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  • 1.
    Aasa, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Norrlandsklinikens hälsocentral, Umeå, Sweden.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain: a randomized controlled trial2015In: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 45, no 2, p. 77-85Article in journal (Refereed)
    Abstract [en]

    Study Design Randomized controlled trial. Background Low back pain is a common disorder. Patients with low back pain frequently have aberrant and pain-provocative movement patterns that often are addressed with motor control exercises. Objective To compare the effects of low-load motor control (LMC) exercise and those of a high-load lifting (HLL) exercise. Methods Seventy participants with recurrent low back pain, who were diagnosed with nociceptive mechanical pain as their dominating pain pattern, were randomized to either LMC or HLL exercise treatments. Participants were offered 12 treatment sessions over an 8-week period. All participants were also provided with education regarding pain mechanisms. Methods Participants were assessed prior to and following treatment. The primary outcome measures were activity (the Patient-Specific Functional Scale) and average pain intensity over the last 7 days (visual analog scale). The secondary outcome measure was a physical performance test battery that included 1 strength, 3 endurance, and 7 movement control tests for the lumbopelvic region. Results Both interventions resulted in significant within-group improvements in pain intensity, strength, and endurance. The LMC group showed significantly greater improvement on the Patient-Specific Functional Scale (4.2 points) compared with the HLL group (2.5 points) (P<.001). There were no significant between-group differences in pain intensity (P = .505), strength, and 1 of the 3 endurance tests. However, the LMC group showed an increase (from 2.9 to 5.9) on the movement control test subscale, whereas the HLL group showed no change (from 3.9 to 3.1) (P<.001). Conclusion An LMC intervention may result in superior outcomes in activity, movement control, and muscle endurance compared to an HLL intervention, but not in pain intensity, strength, or endurance.

  • 2.
    Aasa, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Hellqvist, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A characterisation of pain, disability, kinesiophobia and physical capacity in patients with predominantly peripherally mediated mechanical low back pain2011Conference paper (Refereed)
  • 3.
    Aasa, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Norrlandskliniken, Umeå.
    Lundström, Lena
    Pain Rehabilitation, Norrlands University Hospital, Umeå.
    Papacosta, Daniel
    Norrlandskliniken, Umeå.
    Sandlund, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Do we see the same movement impairments?: the inter-rater reliability of movement tests for experienced and novice physiotherapists2014In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 16, no 16, p. 173-182, article id 3Article in journal (Refereed)
    Abstract [en]

    Study design: Inter-rater reliability study. Background: Physiotherapists (PTs) use clinical tests including movement tests to identify faulty movement patterns. Aims: To investigate the inter-rater-reliability of active movement tests in the cervical spine, shoulder joint and scapulo-thoracic joint, and to describe the reasons for judgment of a positive test. Methodology: Four PTs, two experienced and two recently educated (novice), rated performance of five movement tests for 36 participants. Twenty-one of the participants were patients under treatment because of neck and/or shoulder problems, while 15 participants declared no problem from this region of the body. All tests were video recorded and the ratings were done by observing the video recordings. First, the PTs judged the tests as negative (the movement being ideally performed) or positive (the movement not being ideally performed). Then, the PTs described why the movements that they judged positive were not being ideally performed, using a predefined protocol, which represented different movement quality aspects. The inter-rater reliability was calculated for each test using Kappa statistics between the two experienced and the two novice PTs, respectively, and between each of the experienced and each of the novice PTs. Major findings: The experienced PTs had a higher inter-rater reliability than the novice PTs. The reasons for considering a movement test being positive differed highly between the (novice) PTs. Principal conclusion: This study supports previous studies concluding that the observation of active movement tests is reliable when assessed by experienced PTs. Novice PTs might benefit from further supervision.

  • 4.
    Aasa, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Sandlund, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Rudolfsson, Thomas
    Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Acuity of goal-directed arm movements and movement control: evaluation of differences between patients with persistent neck/shoulder pain and healthy controls2022In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 24, no 1, p. 47-55Article in journal (Refereed)
    Abstract [en]

    Background: The main aim was to examine whether patients with persistent upper quadrant pain have higher end-point variability in goal directed pointing movements than pain-free controls when the pointing task is performed in total darkness and under full vision. An additional aim was to study associations between the magnitude of end-point variability and a clinical movement control test battery and self-rated functioning among patients.

    Methods: Seventeen patients and 17 age- and gender-matched pain-free controls performed a pointing task that evaluated end-point variability of repetitive shoulder movements in horizontal adduction and abduction with full vision, and abduction with no visual information, completed a movement control test battery of neck and shoulder control tests and answered questionnaires.

    Results: Patients had higher end point variability for horizontal abduction when performed with no visual information. For horizontal adduction the variability was higher, but only when it was controlled for movement time. No significant correlations were found between end-point variability and self-rated functioning, nor between end-point variability and neuromuscular control of the glenohumeral joint.

    Conclusions: This study provides preliminary evidence that patients with persistent neck/shoulder pain can partly compensate proprioceptive deficits in goal-directed arm movement when visual feedback is present.

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  • 5.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Barnekow-Bergkvist, Margareta
    Angquist, Karl-Axel
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Relationships between work-related factors and disorders in the neck-shoulder and low-back region among female and male ambulance personnel.2005In: Journal of Occupational Health, ISSN 1341-9145, E-ISSN 1348-9585, Vol. 47, no 6, p. 481-9Article in journal (Refereed)
    Abstract [en]

    This cross-sectional study on a random sample of 1,500 ambulance personnel investigated the relationships between self-reported work-related physical and psychosocial factors, worry about work conditions, and musculoskeletal disorders among female and male ambulance personnel. Three different outcomes, complaints, activity limitation, and sick leave, for the neck-shoulder and low-back region, respectively, were chosen. Among the female personnel, physical demands was significantly associated with activity limitation in the neck-shoulder (OR 4.13) and low-back region (OR 2.17), and psychological demands with neck-shoulder (OR 2.37) and low-back (OR 2.28) complaints. Among the male personnel, physical demands was significantly associated with low-back complaints (OR 1.41) and activity limitation (OR 1.62). Psychological demands and lack of social support were significantly associated with neck-shoulder complaints (OR 1.86 and OR 1.58, respectively) and activity limitation (OR 3.46 and OR 1.71) as well as activity limitation due to low-back complaints (OR 2.22 and OR 1.63). Worry about work conditions was independently associated with activity limitation due to low-back complaints among the female (OR 5.28), and to both neck-shoulder and low-back complaints (OR 1.79 and OR 2.04, respectively) and activity limitation (OR 2.32 and OR 1.95) among the male personnel. In conclusion, the association patterns between physical and psychological demands and MSDs suggest opportunities for intervention.

  • 6.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Bengtsson, Victor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Variability of lumbar spinal alignment among power- and weightlifters during the deadlift and barbell back squat2022In: Sports Biomechanics, ISSN 1476-3141, E-ISSN 1752-6116, Vol. 21, no 6, p. 707-717Article in journal (Refereed)
    Abstract [en]

    The aims of the study were to evaluate the relative and absolute variability of upper (T11-L2) and lower (L2-S2) lumbar spinal alignment in power- and weightlifters during the deadlift and back squat exercises, and to compare this alignment between the two lifting groups. Twenty-four competitive powerlifters (n = 14) and weightlifters (n = 10) performed three repetitions of the deadlift and the back squat exercises using a load equivalent to 70% of their respective one-repetition maximum. The main outcome measures were the three-dimensional lumbar spinal alignment for start position, minimum and maximum angle of their spinal alignment, and range of motion measured using inertial measurement units. Relative intra-trial reliability was calculated using the two-way random model intraclass correlation coefficient (ICC) and absolute reliability with minimal detectable change (MDC). The ICC ranged between 0.69 and 0.99 and the MDC between 1 degrees-8 degrees for the deadlift. Corresponding figures for the squat were 0.78-0.99 and 1 degrees-6 degrees. In all participants during both exercises, spinal adjustments were made in both thoracolumbar and lumbopelvic areas in all three dimensions. In conclusion, when performing three repetitions of the deadlift and the squat, lumbar spinal alignment of the lifters did not change much between repetitions and did not differ significantly between power- and weightlifters.

