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  • 1. Aman, Malin
    et al.
    Forssblad, Magnus
    Henriksson-Larsén, Karin
    Insurance claims data: a possible solution for a national sports injury surveillance system? An evaluation of data information against ASIDD and consensus statements on sports injury surveillance2014In: BMJ Open, E-ISSN 2044-6055, Vol. 4, no 6, article id e005056Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Before preventive actions can be suggested for sports injuries at the national level, a solid surveillance system is required in order to study their epidemiology, risk factors and mechanisms. There are guidelines for sports injury data collection and classifications in the literature for that purpose. In Sweden, 90% of all athletes (57/70 sports federations) are insured with the same insurance company and data from their database could be a foundation for studies on acute sports injuries at the national level.

    OBJECTIVE: To evaluate the usefulness of sports injury insurance claims data in sports injury surveillance at the national level.

    METHOD: A database with 27 947 injuries was exported to an Excel file. Access to the corresponding text files was also obtained. Data were reviewed on available information, missing information and dropouts. Comparison with ASIDD (Australian Sports Injury Data Dictionary) and existing consensus statements in the literature (football (soccer), rugby union, tennis, cricket and thoroughbred horse racing) was performed in a structured manner.

    RESULT: Comparison with ASIDD showed that 93% of the suggested data items were present in the database to at least some extent. Compliance with the consensus statements was generally high (13/18). Almost all claims (83%) contained text information concerning the injury.

    CONCLUSIONS: Relatively high-quality sports injury data can be obtained from a specific insurance company at the national level in Sweden. The database has the potential to be a solid base for research on acute sports injuries in different sports at the national level.

  • 2. Bo, Kari
    et al.
    Artal, Raul
    Barakat, Ruben
    Brown, Wendy J.
    Davies, Gregory A. L.
    Dooley, Michael
    Evenson, Kelly R.
    Haakstad, Lene A. H.
    Kayser, Bengt
    Kinnunen, Tarja I.
    Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine. The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Mottola, Michelle F.
    Nygaard, Ingrid
    van Poppel, Mireille
    Stuge, Britt
    Khan, Karim M.
    Exercise and pregnancy in recreational and elite athletes: 2016/2017 evidence summary from the IOC expert group meeting, Lausanne. Part 5. Recommendations for health professionals and active women2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 17, p. 1080-1085Article in journal (Refereed)
  • 3.
    Ekberg, Sofie
    et al.
    UiT, The Arctic University of Norway, Norway.
    Morseth, Bente
    UiT, The Arctic University of Norway, Norway.
    Larsén, Karin B.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Wikström-Frisén, Lisbeth
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Does the menstrual cycle influence aerobic capacity in endurance-trained women?2023In: Research Quarterly for Exercise and Sport, ISSN 0270-1367, E-ISSN 2168-3824Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim was to study if aerobic capacity varies during different phases of the menstrual cycle (MC) in endurance-trained female athletes.

    Methods: Ten endurance-trained eumenorrheic women performed a submaximal test followed by an incremental test until exhaustion three times during one MC, early follicular phase (EFP), late follicular phase (LFP), and midluteal phase (MLP). During the submaximal test, the respiratory exchange ratio (RER) and utilization of fat and carbohydrates were analyzed; and, during the incremental test, VO2 peak, maximal heart rate, utilization of fat and carbohydrates, and RER were analyzed. Lactate levels were analyzed at rest, during the submaximal test, and after the incremental test. The anaerobic threshold was determined at RER = 1.

    Results: No significant differences (p <.05) between the MC phases were seen in a maximal heart rate or VO2peak. Similarly, VO2, heart rate, RER, fatty acid oxidation, and carbohydrate oxidation at 70, 80, 90, and 100% of VO2peak did not differ significantly between MC phases. There were no significant differences between these phases in resting lactate before the test or during the submaximal tests, though there was a significant difference in lactate concentration 3 minutes after the incremental test between the EFP and the LFP (p =.043).

    Conclusion: This study did not display variations in physiological parameters between EFP, LFP, and MLP, indicating similar aerobic capacity despite hormonal variations. This knowledge may be useful when planning for competition in aerobic events.

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  • 4.
    Fahlström, M
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Fahlström, P G
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Positive short-term subjective effect of sports drink supplementation during recovery.2006In: J Sports Med Phys Fitness, ISSN 0022-4707, Vol. 46, no 4, p. 578-84Article in journal (Refereed)
  • 5.
    Flodgren, G
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Hedelin, R
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Bone mineral density in flatwater sprint kayakers.1999In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 64, no 5, p. 374-379Article in journal (Refereed)
    Abstract [en]

    To elucidate the possible skeletal benefits of the muscular contractions and the nonweight-bearing loading pattern associated with kayaking, we investigated the bone mineral density (BMD, g/cm2) of 10 elite kayakers, six males and four females, with a median age of 19 years. Each subject was compared with the mean value of two matched controls. BMD of the total body, head, ribs, humerus, legs, proximal femur (neck, wards, trochanter), spine, lumbar spine, and bone mineral content (BMC, g), of the arms was obtained using a dual energy X-ray absorptiometer (DXA). Body composition was also assessed. The kayakers had a significantly (P < 0.05-0.01) greater BMD in most upper body sites: left and right humerus (10.4% and 11. 7%), respectively, ribs (6.4%), spine (10.9%), and a greater BMC of the left and right arm (15.7% and 10.6%, respectively). No significant differences in the BMD of the total body, head, or any of the lower body sites were found, except for the pelvis, which was significantly greater in kayakers (5.1%). The controls had a significantly lesser lean body mass (10.4%) and greater percentage of body fat (19.5%) than the kayakers. Bivariate correlation analysis in the controls demonstrated significant and strong relationships between BMD in upper body sites and lean body mass, weight, and fat; the effects of training seem to outweigh most such relationships in kayakers. In conclusion, it seems that the loading pattern and muscular contractions associated with kayaking may result in site-specific adaptations of the skeleton.

  • 6.
    Gilenstam, Kajsa
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Gendered expectations and structural conditions in ice hockeyManuscript (preprint) (Other academic)
    Abstract [en]

    Using player questionnaires (72 women, 42 men) and club staff interviews, this paper provides an analysis of the effect of structural conditions on expectations of support and hindrance. In spite of large structural conditions women and men rated similar levels of support and hindrance. Yet, both women and men believed that the situation in sport was better for men. The adult women’s lower expectations may be an indication of their awareness of their lower status within their sport. When comparisons are made between women and men in sport it is important to consider that gender operates at different levels and may affect conditions as well as expectations

  • 7.
    Gilenstam, Kajsa
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Karp, Staffan
    Thorsen, Kim
    Tunga puckar och låga förväntningar - blindskär i damhockeyns utveckling2010In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 19, no 1, p. 46-50Article in journal (Other academic)
  • 8.
    Gilenstam, Kajsa
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Thorsen, Kim
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Influence of stick stiffness and puck weight on puck velocity during slap shots in women's ice hockey2009In: Sports Engineering, ISSN 1369-7072, E-ISSN 1460-2687, Vol. 11, no 3, p. 103-107Article in journal (Refereed)
    Abstract [en]

    Previous studies have found that reduced stick stiffness increases puck velocity in young male ice hockey players. This study investigates the hypothesis that female players are disadvantaged by using equipment that is designed for taller and stronger players. The purpose of this study was to investigate if stick flexibility and puck weight affect puck velocity in standing slap shots performed by female ice hockey players. There was a significant increase in puck velocity (4.1% p=0.037) when stick stiffness and puck weight were reduced. ANOVA revealed that there was a significant correlation between stick, puck and the participant herself (R2=0.987). Spearman’s correlation analysis revealed that participants with higher puck velocities benefitted the most when the stick flexibility and puck weight were reduced (r=0.648; p=0.043). It was concluded that decreased stick stiffness and puck weight increased puck velocity in standing slap shots for female ice hockey players.

