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Aasa, Björn
Publications (10 of 13) Show all publications
Aasa, B., Sandlund, J., Rudolfsson, T. & Aasa, U. (2022). Acuity of goal-directed arm movements and movement control: evaluation of differences between patients with persistent neck/shoulder pain and healthy controls. European Journal of Physiotherapy, 24(1), 47-55
Open this publication in new window or tab >>Acuity of goal-directed arm movements and movement control: evaluation of differences between patients with persistent neck/shoulder pain and healthy controls
2022 (English)In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 24, no 1, p. 47-55Article in journal (Refereed) Published
Abstract [en]

Background: The main aim was to examine whether patients with persistent upper quadrant pain have higher end-point variability in goal directed pointing movements than pain-free controls when the pointing task is performed in total darkness and under full vision. An additional aim was to study associations between the magnitude of end-point variability and a clinical movement control test battery and self-rated functioning among patients.

Methods: Seventeen patients and 17 age- and gender-matched pain-free controls performed a pointing task that evaluated end-point variability of repetitive shoulder movements in horizontal adduction and abduction with full vision, and abduction with no visual information, completed a movement control test battery of neck and shoulder control tests and answered questionnaires.

Results: Patients had higher end point variability for horizontal abduction when performed with no visual information. For horizontal adduction the variability was higher, but only when it was controlled for movement time. No significant correlations were found between end-point variability and self-rated functioning, nor between end-point variability and neuromuscular control of the glenohumeral joint.

Conclusions: This study provides preliminary evidence that patients with persistent neck/shoulder pain can partly compensate proprioceptive deficits in goal-directed arm movement when visual feedback is present.

Place, publisher, year, edition, pages
Routledge, 2022
Keywords
Motor control, visual input, ergonomics, proprioception
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-173768 (URN)10.1080/21679169.2020.1785004 (DOI)000549583400001 ()2-s2.0-85087643824 (Scopus ID)
Available from: 2020-07-31 Created: 2020-07-31 Last updated: 2022-07-06Bibliographically approved
Berglund, L., Aasa, B., Michaelson, P. & Aasa, U. (2018). Sagittal lumbopelvic alignment in patients with low back pain and the effects of a high-load lifting exercise and individualized low-load motor control exercises: a randomized controlled trial. The spine journal, 18(3), 399-406
Open this publication in new window or tab >>Sagittal lumbopelvic alignment in patients with low back pain and the effects of a high-load lifting exercise and individualized low-load motor control exercises: a randomized controlled trial
2018 (English)In: The spine journal, ISSN 1529-9430, E-ISSN 1878-1632, Vol. 18, no 3, p. 399-406Article in journal (Refereed) Published
Abstract [en]

Background Context Assessment of posture and lumbopelvic alignment is often the main focus in the classification and treatment of patients with low back pain (LBP). However, little is known regarding the effects of motor control interventions on objective measures of lumbopelvic alignment.

Purpose The primary aim of this study was to describe the variation of sagittal lumbopelvic alignment in patients with nociceptive mechanical LBP. The secondary aim was to compare the effects of a high-load lifting exercise (HLL) and low-load motor control exercises (LMC) on the change in lumbopelvic alignment with a special emphasis on patients with high and low degrees of lumbar lordosis (lu) and sacral angle (sa).

Study Design This study is a secondary analysis of a randomized controlled trial evaluating the effects of HLL and LMC.

Patient Sample Patients from the primary study, that is, patients categorized with nociceptive mechanical LBP, who agreed to participate in the radiographic examination were included (n=66).

Outcome Measures Lateral plain radiographic images were used to evaluate lumbopelvic alignment regarding the lumbar lordosis and the sacral angle as outcomes, with posterior bend as an explanatory variable.

Materials and Methods The participants were recruited to the study from two occupational health-care facilities. They were randomized to either the HLL or the LMC intervention group and offered 12 supervised exercise sessions. Outcome measures were collected at baseline and following the end of intervention period 2 months after baseline. Between- and within-group analyses of intervention groups and subgroups based on the distribution of the baseline values for the lumbar lordosis and the sacral angle, respectively (LOW, MID, and HIGH), were performed using both parametric and non-parametric statistics.

