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Stenlund, T., Öhberg, F., Lundström, R., Lindroos, O., Häger, C., Neely, G. & Rehn, B. (2018). Double-sided Mechanical Shocks Provoke Larger Seated Postural Reactions Compared to Single-Sided Mechanical Shocks. Spine, 43(8), E482-E487
Open this publication in new window or tab >>Double-sided Mechanical Shocks Provoke Larger Seated Postural Reactions Compared to Single-Sided Mechanical Shocks
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2018 (English)In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 43, no 8, p. E482-E487Article in journal (Refereed) Published
Abstract [en]

STUDY DESIGN: Human volunteers were exposed experimentally to single-sided mechanical shocks (SSMS) and double-sided mechanical shocks (DSMS) while seated.

OBJECTIVE: To describe and contrast seated postural reactions due to SSMS or DSMS in healthy male adults.

SUMMARY OF BACKGROUND DATA: Mechanical shocks to the body, caused when driving on irregular terrain, are suggested to be hazardous to the spine and may be associated with the reported musculoskeletal pain of the back and neck among professional drivers. However, very little is known about the characteristics of seated postural reactions and the biomechanical effects caused by mechanical shocks.

METHODS: Twenty healthy male subjects (18-43 years old) were exposed while seated to 5 SSMS and 15 DSMS in lateral directions. The second acceleration in the DSMS was in the opposite direction to the first acceleration and was either fast, medium or slow depending on the speed of direction change. Surface electromyography (EMG) was recorded in muscles of the upper neck, trapezius, erector spinae and external oblique while kinematics were recorded with inertial sensors placed at the neck, trunk and pelvis. Muscle activity was normalized to maximum voluntary contractions (MVC).

RESULTS: The EMG amplitudes were significantly higher (0.6-1%; p < 0.001) for the fast DSMS compared to all other shocks. Range of motion (ROM) of the neck and trunk was greater during the DSMS compared to the SSMS. Evoked muscle activity was less than 2% MVC in the trapezius, less than 10% MVC in the erector spinae and upper neck while the activity exceeded 10% MVC in the external oblique muscles.

CONCLUSION: Fast DSMS in lateral directions appear more demanding compared to SSMS, demonstrating augmented seated postural reactions. However, the present mechanical shocks employed did not seem to induce postural reactions with regard to ROM or muscle activity of a magnitude likely to cause musculoskeletal overload.

LEVEL OF EVIDENCE: 4.

National Category
Physiotherapy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-144712 (URN)10.1097/BRS.0000000000002396 (DOI)000440520600008 ()28858181 (PubMedID)
Funder
AFA Insurance
Available from: 2018-02-12 Created: 2018-02-12 Last updated: 2018-09-13Bibliographically approved
Lundell, S., Tistad, M., Rehn, B., Wiklund, M., Holmner, Å. & Wadell, K. (2017). Building COPD care on shaky ground: a mixed methods study from Swedish primary care professional perspective. BMC Health Services Research, 17, Article ID 467.
Open this publication in new window or tab >>Building COPD care on shaky ground: a mixed methods study from Swedish primary care professional perspective
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2017 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, article id 467Article in journal (Refereed) Published
Abstract [en]

Background: Chronic obstructive pulmonary disease (COPD) is a public health problem. Interprofessional collaboration and health promotion interventions such as exercise training, education, and behaviour change are cost effective, have a good effect on health status, and are recommended in COPD treatment guidelines. There is a gap between the guidelines and the healthcare available to people with COPD. The aim of this study was to increase the understanding of what shapes the provision of primary care services to people with COPD and what healthcare is offered to them from the perspective of healthcare professionals and managers.

