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Molander, P., Novo, M., Ringqvist, Å., Hållstam, A., Hesser, H., Löfgren, M., . . . Gerdle, B. (2024). Interdisciplinary pain rehabilitation for patients with Ehlers-Danlos syndrome and hypermobility spectrum disorders. Journal of Rehabilitation Medicine, 56, Article ID jrm12431.
Open this publication in new window or tab >>Interdisciplinary pain rehabilitation for patients with Ehlers-Danlos syndrome and hypermobility spectrum disorders
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2024 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 56, article id jrm12431Article in journal (Refereed) Published
Abstract [en]

Objective: Chronic pain is a common manifestation of Ehlers-Danlos syndrome and hypermobility spectrum disorders; thus it is often suggested that patients undergo generic interdisciplinary pain rehabilitation, despite there being little evidence to support this decision. The aim of this study is to examine the effectiveness of standard rehabilitation programmes for chronic pain on patients with Ehlers-Danlos syndrome and hypermobility spectrum disorders, compared with patients with other chronic pain disorders.

Subjects: Data, collected between 2008 and 2016, were extracted from a Swedish national registry. The patient data comprised of 406 cases with Ehlers-Danlos syndrome or hypermobility spectrum disorders, 784 cases with a whiplash-related diagnosis, 3713 cases with diagnoses relating to spinal pain, and 2880 cases of fibromyalgia.

Methods: The differences between groups on key outcome measures from pre-to 1-year follow-up after interdisciplinary pain rehabilitation were analysed using linear mixed effects models. Sensitivity analysis in the form of pattern-mixture modelling was conducted to discern the impact of missing data.

Results: No significant differences were found in improvements from pre-to 1-year follow-up for patients with Ehlers-Danlos syndrome or hypermobility spectrum disorder compared with other diagnostic groups regarding measures of health-related quality of life, mental health, or fatigue. At follow-up, differences in pain interference (d = –0.34 (95% confidence interval [95% CI] –0.5 to –0.18)), aver-age pain (d = 0.22 (95% CI 0.11–0.62)) and physical functioning (d = 2.19 (95% CI 1.61–2.77)) were detected for the group with spinal-related diagnoses in relation to those with EDS/HSD, largely due to pre-treatment group differences. Sensitivity analysis found little evidence for missing data influencing the results.

Conclusion: This study suggests that patients with Ehlers-Danlos syndrome/hypermobility spectrum disorders may benefit from inclusion in an interdisciplinary pain rehabilitation programme.

Place, publisher, year, edition, pages
Medical Journals Sweden, 2024
Keywords
chronic pain, Ehlers-Danlos syndrome, rehabilitation
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-222337 (URN)10.2340/jrm.v56.12431 (DOI)001166964300001 ()38323531 (PubMedID)2-s2.0-85186941238 (Scopus ID)
Available from: 2024-03-18 Created: 2024-03-18 Last updated: 2024-03-18Bibliographically approved
Yekkalam, N., Novo, M. & Wänman, A. (2024). Treatments related to temporomandibular disorders among patients with prevalent types of Ehlers-Danlos syndrome in Sweden. Cranio
Open this publication in new window or tab >>Treatments related to temporomandibular disorders among patients with prevalent types of Ehlers-Danlos syndrome in Sweden
2024 (English)In: Cranio, ISSN 0886-9634, E-ISSN 2151-0903Article in journal (Refereed) Epub ahead of print
Abstract [en]