  • 9.
    Gilenstam, Kajsa
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Karp, Staffan
    Umeå University, Faculty of Social Sciences, Department of Education.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Gender in ice hockey: women in a male territory2008In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 18, no 2, p. 235-249Article in journal (Refereed)
    Abstract [en]

    This study investigates how female ice hockey players describe and explain their situation within as well as outside their sport. Information was obtained by semi-structured interviews with female ice hockey players. The results were analyzed in a gender perspective where the main starting point was the concepts of different levels of power relations in society developed by Harding and applied to sports by Kolnes (the symbolic, structural and individual level). The study shows that the players appeared to share the traditional views of men and women. They also described gender differences in terms of financial and structural conditions as well as differences in ice hockey history. Even though the players described structural inequalities, they were quite content with their situation and the differences in conditions were not considered when they explained the gender differences in ice hockey performance. On the individual level the players considered themselves different from other women and appeared to share the traditional views of femininity and masculinity.

    It has been suggested that performance of a sport traditionally associated with the other sex might alter the traditional view of men and women, however our results give little support to that suggestion.

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  • 10.
    Gilenstam, Kajsa M.
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Thorsen, Kim
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsén, Karin B.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Physiological Correlates of Skating Performance in Women's and Men's Ice Hockey2011In: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 25, no 8, p. 2133-2142Article in journal (Refereed)
    Abstract [en]

    The purpose of the current investigation was to identify relationships between physiological off-ice tests and on-ice performance in female and male ice hockey players on a comparable competitive level. Eleven women, 24 ± 3.0 years, and 10 male ice hockey players, 23 ± 2.4 years, were tested for background variables: height, body weight (BW), ice hockey history, and lean body mass (LBM) and peak torque (PT) of the thigh muscles, [latin capital V with dot above]o2peak and aerobic performance (Onset of Blood Lactate Accumulation [OBLA], respiratory exchange ratio [RER1]) during an incremental bicycle ergometer test. Four different on-ice tests were used to measure ice skating performance. For women, skating time was positively correlated (p < 0.05) to BW and negatively correlated to LBM%, PT/BW, OBLA, RER 1, and [latin capital V with dot above]o2peak (ml O2·kg-1 BW-1·min-1) in the Speed test. Acceleration test was positively correlated to BW and negatively correlated to OBLA and RER 1. For men, correlation analysis revealed only 1 significant correlation where skating time was positively correlated to [latin capital V with dot above]o2peak (L O2·min-1) in the Acceleration test. The male group had significantly higher physiological test values in all variables (absolute and relative to BW) but not in relation to LBM. Selected off-ice tests predict skating performance for women but not for men. The group of women was significantly smaller and had a lower physiological performance than the group of men and were slower in the on-ice performance tests. However, gender differences in off-ice variables were reduced or disappeared when values were related to LBM, indicating a similar capacity of producing strength and aerobic power in female and male hockey players. Skating performance in female hockey players may be improved by increasing thigh muscle strength, oxygen uptake, and relative muscle mass.

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  • 11.
    Hedelin, R
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Bjerle, P
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Heart rate variability in athletes: relationship with central and peripheral performance.2001In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 33, no 8, p. 1394-1398Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate relationships between heart rate variability (HRV) and peripheral and central performance measures, 17 cross-country (X-C) skiers and seven canoeists were studied before and after a training period of 7 months. METHODS: For the skiers and canoeists respectively, leg and arm peak torque (Tq), time to peak torque (TiTq), and total work (Wrk) were measured in an isokinetic dynamometer. Maximal oxygen uptakes (VO(2max)) were obtained from treadmill tests. Power spectral analysis of HRV was performed on electrocardiographic recordings in the resting supine position and after a tilt to yield power in the low-frequency (0.04--0.15 Hz) and high-frequency (0.15--0.45 Hz) components of HRV. RESULTS: The change in normalized LF-variability in standing (Delta LFnT) correlated (P < 0.01) with the changes in TiTq (r = 0.63), max lactate (r = -0.63), and VO(2max) (r = -0.53). The change in absolute LFT was inversely correlated with the change in Tq. Subjects who improved VO(2max) were characterized by consistently higher high-frequency and total HRV than subjects with deteriorated aerobic capacity (P < 0.05). CONCLUSION: The results suggest that improved measures of both peripheral and central (aerobic) work capacities were associated with a reduction of low-frequency HRV in the tilted position. High-frequency and total HRV did not change in proportion with changes in muscle performance or aerobic capacity, but the ability to further improve VO(2max) with training in these already fit subjects seemed to depend on their average levels of these HRV measures, interpreted to reflect parasympathetic activity.

  • 12.
    Hedelin, R
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Wiklund, U
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Bjerle, P
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Henriksson-Larsén, K
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Pre- and post-season heart rate variability in adolescent cross-country skiers.2000In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 10, no 5, p. 298-303Article in journal (Refereed)
    Abstract [en]

    To investigate the effects on cardiac autonomic control after a competitive cross-country skiing season, 9 females and 8 males, 16-19 years old, performed tilt-table heart rate variability (HRV) recordings and incremental treadmill tests before (August), and after (April the following year) the most intensive period of training and competition. Spectral analysis of HRV showed increased total variability at rest and reduced low frequency variability in the tilted position (LFtilt) at the second test (P<0.05). The female subgroup showed consistently higher high frequency (HF) and total heart rate variability than males. Total run time (RunT) increased from 18.5+/-1.9 min to 19.4+/-1.7 min (mean+/-SD) in the entire group (P<0.05), while VO2max only showed a non-significant increase (0.05

    <0.10). Submaximal heart rates (HRsubm) were reduced by an average of 4 beats (P<0.01) but maximal HR was unchanged. Performance data suggest a positive training effect. Following training, the increased total HRV the reduced LFtilt (both at rest), and the lower submaximal heart rates indicate an altered control of heart rate both at rest and during exercise. The consistently higher HF and total variability in the females indicate an increased parasympathetic activity in females compared with males.

  • 13.
    Hedelin, Rikard
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Kenttä, Göran
    Wiklund, Urban
    Bjerle, Per
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Short-term overtraining: effects on performance, circulatory responses, and heart rate variability.2000In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 32, no 8, p. 1480-1484Article in journal (Refereed)
    Abstract [en]

    PURPOSE AND METHODS: Nine elite canoeists were investigated concerning changes in performance, heart rate variability (HRV), and blood-chemical parameters over a 6-d training camp. The training regimen consisted of cross-country skiing and strength training, in total 13.0+/-1.6 h, corresponding to a 50% increase in training load. RESULTS: Time to exhaustion (RunT) decreased from 19.1+/-1.0 to 18.0+/-1.2 min (P < 0.05). VO2max and max lactate (La(max)) both decreased significantly (P < 0.05) over the training period (4.99+/-0.97 to 4.74+/-0.98 L x min(-1) and from 10.08+/-1.25 to 8.98+/-1.03 mmol x L(-1) respectively). Heart rates (HR) decreased significantly at all workloads. Plasma volume increased by 7+/-7% (P < 0.05). Resting cortisol, decreased from 677+/-244 to 492+/-222 nmol x L(-1) (P < 0.05), whereas resting levels of adrenaline and noradrenaline remained unchanged. The change between tests in RunT correlated significantly with the change in HRmax (r = 0.79; P = 0.01). There were no group changes in high or low frequency HRV, neither at rest nor following a tilt. CONCLUSIONS: The reduced maximal performance indicates a state of fatigue/overreaching and peripheral factors are suggested to limit performance even though HRmax and La(max) both were reduced. The reduced submaximal heart rates are probably a result of increased plasma volume. HRV in this group didn't seem to be affected by short-term overtraining.