Methods: The study was conducted in primary care in a Swedish county council during January to June 2015. A qualitatively driven mixed methods design was applied. Qualitative and quantitative findings were merged into a joint analysis. Interviews for the qualitative component were performed with healthcare professionals (n = 14) from two primary care centres and analysed with qualitative content analysis. Two questionnaires were used for the quantitative component; one was answered by senior managers or COPD nurses at primary care centres (n = 26) in the county council and the other was answered by healthcare professionals (n = 18) at two primary care centres. The questionnaire data were analysed with descriptive statistics.

Results: The analysis gave rise to the overarching theme building COPD care on shaky ground. This represents professionals driven to build a supportive COPD care on 'shaky' organisational ground in a fragmented and non-compliant healthcare organisation. The shaky ground is further represented by uninformed patients with a complex disease, which is surrounded with shame. The professionals are autonomous and pragmatic, used to taking responsibility for their work, and with limited involvement of the management. They wish to provide high quality COPD care with interprofessional collaboration, but they lack competence and are hindered by inadequate routines and lack of resources.

Conclusions: There is a gap between COPD treatment guidelines and the healthcare that is provided in primary care. To facilitate implementation of the guidelines several actions are needed, such as further training for professionals, additional resources, and improved organisational structure for interprofessional collaboration and patient education.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
Chronic obstructive pulmonary disease, Primary care, Healthcare professionals, Mixed methods, Healthcare system, Organisation, Implementation, Health promotion, Treatment guidelines, Sweden
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-137946 (URN)10.1186/s12913-017-2393-y (DOI)000405243000001 ()
Available from: 2017-08-02 Created: 2017-08-02 Last updated: 2018-10-17Bibliographically approved
Rehn, B. (2017). Clinical exercise pathophysiology for physical therapy: Examination, testing, and exercise prescription for movement-related disorders [Review]. European Journal of Physiotherapy, 19(2), 116-116
Open this publication in new window or tab >>Clinical exercise pathophysiology for physical therapy: Examination, testing, and exercise prescription for movement-related disorders
2017 (English)In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 19, no 2, p. 116-116Article, book review (Other academic) Published
Place, publisher, year, edition, pages
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2017
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-138627 (URN)10.1080/21679169.2016.1248433 (DOI)000406051700009 ()
Available from: 2017-09-29 Created: 2017-09-29 Last updated: 2018-06-09Bibliographically approved
Rehn, B., Hedlund, M. & Sandlund, J. (2017). Flippade klassrum om människokroppens funktion för fysioterapeutstudenter. In: : . Paper presented at Universitetspedagogisk konferens. Umeå universitet..
Open this publication in new window or tab >>Flippade klassrum om människokroppens funktion för fysioterapeutstudenter
2017 (Swedish)Conference paper, Oral presentation with published abstract (Other (popular science, discussion, etc.))
Abstract [sv]

Människokroppens funktion handlar om grundläggande biologiska förutsättningar för att möjliggöra kroppsrörelser, båda för friska människor och de med rörelsehinder, ett signum för fysioterapi och fysioterapeututbildningar. Traditionellt har undervisning inom detta område skett genom katedralföreläsningar. Syftet med det här projektet var att implementera och utvärdera flippade klassrum om människokroppens funktion för fysioterapeutstudenter i termin 2. Förhoppningen var att den nya undervisningsformen skulle fördjupa lärandet. För ett antal områden har filmer producerats och lagts ut på Umu-play i lärplattformen Cambro. Dessa filmer skulle ses av studenterna innan träff med läraren. Filmerna tog upp huvuddragen kring områdena och en del kända svåra passager. Studenterna var i övrigt hänvisade till kurslitteratur och målbeskrivning. Vid träff med läraren strukturerades denna på olika sätt, så att studenterna tillsammans och med läraren kunde diskutera innehållet. Detta ansågs av lärarna vara den viktigaste och svåraste delen med flippade klassrum, men att det skapade dialog med studenterna. Några av studenterna gillade undervisningsformen, men den kräver att man är förberedd vid träff med läraren.  Andra studenter föredrag vanliga föreläsningar. Projektet började i liten skala med förändring av några områden, men kommer att gälla fler områden i framöver.