The aim of this study was to assess the received TMD treatment modalities and the perceived outcome among the frequent types of EDS. A digital questionnaire was sent to the member of the National Swedish EDS Association during January-March 2022. The subsamples of hypermobile and classical EDS were constructed. Almost 90% reported TMD symptoms. Bite splint therapy, counselling, jaw training and occlusal adjustment were reported as the most common treatments with no statistically significant difference in terms of good effect between the two subsamples. Hypermobile and classical EDS might consider as an entity with regards to TMD.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Temporomandibular disorders, Ehlers-Danlos syndrome, hypermobility, splint therapy, jaw exercises, occlusal adjustment, counselling
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-221701 (URN)10.1080/08869634.2024.2319565 (DOI)2-s2.0-85186567425 (Scopus ID)
Available from: 2024-03-01 Created: 2024-03-01 Last updated: 2024-03-14
Molander, P., Novo, M., Hallstam, A., Lofgren, M., Stålnacke, B.-M. & Gerdle, B. (2020). Ehlers-Danlos Syndrome and Hypermobility Syndrome Compared with Other Common Chronic Pain Diagnoses-A Study from the Swedish Quality Registry for Pain Rehabilitation. Journal of Clinical Medicine, 9(7), Article ID 2143.
Open this publication in new window or tab >>Ehlers-Danlos Syndrome and Hypermobility Syndrome Compared with Other Common Chronic Pain Diagnoses-A Study from the Swedish Quality Registry for Pain Rehabilitation
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2020 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 9, no 7, article id 2143Article in journal (Refereed) Published
Abstract [en]

Although chronic pain is common in patients with Ehlers-Danlos syndrome (EDS) and hypermobility syndromes (HMS), little is known about the clinical characteristics of these groups. The main aim was to compare EDS/HMS with common local and generalized pain conditions with respect to Patient Reported Outcome Measures (PROMs). Data from the Swedish Quality Register for Chronic Pain (SQRP) from 2007 to 2016 (n= 40,518) were used, including patients with EDS/HMS (n= 795), fibromyalgia (n= 5791), spinal pain (n= 6693), and whiplash associated disorders (WAD) (n= 1229). No important differences in the PROMs were found between EDS and HMS. Women were represented in > 90% of EDS/HMS cases and fibromyalgia cases, and in about 64% of the other groups. The EDS/HMS group was significantly younger than the others but had a longer pain duration. The pain intensity in EDS/HMS was like those found in spinal pain and WAD; fibromyalgia had the highest pain intensity. Depressive and anxiety symptoms were very similar in the four groups. Vitality-a proxy for fatigue-was low both in EDS/HMS and fibromyalgia. The physical health was lower in EDS/HMS and fibromyalgia than in the two other groups. Patients with EDS/HMS were younger, more often female, and suffered from pain for the longest time compared with patients who had localized/regional pain conditions. Health-care clinicians must be aware of these issues related to EDS/HMS both when assessing the clinical presentations and planning treatment and rehabilitation interventions.

Place, publisher, year, edition, pages
MDPI, 2020
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-174626 (URN)10.3390/jcm9072143 (DOI)000558311200001 ()32645981 (PubMedID)2-s2.0-85104375863 (Scopus ID)
Available from: 2020-08-31 Created: 2020-08-31 Last updated: 2023-03-24Bibliographically approved
Gerdle, B., Bäckryd, E., Novo, M., Roeck-Hansen, E., Rothman, M., Stålnacke, B.-M., . . . Rivano Fischer, M. (2020). Smärtanalys: diagnos, smärtmekanismer, psykologisk och social bedömning (1ed.). Studentlitteratur AB
Open this publication in new window or tab >>Smärtanalys: diagnos, smärtmekanismer, psykologisk och social bedömning
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2020 (Swedish)Book (Other academic)
Place, publisher, year, edition, pages
Studentlitteratur AB, 2020. p. 194 Edition: 1
National Category
Psychiatry Physiotherapy
Identifiers
urn:nbn:se:umu:diva-178509 (URN)9789144129006 (ISBN)
Available from: 2021-01-13 Created: 2021-01-13 Last updated: 2021-01-22Bibliographically approved
Djekic, D., Nicoll, R., Novo, M. & Henein, M. (2015). Metabolomics in atherosclerosis. International Journal of Cardiology Metabolic & Endocrine, 8, 26-30
Open this publication in new window or tab >>Metabolomics in atherosclerosis
2015 (English)In: International Journal of Cardiology Metabolic & Endocrine, E-ISSN 2214-7624, Vol. 8, p. 26-30Article in journal (Refereed) Published
Abstract [en]