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  • 7.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Umeå University, Faculty of Social Sciences, Umeå School of Sport Sciences.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Umeå University, Faculty of Social Sciences, Umeå School of Sport Sciences.
    A descriptive analysis of functional impairments and patho-anatomical findings in eight powerlifters2020In: Journal of Sports Medicine and Physical Fitness, ISSN 0022-4707, E-ISSN 1827-1928, Vol. 60, no 4, p. 582-593Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Low back pain (LBP) is a common pain problem in powerlifters. There is a lack of evidence to guide powerlifters and health-care professionals in understanding the role of powerlifting in the development of LBP and treatment of injuries in powerlifters. This study aimed to describe functional impairments and patho-anatomical findings in eight powerlifters with and without LBP. METHODS: First, four powerlifters with LBP were recruited. Each powerlifter was then matched with a pain-free lifter (Control) by age, Body Mass Index and competition weight class. They all performed physical performance tests and were examined with magnetic resonance imaging. Four weeks prior to the examination the powerlifters also recorded training load. Powerlifters with LBP were also examined by a physiotherapist in order to define their pain and impairments. RESULTS: The four male powerlifters with LBP had a nociceptive pain associated with non-ideal squatting technique, higher flexibility in their lumbar spine than in their hips and patho-anatomical findings such as degenerated discs (four), spondylolysis (one) and spinal stenosis (one). However, the controls also showed similar functional impairments and patho-anatomical findings. CONCLUSIONS: Powerlifters with and without LBP show similar functional impairments and patho-anatomical findings. However, powerlifters' LBP seems associated with pain during movement and loading of the lumbar spine. The association and causation between specific functional impairments, patho-anatomical findings and LBP in powerlifters has to be further investigated in studies including more participants.

  • 8.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Krafttag ska stoppa styrkelyftarnas skador2015In: Svensk idrottsforskning, ISSN 1103-4629, no 4, p. 29-31Article in journal (Other (popular science, discussion, etc.))
  • 9.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ängquist, Karl-Axel
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Barnekow-Bergkvist, Margareta
    Work-related psychosocial factors, worry about work conditions and health complaints among female and male ambulance personnel.2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 3, p. 251-258Article in journal (Refereed)
  • 10.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Jaric, S
    Barnekow-Bergkvist, M
    Johansson, H
    Muscle strength assessment from functional performance tests: role of body size2003In: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 17, no 4, p. 664-670Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to test the hypothesis that the body size plays an important role in assessment of muscle ability to exert force by standard functional performance tests. Twenty-one male students were tested on maximal isometric lift, one leg rising, vertical jump, and box lift tests, and the maximal isokinetic strength of hip and knee extensors was also recorded. When indices of the 4 functional performance tests were related to the strength of each of the 2 leg extensor muscle groups, only maximal isometric lift demonstrated positive correlation with knee extensors strength. When muscle strength was corrected for body mass, however, the aforementioned relationship became insignificant, but the 1 leg rising performance demonstrated a positive relationship with knee extensor strength. In addition, maximal isometric lift and 1 leg rising test performance provided positive and negative correlation, respectively, with body mass. The obtained findings were in line with the effects of scale applied on the tested performance. We generally conclude that the assessment of muscle capability to exert force based on some standard functional performance tests could be confounded by the body size effect.

  • 11.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, University of Gävle, Sweden.
    Jensen, Bente R
    Department of Exercise and Sport Sciences, University of Copenhagen, Denmark .
    Sandfeld, Jesper
    Department of Exercise and Sport Sciences, University of Copenhagen, Denmark .
    Richter, Hans
    Centre for Musculoskeletal Research, University of Gävle, Sweden.
    Lyskov, Eugene
    Centre for Musculoskeletal Research, University of Gävle, Sweden.
    Crenshaw, Albert
    Centre for Musculoskeletal Research, University of Gävle, Sweden.
    The impact of object size and precision demands on fatigue during computer mouse use2011In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 13, no 3, p. 118-127Article in journal (Refereed)
    Abstract [en]

    Prolonged computer use, especially if fatigue ensues, is associated with visual and musculoskeletal symptoms. The aim was to determine the time-course of perceived fatigue in the wrist, forearm, shoulder and eyes during a 60-min mouse task (painting rectangles), and whether object size and/or mouse use demands were of infl uence. Also, we investigated performance (number of rectangles painted), and whether perceived fatigue was paralleled by local muscle fatigue or tissue oxygenation.

    Ten women performed the task for three conditions (crossover design). At condition 1, rectangles were 45 25 mm, square paint cursor size 1.3 1.3 mm, and mouse – pointer movement ratio 1:26. At condition 2, the same cursor size and mouse – pointer movement ratio was used, but rectangles were smaller. At condition 3, the smaller rectangles were used, but the cursor size was also smaller and mouse – pointer movement ratio was 1:8. The results showed increased self-reported fatigue over time, with the observed increase greater for the eyes, but no change in physiological responses. Condition 2 resulted in higher performance and increased eye fatigue. Perceived fatigue in the muscles or physiological responses did not differ between conditions. In conclusion, computer work tasks imposing high visual and motor demands, and with high performance, seemed to have an infl uence on eye fatigue.

  • 12. Aasa, Ulrika
    et al.
    Kalezic, Nebojsa
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Lyskov, Eugene
    Ängquist, Karl-Axel
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Barnekow-Bergkvist, Margareta
    Stress monitoring of ambulance personnel during work and leisure time.2006In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 80, no 1, p. 51-59Article in journal (Refereed)
  • 13.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundell, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences. Norrlandskliniken, Umeå, Sweden.
    Westerståhl, Maria
    Institutionen för laboratoriemedicin, Karolinska institutet.
    Physical Activity Might Be of Greater Importance for Good Spinal Control Than If You Have Had Pain or Not: A Longitudinal Study2015In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 40, no 24, p. 1926-1933Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN: Longitudinal design. A cohort followed in 3 waves of data collection.

    OBJECTIVE: The aim of the study was to describe the relationships between the performance of 2 tests of spinal control at the age of 52 years and low back pain, physical activity level, and fitness earlier in life, as well as to describe the cross-sectional relationships between these measures.

    SUMMARY OF BACKGROUND DATA: Altered spinal control has been linked to pain; however, other stimuli may also lead to inability to control the movements of the spine.

    METHODS: Participants answered questions about physical activity and low back pain, and performed physical fitness tests at the age of 16, 34, and 52 years. The fitness test battery included tests of endurance in the back and abdominal muscles, a submaximal bicycle ergometer test to estimate maximal oxygen uptake, and measurements of hip flexion, thoracic spine flexibility, and anthropometrics. Two tests were aggregated to a physical fitness index. At the age of 52, also 2 tests of spinal control, the standing Waiter's bow (WB) and the supine double leg lower (LL) were performed.