Results The ranges of values for the present sample were 26.9–91.6° (M=59.0°, standard deviation [SD]=11.5°) for the lumbar lordosis and 18.2–72.1° (M=42.0°, SD=9.6°) for the sacral angle. There were no significant differences between the intervention groups in the percent change of eitheroutcome measure. Neither did any outcome change significantly over time within the intervention groups. In the subgroups, based on the distribution of respective baseline values, LOWlu showed a significantly increased lumbar lordosis, whereas HIGHsa showed a significantly decreased sacral angle following intervention.

Conclusions This study describes the wide distribution of values for lumbopelvic alignment for patients with nociceptive mechanical LBP. Further research is needed to investigate subgroups of other types of LBP and contrast findings to those presented in this study. Our results also suggest that retraining of the lumbopelvic alignment could be possible for patients with LBP.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Alignment, Deadlift, Low back pain, Lumbar lordosis, Lumbopelvic, Motor control, Sacral angle
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-119934 (URN)10.1016/j.spinee.2017.07.178 (DOI)000427617300003 ()28757287 (PubMedID)2-s2.0-85028334898 (Scopus ID)
Note

Originally published in manuscript form with title [Sagittal lumbo-pelvic alignment in patients with low back pain and the effects of a high-load lifting exercise and individualized low-load motor control exercises - a randomized controlled trial]

Available from: 2016-05-03 Created: 2016-05-03 Last updated: 2023-03-23Bibliographically approved
Berglund, L., Aasa, B., Michaelson, P. & Aasa, U. (2017). Effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness: a randomized controlled trial. Spine, 42(15), E876-E882
Open this publication in new window or tab >>Effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness: a randomized controlled trial
2017 (English)In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 42, no 15, p. E876-E882Article in journal (Refereed) Published
Abstract [en]

Study Design: Randomized controlled trial

Objective: The aim of this study was to compare the effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness among patients with nociceptive mechanical low back pain.

Summary of Background Data: There is evidence that patients with low back pain may have a decreased size of the lumbar multifidus muscles with an asymmetry between left/right sides in the lower back. It has also been shown that low-load motor control training can affect this asymmetry; essentially, it is effective in equalizing side differences in lumbar multifidus muscle size. It is, however, not known whether a high-load exercise has the same effect.

Methods: Sixty-five participants diagnosed with nociceptive mechanical low back pain were included and randomized into low-load motor control exercises or a high-load lifting exercise, the deadlift. The lumbar multifidus thickness at the fifth lumbar vertebra was measured, using rehabilitative ultrasound imaging, at baseline and after a 2-month training period.

Results: There were no differences between interventions regarding effect on lumbar multifidus muscle thickness. However, the linear mixed model analysis showed a significant effect for asymmetry. The thickness of the lumbar multifidus muscle on the small side increased significantly compared to the large side in both intervention groups.

Conclusions: There was a difference in thickness of the lumbar multifidus muscles between sides. It seems that exercises focusing on spinal alignment may increase the thickness of the lumbar multifidus muscles on the small side, irrespective of exercise load.

Place, publisher, year, edition, pages
Wolters Kluwer, 2017
Keywords
asymmetry, deadlift, exercise, low back pain, morphology, motor control, movement control, pain intensity, physical therapy, resistance training, stabilization training, ultrasonography multifidus
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-119936 (URN)10.1097/brs.0000000000001989 (DOI)000406277300001 ()27870804 (PubMedID)2-s2.0-84996721427 (Scopus ID)
Funder
Visare NorrNorrbotten County Council
Note

Originally included in thesis in manuscript form with title: "The effects of low-loadmotor control exercises and a high-load lifting exercise on lumbarmultifidus thickness – a randomized controlled trial"

Available from: 2016-05-03 Created: 2016-05-03 Last updated: 2023-08-15Bibliographically approved
Berglund, L., Aasa, B., Aasa, U. & Michaelson, P. (2017). Styrketräning som behandling vid långvariga ländryggsbesvär. Fysioterapi (4), 28-33
Open this publication in new window or tab >>Styrketräning som behandling vid långvariga ländryggsbesvär
2017 (Swedish)In: Fysioterapi, ISSN 1653-5804, no 4, p. 8p. 28-33Article, review/survey (Other academic) Published
Abstract [sv]