  • 14.
    Hedelin, Rikard
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Wiklund, Urban
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Bjerle, Per
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Henriksson-Larsén, K
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Cardiac autonomic imbalance in an overtrained athlete.2000In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 32, no 9, p. 1531-1533Article in journal (Refereed)
    Abstract [en]

    PURPOSE: In order to investigate overtraining-related adaptations in the autonomic nervous system, cardiac autonomic activity was examined in a junior cross-country skier who presented with reduced performance in competitions, early breathlessness during training sessions, and accumulated central fatigue. METHODS: Power spectral analysis of heart rate variability (HRV) was performed before, when overtrained (OT), and after recovery (Rec). RESULTS: In the overtrained state, high frequency (HF) and total powers in the lying position were higher compared with before and after. In normalized units, the increased HF in OT was even more prominent and clearly higher than in any control subject, and it was reversed in Rec. Resting heart rate was slightly reduced in OT and returned to baseline in Rec. CONCLUSIONS: The shift toward increased heart rate variability, particularly in the HF range, together with a reduced resting heart rate suggest a cardiac autonomic imbalance with extensive parasympathetic modulation in this athlete when overtrained.

  • 15.
    Janaudis-Ferreira, Tania
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Henriksson-Larsn, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lundgren, Rune
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Differences in training effects following training with and without supplemental oxygen in patients with COPD2009In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 11, p. 186-192Article in journal (Refereed)
  • 16.
    Larsson, P U
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Wadell, K M E
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Jakobsson, E J I
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Burlin, L U
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsén, K B
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Validation of the MetaMax II portable metabolic measurement system.2004In: International Journal of Sports Medicine, ISSN 0172-4622, E-ISSN 1439-3964, Vol. 25, no 2, p. 115-123Article in journal (Refereed)
  • 17.
    Larsson, Peter
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Burlin, Lennart
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Jakobsson, Erkki
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Analysis of performance in orienteering with treadmill tests and physiological field tests using a differential global positioning system.2002In: Journal of Sports Sciences, ISSN 0264-0414, E-ISSN 1466-447X, Vol. 20, no 7, p. 529-535Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to determine the physiological responses to orienteering by examining the interrelationships between the information provided by a differential global positioning system (dGPS) about an orienteer's route, speed and orienteering mistakes, portable metabolic gas analyser data during orienteering and data from incremental treadmill tests. Ten male orienteers completed a treadmill threshold test and a field test; the latter was performed on a 4.3 km course on mixed terrain with nine checkpoints. The anaerobic threshold, threshold of decompensated metabolic acidosis, respiratory exchange ratio, onset of blood lactate accumulation and peak oxygen uptake (VO2peak) were determined from the treadmill test. Time to complete the course, total distance covered, mean speed, distance and timing of orienteering mistakes, mean oxygen uptake, mean relative heart rate, mean respiratory exchange ratio and mean running economy were computed from the dGPS data and metabolic gas analyser data. Correlation analyses showed a relationship between a high anaerobic threshold and few orienteering mistakes (r = - 0.64, P < 0.05). A high threshold of decompensated metabolic acidosis and VO2peak were related to a fast overall time (r = -0.70 to -0.72, P < 0.05) and high running speed (r = 0.64 to 0.79, P < 0.05 and P < 0.01, respectively), and were thus the best predictors of performance.

  • 18.
    Larsson, Peter
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsén, K
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Body composition and performance in cross-country skiing.2008In: International Journal of Sports Medicine, ISSN 0172-4622, E-ISSN 1439-3964, Vol. 29, no 12, p. 971-5Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate the relationships between body composition and performance in cross-country skiing. Ten male college-aged elite cross-country skiers (17.9 yrs; S 1.0 yrs) participated in a 5.6-km cross-country skiing time trial and in dual energy X-ray absorptiometry (DXA, Lunar DPX-L, Madison, WI, USA) body composition measurements. A differential global positioning system (dGPS, GPS 12 CX, Garmin Int. Inc., Olathe, KS, USA; RXMAR 2, Aztec SA, Strasbourg, France) was used to compute speed in different sections of the course. Spearman correlation analyses were applied. Total body weight and absolute lean body mass were significantly related to final time (r = - 0.721; p < 0.05 and - 0.830; p < 0.01, respectively). Absolute lean arm mass (kg) was negatively correlated to final time (r = - 0.648; p < 0.05) and the relative lean arm mass was significantly related to speed mainly in uphill sections (r = 0.636 to 0.867; p < 0.05 to p < 0.01). We suggest that large amounts of lean body mass, especially in the arms, seem to be of great importance for cross-country skiing performance.

  • 19. Larsson, Peter
    et al.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Combined metabolic gas analyser and dGPS analysis of performance in cross-country skiing.2005In: J Sports Sci, ISSN 0264-0414, Vol. 23, no 8, p. 861-70Article in journal (Refereed)
  • 20.
    Larsson, Peter
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    The use of dGPS and simultaneous metabolic measurements during orienteering.2001In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 33, no 11, p. 1919-1924Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The Global Positioning System (GPS) is a satellite-based system for navigation. With this system, it is possible to pinpoint a subject's location on earth and to display the speed of movement. With the use of differentiation (dGPS), the accuracy of the GPS position and speed measurements can be improved. Our purpose was to investigate whether it would be possible to relate dGPS data with physiological variables in a field test and thus achieve a more controlled field test and hence improve the value of sport-specific testing. METHODS: 10 male orienteers were equipped with a portable metabolic gas analyzer and a differential Global Positioning System (dGPS). A field test was performed on a 4.3-km orienteering course. Oxygen uptake, carbon dioxide excretion, and heart rate were determined every 10 s. Speed was calculated by Doppler shift every 2 s and by differences in dGPS time and position. Validation of dGPS position, distance, and speed measurements was made on two fixed positions and on a 115-m straight asphalt road. RESULTS: The orienteers' route was visualized by the dGPS equipment. Detailed analysis of running speed in different sections of the course was made possible. Further, it was possible to relate each physiological data to the location of the subject. The correlation coefficient between speed measured by dGPS and speed measured by chronometry was r = 0.9995-0.9996. The mean errors of distance and position measurements were 0.04-0.7% and 1.94-2.13 m, respectively. CONCLUSION: dGPS was shown to be a method that could give detailed information about a subject's speed and position. It was further demonstrated that physiological variables could be related to dGPS data.