    RESULTS: Logistic regression analyses showed that higher back muscle endurance at the age of 34 years could positively predict WB performance at 52 years and higher physical fitness at the age of 34 could positively predict LL performance at 52 years. Regarding cross-sectional relationships, an inability to perform the WB correctly was associated with lower physical fitness, flexibility and physical activity, and larger waist circumference. An inability to correctly perform the LL was associated with lower physical fitness. One-year prevalence of pain was not significantly associated with WB or LL test performance.

    CONCLUSION: An active life resulting in higher physical fitness is related to better spinal control in middle-aged men and women. This further strengthens the importance of physical activity throughout the life span.

    LEVEL OF EVIDENCE: 3.

  • 14.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundell, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Barnekow-Bergkvist, Margareta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Jansson, Eva
    Westerståhl, Maria
    The Swedish physical activity and fitness cohort born in 1958 - dropout analysis and overview at 36-year follow-up2017In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 27, no 4, p. 418-429Article in journal (Refereed)
    Abstract [en]

    The main aim of the Swedish physical activity and fitness cohort study (SPAF-1958) was to describe physical fitness, physical activity, health, and lifestyle across part of the lifespan, and to assess the influences on these factors from the environment, personal factors, and genetics. There is inevitable dropout from longitudinal studies, and it may be systematic. The aim of this first paper of the second follow-up of SPAF-1958 was to provide a dropout analysis to consider to what extent the participants, at 52 years of age, remain a representative sample of the original adolescent study population. Additional aims were to provide an overview of the study protocol and the ongoing study population. Ongoing study participants in SPAF born in 1958 were, at the second follow-up at the age of 52, still representative of the study cohort in terms of sex, adolescent geographical area, upper secondary school program, adolescent body composition, muscular strength, and muscular endurance. However, a higher physical activity and, among women, a higher aerobic capacity in adolescence decreased the risk for dropout. It is important when interpreting results from longitudinal studies to adjust for the systematic dropout that could bias the conclusions drawn from the results.

  • 15.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Paulin, Johan
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Madison, Guy
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Correspondence between physical self-concept and participation in, and fitness change after, bi-weekly body conditioning classes in sedentary women2017In: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 31, no 2, p. 451-461Article in journal (Refereed)
    Abstract [en]

    The aims of the study were (1) to investigate the effects of participation in low impact body conditioning classes on physical fitness in sedentary women at different ages and (2) to examine the correspondence between physical self-concept and participation in, and fitness change after, the participation. Ninety-two sedentary women (mean age 44.2 years) participated in 11-weeks of bi-weekly classes that included cardiovascular, strength, core, endurance and mobility exercises, all performed in synchrony with music. Cardiorespiratory fitness, maximal lifting strength, mobility and balance tests were performed pre- and post the exercise period and the short-form Physical Self-Description Questionnaire (PSDQ-S) was completed. Zero-order Spearman correlation analyses showed that women who rated the PSDQ-S dimension Sport competence higher participated in a larger number of sessions (rs=0.24, p=0.040). At post-tests, all participants had increased their balance, the participants aged 20-34 years had increased their lifting strength, and the participants aged 35-65 years had increased their cardiorespiratory fitness and mobility. Most PSDQ-S dimensions did not affect performance change, but the perception of being physically active was related to increased cardiovascular fitness. We conclude that women with a sedentary lifestyle who wish to increase their physical capacity benefit from music exercise and that inquiries about perceived sport competence and physical activity can improve recommendations made by strength and conditioning professionals.

  • 16.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Svartholm, Ivar
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Andersson, Fredrik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Injuries among weightlifters and powerlifters: a systematic review2017In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 51, no 4, p. 211-219Article in journal (Refereed)
    Abstract [en]

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

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

    Design Systematic review.

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

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

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

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

    Trial registration number PROSPERO CRD42015014805.

  • 17.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Westerståhl, Maria
    Institutionen för laboratoriemedicin avd för klinisk fysiologi Karolinska institutet .
    Barnekow-Bergkvist, Margareta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Jansson, Eva
    Institutionen för laboratoriemedicin avd för klinisk fysiologi Karolinska institutet .
    Hälsoresan till medelåldern2011In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, no 2, p. 4p. 40-43Article in journal (Other academic)
    Abstract [sv]

    Vad är viktigast för att få en god hälsa som vuxen? Sedan 1974 har vi följt samma personer från 16 års ålder in i medelåldern och studerat deras hälsa från flera olika synvinklar. Nu pågår den tredje mätomgången.

  • 18.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wiitavaara, Birgitta
    Högskolan i Gävle.
    Personalens hälsa och arbetsmiljö2009In: Prehospital akutsjukvård / [ed] Björn-Ove Suserud och Leif Svensson, Stockholm: Liber, 2009, p. 33-38Chapter in book (Other (popular science, discussion, etc.))
  • 19.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ängquist, Karl-Axel
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Barnekow-Bergkvist, Margareta
    The effects of a 1-year physical exercise programme on development of fatigue during a simulated ambulance work task.2008In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 51, no 8, p. 1179-94Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to evaluate the effects of individually prescribed physical exercise programmes on development of fatigue during the carrying of a loaded stretcher up and down the stairs. Nineteen ambulance personnel performed the training for 1 year. Testing occurred before and after 1 year of the training. Both the training group (n = 19) and the control group (n = 15) were assessed for physical capacity and lactate concentration in blood and ratings of perceived exertion during carrying a stretcher on the stairs. When comparisons were made between those who had been training three times/week for 1 year and the control group, lactate concentration was significantly decreased. In conclusion, markers of fatigue during stretcher carrying can be reduced by the use of individually prescribed physical exercise programmes.

  • 20. af Wåhlberg, A. E.
    et al.
    Madison, Guy
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Yu, Jeong Jin
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Meta-Analytic Analysis of Invariance Across Samples: Introducing a Method That Does Not Require Raw Data2021In: Basic and Applied Social Psychology, ISSN 0197-3533, E-ISSN 1532-4834, Vol. 43, no 1, p. 68-80Article in journal (Refereed)
    Abstract [en]

    Invariance of surveys across different groups means that the respondents interpret the items in the same way, as reflected in similar factor loadings, for example. Invariance can be assessed using various statistical procedures, such as Multi-Group Confirmatory Factor Analysis. However, these analyses require access to raw data. Here, we introduce a meta-analytic method that requires only the factor correlation matrices of samples as input. It compares the structures of intercorrelations of factors by correlating these values across two samples, yielding a value of overall similarity for how the factors intercorrelate in different samples. This method was tested in three different ways. We conclude that the method yields useful results and can assess invariance when raw data are not available.

  • 21. Barnekow-Bergkvist, M
    et al.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Angquist, K-A
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Johansson, H
    Prediction of development of fatigue during a simulated ambulance work task from physical performance tests.2004In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 47, no 11, p. 1238-1250Article in journal (Refereed)
    Abstract [en]

    The aims of this study were (1) to identify which physical performance tests could best explain the development of fatigue during a simulated ambulance work task, (2) to investigate the effect of height and weight and (3) to investigate in what respects these findings differ between female and male ambulance personnel. Forty-eight male and 17 female ambulance personnel completed a test battery assessing cardio-respiratory capacity, muscular strength and endurance, and co-ordination. The subjects also completed a simulated ambulance work task -- carrying a loaded stretcher. The work task was evaluated by development of fatigue. Univariate and multiple regression analyses were used to investigate to what extent the tests in the test battery were able to explain the variance of developed fatigue. The explained variance was higher for female than for male ambulance personnel (time > 70% of HRpeak: R2 = 0.75 vs 0.10, accumulated lactate: R2 = 0.62 vs 0.42, perceived exertion: R2 = 0.75 vs 0.10). Significant predictors in the models were VO2max, isometric back endurance, one-leg rising, isokinetic knee flexion and shoulder extension strength. Height, but not weight, could further explain the variance. The high physical strain during carrying the loaded stretcher implies the importance of investigating whether improved performance, matching the occupational demands, could decrease the development of fatigue during strenuous tasks.