It is well established that atherosclerotic cardiovascular disease (ACD) is a leading cause of death in the West. There are several predisposing factors for ACD, which can be divided into two groups: firstly modifiable risk factors, including hypertension, dyslipidaemia, type 2 diabetes mellitus, obesity, smoking and a sedentary lifestyle and secondly the unmodifiable risk factors such as age, gender and heredity. Since single biomarkers are unable to provide sufficient information about the biochemical pathways responsible for the disease, there is a need for a holistic approach technology, e.g. metabolomics, that provide sufficiently detailed information about the metabolic status and assay results will be able to guide food, drug and lifestyle optimisation. Rather than investigating a single pathway, metabolomics deal with the integrated identification of biological and pathological molecular pathways. Mass spectrometry (MS) and nuclear magnetic resonance (NMR) spectroscopy are the two most commonly used techniques for metabolite profiling. This detailed review concluded that metabolomics investigations seem to have great potential in identifying small groups of disturbed metabolites which if put together should draw various metabolic routs that lead to the common track pathophysiology. The current evidence in using metabolomics in atherosclerotic cardiovascular disease is also limited and morewell designed studies remain to be established, which might significantly improve the comprehension of atherosclerosis pathophysiology and consequently management.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
Atherosclerotic cardiovascular disease, metabolomics, proteomics, lipidomics, atherosclerosis
National Category
Cardiac and Cardiovascular Systems
Research subject
Cardiology; cardiovascular disease
Identifiers
urn:nbn:se:umu:diva-103612 (URN)10.1016/j.ijcme.2014.11.004 (DOI)000372442100006 ()2-s2.0-84946416732 (Scopus ID)
Available from: 2015-05-25 Created: 2015-05-25 Last updated: 2023-11-28Bibliographically approved
Nyberg, V. E., Novo, M. & Sjölund, B. H. (2014). Changes in multidimensional pain inventory profile after a pain rehabilitation programme indicate the risk of receiving sick leave benefits one year later. Journal of Rehabilitation Medicine, 46(10), 1006-1013
Open this publication in new window or tab >>Changes in multidimensional pain inventory profile after a pain rehabilitation programme indicate the risk of receiving sick leave benefits one year later
2014 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 10, p. 1006-1013Article in journal (Refereed) Published
Abstract [en]

Objectives: To determine whether coping profile changes after rehabilitation, assessed with the Multidimensional Pain Inventory (MPI), can predict which persons disabled by chronic musculoskeletal pain will be in receipt of sick leave benefits in the long term. Methods: Study of MPI data from 2,784 patients (709 men and 2,075 women) collected from the Swedish Quality Register for Pain Rehabilitation (SQRP) before and at the end of rehabilitation and compared with independent sick leave data for 1 year later. Results: After rehabilitation there was a significantly decreased share of Dysfunctional profiles (DYS) among both men (44% before, 31% after) and women (39% before, 26% after), but an increased share of Adaptive Coper profiles (men 15% before, 24% after, women 14% before, 24% after). The number of patients on full-time sick leave decreased significantly among men (from 57% to 46%) and women (from 57% to 50%). Persons with a DYS profile after rehabilitation had a low probability of having no or part-time sick leave. Conclusion: The number of persons with DYS profiles decreased after rehabilitation. Those with other profiles had less full-time sick leave one year later than those with DYS profiles, indicating that leaving the DYS profile is a positive prognostic sign long-term. Furthermore, the gender differences observed suggest the need to tailor rehabilitative strategies differently for men and women.

Keywords
chronic musculoskeletal pain, disability, sick leave benefits, rehabilitation, Multidimensional Pain Inventory
National Category
Health Sciences
Identifiers
urn:nbn:se:umu:diva-104155 (URN)10.2340/16501977-1872 (DOI)000345106400009 ()25148537 (PubMedID)2-s2.0-84922263205 (Scopus ID)
Available from: 2015-06-18 Created: 2015-06-08 Last updated: 2023-03-23Bibliographically approved
Reine, I., Novo, M. & Hammarström, A. (2013). Unemployment and ill health - a gender analysis: results from a 14-year follow-up of the Northern Swedish cohort. Public Health, 127(3), 214-222
Open this publication in new window or tab >>Unemployment and ill health - a gender analysis: results from a 14-year follow-up of the Northern Swedish cohort
2013 (English)In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 127, no 3, p. 214-222Article in journal (Refereed) Published
Abstract [en]