  • 21.
    Larsson, Peter
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Olofsson, P
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Jacobsson, Erkki
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Burlin, Lennart
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Physiological predictors of performance in cross-country skiing from treadmill tests in male and female subjects.2002In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 12, no 6, p. 347-353Article in journal (Refereed)
    Abstract [en]

    In order to study which parameter that best corresponds to performance during cross-country skiing, seven male and nine female cross-country skiers were tested with treadmill tests. Parameters measured or computed by metabolic gas measurements were the anaerobic threshold (AT), threshold of decompensated metabolic acidosis (TDMA), the exercise intensity where the Respiratory exchange ratio reaches 1.0 (R = 1) and peak oxygen (O2) uptake (VO2peak). Onset of blood lactate accumulation (OBLA, 4 mmol.l-1 blood lactate) was also measured. The various parameters were measured in percentage of maximal heart rate, percentage of peak O2 uptake, VO2 ml.kg-1.min-1, VO2 ml.min-1.kg-2/3 and VO2 l.min-1. Results from four large competitions were also collected to rank the subjects. With correlation analysis, it was revealed that in male subjects a high OBLA was associated with good ranking results (r = (-0.829) - (-0.964); P < 0.05-0.001). In female subjects, the best association with competition results was found for R = 1 (r = (-0.715) - (-0.810); P < 0.05). Concerning VO2 measurements, for male subjects the unit l.min-1 is suggested to be used and for female subjects either the units l.min-1, ml.min-1.kg-2/3, or ml.kg-1.min-1 could be used when predicting performance in cross-country skiing. In conclusion, treadmill tests can be used for the prediction of performance in cross-country skiing. Further, various parameters from treadmill tests in men and women are best used as predictors of performance in cross-country skiing.

  • 22.
    Martin, Fahlström
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professionell Development.
    Fahlström, P G
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Positive short-term subjective effect of sports drink supplementation during recovery.2006In: J Sports Med Phys Fitness, ISSN 0022-4707, Vol. 46, no 4, p. 578-84Article in journal (Refereed)
  • 23.
    Pettersson, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Alfredson, Håkan
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Bone mass in female cross-country skiers: relationship between muscle strength and different BMD sites.2000In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 67, no 3, p. 199-206Article in journal (Refereed)
    Abstract [en]

    In this cross-sectional study, bone mass and muscle strength of the thigh were investigated in 16 Caucasian female cross-country skiers, age 16.2 +/- 0.3 years, that had been ski-training for 6.4 +/- 1.8 years (range 3-9 years) and were now training for 6.3 +/- 2.4 hours/week (range 3-12 hours). They were compared with 16 nonactive females, age 16.4 +/- 0.7 years. The groups were matched according to age, weight, height, and pubertal status. Areal bone mineral density (BMD) was measured using dual energy X-ray absorptiometry, in the total body, head, both total humerus and humerus diaphyses, spine, and in the right femoral neck, greater trochanter, femoral diaphysis, distal femur, proximal tibia, and tibia diaphysis. Bone mineral apparent density (BMAD) was also calculated for the femoral neck and humerus diaphyses. Isokinetic muscle strength of the quadricep and hamstring muscles was measured in an isokinetic dynamometer. Compared with the controls, the cross-country skiing group had significantly higher BMD in the right whole humerus (6.9%), left whole humerus (9.2%), left humerus diaphysis (8.1%), femoral neck (8.9%), greater trochanter (9.3%), femur diaphysis (7.6%), and BMAD of the femoral neck (+19.4%). In the nonactive group there were significant side-to-side differences in BMD of the whole humeri, humerus diaphyses, and BMAD of the humerus diaphyses (3.1%, 5.4%, and 8.8% higher in the right arm, respectively). No such differences were found in the cross-country skiing group. Lean body mass was significantly higher in the cross-country skiers (21.7%), and fat mass (-25.5%) and body fat percent (-28.0%) were significantly lower compared with the nonactive group. There were, however, no significant differences in concentric peak torque of the thigh muscles between the two groups. Stepwise regression analyses revealed that BMI was the best predictor of several sites in the nonactive group. In the cross-country group, on the other hand, muscle strength was a strong predictor of BMD, both at adjacent and more distant BMD sites. In conclusion, it seems that this type of endurance training is associated with a site-specific higher bone mass that may be associated with the type and magnitude of loading during off-season and during the main sports activity, cross-country skiing.

  • 24.
    Pettersson, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Alfredson, Håkan
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsen, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Effect of high impact activity on bone mass and size in adolescent females: A comparative study between two different types of sports.2000In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 67, no 3, p. 207-214Article in journal (Refereed)
    Abstract [en]

    The purpose of this cross-sectional study was to investigate the influence of two different types of weight-bearing activity, muscle strength, and body composition on bone mineral density (BMD), bone mineral content (BMC), and bone area in three different groups of late adolescent girls. The first group consisted of 10 females participating in competitive rope-skipping (age 17.8 +/- 0.8 years) training for 6.7 +/- 3.1 hours/week; the second group consisted of 15 soccer players (age 17.4 +/- 0.8 years) training for 6.1 +/- 2.0 hours/week; and the third group consisted of 25 controls (age 17.6 +/- 0.8 years) with physical activity of 0.9 +/- 1.1 hours/week. The groups were matched for age, height, and weight. BMD (g/cm(2)), BMC (g), and bone area (cm(2)) of the total body, lumbar spine, hip, total femur, distal femur, diaphyses of femur and tibia, proximal tibia, and humerus were measured using dual-energy X-ray absorptiometry (DXA). Bone density was also assessed in the radial forearm site of the dominant limb in the rope skippers and in 10 matched controls. The rope skippers had 22% higher BMD at the ultradistal site (P < 0.01). Both high-activity groups had significantly higher BMD (P < 0.05) at most loaded sites compared with the control group. When adjusting for differences in lean mass and starting age of sport-specific training between the activity groups, the rope-skipping group had a higher BMD of the total body, lumbar spine, and right humerus compared with the soccer group. They also had a significantly higher bone area of the total body, total femur, and the proximal femur than both other groups, and a significantly higher bone area of the tibia diaphysis, compared with the soccer group. In a multivariate analysis among all subjects (n = 50), all BMD sites, except the femur diaphysis, distal femur, and proximal tibia, were significantly related to type of physical activity (beta = 0.25-0.43, P < 0.05). The bone area values at different sites were strongly related to muscle strength and parameters related to body size [height, weight, lean mass, fat mass, and body mass index (BMI)]. In conclusion, it appears that in late adolescent women, weight-bearing activities are an important determinant for bone density, and high impact activities such as jumping also seem to be associated with a modification of the bone geometry (hence, the bone width) at the loaded sites.