  • 22.
    Bengtsson, Victor
    et al.
    Department of Neuroscience, Uppsala University, Sweden.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Thoracolumbar and lumbopelvic spinal alignment during the deadlift exercise: a comparison between men and women2022In: International Journal of Sports Physical Therapy, E-ISSN 2159-2896, Vol. 17, no 6, p. 1063-1074Article in journal (Refereed)
    Abstract [en]

    Background: A neutral spinal alignment is considered important during the execution of the deadlift exercise to decrease the risk of injury. Since male and female powerlifters experience pain in different parts of their backs, it is important to examine whether men and women differ in spinal alignment during the deadlift.

    Objectives: The purpose of this study was to quantify the spinal alignment in the upper (thoracolumbar, T11-L2) and lower (lumbopelvic, L2-S2) lumbar spine during the deadlift exercise in male and female lifters. Secondary aims were to compare lumbar spine alignment during the deadlift to standing habitual posture, and determine whether male and female lifters differ in these aspects.

    Study Design: Observational, Cross-sectional.

    Methods: Twenty-four (14 men, 10 women) lifters performed three repetitions of the deadlift exercise using 70% of their respective one-repetition maximum. Spinal alignment and spinal range of motion were measured using three inertial measurement units placed on the thoracic, lumbar and sacral spine. Data from three different positions were analyzed; habitual posture in standing, and start and stop positions of the deadlift, i.e. bottom and finish position respectively.

    Results: During the deadlift, spinal adjustments were evident in all three planes of movement. From standing habitual posture to the start position the lumbar lordosis decreased 13° in the upper and 20° in the lower lumbar spine. From start position to stop position the total range of motion in the sagittal plane was 11° in the upper and 22° in the lower lumbar spine. The decreased lumbar lordosis from standing habitual posture to the start position was significantly greater among men.

    Conclusions: Men and women adjust their spinal alignment in all three planes of movement when performing a deadlift and men seem to make greater adjustments from their standing habitual posture to start position in the sagittal plane. Level of Evidence 3.

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  • 23.
    Bengtsson, Victor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center. Medfit, Primary Care Rehabilitation and Fitness Centre, Stockholm, Sweden.
    Narrative review of injuries in powerlifting with special reference to their association to the squat, bench press and deadlift2018In: BMJ Open Sport & Exercise Medicine, E-ISSN 2055-7647, Vol. 4, article id e000382Article in journal (Refereed)
    Abstract [en]

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

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  • 24.
    Bengtsson, Victor
    et al.
    Department of Women's and Children's Health, Uppsala university.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Thoracolumbar and Lumbopelvic Spinal Alignment During the Barbell Back Squat: A Comparison Between Men and Women2023In: International Journal of Sports Physical Therapy, E-ISSN 2159-2896, Vol. 18, no 4, p. 820-830Article in journal (Refereed)
    Abstract [en]

    Background:  Maintaining neutral spinal alignment is considered important when performing the barbell back squat exercise. Since male and female lifters may differ in injury location it is important to examine whether they differ in spinal alignment during the back squat.

    Objectives:  The study aimed to quantify the spinal alignment in the upper and lower lumbar spine during the barbell back squat exercise in male and female lifters. Secondary aims were to compare alignment during the back squat to standing habitual lumbar spine alignment and determine whether male and female lifters differ in these aspects.

    Study design:  Observational, Cross-sectional.

    Methods:  Competitive power- and weightlifters were recruited and performed three repetitions of the barbell back squat exercise using a load equivalent to 70% of their one-repetition maximum. Spinal alignment and range of motion were measured using inertial measurement units placed on the thoracic, lumbar and sacral spine. Data was presented descriptively and comparisons between men and women as well as spinal alignment in four different positions were done with a factorial repeated measures analysis of variance.

    Results:  Twenty-three (14 males, 9 females) were included. During execution of the squat, spinal alignment adjustments in the lumbar spine were made in all three planes of movement, compared to the start position, in both male and female lifters. Compared to their standing habitual posture, all lifters adjusted their upper lumbar spine to a less lordotic position when in the start position of the back squat (standing upright with the barbell on their back). Only male lifters assumed a less lordotic alignment in their lower lumbar spine in the start position compared their habitual posture.

    Conclusions:  Adjustments of spinal alignment, predominantly in the sagittal plane, are made during execution of the back squat in both male and female lifters. Further, lifters adopt a less lordotic alignment with a heavy barbell on their upper back, more so in male than female lifters. In conclusion, it seems that spinal alignment changes noticeably during the barbell back squat.

    Level of evidence:  3

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  • 25.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Styrketräning som behandling vid långvariga ländryggsbesvär2017In: Fysioterapi, ISSN 1653-5804, no 4, p. 8p. 28-33Article, review/survey (Other academic)
    Abstract [sv]

    Fysisk träning är viktigt för en god hälsa och fungerar även som behandlingsform vid många sjukdomar, så även ländryggsbesvär. Styrketräning har visat sig vara en mer effektiv träningsform än till exempel aerob träning vid behandling av långvariga ländryggsbesvär. I dagsläget finns det ingen konsensus kring vilket det mest effektiva styrketräningsupplägget kan vara. Den vanligaste designen av styrketräningsprogram vid ländryggsbesvär tycks vara ett upplägg med syftet att förbättra styrkan/uthålligheten av ryggsträckarmuskulaturen och därigenom uppnå smärtlindring och funktionsförbättring. I en studie från Umeå universitet och Luleå tekniska universitet har träning av marklyft för patienter med långvariga ländryggsbesvär utvärderats. Marklyftsträningen förväntades öka deltagarnas bålstyrka samtidigt som den fokuserade på förbättring av rörelsekontroll kring såväl höft som ländrygg. När den åtta veckor långa träningsperioden var slut, visade det sig att gruppen som tränat marklyft hade ökat sin bålstyrka, minskat smärta, ökat funktionsförmåga och hälsorelaterad livskvalitet i samma omfattning som gruppen som tränade individanpassad träning av rörelsekontroll. Men de hade inte förbättrats lika mycket gällande rörelsekontroll eller vardagsfunktion. Vidare forskning pågår vid Umeå universitet om skador i samband med tung styrketräning samt lyftteknikens betydelse för skador och besvär vid tung styrketräning.

  • 26.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Hellqvist, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Which patients with low back pain benefit from deadlift training?2015In: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 29, no 7, p. 1803-1811Article in journal (Refereed)
    Abstract [en]

    Recent studies have indicated that the deadlift exercise may be effective in decreasing pain intensity and increasing activity for most, but not all, patients with a dominating mechanical low back pain pattern. This study aimed to evaluate which individual factors measured at baseline could predict activity, disability, and pain intensity in patients with mechanical low back pain after an 8-week training period involving the deadlift as a rehabilitative exercise. Thirty-five participants performed deadlift training under the supervision of a physical therapist with powerlifting experience. Measures of pain-related fear of movement, hip and trunk muscle endurance and lumbopelvic movement control were collected at baseline. Measures of activity, disability and pain intensity were collected at baseline and at follow-up. Linear regression analyses were used to create models to predict activity, disability and pain intensity at follow-up. Results showed that participants with less disability, less pain intensity and higher performance on the Biering-Sørensen test, which tests the endurance of hip and back extensor muscles, at baseline benefit from deadlift training. The Biering-Sørensen test was the strongest predictor since it was included in all predictive models. Pain intensity was the next best predictor as it was included in two predictive models. Thus, for strength and conditioning professionals who use the deadlift as a rehabilitative exercise for individuals with mechanical low back pain, it is important to ensure that clients have sufficient back extensor strength and endurance and a sufficiently low pain intensity level to benefit from training involving the deadlift exercise.