National Category
Pedagogical Work
Identifiers
urn:nbn:se:umu:diva-141599 (URN)
Conference
Universitetspedagogisk konferens. Umeå universitet.
Available from: 2017-11-09 Created: 2017-11-09 Last updated: 2018-06-09
Blomqvist, S., Lönnberg, L., Sundelin, G., Wester, A. & Rehn, B. (2017). Physical Exercise Frequency Seem not to Influence Postural Balance but Trunk Muscle Endurance in Young Persons with Intellectual Disability. Journal of Physical Education and Sports Management, 4(2), 38-47
Open this publication in new window or tab >>Physical Exercise Frequency Seem not to Influence Postural Balance but Trunk Muscle Endurance in Young Persons with Intellectual Disability
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2017 (English)In: Journal of Physical Education and Sports Management, ISSN 2373-2156, E-ISSN 2373-2164, Vol. 4, no 2, p. 38-47Article in journal (Refereed) Published
Abstract [en]

Background: The influence of various physical exercise frequencies on postural balance and muscle performance among young persons with intellectual disability (ID) is not well understood.

Method: Cross-sectional data from 26 elite athletes were compared with 37 students at a sports school and to 57 students at a special school, all diagnosed with mild to moderate ID and with different exercise frequencies. Data were also compared with a group of 149 age-matched participants without ID.

Results: There were no significant differences in postural balance between young ID groups regardless of physical exercise frequency, all of them had however impaired postural balance compared to the non-ID group. The group with high exercise performed better than the other ID groups in the trunk muscle endurance test.

Conclusions: It appears as if physical exercise frequency don’t improve postural balance but endurance in the trunk muscles for young persons with ID.

Place, publisher, year, edition, pages
American Research Institute for Policy Development, 2017
Keywords
mental retardation, young, teenager, postural control, strength
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-146869 (URN)10.15640/jpesm.v4n2a5 (DOI)
Available from: 2018-04-20 Created: 2018-04-20 Last updated: 2018-06-14Bibliographically approved
Stenlund, T., Öhberg, F., Lundström, R., Lindroos, O., Häger, C., Neely, G. & Rehn, B. (2016). Adaptation of postural reactions in seated positions and influence of head posture when exposed to a single sideway perturbation: relevance for driving on irregular terrain. Journal of Novel Physiotherapy and Physical Rehabilitation, 3(1), 022-029
Open this publication in new window or tab >>Adaptation of postural reactions in seated positions and influence of head posture when exposed to a single sideway perturbation: relevance for driving on irregular terrain
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2016 (English)In: Journal of Novel Physiotherapy and Physical Rehabilitation, ISSN 2455-5487, Vol. 3, no 1, p. 022-029Article in journal (Refereed) Published
Abstract [en]

 Background and objectives: Mechanical perturbations in seated positions caused by driving on irregular terrain destabilize the driver which, combined with the drivers’ posture, may cause musculoskeletal disorders. The aim of this study was to investigate adaptation and the effect of different head postures on seated postural reactions caused by perturbations. 

Materials and Methods: Twenty healthy male participants, aged 18-43 years, were tested on a movable platform delivering 15 sideways perturbations (peak acceleration 13.3 m/s2) while the participants held their head in a neutral or a laterally flexed posture. Surface electromyography (EMG) signals were recorded bilaterally in upper neck, trapezius, erector spinae and external oblique, while kinematics were recorded with inertial sensors for the head, trunk and pelvis. EMG amplitudes, muscle onset latencies and angular displacements in the frontal plane were analyzed. 

Results: In the neutral position, the EMG amplitudes and neck angular displacements significantly decreased by 0.2% and more than 1.6° respectively after repeated perturbations. Muscle onset latencies remained unchanged. During lateral flexion of the head, the EMG amplitudes decreased by 0.5% but the muscular onset latencies increased by more than 9 ms. 

