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Berglund, Lars
Publications (10 of 17) Show all publications
Sjöberg, H., Aasa, U., Rosengren, M. & Berglund, L. (2018). Content validity index and reliability of a new protocol for evaluation of lifting technique in the powerlifting squat and deadlift. Journal of Strength and Conditioning Research
Open this publication in new window or tab >>Content validity index and reliability of a new protocol for evaluation of lifting technique in the powerlifting squat and deadlift
2018 (English)In: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to create a protocol to cover aspects of technique considered to be associated with risk of injury in the powerlifting squat and deadlift and to examine the content validity and reliability of the aspects included in the protocols. For the content validity investigation, a consensus group of 3 powerlifting physiotherapists identified the domains of content (risk of injury) for 2 protocols (1 for squat and 1 for deadlift) of essential aspects of lifting technique through discussions and a review of the literature. Eight selected powerlifting experts rated the relevance of each aspect in relation to risk of injury (acute or by overuse), and a quantitative estimate of the content validity of each aspect was measured through calculations of a Content Validity Index (CVI). Aspects of low content validity were discarded, and the remainders were evaluated for their inter-rater and intra-rater reliability among 4 experienced powerlifters used to coaching and evaluating powerlifting technique. The reliability was calculated and analyzed with kappa and percentage of agreement. The final protocols included 17 aspects of squat technique and 10 aspects of deadlift technique that showed good to excellent CVI and percentage of agreement between 64 and 100%. The protocols, formed in this study, will provide evidence-based recommendations on safe lifting technique for coaches and strength practitioners' to use to make relevant assessments and instructions.

Place, publisher, year, edition, pages
National Strength and Conditioning Association, 2018
Keywords
injury prevention, sports medicine, acute injury, overuse injury, resistance training, weightlifting
National Category
Physiotherapy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-152499 (URN)10.1519/JSC.0000000000002791 (DOI)
Available from: 2018-10-08 Created: 2018-10-08 Last updated: 2018-11-06Bibliographically approved
Bengtsson, V., Berglund, L. & Aasa, U. (2018). Narrative review of injuries in powerlifting with special reference to their association to the squat, bench press and deadlift. BMJ Open Sport & Exercise Medicine, 4, Article ID e000382.
Open this publication in new window or tab >>Narrative review of injuries in powerlifting with special reference to their association to the squat, bench press and deadlift
2018 (English)In: BMJ Open Sport & Exercise Medicine, E-ISSN 2055-7647, Vol. 4, article id e000382Article in journal (Refereed) Published
Abstract [en]

Pain and injuries are considered a common problem among elite athletes and recreational lifters performing the squat, bench press and deadlift. Since all three lifts engage multiple joints and expose the lifters' bodies to high physical demands often several times a week, it has been suggested that their injuries might be related to the excessively heavy loads, the large range of motion during the exercises, insufficient resting times between training sessions and/or faulty lifting technique. However, no previous article has summarised what is known about specific injuries and the injury aetiology associated with the three lifts. Thus, the aim of this narrative review was to summarise what is known about the relationships between the powerlifting exercises and the specific injuries or movement impairments that are common among lifters and recreationally active individuals.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
National Category
Physiotherapy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-152500 (URN)10.1136/bmjsem-2018-000382 (DOI)
Available from: 2018-10-08 Created: 2018-10-08 Last updated: 2018-12-18Bibliographically approved
Strömbäck, E., Aasa, U., Gilenstam, K. & Berglund, L. (2018). Prevalence and consequences of injuries in powerlifting: a cross-sectional study. The Orthopaedic Journal of Sports Medicine, 6(5), Article ID 2325967118771016.
Open this publication in new window or tab >>Prevalence and consequences of injuries in powerlifting: a cross-sectional study
2018 (English)In: The Orthopaedic Journal of Sports Medicine, ISSN 2325-9671, Vol. 6, no 5, article id 2325967118771016Article in journal (Refereed) Published
Abstract [en]

Background: Powerlifting consists of the squat, bench press, and dead lift, and extreme loads are lifted during training and competitions. Previous studies, which have defined an injury as an event that causes an interruption in training or competitions, have reported a relatively low frequency of powerlifting injuries (1.0-4.4 injuries/1000 hours of training). No previous study has investigated the prevalence of injuries, defined as a condition of pain or impairment of bodily function that affects powerlifters’ training, in a balanced sample of men and women, and no studies have established possible risk factors for an injury.

Purpose: To investigate the prevalence, localization, and characterization of injuries among Swedish subelite classic powerlifters, with an emphasis on differences between men and women, and to investigate whether training and lifestyle factors are associated with an injury.