  • 27.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Umeå University, Faculty of Social Sciences, Umeå School of Sport Sciences.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Norrlandskliniken Health Care Centre, Umeå, Sweden.
    Michaelson, Peter
    Division of Health and Rehabilitation, Department of Health Science, Luleå University of Technology, Luleå, Sweden.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå School of Sport Sciences.
    Effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness: a randomized controlled trial2017In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 42, no 15, p. E876-E882Article in journal (Refereed)
    Abstract [en]

    Study Design: Randomized controlled trial

    Objective: The aim of this study was to compare the effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness among patients with nociceptive mechanical low back pain.

    Summary of Background Data: There is evidence that patients with low back pain may have a decreased size of the lumbar multifidus muscles with an asymmetry between left/right sides in the lower back. It has also been shown that low-load motor control training can affect this asymmetry; essentially, it is effective in equalizing side differences in lumbar multifidus muscle size. It is, however, not known whether a high-load exercise has the same effect.

    Methods: Sixty-five participants diagnosed with nociceptive mechanical low back pain were included and randomized into low-load motor control exercises or a high-load lifting exercise, the deadlift. The lumbar multifidus thickness at the fifth lumbar vertebra was measured, using rehabilitative ultrasound imaging, at baseline and after a 2-month training period.

    Results: There were no differences between interventions regarding effect on lumbar multifidus muscle thickness. However, the linear mixed model analysis showed a significant effect for asymmetry. The thickness of the lumbar multifidus muscle on the small side increased significantly compared to the large side in both intervention groups.

    Conclusions: There was a difference in thickness of the lumbar multifidus muscles between sides. It seems that exercises focusing on spinal alignment may increase the thickness of the lumbar multifidus muscles on the small side, irrespective of exercise load.

  • 28.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Norrlandskliniken Health Care Centre, Umeå, Sweden.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Sagittal lumbopelvic alignment in patients with low back pain and the effects of a high-load lifting exercise and individualized low-load motor control exercises: a randomized controlled trial2018In: The spine journal, ISSN 1529-9430, E-ISSN 1878-1632, Vol. 18, no 3, p. 399-406Article in journal (Refereed)
    Abstract [en]

    Background Context Assessment of posture and lumbopelvic alignment is often the main focus in the classification and treatment of patients with low back pain (LBP). However, little is known regarding the effects of motor control interventions on objective measures of lumbopelvic alignment.

    Purpose The primary aim of this study was to describe the variation of sagittal lumbopelvic alignment in patients with nociceptive mechanical LBP. The secondary aim was to compare the effects of a high-load lifting exercise (HLL) and low-load motor control exercises (LMC) on the change in lumbopelvic alignment with a special emphasis on patients with high and low degrees of lumbar lordosis (lu) and sacral angle (sa).

    Study Design This study is a secondary analysis of a randomized controlled trial evaluating the effects of HLL and LMC.

    Patient Sample Patients from the primary study, that is, patients categorized with nociceptive mechanical LBP, who agreed to participate in the radiographic examination were included (n=66).

    Outcome Measures Lateral plain radiographic images were used to evaluate lumbopelvic alignment regarding the lumbar lordosis and the sacral angle as outcomes, with posterior bend as an explanatory variable.

    Materials and Methods The participants were recruited to the study from two occupational health-care facilities. They were randomized to either the HLL or the LMC intervention group and offered 12 supervised exercise sessions. Outcome measures were collected at baseline and following the end of intervention period 2 months after baseline. Between- and within-group analyses of intervention groups and subgroups based on the distribution of the baseline values for the lumbar lordosis and the sacral angle, respectively (LOW, MID, and HIGH), were performed using both parametric and non-parametric statistics.

    Results The ranges of values for the present sample were 26.9–91.6° (M=59.0°, standard deviation [SD]=11.5°) for the lumbar lordosis and 18.2–72.1° (M=42.0°, SD=9.6°) for the sacral angle. There were no significant differences between the intervention groups in the percent change of eitheroutcome measure. Neither did any outcome change significantly over time within the intervention groups. In the subgroups, based on the distribution of respective baseline values, LOWlu showed a significantly increased lumbar lordosis, whereas HIGHsa showed a significantly decreased sacral angle following intervention.

    Conclusions This study describes the wide distribution of values for lumbopelvic alignment for patients with nociceptive mechanical LBP. Further research is needed to investigate subgroups of other types of LBP and contrast findings to those presented in this study. Our results also suggest that retraining of the lumbopelvic alignment could be possible for patients with LBP.

  • 29.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Falk, Jimmy
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Eliasson, Kim
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    What is the best squat and deadlift technique?2015Conference paper (Other academic)
  • 30.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hellqvist, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Holmberg, David
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Which patients with persistent mechanical low back pain will respond to high load motor control training?2011Conference paper (Refereed)
  • 31.
    Elcadi, Guilherme H.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Forsman, Mikael
    Public Health Sciences, Karolinska Institute, Centre for Musculoskeletal Research, University of Gävle.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fahlström, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Crenshaw, Albert G.
    Department of Occupational and Public Health , University of Gävle.
    Shoulder and forearm oxygenation and myoelectric activity in patients with work related muscle pain and healthy subjects2013In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 113, no 5, p. 1103-1115Article in journal (Refereed)
    Abstract [en]

    We tested hypotheses of (i) reduced oxygen usage, oxygen recovery, blood flow and oxygen consumption; and (ii) increased muscle activity for patients diagnosed with work related muscle pain in comparison to healthy controls. Oxygenation was measured with near infrared spectroscopy (NIRS), and muscle activity with EMG for the extensor carpi radialis (ECR) and trapezius descendens (TD) muscles. Eighteen patients with diffuse neck-shoulder-arm pain and seventeen controls (matched in age and sex) were equipped with NIRS and EMG probes. After determining an individual’s maximum voluntary contraction (MVC) force, short term (20 sec) isometric contractions for the ECR and TD of 10%, 30%, 50% and 70% MVC generated ∆StO2% and StO2% recovery (Rslope) from NIRS, and RMS%max from EMG signals. In addition, upper arm venous (VO) and arterial (AO) occlusions generated slopes of total hemoglobin (HbTslope) and deoxyhemoglobin (HHbslope) for the resting ECR as surrogates of blood flow and oxygen consumption, respectively. Mixed Model analyses, t-tests, and Mann-Whitney test were used to assess differences between groups. There was no significant difference in MVC between groups for either muscle. Also, ∆StO2%, Rslope for either muscle, and ECR-HbTslope were not different between groups, thus our hypotheses of reduced oxygen use, recovery, and blood flow for patients were not confirmed. However, patients had a significantly lower ECR-HHbslope confirming our hypothesis of reduced consumption. Further, there was no difference in RMS%max during contractions meaning that the hypothesis of increased activity for patients was not confirmed. When taking into account the number of NIRS variables studied, differences we found between our patient group and healthy controls (i.e. in forearm oxygen consumption and shoulder oxygen saturation level) may be considered modest. Overall our findings may have been impacted by the fact that our patients and controls were similar in muscle strength, which is in contrast to previous studies.