Objectives. To investigate the experience of suicidal expressions (death wishes, life weariness, ideation, plans and attempts) in young Swedish Sami, their attitudes toward suicide (ATTS), and experience of suicidal expressions and completed suicide in significant others and to compare with Swedes in general. Methods. A cross-sectional study comprising 516 Swedish Sami, 18-28 years of age together with an age and geographically matched reference group (n = 218). Parts of the ATTS questionnaire have been used to cover different aspects of the suicidal complex. Data were analysed with regard to gender, occupation, counties and experience of negative societal treatment due to Sami background. Results. Both young Sami and young Swedes reported suicidal ideation, life weariness, and death wishes in a high degree (30-50%), but it was more common among the Sami. Having had plans to commit suicide showed a significant gender difference only in the Sami. The prevalence of suicide attempts did not differ significantly between Sami and Swedes. Subgroups of the Sami reported a higher degree of suicidal behaviour, Sami women and reindeer herders reported a 3, 5-fold higher odds of suicide attempts and a 2-fold higher odds having had plans committing suicide. Sami living in Vasterbotten/Jamtland/Vasternorrland and Sami with experience of ethnicity related bad treatment 2-fold higher odds of suicidal plans compared to those living in other counties. Conclusion. An increased occurrence of suicidal ideation/death wishes/life weariness in young Sami compared to young majority Swedes was found, but not an increased prevalence of suicide attempts and positive attitudes together with an increased awareness to handle suicide problems could be a contributing factor. Severe circumstances and experience of ethnicity-related bad treatment seems to contribute to increased levels of suicidal plans and attempts in subgroups of Sami.

Place, publisher, year, edition, pages
Saunders Elsevier, 2013
Keywords
suicide ideation, suicide attempts, gender, reindeer herders, indigenous Sami, attitudes toward suicide
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-26495 (URN)10.1016/j.puhe.2012.12.005 (DOI)000316797100004 ()2-s2.0-84875244658 (Scopus ID)
Note

Original included in thesis in manuscript form.

Available from: 2009-10-12 Created: 2009-10-12 Last updated: 2023-03-23Bibliographically approved
Harryson, L., Novo, M. & Hammarström, A. (2012). Is gender inequality in the domestic sphere associated with psychological distress among women and men? Results from the Northern Swedish Cohort. Journal of Epidemiology and Community Health, 66(3), 271-276
Open this publication in new window or tab >>Is gender inequality in the domestic sphere associated with psychological distress among women and men? Results from the Northern Swedish Cohort
2012 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 66, no 3, p. 271-276Article in journal (Refereed) Published
Abstract [en]

Aim The aim of this study was to analyse whether gender inequality in the domestic sphere was associated with psychological distress among women and men.

Methods In a cohort study, all pupils in the last year of compulsory school in a middle-sized industrial town in northern Sweden were followed until the age of 42. For this study a sample of cohabiting participants (n¼372 women, 352 men) was selected. Gender inequality was measured as perceptions of gender inequality in the couple relationship, time spent on household work, responsibility for domestic work and childcare, and was analysed in relation to psychological distress, after taking possible background variables as well as earlier health status into account.

Results In the multivariate analyses, perception of gender inequality in the couple relationship was associated with psychological distress for both women (OR 2.23, CI 1.20 to 4.18) and men (OR 3.51, CI 1.69 to 7.31). For women only, taking whole responsibility for domestic work was associated with the outcome (OR 2.17, CI 1.05 to 4.48). For men, taking less than half of the responsibility for domestic work was associated with psychological distress (OR 2.25, CI 1.24 to 3.91).

Conclusions Gender inequality in the domestic sphere seems to be an important determinant of psychological distress for both women and men.

Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2012
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-41372 (URN)10.1136/jech.2010.109231 (DOI)000300039600013 ()20940171 (PubMedID)2-s2.0-84857192611 (Scopus ID)
Available from: 2011-03-23 Created: 2011-03-23 Last updated: 2023-03-23Bibliographically approved
Nyberg, V. E., Novo, M. & Sjölund, B. H. (2011). Do multidimensional pain inventory scale score changes indicate risk of receiving sick leave benefits 1 year after a pain rehabilitation programme?. Disability and Rehabilitation, 33(17-18), 1548-1556
Open this publication in new window or tab >>Do multidimensional pain inventory scale score changes indicate risk of receiving sick leave benefits 1 year after a pain rehabilitation programme?
2011 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 17-18, p. 1548-1556Article in journal (Refereed) Published
Abstract [en]

Purpose: To study whether scale score changes in the Multidimensional Pain Inventory (MPI) can predict which persons disabled by pain will receive sick leave benefits 1 year after completing a pain rehabilitation programme.

Method: An observational study of MPI data derived from 1468 patients, 388 men and 1080 women, who had participated in multidisciplinary cognitive-behavioural oriented pain rehabilitation programmes in Sweden, collected from the Swedish Quality Register for Pain Rehabilitation, before, at the end and 1 year after the programme.

Results: Most MPI scale scores showed improvements after completing a pain rehabilitation programme and this improvement was sustained after 1 year. Moreover, we found that a decrease in MPI scales scores for Pain severity and Interference immediately after the pain rehabilitation programme decreased the risk of being on full-time sick leave 1 year later [OR 0.85, (95% CI 0.73–0.99) and OR 0.73, (95% CI 0.61–0.87), respectively]. The Interference scale, which may be considered to include ICF components of both activities and participation, might represent the core of suffering among persons disabled with pain.

Conclusions: A rehabilitation intervention directed to combating the consequences of pain in activities and participation rather than against pain per se might lead to improved working capacity.

Place, publisher, year, edition, pages
London: Taylor & Francis, 2011
Keywords
Chronic pain, sick leave benefits, pain rehabilitation, Multidimensional Pain Inventory
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-42857 (URN)10.3109/09638288.2010.533815 (DOI)000294173200007 ()2-s2.0-79960786275 (Scopus ID)
Available from: 2011-04-14 Created: 2011-04-14 Last updated: 2023-03-24Bibliographically approved
Reine, I., Novo, M. & Hammarström, A. (2011). Is participation in labour market programmes related to mental health?: results from a 14-year follow-up of the Northern Swedish cohort. Scandinavian Journal of Public Health, 39(1), 26-34
Open this publication in new window or tab >>Is participation in labour market programmes related to mental health?: results from a 14-year follow-up of the Northern Swedish cohort
2011 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 1, p. 26-34Article in journal (Refereed) Published
Abstract [en]

Aims: There is a lack of empirical studies assessing the possible impact of active labour market programmes (ALMP) on health. The aim of this study was to analyze whether participation in ALMP, in contrast to being unemployed and not participating in ALMP (UNALMP), was related to mental health at different ages.

Methods: The study was carried out in a medium-sized industrial town in the north of Sweden. The cohort, consisting of all 1,083 pupils who attended or should have attended the last year of compulsory school in 1981, was followed up at the ages of 16, 18, 21 and 30. Data on 381 individuals at age 21, and 281 at age 30 were used in the study. The main health measurement was psychological symptoms among participants of ALMP in contrast to UNALMP at ages 21 and 30, and was analyzed by propensity score matching method (PSM) and multivariate logistic regression.

Results: Generally, ALMP had higher scores of psychological symptoms than UNALMP. Nevertheless, participation in ALMP was not related to mental health. Due to methodological shortages our results have to be interpreted with caution. Adjustment for either all background selection variables or the propensity score in multivariate logistic regression showed similar associations, suggesting that propensity score could be used to adjust for background selection variables.

Conclusions: There is a need for more well-designed studies, using a theoretical framework, within the field, that are based on larger samples.

Keywords
Age, gender, longitudinal, propensity score
National Category
General Practice
Identifiers
urn:nbn:se:umu:diva-26494 (URN)10.1177/1403494810391523 (DOI)2-s2.0-79952258140 (Scopus ID)
Available from: 2009-10-12 Created: 2009-10-12 Last updated: 2023-03-24Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6844-9299

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