadriceps strength, pain, proprioception, demographics, and anthropometrics were assessed in 23 unilateral TKA-subjects ~ 19 months post-operatively, and in 23 controls. PKSD, PPKF and quadriceps strength were reduced in the TKA-side, but also in the contralateral side. A multiple regression analysis identified PPKF as the only predictor (57%) to explain the relationship with PKSD. PPKF was, however sufficient for normal PKSD. Deficits in quadriceps strength in TKA-group suggest that strength is also contributing to smaller PKSD. Increased hip adduction at PKSD may indicate both compensatory strategy and reduced hip strength.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
total knee arthroplasty, gait analysis, range of motion, kinematics
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-80010 (URN)10.1016/j.arth.2013.07.010 (DOI)000334094000017 ()
Available from: 2013-09-06 Created: 2013-09-06 Last updated: 2018-06-08Bibliographically approved
Stensdotter, A.-K., Tengman, E., Brax Olofsson, L. & Häger, C. (2013). Deficits in single-limb stance more than 20 years after ACL injury. European Journal of Physiotherapy, 15(2), 78-85
Open this publication in new window or tab >>Deficits in single-limb stance more than 20 years after ACL injury
2013 (English)In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 15, no 2, p. 78-85Article in journal (Refereed) Published
Abstract [en]

Aim: To investigate the long-term effect on balance during single-limb stance after unilateral anterior cruciate ligament (ACL) injury across two groups who had rehabilitation including ACL reconstruction (ACLR) or a tailored physiotherapy program (ACLTPP), compared with knee-healthy controls.

Methods: Single-limb stance was monitored for floor-supports with the contralateral foot. Single-limb stance without floor-supports was assessed with analyses of center of pressure (CoP) for further discrimination. Comparisons were made between ACLR (n = 28) and ACLTPP (n = 28) and with controls (n = 18). The injured and uninjured legs were compared within ACL-injured subjects.

Results: Single-limb balance was equally inferior in both ACL-injured groups and on both legs compared with knee-healthy controls. In ACLR and ACLTPP, 39% and 50%, respectively, failed to stand on one leg without floor-supports with the contralateral foot. No contralateral supports occurred in knee-healthy controls. CoP measures for subjects who stood without contralateral floor-supports did not reveal any further differences. Older age and higher body mass index (BMI) correlated with larger migration of CoP.

Conclusion: Inability to stand without contralateral supports showed that balance in single-limb stance was inferior in ACL-injured subjects, independently of which initial treatment that was given. Age and BMI need consideration in studies assessing balance in single-limb stance.

Keywords
Balance, CoP, knee, long-term perspective
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-80262 (URN)10.3109/21679169.2013.791718 (DOI)
External cooperation:
Available from: 2013-09-13 Created: 2013-09-13 Last updated: 2018-06-08Bibliographically approved
Grenholm, A., Stensdotter, A.-K. & Häger-Ross, C. (2009). Kinematic analyses during stair descent in young women with patellofemoral pain. Clinical Biomechanics, 24(1), 88-94
Open this publication in new window or tab >>Kinematic analyses during stair descent in young women with patellofemoral pain
2009 (English)In: Clinical Biomechanics, ISSN 0268-0033, E-ISSN 1879-1271, Vol. 24, no 1, p. 88-94Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Compensatory movement strategies may develop in response to pain to avoid stress on the affected area. Patellofemoral pain is characterised by intermittent periods of pain and the present study addresses whether long-term pain leads to compensatory movement strategies that remain even when the pain is absent. METHOD: Lower extremity kinematics in three dimensions was studied in stair descent in 17 women with patellofemoral and in 17 matched controls. A two-dimensional geometric model was constructed to normalise kinematic data for subjects with varying anthropometrics when negotiating stairs of fixed proportions. RESULTS: There were minor differences in movement patterns between groups. Knee joint angular velocity in the stance leg at foot contact was lower and the movement trajectory tended to be jerkier in the patellofemoral group. The two-dimensional model showed greater plantar flexion in the swing leg in preparation for foot placement in the patellofemoral group. INTERPRETATION: The results indicate that an altered stair descent strategy in the patellofemoral group may remain also in the absence of pain. The biomechanical interpretation presumes that the strategy is aimed to reduce knee joint loading by less knee joint moment and lower impact force.

National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-22128 (URN)10.1016/j.clinbiomech.2008.09.004 (DOI)000262593600015 ()18986741 (PubMedID)
Available from: 2009-04-23 Created: 2009-04-23 Last updated: 2018-06-08Bibliographically approved
Stensdotter, A.-K., Andersson, P.-I., Rydh, A. & Häger-Ross, C. (2009). Q-angle variations in standing and supine positions and for different measurement methods in women with and without patellofemoral pain. Advances in Physiotherapy, 11(2), 88-96
Open this publication in new window or tab >>Q-angle variations in standing and supine positions and for different measurement methods in women with and without patellofemoral pain
2009 (English)In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 11, no 2, p. 88-96Article in journal (Refereed) Published
Keywords
Goniometry, kinematics, positions, quadriceps angle, radiography
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-23334 (URN)10.1080/14038190802585485 (DOI)
Available from: 2009-06-11 Created: 2009-06-11 Last updated: 2018-06-08Bibliographically approved
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