  • 32.
    Elcadi, Guilherme H
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Forsman, Mikael
    Public Health Sciences, Karolinska Institute, Centre for Musculoskeletal Research, University of Gävle.
    Hallman, David
    Department of Occupational and Public Health, University of Gävle .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fahlström, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Crenshaw, Albert G
    Department of Occupational and Public Health, University of Gävle .
    No differences in oxygenation in the forearm and shoulder of patients with work-related muscle pain and healthy subjects during a low-load sustained contractionManuscript (preprint) (Other academic)
    Abstract [en]

    A frequently ascribed symptom associated to work-related muscle pain (WRMP) is muscle fatigue. Studies investigating oxygenation and hemodynamics in association to fatigue development in the muscles of patients with WRMP are sparse. Inadequate oxygen consumption and/or inadequate blood supply can influence the ability of the muscles to withstand fatigue. In this study we applied near-infrared spectroscopy (NIRS) and electromyography (EMG) to investigate oxygenation, hemodynamics and muscle activity in the extensor carpi radialis (ECR) and trapezius (TD) muscles of patients with WRMP and healthy controls. Eighteen patients with diffuse neck-shoulder-arm pain and 17 controls (matched in age and sex) were equipped with NIRS and EMG probes. After determination of maximal voluntary contraction (MVC) a sustained contraction of 15% MVC was performed with a cutoff for the maximum time of 12 min. Variables generated were StO2% and HbT from NIRS and RMS%max and MPF from EMG during the contraction. T tests and Mann-Whitney tests were used for analyzes of differences in MVC and endurance times. Full factorial repeated measures analyses of variance (ANOVA) were used to assess differences between patients and controls in NIRS and EMG parameters over time. Results showed no differences in MVC between patients and controls. We found, however, a shorter endurance time for patients compared to controls. There were no significant differences in StO2%, HbT, RMS and MPF responses during contraction between groups for the ECR. For the TD there was a group effect for StO2% with patients showing a lower level at rest and throughout the contraction. For the ECR and TD oxygenation, hemodynamics, RMS and MPF there were no straightforward differences between patients and controls that could explain the differences in endurance time. Therefore, we conclude that the shorter endurance time seen in the present study was not measurable by physiological indicators investigated in this group of patients.

  • 33.
    Elcadi, Guilherme H
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Högskolan Gävle.
    Forsman, Mikael
    Högskolan Gävle; Karolinska institutet Stockholm.
    Hallman, David M
    Högskolan Gävle.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fahlstrom, Martin
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professionell Development. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Crenshaw, Albert G
    Högskolan Gävle.
    Oxygenation and hemodynamics do not underlie early muscle fatigue for patients with work-related muscle pain.2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 4, article id e95582Article in journal (Refereed)
    Abstract [en]

    Patients suffering from work-related muscle pain (WRMP) fatigue earlier during exercise than healthy controls. Inadequate oxygen consumption and/or inadequate blood supply can influence the ability of the muscles to withstand fatigue. However, it remains unknown if oxygenation and hemodynamics are associated with early fatigue in muscles of WRMP patients. In the present study we applied near-infrared spectroscopy (NIRS) on the extensor carpi radialis (ECR) and trapezius (TD) muscles of patients with WRMP (n = 18) and healthy controls (n = 17). Our objective was to determine if there were group differences in endurance times for a low-level contraction of 15% maximal voluntary contraction (MVC)--sustained for 12-13 min, and to see if these differences were associated with differences in muscle oxygenation and hemodynamics. At baseline, oxygen saturation (StO2%) was similar between groups for the ECR, but StO2% was significantly lower for TD for the WRMP patients (76%) compared to controls (85%) (P<0.01). Also, baseline ECR blood flow was similar in the two groups. For both muscles there were a larger number of patients, compared to controls, that did not maintain the 15% MVC for the allotted time. Consequently, the endurance times were significantly shorter for the WRMP patients than controls (medians, ECR: 347 s vs. 582 s; TD: 430 s vs. 723 s respectively). Responses in StO2% during the contractions were not significantly different between groups for either muscle, i.e. no apparent difference in oxygen consumption. Overall, we interpret our findings to indicate that the early fatigue for our WRMP patients was not associated with muscle oxygenation and hemodynamics.

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  • 34.
    Falk, Jimmy
    et al.
    Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    How accurate are visual assessments by physical therapists of lumbo-pelvic movements during the squat and deadlift?2021In: Physical Therapy in Sport, ISSN 1466-853X, E-ISSN 1873-1600, Vol. 50, p. 195-200Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate the accuracy of visual assessments made by physical therapists of lumbo-pelvic movements during the squat and deadlift and how much movement is considered injurious.

    Design: Quantitative Cross-sectional.

    Participants: 14 powerlifters, 10 Olympic weightlifters and six physical therapists.

    Setting: The lifters were recorded simultaneously by video and an inertial measurement unit (IMU) system while performing squats and deadlifts. The physical therapists assessed the videos and rated whether specific lumbo-pelvic movements were visible during the lifts and whether the movement amplitude was considered injurious.

    Main outcome measures: The nominal visual assessments, if there was a movement and if it was considered injurious, were compared to the degrees of movement attained from the IMU system.

    Results: During the squat, a posterior pelvic tilt of ≥34° was required to visually detect the movement. For other lumbo-pelvic movements, there was no significant difference in the amount of movement between those who were assessed as moving or not moving their lumbo-pelvic area, nor was there a difference in movement amplitude between those who were assessed as having an increased risk of injury or not.

    Conclusions: Physical therapists did not consistently detect lumbo-pelvic movements during squats and deadlifts when performed by competitive lifters.

  • 35.
    Grönblom Lundström, Lena
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Zhang, Yan
    Sundberg, Tobias
    Health care in light of different theories of health: A proposed framework for integrating a social humanistic perspective into health care2019In: Journal of Integrative Medicine, ISSN 2095-4964, Vol. 17, no 5, p. 321-327Article, review/survey (Refereed)
    Abstract [en]

    The objective of this paper is to provide an overview of the biomedical, the biopsychosocial, and the social humanistic theories of health and to propose a framework for integrating the latter into health care. In summary, the definitions of health, illness and disease are essential to the practice of health care and play fundamental roles in how patients’ experiences of being ill are valued and assessed within health care systems. Principally, the biomedical perspective proceeds from pathoanatomical deficiencies defining disease and malfunction; the addition of psychosocial components forms a biopsychosocial perspective. In addition, the social humanistic perspective extends from a person’s will, their ability to act, and the possibility to fulfill wanted actions. Thus, health care that does not address the social humanistic perspective may lack the power to describe how these entities are related to the patient on a personal level; thus, the will of the patient is not always fully addressed. Importantly, by targeting the will of the patient and the patient’s ability to act, the proposed framework of integrating a social humanistic perspective into health care may further emphasize and strengthen the interrelatedness of medical perspectives. A framework for integrating a social humanistic perspective into health care is proposed and its potential impact on health care is discussed.

  • 36.
    Hesselman Borg, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Westerståhl, Maria
    Institutionen för laboratoriemedicin, Karolinska institutet.
    Lundell, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Madison, Guy
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Longitudinal study exploring factors associated with neck/shoulder pain at 52 years of age2016In: Journal of Pain Research, E-ISSN 1178-7090, Vol. 9, p. 303-310Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate the ability of work-related measurements, body composition, physical activity, and fitness levels to predict neck/shoulder pain (upper body pain, UBP) at the age of 52 years. Another aim was to investigate the cross-sectional relationships between UBP, work-related factors, and individual factors at the age of 52 years.