Study Design: Cross-sectional study; Level of evidence, 3.

Methods: A total of 53 female and 51 male Swedish subelite powerlifters answered an online questionnaire including questions about background characteristics, training habits, and lifestyle factors. The main part of the questionnaire included questions about injuries and their consequences. An injury was defined as a condition of pain or impairment of bodily function that affects powerlifters’ training.

Results: Seventy percent (73/104) of participants were currently injured, and 87% (83/95) had experienced an injury within the past 12 months. The lumbopelvic region, shoulder, and hip were the most commonly injured areas for both sexes. Women experienced a significantly greater frequency of injuries in the neck and thoracic region than men. Injuries seemed to occur during training, although only 16% (11/70) of those currently injured had to completely refrain from training. Training frequency, greater personal best in the dead lift, injury onset during bench-press and dead-lift training, use of straps, alcohol consumption, and dietary issues were associated with current injuries.

Conclusion: Injuries are very common in subelite powerlifters. Men and women report similar injury frequencies but different anatomic locations. These injuries do not prevent powerlifters from training and competing, but they may change the content of training sessions. Why powerlifters develop injuries is still unclear; however, it is likely that the management of training loads and optimization of the lifting technique during the squat, bench press, and dead lift are of importance.

Place, publisher, year, edition, pages
Thousand Oaks, California: Sage Publications, 2018
Keywords
sports injury, risk factors, resistance training, low back pain
National Category
Physiotherapy Sport and Fitness Sciences Other Medical Sciences not elsewhere specified
Research subject
physiotherapy; biomechanics
Identifiers
urn:nbn:se:umu:diva-147734 (URN)10.1177/2325967118771016 (DOI)000432239400001 ()
Available from: 2018-05-16 Created: 2018-05-16 Last updated: 2018-06-13Bibliographically 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)
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: 2018-06-07Bibliographically approved
Olofsson, P., Aasa, U. & Berglund, L. (2017). Clinical examination of physical problems in powerlifters: Development and applicability of a physical examination protocol. In: : . Paper presented at Annual congress OMT/FYIM, Road to Recovery, March 24-25, 2017, Stockholm, Sweden.
Open this publication in new window or tab >>Clinical examination of physical problems in powerlifters: Development and applicability of a physical examination protocol
2017 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-136118 (URN)
Conference
Annual congress OMT/FYIM, Road to Recovery, March 24-25, 2017, Stockholm, Sweden
Available from: 2017-06-13 Created: 2017-06-13 Last updated: 2018-06-09
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 (LMC) exercises and a high-load lifting (HLL) exercise, on lumbar multifidus (LM) thickness on either side of the spine and whether the effects were affected by pain intensity or change in pain intensity. Summary of Background Data. There is evidence that patients with low back pain (LBP) may have a decreased size of the LM muscles with an asymmetry between sides in the lower back. It has also been shown that LMC training can affect this asymmetry. It is, however, not known whether a high-load exercise has the same effect. Methods. Sixty-five participants diagnosed with nociceptive mechanical LBP were included and randomized into LMC exercises or a HLL exercise, the deadlift. The LM thickness was measured using rehabilitative ultrasound imaging (RUSI), at baseline and after a 2-month training period. Results. There were no differences between interventions regarding effect on LM muscle thickness. However, the analysis showed a significant effect for asymmetry. The thickness of the LM muscle on the small side increased significantly compared with the large side in both intervention groups, without influence of pain at baseline, or change in pain intensity.Conclusion. At baseline, there was a difference in thickness of the LM muscles between sides. It seems that exercises focusing on spinal alignment may increase the thickness of the LM muscles on the small side, irrespective of exercise load. The increase in LM thickness does not appear to be mediated by either current pain intensity or the magnitude of change in pain intensity.

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-135618 (URN)10.1097/BRS.0000000000001989 (DOI)000406277300001 ()27870804 (PubMedID)
Available from: 2017-05-31 Created: 2017-05-31 Last updated: 2018-06-09Bibliographically approved
Aasa, U., Svartholm, I., Andersson, F. & Berglund, L. (2017). Injuries among weightlifters and powerlifters: a systematic review. British Journal of Sports Medicine, 51(4), 211-219
Open this publication in new window or tab >>Injuries among weightlifters and powerlifters: a systematic review
2017 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 51, no 4, p. 211-219Article in journal (Refereed) Published
Abstract [en]

Background Olympic weightlifting and powerlifting are two sports that expose the body to great forces. Injury characteristics have not been systematically reviewed for these two growing sports.

