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  • 1. Ertzgaard, Per
    et al.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Umeå University, Faculty of Science and Technology, Centre for Biomedical Engineering and Physics (CMTF).
    Gerdle, Björn
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Umeå University, Faculty of Science and Technology, Centre for Biomedical Engineering and Physics (CMTF).
    A new way of assessing arm function in activity using kinematic Exposure Variation Analysis and portable inertial sensors - A validity study2016In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 21, 241-249 p.Article in journal (Refereed)
    Abstract [en]

    Portable motion systems based on inertial motion sensors are promising methods, with the advantage compared to optoelectronic cameras of not being confined to a laboratory setting. A challenge is to develop relevant outcome measures for clinical use. The aim of this study was to characterize elbow and shoulder motion during functional tasks, using portable motion sensors and a modified Exposure Variation Analysis (EVA) and evaluate system accuracy with optoelectronic cameras. Ten healthy volunteers and one participant with sequel after stroke performed standardised functional arm tasks. Motion was registered simultaneously with a custom developed motion sensor system, including gyroscopes and accelerometers, and an optoelectronic camera system. The EVA was applied on elbow and shoulder joints, and angular and angular velocity EVA plots was calculated. The EVA showed characteristic patterns for each arm task in the healthy controls and a distinct difference between the affected and unaffected arm in the participant with sequel after stroke. The accuracy of the portable system was high with a systematic error ranging between -1.2 degrees and 2.0 degrees. The error was direction specific due to a drift component along the gravity vector. Portable motion sensor systems have high potential as clinical tools for evaluation of arm function. EVA effectively illustrates joint angle and joint angle velocity patterns that may capture deficiencies in arm function and movement quality. Next step will be to manage system drift by including magnetometers, to further develop clinically relevant outcome variables and apply this for relevant patient groups.

  • 2.
    Fyhr, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gustavsson, Linnea
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wassinger, Craig
    Department of Physical Therapy, East Tennessee State University, USA.
    Sole, Gisela
    Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand.
    The effects of shoulder injury on kinaesthesia: A systematic review and meta-analysis2015In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 20, no 1, 28-37 p.Article, review/survey (Refereed)
    Abstract [en]

    The aim of this systematic review was to synthesize the evidence for changes for proprioceptive variables consisting of movement and position sense in participants with glenohumeral musculoskeletal disorders. Five databases were searched until 13th August 2013. Methodological quality was assessed and meta-analyses were performed for active and passive joint reposition sense (AJPS and PJPS) and movement sense, determined with threshold to detection of passive motion (TTDPM). The search yielded 17 studies, four of which were classified as having high methodological quality, seven as moderate and six as low quality. For participants with post-traumatic glenohumeral instability, pooled findings indicate moderate evidence for higher TTDPM for involved shoulders compared to control groups and the contralateral uninvolved side, indicating decreased movement sense. For AJPS and PJPS there was moderate to limited evidence for significant increased errors for involved compared to uninvovled shoulders, but not when compared to the control groups. Limited evidence was found for decreased AJPS acuity for patients with chronic rotator cuff pain and for patients with unspecified shoulder pain compared to healthy controls. Movement sense is most likely to be impaired after shoulder injury involving post-traumatic instability when compared to the contralateral shoulder and to controls, while deficits for AJPS and PJPS are more likely to be evident compared to the contralateral shoulder in participants with glenohumeral musculoskeletal disorders. (C) 2014 Elsevier Ltd. All rights reserved.

  • 3.
    Holmgren, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Waling, Kerstin
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Inter-examiner reliability of four static palpation tests used for assessing pelvic dysfunction2008In: Manual Therapy, ISSN 1356-689X, Vol. 13, no 1, 50-56 p.Article in journal (Refereed)
  • 4. Landén Ludvigsson, Maria
    et al.
    Peterson, Gunnel
    Jull, Gwendolen
    Trygg, Johan
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Peolsson, Anneli
    Mechanical properties of the trapezius during scapular elevation in people with chronic whiplash associated disorders: A case-control ultrasound speckle tracking analysis2016In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 21, 177-182 p.Article in journal (Refereed)
    Abstract [en]

    Background: Approximately 50% of people with Whiplash Associated Disorders (WAD) report longstanding symptoms. The upper trapezius is commonly painful yet its mechanical properties are not fully understood.

    Objectives: This study examined the deformation of different depths of the upper trapezius muscle during a scapular elevation task (shoulder shrugging) before and following loaded arm abduction. Design and Methods: A cross-sectional case-control study of 36 people (26 female and 10 male, mean age 38 (SD 11)) with chronic WAD and 36 controls, matched for age and gender. Real-time ultrasound recordings of upper trapezius were taken during both scapular elevation tasks. Post-process speckle tracking analysis was undertaken of three different sections of the upper trapezius muscle (superficial, middle, deep).