  • 25.
    Pettersson, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Ahlénius, Gerd-Marie
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Low bone mass density at multiple skeletal sites, including the appendicular skeleton in amenorrheic runners1999In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 64, no 2, p. 117-125Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate any difference in bone mass at different sites between female long-distance runners with amenorrhea and those with eumenorrhea. We compared 10 amenorrheic and 10 eumenorrheic athletes to determine whether athletes with amenorrhea have lower BMD in multiple skeletal regions, including weight-bearing lower limbs. The amenorrheic group had experienced menstrual dysfunction ranging from 3 to 43 months. As a further control group, 16 eumenorrheic soccer players were compared with the former two running groups regarding their BMD measurements. The two groups were matched for age, height, and amount of training. Areal bone mineral density (BMD) was measured and was found to be significantly lower in the total body, humerus, spine, lumbar spine, pelvis, femoral neck, trochanter, total femur, femur diaphysis, tibia diaphysis and in the nonweight-bearing head of the femur in the amenorrheic group. Body weight, BMI, fat mass, and body fat percent were significantly lower in the amenorrheic group. The differences in the BMD of the head, humerus, femoral neck, total femur, femur diaphysis, and tibia diaphysis disappeared when adjusted for body weight. Compared with the soccer group, the amenorrheic subjects had significantly lower BMD values at all sites except for the head, Ward's triangle, and femur diaphysis. Blood samples were obtained in the two running groups for analysis of osteocalcin, carboxy terminal telopeptide (ICTP), procollagen I (PICP), and estradiol. There were no significant differences between the groups but there was a strong tendency towards a lower estradiol level and a higher osteocalcin level in the amenorrheic group. A free estradiol index (FE2) was derived as the ratio of estradiol to sex hormone binding globulin (SHBG) and was significantly lower in the amenorrheic group. No difference in their daily intake of total energy, protein, carbohydrates, fiber, calcium, and vitamin D was observed. However, both groups showed a surprisingly low energy intake in relation to their training regimens. Stepwise regression analyses revealed that weight was the best predictor of spine BMD in both groups. Estradiol and FE2 were significant predictors of the BMD of the proximal femur in the eumenorrheic group, but did not predict any BMD site in the amenorrheic group. In conclusion, amenorrhea in athletic women affects trabecular and cortical bone in both axial and appendicular skeleton. However, some of the discrepancy can be explained by a lower body weight. Physical weight-bearing activity does not seem to completely compensate for the side effects of reduced estrogen levels even in weight-bearing bones in the lower extremity and spine.

  • 26.
    Sundell, Claes-Göran
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports Medicine.
    Bergström, Erik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Low back pain and associated disability in Swedish adolescents2019In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 29, p. 393-399Article in journal (Refereed)
    Abstract [en]

    Introduction: Low back pain (LBP) defined as ache or pain in the lowest part of the back is a common experience among people all over the world. The lifetime prevalence is reported to be as high as 84%, and the prevalence of LBP seems to be almost the same among adolescents as among adults. The risk for having LBP later in life if you experienced LBP in adolescence is high.

    Material and Methods: In this cross‐sectional study of 2550 students aged 16‐20 years, we used the Standardized Nordic Questionnaire for the analysis of musculo‐skeletal symptoms. We studied gender difference, prevalence, and disability of Low back pain. We also studied differences in LBP in adolescent athletes depending on hours spent on sports or physical activity.

    Results: Significantly, more girls than boys had had problems sometimes during their life. Those who participated in sports reported LBP to a significantly higher extent than those who were physically inactive in their spare time. Gender and spare time sports were important risk factors for getting LBP some time in life. There was a higher risk for girls to have low back pain problems more than 30 days or daily the last year if they had had low back pain some time earlier in life.

    Conclusion: This study shows that low back pain (LBP) is common among Swedish adolescents, more common among girls than boys. High sport activity was associated with the risk of having LBP, length of time with LBP, and disability due to LBP.

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  • 27.
    Sundell, Claes-Göran
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Jonsson, H.
    Ådin, L.
    Larsén, Karin H
    The Swedish school of Sport and health science, Deans office, Stockholm, Sweden.
    Clinical Examination, Spondylolysis and Adolescent Athletes2013In: International Journal of Sports Medicine, ISSN 0172-4622, E-ISSN 1439-3964, Vol. 34, no 3, p. 263-267Article in journal (Refereed)
    Abstract [en]

    Symptomatic spondylolysis is a stress reaction caused by microtrauma during physical exercise, an imaging diagnostic subgroup of Adolescent Low Back Pain (ALBP), found in adolescent athletes. Early diagnosis increases the possibility of healing. Thus, it is important to divide ALBP into subgroups. The aim of this study was to evaluate clinical tests that can distinguish symptomatic spondylolysis from other forms of ALBP in order to facilitate early referral for diagnostic imaging. The investigation subjects were a prospective case series with a control group, 25 subjects with ALBP and 13 subjects that had no history of LBP. The 2 groups were examined using the same clinical protocol. MRI of the whole lumbar spine was performed in both the case and control groups and CT investigations of the L4 and L5 vertebrae were performed in the case group. Significant differences between the 2 groups were found in 8 of our clinical tests. No clinical test, alone or in combination, could distinguish between spondylolysis and other forms of ALBP. As 88% of the subjects in the case group had MRI findings and almost 50% had spondylolysis, MRI should be performed at an early age in young athletes with ALBP.

  • 28.
    Sundell, Claes-Göran
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Jonsson, Håkan
    Department of Orthopaedics, Spinal Unit, Akademiska sjukhuset, Uppsala, Sweden.
    Ådin, L.
    Diagnostic Radiology, Skellefteå, Sweden.
    Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology. The Swedish School of Sport and Health sciences, Dean’s office, Stockholm, Sweden.
    Stress Fractures of Pars Interarticularis in Adolescent Athletes a Classification System with MRI and CT Enabling Evaluation of The Healing Process2018In: Journal of Exercise, Sports & Orthopedics, E-ISSN 2374-6904, Vol. 5, no 1Article in journal (Refereed)
    Abstract [en]

    Introduction: The purpose of this study was to evaluate healing frequency in different stages of stress reactions in the Pars Interarticularis (PI) using a classification system with MRI and CT. The intervention was 3-month rest from physical activity, without a brace, with the exception of activities of daily living.

    Materials & Method: Twelve adolescent athletes with different stages of Spondolysis were included in the study. They had pathology in the Pars Interarticularis and were clinically examined with MRI and CT 3-6 weeks after debut of Low Back Pain (LBP) and re-evaluated after 3 months intervention with rest from physical activity.

    Results: A combination of MRI and CT scanning to investigate suspected injuries to Pars Interarticularis in adolescent athletes revealed 6 different stages of Spondolysis that ranged from marrow oedema to pseudoarthrosis. After 3 months of rest from physical activity the early stages of Pars Interarticularis injuries healed significantly better than the later stages with rest from physical activity.

    Conclusion: The combination of MRI and CT revealed 6 stages of stress reactions instead of 4 as in Hollenberg’s staging with MRI only. In the 3 earliest stages, of these 6, rest from physical activity for 3 months can heal the stress reaction.

  • 29.
    Sundell, Claes-Göran
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Ådin, Lars
    Bild och funktionsmedicin, Västerbotten.
    Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Low back stress fracture, spondylolysis and the importance of diagnosis: a retrospective MRI/CT and clinical study of stress reactions in the spine of young athletesManuscript (preprint) (Other academic)
    Abstract [en]

    Low back pain (LBP) is common in adolescence as well as in adulthood but the reason for LBP differs between the different age groups. Stress reaction is a reason for LBP in adolescence and there is a discussion about the progression from stress reactions to spondylolysis, which in turn can develop into spondylolisthesis.

    Sixteen out of nineteen MRI identified subjects with spondylolysis agreed to take part in the whole investigation that included a questionnaire and reexamination of MRI scans performed at the time of diagnose and after the initial treatment (84,2%) with mean age of 15,5 years at diagnosis and mean age of 20.8 at the time of follow-up 1-12 years after diagnosing.

    We found a mean time between first symptom of low back pain and time of diagnosis of 28 weeks (0-127 weeks) and a mean activity level of 8.9 hours a week at follow-up with the questionnaire. From the studied MRI investigations seventeen pedicels out of 31 had healed with rest from physical activity as treatment. Seven individuals that displayed spondylolysis on the final MRI had at follow-up (1-12 years after diagnosing) got relief of symptoms and had return to a high level of physical activity. The subject that developed spondylolysis with out healing could thus to a great extent still be physically active.