Objective The purpose of this study was to systematically review the literature regarding various definitions of injuries used, injury localisation, the prevalence and incidence of injuries and the associated risk factors for injuries in weightlifting and powerlifting.

Design Systematic review.

Data sources Five databases, PubMed, MEDLINE, SPORTDiscus, Scopus and Web of Science, were searched between 9 March and 6 April 2015.

Eligibility criteria for selecting studies Studies assessing injury incidence and prevalence in Olympic weightlifting and powerlifting were included. The Quality assessment tool for observational cohort and cross-sectional studies was used to assess methodological quality.

Results 9 studies were included in the review. Injury was defined fairly consistently across studies. Most studies were of low methodological quality. The spine, shoulder and the knee were the most common injury localisations in both sports. The injury incidence in weightlifting was 2.4–3.3 injuries/1000 hours of training and 1.0–4.4 injuries/1000 hours of training in powerlifting. Only one retrospective study had analysed possible risk factors.

Summary/conclusions The risk of injury in both sports were similar to other non-contact sports also requiring strength/power, but low compared to contact sports. The severity of injuries differed in the included studies. Since little has been studied regarding possible risk factors to injuries, further research is therefore warranted to explain why athletes get injured and how to prevent injuries.

Trial registration number PROSPERO CRD42015014805.

National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-126433 (URN)10.1136/bjsports-2016-096037 (DOI)000394540300001 ()27707741 (PubMedID)2-s2.0-84991691544 (Scopus ID)
Available from: 2016-10-06 Created: 2016-10-06 Last updated: 2018-06-09Bibliographically 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
Berglund, L. (2016). Deadlift training for patients with mechanical low back pain: a comparison of the effects of a high-load lifting exercise and individualized low-load motor control exercises. (Doctoral dissertation). Umeå: Umeå universitet
Open this publication in new window or tab >>Deadlift training for patients with mechanical low back pain: a comparison of the effects of a high-load lifting exercise and individualized low-load motor control exercises
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Disability due to low back pain is common. While evidence exist that exercise is effective in reducing pain and disability, it is still largely undetermined which kind of exercises that are most effective. The overall aim of this thesis was to evaluate and compare the effects of a high-load lifting exercise and individualized low-load motor control exercises for patients with nociceptive mechanical low back pain. A secondary aim was to evaluate which patients benefit from training with a high-load lifting exercise.

All four papers in this thesis were based on a randomized controlled trial including 70 participants with nociceptive mechanical low back pain as their dominating pain pattern. Participants were randomized into training with either a high-load lifting exercise (HLL), the deadlift, (n=35) or individualized low-load motor control exercises (LMC) (n=35). Both interventions included aspects of pain education. All participants were offered twelve sessions during an eight week period. The effects of the interventions were evaluated directly after and twelve months after the end of the intervention period. Outcome measures were pain intensity, activity, disability, physical performance, lumbo-pelvic alignment and lumbar multifidus muscle thickness.

There was a significant between-group effect in favour of the LMC intervention regarding improvements in activity, movement control tests and some tests of trunk muscle endurance. For pain intensity there were no significant differences between groups. A majority of participants in both intervention groups showed clinically meaningful improvements from baseline to two and twelve month follow-up regarding pain intensity and activity. There were no significant differences between HLL and LMC regarding the effect on lumbo-pelvic alignment or lumbar multifidus thickness. The participants who benefit the most from the HLL intervention were those with a low pain intensity and high performance in the Biering-Sørensen test at baseline.

The results of this thesis showed that the HLL intervention was not more effective than the LMC intervention. The LMC was in fact more effective in improving activity, performance in movement control tests and some tests of trunk muscle endurance, compared to the HLL intervention.

The results imply that the deadlift, when combined with education, could be considered as an exercise to produce clinically relevant improvements on pain intensity in patients who prefer a high-load exercise. However, before considering deadlift training, the results suggest that pain intensity and performance in the Biering-Sørensen test should be evaluated.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2016. p. 66
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1806
Keywords
Low back pain, Motor control, Deadlift, Randomized controlled trial, Pain, Disability, Activity
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-119939 (URN)978-91-7601-481-3 (ISBN)
Public defence
2016-06-02, Aulan, Vårdvetarhuset, Umeå universitet, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2016-05-12 Created: 2016-05-03 Last updated: 2018-06-07Bibliographically 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)
Available from: 2015-03-03 Created: 2015-03-03 Last updated: 2018-06-07Bibliographically approved
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