    Results: The WAD group had lower deformation of the superficial section of the upper trapezius compared to the control group in both concentric and eccentric phases of scapular elevation (p < 0.05) especially before the loaded arm abduction. After arm abduction, the deformation of the trapezius was reduced in both groups but only significantly in the WAD-group (p = 0.03). Within-group analysis revealed that the control group least engaged the deep section of upper trapezius during the task (p < 0.01).

    Conclusion: This study, measuring mechanical deformation of the upper trapezius during a scapular elevation task indicates that persons with WAD may display different patterns in engagement of the muscle sections than those in the control group. Further research is needed to replicate and understand the reasons for and implications of this possible change in motor strategy within upper trapezius.

  • 5.
    Lorås, H.
    et al.
    Trondheim, Norway.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Vasseljen, O.
    Trondheim, Norway.
    Stensdotter, A. K.
    Trondheim, Norway.
    Frame-difference analysis of video-recorded laser-beam projections2015In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 20, no 6, 879-883 p.Article in journal (Refereed)
    Abstract [en]

    Laser beams have been applied in many human motion research contexts to project movements in specific motor tasks. Currently, there are no objective analysis methods for laser projection recordings. The principal aim of this study was to investigate the feasibility of quantifying motion by applying frame differencing and image analysis methods to video streams of laser beam projections. The laser projection was controlled by a mechanical device that produced pseudo random rotations. The 2D motion recorded by the video was compared with recordings obtained with an electromagnetic system where a sensor was fixed to the same device as the laser. High correlations in the time and frequency domains were found between the methods. We conclude that the proposed method can accurately quantify complex motion patterns from laser beam projections. (C) 2015 Elsevier Ltd. All rights reserved.

  • 6.
    Peolsson, A.
    et al.
    Umeå University, Faculty of Science and Technology, Department of Chemistry. Medical and Health Sciences, Physiotherapy, Linköping University, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Sweden.
    Peterson, G.
    Trygg, Johan
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Nilsson, David
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Altered mechanical deformation of the trapezius and multifidus muscles registered with ultrasonography in women with chronic whiplash-associated disorders2016In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 25, e58- p.Article in journal (Refereed)
    Abstract [en]

    Background: The deformation and deformation rate of the dorsal neck muscle layers in individuals with chronic whiplash associated disorders (WAD) is rarely evaluated, and the mechanical behaviour during dynamic neck extension remains to be investigated.

    Purpose: To compare the deformation and deformation rate of dorsal neck muscles (trapezius, splenius capitis, semispinalis capitis and cervicis, and multifidus) in women with chronic WAD compared with healthy controls during a dynamic resisted neck extension.

    Methods: Nine women with chronic grade 2 and 3 WAD (mean age 38 years, standard deviation [SD] 11.3) and nine age- and gender-matched healthy controls (mean age 38 years, SD 11.6) participated in this cross-sectional, controlled study. Ultrasonography movies and post-process speckle tracking were used to investigate real-time mechanical dorsal neck muscle behaviour at the C4 segmental level during a low-loaded dynamic standardized neck extension. Deformation (longitudinal shortening and elongation) and deformation rate (speed of deformation) were calculated during the entire exercise sequence.

    Results: There were significant differences between the WAD and control groups in total deformation for the trapezius (p < 0.04) and multifidus (p < 0.03). The WAD group showed more shortening in the deformation pattern during the concentric contraction phase in the trapezius muscle, and during both the concentric and eccentric phase in the multifidus muscle compared to healthy controls. There were no other significant differences between groups either in deformation or deformation rate.

    Conclusion: There were altered mechanical deformations of the trapezius and multifidus muscles, with preliminary evidence for overuse in individuals with WAD compared to healthy controls. The findings must be interpreted with caution due to the small sample size.

    Implications: An ultrasound investigation made it possible to non-invasively capture multi-layered muscles in real time, adding new information of value for clinical practice of patients with WAD, which may impact future rehabilitation.

  • 7. Peolsson, Anneli
    et al.
    Löfstedt, Tommy
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Trygg, Johan
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Peolsson, Michael
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Ultrasound imaging with speckle tracking of cervical muscle deformation and deformation rate: isometric contraction of patients after anterior cervical decompression and fusion for cervical disc disease and controls2012In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 17, no 6, 519-525 p.Article in journal (Refereed)
    Abstract [en]