  • 30.
    Wadell, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lundgren, Rune
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Physical training with and without oxygen in patients with chronic obstructive pulmonary disease and exerciseinduced hypoxaemia2001In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 33, no 5, p. 200-205Article in journal (Refereed)
    Abstract [en]

    A randomized, controlled, single-blind study was performed on 20 patients with chronic obstructive pulmonary disease and exercise-induced hypoxaemia. Ten patients each were randomly assigned to one of two groups, one training with air and the other training with oxygen. There were no significant differences between the groups regarding values measured prior to the study. The patients trained 3 times per week for 30 minutes each time for a duration of 8 weeks. The training consisted of interval walking on a treadmill (intensity set according to Borg ratings) with either air or oxygen administered through a nasal cannula at a rate of 5 l/min. Training significantly improved the 6-minute walking distance by 20% and 14% in the air and oxygen group, respectively, when the patients were tested on air. In the same test the air group significantly decreased Borg ratings for perceived exertion. Borg ratings for dyspnoea and perceived exertion significantly decreased in the oxygen group when they were tested on oxygen. It was concluded that oxygen supplementation did not further improve the training effect, compared with training with air, in patients with chronic obstructive pulmonary disease and exercise-induced hypoxaemia.

  • 31.
    Wadell, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lundgren, Rune
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Group training in patients with COPD: long-term effects of decreased training frequency2005In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 27, no 10, p. 571-581Article in journal (Refereed)
    Abstract [en]

    Purpose.To investigate effects of decreased training frequency in patients with COPD.

    Methods.Forty-three COPD patients participated in a controlled study. The intervention group (30 patients) trained 3 times a week during 3 months and once a week during 6 months. Before, after 3 and 9 months all patients performed walking tests, cycle ergometer tests and responded questionnaires on health-related quality of life (HRQoL) (SGRQ, SF-36).

    Results.At 9 months compared to 3 months there were no changes in distance walked in the groups. Both groups decreased their VO2peak and the training group deteriorated in HRQoL. At 9 months compared to baseline the training group showed increased distance walked compared to the control group. In the disease-specific SGRQ the training group tended to improve their activity score while the control group tended to deteriorate in total score. In SF-36 the control group decreased their physical component score.

    Conclusion.Training once a week does not seem to be sufficient to maintain the level achieved after the 3-month period of training in COPD patients. However, training once a week during 6 months preceded by 3 months of high frequency training seems to prevent deterioration in physical capacity and HRQoL compared to baseline. Further studies are needed to investigate how to best sustain the benefits gained after physical training.

  • 32.
    Wadell, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lundgren, Rune
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    High intensity physical training in water: an effective training modality for patients with COPD2004In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 98, no 5, p. 428-438Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine the effect of high intensity physical group training in water and on land for patients with COPD with regard to physical capacity and health related quality of life (HRQoL). A controlled, semi-randomised study was conducted where 30 patients were randomised to training either in water or on land. Thirteen patients constituted a control group. Forty-three outpatients, with moderate to severe COPD (27w/16m), from two local hospitals in northern Sweden, were included in the study. High intensity physical group training in water (water group) or on land (land group) was performed for 12weeks, three times per week, 45min per session. The control group received no intervention. Pre- and post-intervention, all patients performed incremental and endurance shuttle walking tests (ISWT and ESWT), cycle ergometer tests and responded questionnaires about HRQoL (St. Georges Respiratory Questionnaire--SGRQ and SF-36). The patients trained with a mean heart rate of 80-90% of peak heart rate. Both training groups increased the distance walked, i.e. land group in ISWT (25m) and water group in ESWT (179m). The water group increased the distance in ESWT significantly more that both the land and the control groups. Both training groups increased the time cycled (40-85s) and work load (10-20W) in the cycle ergometer test. The control group deteriorated in HRQoL according to total score in SGRQ while the training groups remained constant. The water group improved their activity score in SGRQ and their physical health score in SF-36 and those improvements were significant as compared to the land and the control groups. In conclusion, high intensity physical group training in water is of benefit for patients with COPD. It was in some areas found to be even more effective regarding improvements in physical capacity and experienced physical health compared to the same kind of training on land.

  • 33.
    Wadell, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundgren, Rune
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Muscle performance in patients with chronic obstructive pulmonary disease: Effects of a physical training programme2005In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 7, no 2, p. 51-59Article in journal (Refereed)
    Abstract [en]

    The main aim was to evaluate how thigh muscle performance in patients with chronic obstructive pulmonary disease (COPD) is affected after a 3-month training programme. Another aim was to investigate if responders to training could be discriminated from non-responders. Thirty patients participated in high-intensity physical training in water or on land, three times per week, and 13 patients constituted a non-training control group. Maximal dynamic strength and endurance in thigh muscles were tested in an isokinetic dynamometer (KinCom) before and after training. At baseline, physical and pulmonary function were tested and used in the analysis of responders/non-responders. Maximal knee flexion strength improved in both training groups, whereas knee extension was improved in the land and control group. Sixty-four percent of all patients were not able to complete the muscle endurance test at baseline and no change was seen in muscle endurance after training within or between groups. A normal body mass index seemed to predict an improvement in muscle performance in responders. We conclude that physical training in water and on land is effective regarding maximal thigh muscle strength in COPD patients. BMI seems to be a discriminating factor for an increased muscle strength. Thigh muscle endurance was decreased in the majority of the patients and did not improve with the evaluated training programme.

  • 34.
    Wichardt, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Mattsson, C Mikael
    Ekblom, Björn
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Rhabdomyolysis/myoglobinemia and NSAID during 48 h ultra-endurance exercise (adventure racing)2011In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 111, no 7, p. 1541-4Article in journal (Refereed)
    Abstract [en]

    Our purpose is to determine whether rhabdomyolysis with myoglobinemia exists during a 48+ h adventure race and if there is a correlation with NSAID use, race time and perceived pain or exertion. Blood samples for analyses of myoglobin (Mb) were collected, and perception of exertion and pain was registered on the Borg-RPE and CR scales, from 20 subjects (3 female, 17 male) Pre-, Mid- and Post-race. Subjects were asked about NSAID use at each sampling and within 12 h pre-race. The result observed was a significant rise in Mb throughout the race, with the NSAID group (n = 6) having significantly lower Mb-Post than the no-NSAID group (n = 14). High Mb-Pre and Post correlated to shorter race time and high Mb-Pre to lower Pain-post. Race time also correlated to NSAID use, with the NSAID group having significantly longer race time than the no-NSAID group. Rhabdomyolysis with myoglobinemia, which might be reduced with NSAID use, exists during a 48+ h adventure race. Indications that high Mb-levels correlate with shorter race time and less pain, and the reasons for the NSAID groups longer race time, warrants further investigation.

  • 35.
    Wikström-Frisén, Lisbeth
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Boraxbekk, Carl Johan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine. The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Effects on power, strength and lean body mass of menstrual/oral contraceptive cycle based resistance training2017In: Journal of Sports Medicine and Physical Fitness, ISSN 0022-4707, E-ISSN 1827-1928, Vol. 57, no 1-2, p. 43-52Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The purpose of this study was to investigate the effects of menstrual and oral contraceptive cycle on a high frequency periodized leg resistance training in trained women. METHODS: Two groups performed high frequency leg resistance training for two weeks of each menstrual/oral contraceptive cycle for four months. The remaining part of the cycle they performed the leg training once a week. Group 1 (N.=19) trained with high frequency (5 times-w-') during the first two weeks of each cycle, and group 2 (N.=19) during the last two weeks of each cycle. A control group (N.=21) performed regurlar (3 times.w(-1)) leg resistance training for four months. RESULTS: Significant increase in squat and countermovement jump, and peak torque values in hamstrings for group 1 were observed, but not in group 2. In the control group an increase in squat and countermovement jump, and peak torque (only left hamstring) was also observed. There was also a significant increase in lean body mass of the legs in group 1 only. There were no evident differences in the training effects between women with or without oral contraceptive. CONCLUSIONS: The high frequency periodized leg resistance training during the first two weeks of the menstrual cycle is more beneficial to optimize training than in the last two weeks. Resistance training during the first two weeks of the menstrual cycle even resulted in a larger gain of lean body mass than regular training.