    METHODS: We followed a randomly selected cohort of 429 adolescents that was recruited in 1974 (baseline), when they were 16 years old. The participants completed physical fitness tests, questions about sociodemographic and lifestyle factors at 16, 34, and 52 years of age, and questions about work-related factors and pain in the follow-ups. Logistic regression analyses were used to examine the associations between UBP and the other variables.

    RESULTS: Univariate logistic regression analyses showed that high body mass index and the work-related factors, low control, and low social support at the age of 34 years were related to UBP at the age of 52 years. For social support, there was an interaction between men and women where the relationship between low social support and the experience of pain was more evident for women. Among women, body mass index and social support remained significantly related in the multivariate analyses. For men, social support remained significantly related. Cross-sectional relationships at the age of 52 differed from the longitudinal in the sense that measures of joint flexibility and work posture were also significantly associated with UBP.

    CONCLUSION: The fact that the cross-sectional differed from the longitudinal relationships strengthens the importance of performing longitudinal studies when studying factors that might influence the initiation of pain. UBP preventative measures might need to include both lifestyle (such as dietary habits and physical activity to ensure that the individuals are not becoming overweight) and work-related factors such as social support.

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  • 37. Larsson, Helena
    et al.
    Tegern, Matthias
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet.
    Monnier, Andreas
    Skoglund, Jörgen
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Helander, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Persson, Emelie
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Malm, Christer
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Broman, Lisbet
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet.
    Content Validity Index and Intra- and Inter-Rater Reliability of a New Muscle Strength/Endurance Test Battery for Swedish Soldiers2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 7, article id e0132185Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to examine the content validity of commonly used muscle performance tests in military personnel and to investigate the reliability of a proposed test battery. For the content validity investigation, thirty selected tests were those described in the literature and/or commonly used in the Nordic and North Atlantic Treaty Organization (NATO) countries. Nine selected experts rated, on a four-point Likert scale, the relevance of these tests in relation to five different work tasks: lifting, carrying equipment on the body or in the hands, climbing, and digging. Thereafter, a content validity index (CVI) was calculated for each work task. The result showed excellent CVI (>= 0.78) for sixteen tests, which comprised of one or more of the military work tasks. Three of the tests; the functional lower-limb loading test (the Ranger test), dead-lift with kettlebells, and back extension, showed excellent content validity for four of the work tasks. For the development of a new muscle strength/endurance test battery, these three tests were further supplemented with two other tests, namely, the chins and side-bridge test. The inter-rater reliability was high (intraclass correlation coefficient, ICC2,1 0.99) for all five tests. The intra-rater reliability was good to high (ICC3,1 0.82-0.96) with an acceptable standard error of mean (SEM), except for the side-bridge test (SEM%>15). Thus, the final suggested test battery for a valid and reliable evaluation of soldiers' muscle performance comprised the following four tests; the Ranger test, dead-lift with kettlebells, chins, and back extension test. The criterion-related validity of the test battery should be further evaluated for soldiers exposed to varying physical workload.

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  • 38. Lindberg, Jonatan
    et al.
    Reiz, Johanna
    Lundin Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    En spark i baken för ett aktivare liv2011Report (Other academic)
    Abstract [sv]

    Efter årtionden av inaktivitet fick några patienter i 60-årsåldern fysisk aktivitet på recept (FaR). Vår studie pekar på att det var ett bra sätt att hjälpa dem att finna motivation och att ta ett första steg mot ett aktivare liv.

  • 39.
    Lundell, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Mian, Louise
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Westerståhl, Maria
    Reasons for being physically active in middle age and longitudinal associations between physical activity and physical capacity2020In: Translational Sports Medicine, ISSN 2573-8488, Vol. 55, no 1, p. 55-62Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate self-reported reasons for being leisure-time physically active (LTPA) at ages 34 and 52 and explore associations between LTPA at age 52 and physical activity, physical capacity, and health earlier in life. Cohort participants answered questions about physical activity and health and performed tests of physical capacity at ages 16, 34, and 52. The most frequently reported reasons for being LTPA or not at ages 34 and 52 were similar. Participants enjoyed being active and health benefits related to physical activity was important. Common barriers were other priorities, disability, and feeling too tired. A significantly higher percentage of those who were LTPA at the ages of 34 and 52 rated their general health to be good when compared to those who were not physically active. Analyses showed that higher muscle strength and endurance at the age of 34 could positively predict LTPA at 52. At ages 34 and 52, the cohort members presented with similar reasons for, and similar barriers to physical activity. Those who were LTPA rated their health better, and there was a significant association between physical capacity at the age of 34 and future physical activity.

  • 40.
    Madison, Guy
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Paulin, Johan
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Musikens positiva kraft2011In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 20, no 1, p. 46-49Article in journal (Other academic)
  • 41.
    Madison, Guy
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Wallert, John
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Woodley, Michael A
    Umeå University, Faculty of Social Sciences, Department of Psychology. Vrije Univ Brussel, Ctr Leo Apostel, Brussels, Belgium.
    Feminist activist women are masculinized in terms of digit-ratio and social dominance: a possible explanation for the feminist paradox2014In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 5, p. 1011-Article in journal (Refereed)
    Abstract [en]

    The feminist movement purports to improve conditions for women, and yet only a minority of women in modern societies self-identify as feminists. This is known as the feminist paradox. It has been suggested that feminists exhibit both physiological and psychological characteristics associated with heightened masculinization, which may predispose women for heightened competitiveness, sex-atypical behaviors, and belief in the interchangeability of sex roles. If feminist activists, i.e., those that manufacture the public image of feminism, are indeed masculinized relative to women in general, this might explain why the views and preferences of these two groups are at variance with each other. We measured the 2D:4D digit ratios (collected from both hands) and a personality trait known as dominance (measured with the Directiveness scale) in a sample of women attending a feminist conference. The sample exhibited significantly more masculine 2D:4D and higher dominance ratings than comparison samples representative of women in general, and these variables were furthermore positively correlated for both hands. The feminist paradox might thus to some extent be explained by biological differences between women in general and the activist women who formulate the feminist agenda.

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  • 42.
    Madison, Guy
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Paulin, Johan
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Physical and psychological effects from supervised aerobic music exercise2013In: American Journal of Health Behavior, ISSN 1087-3244, E-ISSN 1945-7359, Vol. 37, no 6, p. 780-793Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To assess the physical and psychological effects across 11 weeks of music-exercise sessions, the participants' training experience, and attitudes towards physical activity. The effect of different music information was also investigated.

    METHODS: Overall, 146 sedentary volunteers were randomized into 4 exercise groups and each group received different music information. Physical capacity and psychological measures were obtained.

    RESULTS: Increased performance in oxygen uptake and flexibility and decreased blood pressure was found. Participants reported increased wellbeing and body-awareness, and an intention to remain physically active. No differences between groups were found.

    CONCLUSION: Music-exercise can be recommended to promote physical activity among sedentary individuals. The amount of musical information in synchronous music seems not to have any effects on self-selected intensity or physiological benefits.

  • 43. Michaelson, Peter
    et al.
    Holmberg, David
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: a randomized controlled trial with 24-month follow-up2016In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, no 5, p. 456-463Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to compare the effects of a high load lifting exercise with low load motor control exercises on pain intensity, disability and health-related quality of life for patients with mechanical low back pain. Design: A randomized controlled trial. Subjects: Patients with mechanical low back pain as their dominating pain mechanism. Methods: The intervention programme consisted of a high load lifting exercise, while the control group received low load motor control exercises over 8 weeks (12 sessions) with pain education included in both intervention arms. The primary outcome was pain intensity and disability, and the secondary outcome was health-related quality of life. Results: Each intervention arm included 35 participants, analysed following 2-, 12- and 24-month follow-up. There was no significant difference between the high load lifting and low load motor control interventions for the primary or secondary outcome measures. Between 50% and 80% of participants reported a decrease in perceived pain intensity and disability for both short-and long-term follow-up. Conclusion: No difference was observed between the high low load lifting and low load motor control interventions. Both interventions included retraining of movement patterns and pain education, which might explain the positive results over time.