    There is currently a lack of information regarding neck muscle activity during specific exercises. The purpose of the present study was to investigate deformation and deformation rate in different layers of dorsal and ventral neck muscles during isometric neck muscle contraction in individuals after anterior cervical decompression and fusion and in healthy controls. This study included 10 individuals (mean age 60 years; SD 7.1) with a verified, long-standing neck disorder and 10 healthy, age- and sex-matched controls. Ultrasonography and post-process speckle tracking analysis was used to investigate the degree and the rate of neck muscles motions at the C4 segmental level during sub-maximal, isometric resistance of the head in a seated position. None of the analyses performed showed significant differences between groups (p > 0.05). In the dorsal muscles, both groups exhibited a higher deformation rate in the multifidus than in the trapezius, splenius, and semispinalis capitis (p ≤ 0.01). In the neck disorder group, the multifidus also showed a higher deformation rate compared to the semispinalis cervicis (p = 0.02). In the ventral muscles of patients with neck disorders, the longus colli had a higher deformation rate than the sternocleidomastoid (p = 0.02). Among the healthy controls, the multifidus showed a higher degree of deformation (p = 0.02) than the trapezius. In conclusion, our results showed no significant differences between the two groups in mechanical neck muscle activation. Larger studies with different exercises, preferably with a standardized measure of resistance, are needed to investigate whether patients and controls show differences in deformation and deformation rates in neck muscles.

  • 8. Peolsson, Anneli
    et al.
    Marstein, Eivind
    McNamara, Timothy
    Nolan, Damien
    Sjaaberg, Espen
    Peolsson, Michael
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Jull, Gwendolen
    O'Leary, Shaun
    Does posture of the cervical spine influence dorsal neck muscle activity when lifting?2014In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 19, no 1, 32-36 p.Article in journal (Refereed)
    Abstract [en]

    Previous studies have shown that postural orientations of the neck, such as flexed or forward head postures, are associated with heightened activity of the dorsal neck muscles. While these studies describe the impact of variations in neck posture alone, there is scant literature regarding the effect of neck posture on muscle activity when combined with upper limb activities such as lifting. The purpose of this study was to evaluate the effect of three different neck postures on the activity of the different layers of the dorsal neck muscles during a lifting task. Ultrasound measurements of dorsal neck muscle deformation were compared over two time points (rest, during lift) during a lifting task performed in three different neck postural conditions (neutral, flexed and forward head posture) in 21 healthy subjects. Data were analysed by post-process speckle tracking analysis. Results demonstrated significantly greater muscle deformation induced by flexed and forward head postures, compared to the neutral posture, for all dorsal neck muscles at rest (p < 0.05). Significant condition by time interactions associated with the lift was observed for four out of the five dorsal muscles (p < 0.02). These findings demonstrate that posture of the cervical spine influenced the level of muscle deformation not only at rest, but also when lifting. The findings of the study suggest that neck posture should be considered during the evaluation or design of lifting activities as it may contribute to excessive demands on dorsal neck muscles with potential detrimental consequences. (C) 2013 Elsevier Ltd. All rights reserved.

  • 9.
    Peterson, Gunnel
    et al.
    Eskilstuna, Sweden; Linköping, Sweden.
    Dedering, Åsa
    Karolinska Institutet, Sweden; Karolinska University Hospital, Sweden.
    Andersson, Erika
    Linköping, Sweden.
    Nilsson, David
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Trygg, Johan
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Peolsson, Michael
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Wallman, Thorne
    Eskilstuna, Sweden; Uppsala, Swe.
    Peolsson, Anneli
    Linköping, Sweden.
    Altered ventral neck muscle deformation for individuals with whiplash associated disorder compared to healthy controls: A case-control ultrasound study2015In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 20, no 2, 319-327 p.Article in journal (Refereed)
    Abstract [en]

    Previous studies have shown altered neck muscle function in individuals with chronic whiplash associated disorder (WAD). However, we lack real-time investigations with non-invasive methods that can distinguish between the different ventral neck muscle layers. This study investigated deformations and deformation rates in the sternocleidomastoid (SCM), longus capitis (Lcap), and longus colli (Lco) muscles with real-time ultrasonography. Twenty-six individuals with WAD were compared with 26 controls, matched for age and sex. Ultrasound imaging of the SCM, Lcap, and Lco were recorded during 10 repetitive arm elevations. The first and tenth arm elevations were post-process analyzed with speckle tracking. There were few significant differences in the deformations or deformation rates in the SCM, Lcap, and Lco between the WAD and control group. In controls, deformations and deformation rates showed linear positive relationships between SCM/Lcap, SCM/Lco, and Lcap/Lco which increased from the first arm elevation (R-2 = 0.14-0.70); to the tenth arm elevation (R-2 = 0.51-0.71). The WAD group showed similar or weaker linear relationship (R-2 < 0.19) during the tenth compared to the first (R-2 < 0.44) arm elevation except for deformations in Lcap/Lco (R-2 = 0.13-0.57). This result indicated that deformations and deformation rates in one muscle were correlated by similar deformations and deformation rates in other neck muscles in the control group, but this interplay between muscles was not found in the WAD group. (C) 2014 Elsevier Ltd. All rights reserved.