Fysisk träning är viktigt för en god hälsa och fungerar även som behandlingsform vid många sjukdomar, så även ländryggsbesvär. Styrketräning har visat sig vara en mer effektiv träningsform än till exempel aerob träning vid behandling av långvariga ländryggsbesvär. I dagsläget finns det ingen konsensus kring vilket det mest effektiva styrketräningsupplägget kan vara. Den vanligaste designen av styrketräningsprogram vid ländryggsbesvär tycks vara ett upplägg med syftet att förbättra styrkan/uthålligheten av ryggsträckarmuskulaturen och därigenom uppnå smärtlindring och funktionsförbättring. I en studie från Umeå universitet och Luleå tekniska universitet har träning av marklyft för patienter med långvariga ländryggsbesvär utvärderats. Marklyftsträningen förväntades öka deltagarnas bålstyrka samtidigt som den fokuserade på förbättring av rörelsekontroll kring såväl höft som ländrygg. När den åtta veckor långa träningsperioden var slut, visade det sig att gruppen som tränat marklyft hade ökat sin bålstyrka, minskat smärta, ökat funktionsförmåga och hälsorelaterad livskvalitet i samma omfattning som gruppen som tränade individanpassad träning av rörelsekontroll. Men de hade inte förbättrats lika mycket gällande rörelsekontroll eller vardagsfunktion. Vidare forskning pågår vid Umeå universitet om skador i samband med tung styrketräning samt lyftteknikens betydelse för skador och besvär vid tung styrketräning.

Place, publisher, year, edition, pages
Stockholm: Fysioterapeuterna, 2017. p. 8
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-136122 (URN)
Available from: 2017-06-13 Created: 2017-06-13 Last updated: 2018-06-09Bibliographically approved
Michaelson, P., Holmberg, D., Aasa, B. & Aasa, U. (2016). High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: a randomized controlled trial with 24-month follow-up. Journal of Rehabilitation Medicine, 48(5), 456-463
Open this publication in new window or tab >>High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: a randomized controlled trial with 24-month follow-up
2016 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, no 5, p. 456-463Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to compare the effects of a high load lifting exercise with low load motor control exercises on pain intensity, disability and health-related quality of life for patients with mechanical low back pain. Design: A randomized controlled trial. Subjects: Patients with mechanical low back pain as their dominating pain mechanism. Methods: The intervention programme consisted of a high load lifting exercise, while the control group received low load motor control exercises over 8 weeks (12 sessions) with pain education included in both intervention arms. The primary outcome was pain intensity and disability, and the secondary outcome was health-related quality of life. Results: Each intervention arm included 35 participants, analysed following 2-, 12- and 24-month follow-up. There was no significant difference between the high load lifting and low load motor control interventions for the primary or secondary outcome measures. Between 50% and 80% of participants reported a decrease in perceived pain intensity and disability for both short-and long-term follow-up. Conclusion: No difference was observed between the high low load lifting and low load motor control interventions. Both interventions included retraining of movement patterns and pain education, which might explain the positive results over time.

Keywords
mechanical low back pain, exercise therapy, pain intensity, disability, follow-up
National Category
Sport and Fitness Sciences Physiotherapy
Identifiers
urn:nbn:se:umu:diva-121462 (URN)10.2340/16501977-2091 (DOI)000375753300007 ()27097785 (PubMedID)2-s2.0-84964575172 (Scopus ID)
Available from: 2016-06-22 Created: 2016-06-02 Last updated: 2023-03-23Bibliographically approved
Aasa, B., Berglund, L., Michaelson, P. & Aasa, U. (2015). Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain: a randomized controlled trial. Journal of Orthopaedic and Sports Physical Therapy, 45(2), 77-85
Open this publication in new window or tab >>Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain: a randomized controlled trial
2015 (English)In: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 45, no 2, p. 77-85Article in journal (Refereed) Published
Abstract [en]

Study Design Randomized controlled trial. Background Low back pain is a common disorder. Patients with low back pain frequently have aberrant and pain-provocative movement patterns that often are addressed with motor control exercises. Objective To compare the effects of low-load motor control (LMC) exercise and those of a high-load lifting (HLL) exercise. Methods Seventy participants with recurrent low back pain, who were diagnosed with nociceptive mechanical pain as their dominating pain pattern, were randomized to either LMC or HLL exercise treatments. Participants were offered 12 treatment sessions over an 8-week period. All participants were also provided with education regarding pain mechanisms. Methods Participants were assessed prior to and following treatment. The primary outcome measures were activity (the Patient-Specific Functional Scale) and average pain intensity over the last 7 days (visual analog scale). The secondary outcome measure was a physical performance test battery that included 1 strength, 3 endurance, and 7 movement control tests for the lumbopelvic region. Results Both interventions resulted in significant within-group improvements in pain intensity, strength, and endurance. The LMC group showed significantly greater improvement on the Patient-Specific Functional Scale (4.2 points) compared with the HLL group (2.5 points) (P<.001). There were no significant between-group differences in pain intensity (P = .505), strength, and 1 of the 3 endurance tests. However, the LMC group showed an increase (from 2.9 to 5.9) on the movement control test subscale, whereas the HLL group showed no change (from 3.9 to 3.1) (P<.001). Conclusion An LMC intervention may result in superior outcomes in activity, movement control, and muscle endurance compared to an HLL intervention, but not in pain intensity, strength, or endurance.