Conclusion: The developed neuromuscular strategy seem to prefer a reduced EMG amplitude. The modest size of the postural reactions during the conditions presented here do not by themselves explain the musculoskeletal disorders found in drivers.

Keywords
Postural balance, Posture, Electromyography, Musculoskeletal pain, Neck muscles
National Category
Physiotherapy
Research subject
Physiotherapy; injury prevention
Identifiers
urn:nbn:se:umu:diva-117165 (URN)10.17352/2455-5487.000031 (DOI)
Available from: 2016-02-23 Created: 2016-02-23 Last updated: 2018-06-07Bibliographically approved
Larsson, A., Rehn, B. & Blomqvist, S. (2016). Muscle function among healthy adult athletes before and after a postural balance training period. Jacobs Journal of Sports Medicine, 3(2), Article ID 021.
Open this publication in new window or tab >>Muscle function among healthy adult athletes before and after a postural balance training period
2016 (English)In: Jacobs Journal of Sports Medicine, Vol. 3, no 2, article id 021Article in journal (Refereed) Published
Abstract [en]

Background: Postural balance training is primarily used by athletes as rehabilitation after previous injuries or for prevention. A few studies have been made with the aim of investigating whether postural balance training can improve other physical functions in healthy participants. However, there is no consensus regarding effects.

Objective: The aim of this study was to investigate whether postural balance training can improve muscle function in healthy adult athletes.

Method: Seventeen healthy adult (6 males and 11 females) athletes between the ages of 21 and 50 years performed three postural balance exercises once a day 3x30 seconds per exercise on each leg. This intervention was performed daily for six weeks. Their muscle function were assessed with squat jump, heel rise and grip strength (control). Evaluation was done before and after the training period.

Results: Jump height, number of repetitions in heel rise and duration in standing on one leg increased with statistical significance. There were no improvements in postural sway and grip strength.

Conclusion: The results suggest that a postural balance training period can provide a better local muscle function regarding explosive strength and endurance among adult athletes even if postural sway is not affected.

Keywords
Muscle strength, Equilibrium, Exercise, Physical examination
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-125173 (URN)
Available from: 2016-09-07 Created: 2016-09-07 Last updated: 2018-06-07Bibliographically approved
Sundahl, L., Zetterberg, M., Wester, A., Rehn, B. & Blomqvist, S. (2016). Physical activity levels among adolescent and young adult women and men with and without intellectual disability. JARID: Journal of applied research in intellectual disabilities, 29(1), 93-98
Open this publication in new window or tab >>Physical activity levels among adolescent and young adult women and men with and without intellectual disability
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2016 (English)In: JARID: Journal of applied research in intellectual disabilities, ISSN 1360-2322, E-ISSN 1468-3148, Vol. 29, no 1, p. 93-98Article in journal (Refereed) Published
Abstract [en]

Background: As physical activity can prevent overweight and promote general health, the aim was to investigate the amount of physical activity among adolescent and young adult women and men with intellectual disability (ID), compared to age-matched control groups without intellectual disability. A further aim was to examine whether physical activity level was associated with the body mass index (BMI).

Materials and methods: Fifty-two adolescent and young adult women and men with intellectual disability and 48 without intellectual disability, between the ages 16 and 20 years, BMIs ranging from 16.3 to 50.3 kg/m(2), were measured for number of steps taken with a pedometer for five consecutive days (Sunday-Thursday).

Results: The only group to meet recommendations regarding number of steps (10 000-12 000/day) was women without intellectual disability. No significant associations were found between total number of steps taken and BMI.

Conclusion: As the majority of adolescents and young adults with intellectual disability, especially women, did not reach recommended activity levels regardless of their BMIs, this call for broad measures to increase physical activity.