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  • 44.
    Olofsson, Patrik
    et al.
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Clinical examination of physical problems in powerlifters: Development and applicability of a physical examination protocol2017Conference paper (Other academic)
  • 45.
    Paulin, Johan
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Madison, Guy
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Musical properties affect aerobic exercise performance2012Conference paper (Refereed)
  • 46.
    Pedrelli, Matteo
    et al.
    Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Translational Science and Experimental Medicine, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
    Parini, Paolo
    Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Metabolism Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Infection, Karolinska University Hospital, Stockholm, Sweden.
    Kindberg, Jonas
    Norwegian Institute for Nature Research, Trondheim, Norway; Swedish University of Agricultural Sciences, Department of Wildlife, Fish, and Environmental Studies, Umeå, Sweden.
    Arnemo, Jon M.
    Swedish University of Agricultural Sciences, Department of Wildlife, Fish, and Environmental Studies, Umeå, Sweden; Department of Forestry and Wildlife Management, Inland Norway University of Applied Sciences, Campus Evenstad, Koppang, Norway.
    Bjorkhem, Ingemar
    Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Westerståhl, Maria
    Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
    Walentinsson, Anna
    Translational Science and Experimental Medicine, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
    Pavanello, Chiara
    Centro Enrica Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy.
    Turri, Marta
    Centro Enrica Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy.
    Calabresi, Laura
    Centro Enrica Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy.
    Öörni, Katariina
    Atherosclerosis Research Laboratory, Wihuri Research Institute, Helsinki, Finland.
    Camejo, Gérman
    Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
    Fröbert, Ole
    Swedish University of Agricultural Sciences, Department of Wildlife, Fish, and Environmental Studies, Umeå, Sweden; Örebro University, Faculty of Health, Department of Cardiology, Örebro, Sweden.
    Hurt-Camejo, Eva
    Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Translational Science and Experimental Medicine, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
    Vasculoprotective properties of plasma lipoproteins from brown bears (Ursus arctos)2021In: Journal of Lipid Research, ISSN 0022-2275, E-ISSN 1539-7262, Vol. 62, article id 100065Article in journal (Refereed)
    Abstract [en]

    Plasma cholesterol and triglyceride (TG) levels are twice as high in hibernating brown bears (Ursus arctos) than healthy humans. Yet, bears display no signs of early stage atherosclerosis development when adult. To explore this apparent paradox, we analyzed plasma lipoproteins from the same 10 bears in winter (hibernation) and summer using size exclusion chromatography, ultracentrifugation, and electrophoresis. LDL binding to arterial proteoglycans (PGs) and plasma cholesterol efflux capacity (CEC) were also evaluated. The data collected and analyzed from bears were also compared with those from healthy humans. In bears, the cholesterol ester, unesterified cholesterol, TG, and phospholipid contents of VLDL and LDL were higher in winter than in summer. The percentage lipid composition of LDL differed between bears and humans but did not change seasonally in bears. Bear LDL was larger, richer in TGs, showed prebeta electrophoretic mobility, and had 5-10 times lower binding to arterial PGs than human LDL. Finally, plasma CEC was higher in bears than in humans, especially the HDL fraction when mediated by ABCA1. These results suggest that in brown bears the absence of early atherogenesis is likely associated with a lower affinity of LDL for arterial PGs and an elevated CEC of bear plasma.

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  • 47.
    Ramji, Rathi
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Paulin, Johan
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Madison, Guy
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Musical information increases physical performance for synchronous but not asynchronous running2016In: Psychology of Music, ISSN 0305-7356, E-ISSN 1741-3087, Vol. 44, no 5, p. 984-995Article in journal (Refereed)
    Abstract [en]

    Given that physical performance is enhanced by listening to music, what information in the music is the active ingredient? Here, we varied the amount of music information in an otherwise identical piece of music, from only the rhythm, through a synthesized and scaled down version, to the full original version. Twenty-two university students (11 males and 11 females) ran for 10 minutes to each of eight conditions, two with white noise, three with music that facilitated synchronization with the running pace, and three with tempi where synchronization was impossible. Dependent variables were distance run and the number of steps, from which stride length was computed. Heart rate and mood (PANAS) were also measured for control purposes. Participants tended to run a greater distance when there was more music information, which was mainly an effect of longer strides rather than a faster stride rate. This effect was stronger in the synchronous conditions. The results suggest that the motivational effects of music information during running is mostly related to richer temporal information conveyed by faster metrical levels, when attempting to synchronize with the beat in the music

  • 48.
    Sandlund, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Björn
    Berglund, Lars
    Aasa, Ulrika
    Classification accuracy of motor control tests of the lumbar spine for subgroups of mechanical low back pain2012In: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 42, no 10, p. A57-A57Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate the classification accuracy of motor control testsof the lumbar spine in discriminating 5 subgroups of peripherally mediated mechanical low back pain (LBP) suggested in the classification system developed by Peter O’Sullivan.

    RELEVANCE: Identifying clinically relevant subgroups is considered a prioritized area of LBP research. The current study addresses the issue of using accurate, reliable, and standardized tests to guide such classifications.

    METHODS: Seventy subjects with nonspecific LBP were classified by anexpert clinician into 5 subgroups based on the direction of motor control impairment and the assumed mechanism underlying the pain disorder (ie, flexion, lateral shift, active extension, passive extension, andmultidirectional pattern). Thereafter, 5 standardized tests of motor control were performed under the supervision of 2 therapists blinded tothe subgroup classification: “waiters bow,” bilateral and unilateral sitting knee extension, and bilateral and unilateral prone knee flexion. Alack of ability to prevent a compensatory movement (motion give) when instructed to maintain neutral lumbar posture was judged as test failure. Multinomial logistic regression was used to analyze the association between tests and subgroups and to determine the tests’ joint classification accuracy.

    RESULTS: The motor control tests showed significant associations to thedifferent subgroups (χ2 = 37.08, P = .002, Nagelkerke pseudo R2 = 0.431)and displayed significant discriminative ability, increasing the classification accuracy substantially, 95% above chance level overall, and for allsubgroups except for the multidirectional pattern. The different subgroups were characterized by different association patterns, indicating different tests to be important for different subgroups.

    CONCLUSIONS AND CLINICAL IMPLICATIONS: The results indicate a clinical utility of the motor control tests and suggest them to be useful to supplement in subgroup classification of what traditionally have been considered nonspecific mechanical LBP. The findings also support the clinical validity of the approach to subgroup patients according to the direction of motorcontrol impairment.

  • 49.
    Sjöberg, Henrik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Adolf Fredriks Fysiocenter, Physical Therapy Clinic, Stockholm, Sweden.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rosengren, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Adolf Fredriks Fysiocenter, Physical Therapy Clinic, Stockholm, Sweden.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Content validity index and reliability of a new protocol for evaluation of lifting technique in the powerlifting squat and deadlift2020In: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 34, no 9, p. 2528-2536Article in journal (Refereed)
    Abstract [en]

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

  • 50.
    Strömbäck, Edit
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Prevalence and consequences of injuries in powerlifting: a cross-sectional study2018In: The Orthopaedic Journal of Sports Medicine, ISSN 2325-9671, Vol. 6, no 5, article id 2325967118771016Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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