Keywords
deadlift,  functional rehabilitation,  motor learning,  stabilization exercises,  subgrouping
National Category
Orthopaedics Sport and Fitness Sciences
Identifiers
urn:nbn:se:umu:diva-100462 (URN)10.2519/jospt.2015.5021 (DOI)000349593300003 ()25641309 (PubMedID)2-s2.0-84961289981 (Scopus ID)
Available from: 2015-03-03 Created: 2015-03-03 Last updated: 2023-03-24Bibliographically approved
Aasa, U., Berglund, L. & Aasa, B. (2015). Krafttag ska stoppa styrkelyftarnas skador. Svensk idrottsforskning (4), 29-31
Open this publication in new window or tab >>Krafttag ska stoppa styrkelyftarnas skador
2015 (Swedish)In: Svensk idrottsforskning, ISSN 1103-4629, no 4, p. 29-31Article in journal (Other (popular science, discussion, etc.)) Published
Place, publisher, year, edition, pages
Centrum för idrottsforskning, 2015
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-136123 (URN)
Available from: 2017-06-13 Created: 2017-06-13 Last updated: 2020-04-17Bibliographically approved
Aasa, U., Lundell, S., Aasa, B. & Westerståhl, M. (2015). Physical Activity Might Be of Greater Importance for Good Spinal Control Than If You Have Had Pain or Not: A Longitudinal Study. Spine, 40(24), 1926-1933
Open this publication in new window or tab >>Physical Activity Might Be of Greater Importance for Good Spinal Control Than If You Have Had Pain or Not: A Longitudinal Study
2015 (English)In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 40, no 24, p. 1926-1933Article in journal (Refereed) Published
Abstract [en]

STUDY DESIGN: Longitudinal design. A cohort followed in 3 waves of data collection.

OBJECTIVE: The aim of the study was to describe the relationships between the performance of 2 tests of spinal control at the age of 52 years and low back pain, physical activity level, and fitness earlier in life, as well as to describe the cross-sectional relationships between these measures.

SUMMARY OF BACKGROUND DATA: Altered spinal control has been linked to pain; however, other stimuli may also lead to inability to control the movements of the spine.

METHODS: Participants answered questions about physical activity and low back pain, and performed physical fitness tests at the age of 16, 34, and 52 years. The fitness test battery included tests of endurance in the back and abdominal muscles, a submaximal bicycle ergometer test to estimate maximal oxygen uptake, and measurements of hip flexion, thoracic spine flexibility, and anthropometrics. Two tests were aggregated to a physical fitness index. At the age of 52, also 2 tests of spinal control, the standing Waiter's bow (WB) and the supine double leg lower (LL) were performed.

RESULTS: Logistic regression analyses showed that higher back muscle endurance at the age of 34 years could positively predict WB performance at 52 years and higher physical fitness at the age of 34 could positively predict LL performance at 52 years. Regarding cross-sectional relationships, an inability to perform the WB correctly was associated with lower physical fitness, flexibility and physical activity, and larger waist circumference. An inability to correctly perform the LL was associated with lower physical fitness. One-year prevalence of pain was not significantly associated with WB or LL test performance.

CONCLUSION: An active life resulting in higher physical fitness is related to better spinal control in middle-aged men and women. This further strengthens the importance of physical activity throughout the life span.

LEVEL OF EVIDENCE: 3.