  • 36.
    Wikström-Frisén, Lisbeth
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine. The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Increasing training load without risking the female athlete triad: menstrual cycle based periodized training may be an answer?2017In: Journal of Sports Medicine and Physical Fitness, ISSN 0022-4707, E-ISSN 1827-1928, Vol. 57, no 11, p. 1519-1525Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: An improved muscle strength are of great importance in many sports, hence an increased understanding on how to generate optimal strength training programs in women without negative side effects that may lead to the female athlete triad are essential. The purpose of this study was to investigate potential negative effects of high frequency periodized menstrual/OC cycle based leg resistance training on components in the female athlete triad.

    METHODS: Fifty-nine women, with experience of resistance training and with regular menstrual/OC cycles were included in the analyses. The participants were randomly assigned a training program consisted of high frequency leg resistance training, periodized to the first two weeks (group 1) or the last two weeks (group 2) of each cycle, or to a control group performing regular training, during four consecutive menstrual/OC cycles. The main analysis was the pre-to-post change of sex and growth hormones, cortisol, total body fat mass, bone mineral density in the spine. We further examined the participants’ own experience of the training programs.

    RESULTS: No significant negative impact on sex and growth hormones, cortisol, total body fat mass and bone mineral density in the spine, was detected in any of the groups. Moreover, the women in group 1 experienced their training program as positive.

    CONCLUSIONS: The high frequency periodized leg resistance training was not associated with exercise-related negative consequences on components in the female athlete triad. Moreover, the training was well accepted when performed during the first two weeks of each cycle.

  • 37.
    Wikström-Frisén, Lisbeth
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Effekter av konditionsträning periodiserad utifrån menstruationscykeln hos idrottande kvinnor2022Report (Other academic)
    Abstract [sv]

    Senaste decennierna har det skett en kraftig ökning av kvinnors deltagande inom motions- och elitidrott och det har medfört en jämnare könsfördelning av idrottare. Trots det är kvinnliga deltagare inom idrottsforskning underrepresenterade. Orsaken anses bland annat vara att variationen av könshormoner under menstruationscykeln försvårar standardiseringen vid forskning om träningsupplägg och testning. Det saknas därför vetenskapliga studier kring ytterligare utveckling av träningsmodeller specifikt för kvinnliga idrottare utifrån den kvinnliga fysiologin.

    Syftet med denna studie var att undersöka effekter av konditionsträning periodiserad utifrån menstruationscykeln hos idrottande kvinnor för att öka kunskapen om mer specifika träningsupplägg för kvinnor.

    Totalt genomförde 31 kvinnor mellan 18 och 35 år hela studien. Kvinnorna fördelades slumpmässigt i två grupper med varierande träningsfrekvens i relation till sin menstruationscykel. En tredje grupp (kontrollgrupp) fortsatte att träna kondition regelbundet enligt sitt tidigare träningsschema. Kvinnorna tränade under fyra på varandra följande menstruationscykler och deltog i ett test före träningsperioden och ett test efter träningsperioden. Av de två grupper som varierade träningsfrekvens utifrån sin menstruationscykel tränade den ena gruppen kondition fem gånger per vecka under de två första veckorna av menstruationscykeln och kondition en gång per vecka under de sista två veckorna av sin menstruationscykel. Den andra gruppen tränade istället kondition en gång per vecka under de två första veckorna av menstruationscykeln och utförde sedan konditionsträning fem gånger per vecka under de sista två veckorna av sin menstruationscykel. Kontrollgruppen konditionstränade hela tiden tre pass per vecka. Detta resulterade i att varje grupp planerades träna 48 konditionsträningspass under den tid som studien pågick. Deras träning bestod av distanspass samt långa och korta intervallpass. Dessutom bibehöll de sin övriga träning i form av styrketräning, rörlighetsträning och eventuell teknikträning inom sina idrotter. Vid testerna före och efter träningsperioden genomfördes blodprovstagning för allmän hälsokontroll samt för hormonanalys. Båda testerna genomfördes under samma fas av menstruationscykeln. Vid de två testerna genomfördes ett ramptest till utmattning på cykel med kontinuerlig mätning av syreupptag och provtagning av laktat i blod före, under och efter cykeltest. Dessutom fyllde kvinnorna i ett frågeformulär om upplevelsen av träningen samt ett frågeformulär om allmänna måendet för både analys av Profile of Mood States (POMS) och skattning av träningsbelastning.

    Som resultatparametrar från de två cykeltesterna användes det högst uppnådda syreupptaget respektive syreupptaget då försökspersonen hade 2 och 4 mmol/l laktat i blodet. Dessutom mättes laktatnivåerna tre minuter efter arbete. Från POMS-frågeformuläret användes det sammanfattande värdet global POMS.

    Resultaten visade att konditionsträningens upplägg förbättrade deltagarnas aeroba kapacitet (mätt som maximalt uppnådd VO2peak ml/kg/min och VO2 ml/kg/min vid 2 och 4 mmol laktat i blodet) i alla tre träningsgrupperna, men någon skillnad mellan grupperna vad gäller storleken på denna ökning hittades inte. Inga signifikanta förändringar av global POMS eller av laktatnivåer tre minuter efter arbete fanns mellan de två testerna före och efter träningsperioden.

    Slutsatsen av studien är att konditionsträning periodiserad utifrån menstruationscykeln, det vill säga koncentrerad konditionsträning de första två veckorna respektive de sista två veckorna av menstruationscykeln, inte ger extra positiva träningseffekter jämfört med regelbunden konditionsträning som utfördes under hela menstruationscykeln (kontrollgruppen). 

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  • 38.
    Wikström-Frisén, Lisbeth
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Larsson, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Mincheva Nilsson, Lucia
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Clinical Immunology.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine. The Swedish School of Sport and Health Sciences, Sweden.
    Mood and oxytocin blood levels in physically active women with and without oral contraceptive use in relation to seasonal daylight variation2017In: International Journal of Sports and Exercise Medicine, ISSN 2469-5718, Vol. 3, no 3, article id 058Article in journal (Refereed)
    Abstract [en]

    Background

    The aim is to provide normative data on oxytocin, and its seasonality in users and non-users of Oral Contraceptives (OC) in physically active women. Further, to elucidate the relationship between Oxytocin and Profile of Mood States (POMS) for further research to see if Oxytocin can be used as an additional diagnostic marker to detect overreaching/overtraining syndrome or other stress disorders.

    Methods

    Forty-eight women (18-35 years old), 19 with and 29 without OC use, physically active at least 3 times a week at > 13 on the Borg RPE scale. Thirty-three subjects completed the study, 15 with and 18 without OC use. The number of hours from sunrise to sunset averaged 10 h during the autumn, 6 h during the winter, and 15 h during the spring. Once a month, blood samples were taken, weight and the day of menstrual cycle was documented, the POMS questionnaire was filled out as well as a personal daily logbook recording exercise type, duration, and intensity. To evaluate seasonal variations in Oxytocin and Global POMS, repeated measures analysis of variance was used.