  • 10.
    Rudolfsson, Thomas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Djupsjöbacka, Mats
    Centrum för belastningsskadeforskning, Högskolan i Gävle.
    Range of motion in the upper and lower cervical spine in people with chronic neck pain2012In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 17, no 1, 53-59 p.Article in journal (Refereed)
    Abstract [en]

    Reduced cervical range of motion (ROM) is a common finding in people with neck pain. With few exceptions, only the angle between head and thorax has been measured. Our aim was to use an extended model to compare active cervical flexion and extension, separate for upper and lower cervical levels, between people with chronic non-traumatic neck pain and controls. We also investigated associations between ROM measures, symptoms and self-rated functioning. In this cross-sectional study, 102 subjects with neck pain and 33 healthy controls participated. An electromagnetic tracker system was used to measure the kinematics to construct a three-segment model including the thorax, cervical spine and head. Neutral flexion/extension were defined at subjects’ self-selected seated posture. We found that in the neck pain group, extension in the upper cervical levels and predominately flexion for the lower levels were reduced. The ratio between ROM for the upper and lower levels was altered in the neck pain group so that the lower levels contributed to a lesser extent to the total sagittal ROM compared to controls. These findings could not be explained by a greater forward head posture but must have other origins. For the neck pain group, ROM measures were weakly associated to pain and self-rated functioning. Altogether, this implies that using a three-segment model for assessment of ROM can be a valuable improvement for characterisation of patients and treatment evaluation.

  • 11.
    Röijezon, Ulrik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Djupsjöbacka, Mats
    Högskolan i Gävle.
    The slow and fast components of postural sway in chronic neck pain2011In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 16, no 3, 273-278 p.Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the slow and fast components of postural control in quiet stance in subjects with chronic neck pain, associations between postural sway and self-rated characteristics and to study the impact of anthropometrics on postural sway.

    Design: A single-blinded cross-sectional study including two separate data collections.

    Subjects: Sample 1: Persons with chronic non-specific neck pain (NS, n=24), whiplash associated disorders (WAD, n=21). Healthy subjects were controls (CON, n=21). Sample 2: Women only, 98 NS and 32 CON subjects.

    Methods: Subject performed a quiet stance test with eyes closed on a force platform while the center of pressure (CoP) trajectory was measured. Sample 1 was tested on a firm surface for 30 seconds, while sample 2 was tested on both firm and foam surfaces for 190 seconds. The CoP signal was decomposed into the slow and fast components and the magnitude of these signals were calculated. Anthropometrics were included as covariate in the analysis of group differences if correlated with postural sway variables. Group differences in the sway variables were evaluated, as well as association between postural sway and self-ratings of symptoms, functioning and kinesiophobia.

    Results: Increased magnitude of the slow sway component was found for both neck pain groups. Increasing age was associated with increased magnitude of the fast component. Surface conditions had no effect on group difference. For WAD, associations were found between the magnitude of the slow component and self-rated characteristics related to physical functioning, sensory alterations and psychosocial functioning. For NS, concurrent low back pain was associated with increased postural sway.

    Conclusion: Postural control can be altered in chronic neck pain. This effect was present only for the slow sway component, which implies aberration in sensory feedback or processing of sensory information. Associations between postural sway and self-rated characteristics in WAD support the clinical validity of postural control assessment in this group. Increased postural sway found in NS with concurrent low back pain suggests an important role of generalised spinal pain on postural control alterations.

  • 12. Sjölander, P
    et al.
    Michaelson, Peter
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Jaric, S
    Djupsjöbacka, M
    Sensorimotor disturbances in chronic neck pain - range of motion, peak velocity, smoothness of movement, and repositioning acuity.2008In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 13, no 2, 122-131 p.Article in journal (Refereed)
    Abstract [en]

    The purpose of this pilot study was to evaluate sensorimotor functions in patients with chronic neck pain with objective and quantitative methods. A group of 16 patients with chronic idiopathic neck pain of insidious onset or whiplash associated disorders (WAD) was compared to an equally sized group of healthy subjects. Kinematics were investigated during voluntary head rotations by measuring range of motion, variability of range of motion (ROM-Variability), peak velocity, and smoothness of movement (jerk index). Repositioning acuity after cervical rotations was evaluated by analysing constant and variable error (VE). In comparison to the healthy subjects, the patients showed significantly larger jerk index, ROM-Variability and VE. No statistically significant differences were found between insidious neck pain and WAD. It is concluded that jerky and irregular cervical movements and poor position sense acuity are characteristic sensorimotor symptoms in chronic neck pain. The observed individuality in sensorimotor disturbances emphasizes the importance of developing specific rehabilitation programs for specific dysfunctions, and of using objective and quantitative methods for evaluation of rehabilitation.

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