Keywords
core control, instability, low back pain, lumbar spine, motor control, physical fitness
National Category
Physiotherapy Orthopaedics
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-114518 (URN)10.1097/BRS.0000000000001102 (DOI)000369221700022 ()26655805 (PubMedID)2-s2.0-84953231392 (Scopus ID)
Projects
Swedish Physical Activity and Fitness Cohort born in 1958 (SPAF-1958)
Available from: 2016-01-22 Created: 2016-01-22 Last updated: 2023-03-23Bibliographically approved
Berglund, L., Aasa, B., Hellqvist, J., Michaelson, P. & Aasa, U. (2015). Which patients with low back pain benefit from deadlift training?. Journal of Strength and Conditioning Research, 29(7), 1803-1811
Open this publication in new window or tab >>Which patients with low back pain benefit from deadlift training?
Show others...
2015 (English)In: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 29, no 7, p. 1803-1811Article in journal (Refereed) Published
Abstract [en]

Recent studies have indicated that the deadlift exercise may be effective in decreasing pain intensity and increasing activity for most, but not all, patients with a dominating mechanical low back pain pattern. This study aimed to evaluate which individual factors measured at baseline could predict activity, disability, and pain intensity in patients with mechanical low back pain after an 8-week training period involving the deadlift as a rehabilitative exercise. Thirty-five participants performed deadlift training under the supervision of a physical therapist with powerlifting experience. Measures of pain-related fear of movement, hip and trunk muscle endurance and lumbopelvic movement control were collected at baseline. Measures of activity, disability and pain intensity were collected at baseline and at follow-up. Linear regression analyses were used to create models to predict activity, disability and pain intensity at follow-up. Results showed that participants with less disability, less pain intensity and higher performance on the Biering-Sørensen test, which tests the endurance of hip and back extensor muscles, at baseline benefit from deadlift training. The Biering-Sørensen test was the strongest predictor since it was included in all predictive models. Pain intensity was the next best predictor as it was included in two predictive models. Thus, for strength and conditioning professionals who use the deadlift as a rehabilitative exercise for individuals with mechanical low back pain, it is important to ensure that clients have sufficient back extensor strength and endurance and a sufficiently low pain intensity level to benefit from training involving the deadlift exercise.

Keywords
motor control, resistance training, Biering-Sørensen test, pain intensity, prediction
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-100463 (URN)10.1519/JSC.0000000000000837 (DOI)000357270000006 ()25559899 (PubMedID)2-s2.0-84936941645 (Scopus ID)
Available from: 2015-03-03 Created: 2015-03-03 Last updated: 2023-03-23Bibliographically approved
Aasa, B., Lundström, L., Papacosta, D., Sandlund, J. & Aasa, U. (2014). Do we see the same movement impairments?: the inter-rater reliability of movement tests for experienced and novice physiotherapists. European Journal of Physiotherapy, 16(16), 173-182, Article ID 3.
Open this publication in new window or tab >>Do we see the same movement impairments?: the inter-rater reliability of movement tests for experienced and novice physiotherapists
Show others...
2014 (English)In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 16, no 16, p. 173-182, article id 3Article in journal (Refereed) Published
Abstract [en]

Study design: Inter-rater reliability study. Background: Physiotherapists (PTs) use clinical tests including movement tests to identify faulty movement patterns. Aims: To investigate the inter-rater-reliability of active movement tests in the cervical spine, shoulder joint and scapulo-thoracic joint, and to describe the reasons for judgment of a positive test. Methodology: Four PTs, two experienced and two recently educated (novice), rated performance of five movement tests for 36 participants. Twenty-one of the participants were patients under treatment because of neck and/or shoulder problems, while 15 participants declared no problem from this region of the body. All tests were video recorded and the ratings were done by observing the video recordings. First, the PTs judged the tests as negative (the movement being ideally performed) or positive (the movement not being ideally performed). Then, the PTs described why the movements that they judged positive were not being ideally performed, using a predefined protocol, which represented different movement quality aspects. The inter-rater reliability was calculated for each test using Kappa statistics between the two experienced and the two novice PTs, respectively, and between each of the experienced and each of the novice PTs. Major findings: The experienced PTs had a higher inter-rater reliability than the novice PTs. The reasons for considering a movement test being positive differed highly between the (novice) PTs. Principal conclusion: This study supports previous studies concluding that the observation of active movement tests is reliable when assessed by experienced PTs. Novice PTs might benefit from further supervision.

Keywords
examination, motor control, neck pain, shoulder pain, testing
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-92015 (URN)10.3109/21679169.2014.917435 (DOI)2-s2.0-84906497878 (Scopus ID)
Available from: 2014-08-20 Created: 2014-08-20 Last updated: 2023-03-23Bibliographically approved
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