    Results

    A significant seasonal variation in Oxytocin levels within the groups with and without OC respectively and significant differences in Oxytocin levels between the groups at diverse seasons were found. No significant difference in seasonal variation of Global POMS within the groups and no significant differences in levels of Global POMS between the groups with and without OC were seen. Furthermore, no clear relationship between Oxytocin, Global POMS scores, and hours of daylight respectively were detected.

    Conclusions

    Due to seasonality, impact of OC use on oxytocin levels, methodological considerations, and no convincing relationship to Global POMS, oxytocin is not suggested to be an optimal, diagnostic marker alone or in combination with others to detect overreaching and overtraining syndrome in physically active women.

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  • 39.
    Wikström-Frisén, Lisbeth
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Larsén, Karin
    Gymnastik- och Idrottshögskolan, Stockholm.
    Periodisering av träning under menstruationscykeln2017In: Svensk Idrottsmedicin, ISSN 1103-7652, Vol. 36, no 3, p. 12-14p. 12-14Article in journal (Other academic)
    Abstract [sv]

    Kroppens variationer under menstruationscykeln är en central del av kvinnors vardag och därför behöver vi bli bättre på att ta hänsyn till detta när vi optimerar träning för idrottande kvinnor.

  • 40.
    Wikström-Frisén, Lisbeth
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Mincheva-Nilsson, Lucia
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology.
    Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine. The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Impact of Season and Oral Contraceptive use on Cortisol Levelsin Physically Active Women2016In: Journal of Exercise, Sports & Orthopedics, ISSN 2374-6904, Vol. 3, no 2Article in journal (Refereed)
    Abstract [en]

    When athletes optimize their physical performance, an imbalance could occur between the strain of training, time for recovery and the athlete’s individual tolerance of stress that could lead to overreaching and overtraining syndrome. Cortisol has been suggested to be a biological, diagnostic marker to detect overreaching and overtraining syndrome, since it is thought to indicate stress. This study aimed to provide normative data on cortisol levels, hence investigate seasonality and impact of oral contraceptive use to elucidate if cortisol could be used as a diagnostic marker to detect overreaching and overtraining syndrome in female athletes. The women, divided in two groups, oral contraceptive users (n = 15) and non-users (n = 18), were followed over a nine-month period with monthly blood sampling for cortisol testing and a Profile of Mood State questionnaire (POMS) as a subjective measure of overreaching and overtraining syndrome.Findings indicated seasonal variations in cortisol levels, with different pattern in oral contraceptive users to non-users and moreover, higher cortisol levels in users to nonusers irrespective of season. No differences in seasonal variation in Global POMS score within the groups and no differences in Global POMS score between the groups were detected. Due to seasonality, impact of oral contraceptive use on cortisol levels, methodological considerations and standardization, as well as due to no convincing relationship to Global POMS score, cortisol is not suggested to be an optimal biological, diagnostic marker to detect overreaching and overtraining syndrome in physically active women.

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  • 41. Åman, Malin
    et al.
    Forssblad, Magnus
    Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    National injury prevention measures in team sports should focus on knee, head, and severe upper limb injuries2019In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 27, no 3, p. 1000-1008Article in journal (Refereed)
    Abstract [en]

    Purpose: To examine acute injuries in licensed floorball, football, handball, and ice hockey players in all ages nationwide in Sweden, and to identify the most common and severe injuries in each body location and recommend injury prevention measures.

    Methods: Using national sport insurance data from years 2006–2015 was the incidence and proportion of acute injuries, and injuries leading to permanent medical impairment (PMI), calculated in the four team sports. The most common injury type and injured body part was identified, with a particular focus of the severe injuries. Comparison between sexes was made.

    Results: In total, there were 92,162 registered injuries in all sports together. Knee injuries were most common, and also had the highest incidence of PMI, in all ball sports and in female ice hockey players. In male ice hockey, the most common injury was a dental and face injury, and PMI injuries were mostly in the shoulder. The most severe PMI injuries were rare and most often a face/eye injury in male floorball and ice hockey, a concussion in female ice hockey, and a knee injury in female floorball, and in both sexes in football and handball.

    Conclusions: To achieve the greatest impact in reducing the adverse effects of acute sport injuries nationwide in Sweden, preventive measures should focus on knee injuries in all the investigated team sports. The severe head/face and upper limb injuries also need attention. Protective equipment, neuromuscular training programs, rules enforcements, and fair-play interventions may reduce the incidence of injuries

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  • 42. Åman, Malin
    et al.
    Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Forssblad, Magnus
    Näsmark, Annica
    Waldén, Markus
    Hägglund, Martin
    A Nationwide Follow-up Survey on the Effectiveness of an Implemented Neuromuscular Training Program to Reduce Acute Knee Injuries in Soccer Players2018In: The Orthopaedic Journal of Sports Medicine, ISSN 2325-9671, Vol. 6, no 12, article id 2325967118813841Article in journal (Refereed)
    Abstract [en]

    Background: A cruciate ligament (CL) injury is a severe injury in soccer. Neuromuscular training programs have a well-documented preventive effect, but there are few studies on the effectiveness of such a program at a national level. The Swedish Knee Control Program (KCP) was found to be effective in preventing CL injuries in youth female soccer players. The KCP was implemented nationwide in Sweden in 2010.

    Purpose: To evaluate the effectiveness of the Swedish KCP in reducing acute knee injuries in soccer players at a nationwide level.

    Study Design: Descriptive epidemiology study.

    Methods: All licensed soccer players in Sweden are covered by the same insurance company. Using this insurance database, around 17,500 acute knee injuries that were reported to the insurance company between 2006 and 2015 were included in the study. By matching the number of licensed soccer players with the number of reported injuries each year, the annual incidence of knee and CL injuries was able to be calculated. To evaluate the spread of the KCP nationally, a questionnaire was sent to all 24 Swedish district football associations (FAs) with questions regarding KCP education. The number of downloads of the KCP mobile application (app) was obtained.

    Results: The incidence of CL injuries decreased during the study period for both male (from 2.9 to 2.4 per 1000 player-years) and female players (from 4.9 to 3.9 per 1000 player-years). The overall incidence of knee injuries decreased in both male (from 5.6 to 4.6 per 1000 player-years) and female players (from 8.7 to 6.4 per 1000 player-years). Comparing before and after the nationwide implementation of the KCP, there was a decrease in the incidence of CL injuries by 6% (rate ratio [RR], 0.94 [95% CI, 0.89-0.98]) in male players and 13% (RR, 0.87 [95% CI, 0.81-0.92]) in female players and a decrease in the incidence of knee injuries by 8% (RR, 0.92 [95% CI, 0.89-0.96]) and 21% (RR, 0.79 [95% CI, 0.75-0.83]), respectively (P < .01 for all). This trend corresponded to a reduction of approximately 100 CL injuries each year in Sweden. A total of 21 of 24 district FAs held organized KCP educational courses during the study period. The percentage of district FAs holding KCP courses was between 46% and 79% each year. There were 101,236 downloads of the KCP app.

    Conclusion: The KCP can be considered partially implemented nationwide, and the incidence of knee and CL injuries has decreased in both sexes at a nationwide level.

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