Place, publisher, year, edition, pages
Hoboken: Wiley-Blackwell, 2016
Keywords
mental retardation, motor activity, teenagers, youths
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-116087 (URN)10.1111/jar.12170 (DOI)000368133300009 ()25940840 (PubMedID)
Available from: 2016-02-08 Created: 2016-02-08 Last updated: 2018-06-07Bibliographically approved
Rehn, B. & Blomqvist, S. (2015). Fysisk aktivitet och hälsa för personer med utvecklingsstörning: Forskning pågår. Fysioterapi, 1, 26-32
Open this publication in new window or tab >>Fysisk aktivitet och hälsa för personer med utvecklingsstörning: Forskning pågår
2015 (Swedish)In: Fysioterapi, ISSN 1653-5804, Vol. 1, p. 26-32Article, review/survey (Other academic) Published
Abstract [sv]

Hälsa är en förutsättning för att kunna förverkliga sina mål i livet. Personer med utvecklingsstörning, cirka 90 000 i Sverige, har nedsatt hälsa jämfört med personer utan utvecklingsstörning och det leder till att denna grupp har svårare att uppfylla sina mål. Personer med utvecklingsstörning drabbas i större utsträckning av övervikt, typ 2-diabetes, hjärt- och kärlsjukdomar, högt blodtryck, benskörhet och depression. Undersökningar visar också på nedsatt fysisk aktivitet, motorik, syreupptagningsförmåga, muskelstyrka och postural balans hos denna grupp. Dessa sjukdomar och nedsatta förmågor går att påverka i positiv riktning med fysisk aktivitet. Fysioterapeuter som har bred kunskap om hälsa och anpassning av fysisk aktivitet kan vara till stor hjälp vid prevention, bedömning och träning.

Place, publisher, year, edition, pages
Stockholm: Fysioterapeuterna, 2015
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-103326 (URN)
Available from: 2015-05-20 Created: 2015-05-20 Last updated: 2018-06-07Bibliographically approved
Stenlund, T., Lundström, R., Häger, C., Burström, L., Neely, G. & Rehn, B. (2015). Seated postural neck and trunk reactions to sideways perturbations with or without a cognitive task. Journal of Electromyography & Kinesiology, 25(3), 548-556
Open this publication in new window or tab >>Seated postural neck and trunk reactions to sideways perturbations with or without a cognitive task
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2015 (English)In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 25, no 3, p. 548-556Article in journal (Refereed) Published
Abstract [en]

Driving on irregular terrain will expose the driver to sideways mechanical shocks or perturbations that may cause musculoskeletal problems. How a cognitive task, imposed on the driver, affects seated postural reactions during perturbations is unknown. The aim of the present study was to investigate seated postural reactions in the neck and trunk among healthy adults exposed to sideways perturbations with or without a cognitive task. Twenty-three healthy male subjects aged 19-36 years, were seated on a chair mounted on a motion system and randomly exposed to 20 sideways perturbations (at two peak accelerations 5.1 or 13.2 m/s2) in two conditions: counting backwards or not. Kinematics were recorded for upper body segments using inertial measurement units attached to the body and electromyography (EMG) was recorded for four muscles bilaterally in the neck and trunk. Angular displacements (head, neck, trunk and pelvis) in the frontal plane, and EMG amplitude (normalised to maximum voluntary contractions, MVC) were analysed. The cognitive task provoked significantly larger angular displacements of the head, neck and trunk and significantly increased EMG mean amplitudes in the upper neck during deceleration, although 10% of MVC was never exceeded. A cognitive task seems to affect musculoskeletal reactions when exposed to sideways perturbations in a seated position.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
Sideway perturbation, Postural reaction, EMG, Dual task, Neck
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-103258 (URN)10.1016/j.jelekin.2015.03.002 (DOI)000354026200018 ()25843010 (PubMedID)
Available from: 2015-05-19 Created: 2015-05-19 Last updated: 2018-06-07Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7998-9744

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