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  • 1.
    Blomqvist, Sven
    et al.
    Gävle Högskola.
    Lönnberg, Lisa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Skolverket.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Physical Exercise Frequency Seem not to Influence Postural Balance but Trunk Muscle Endurance in Young Persons with Intellectual Disability2017In: Journal of Physical Education and Sports Management, ISSN 2373-2156, E-ISSN 2373-2164, Vol. 4, no 2, p. 38-47Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 2.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Olsson, Josefine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wallin, Louise
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Adolescents with intellectual disability have reduced postural balance and muscle performance in trunk and lower limbs compared to peers without intellectual disability2013In: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 34, no 1, p. 198-206Article in journal (Refereed)
    Abstract [en]

    For adolescent people with ID, falls are more common compared to peers without ID. However, postural balance among this group is not thoroughly investigated. The aim of this study was to compare balance and muscle performance among adolescents aged between 16 and 20 years with a mild to moderate intellectual disability (ID) to age-matched adolescents without ID. A secondary purpose was to investigate the influence of vision, strength, height and Body Mass Index (BMI) on balance. A group of 100 adolescents with ID and a control group of 155 adolescents without ID were investigated with five balance tests and three strength tests: timed up and go test, one leg stance, dynamic one leg stance, modified functional reach test, force platform test, counter movement jump, sit-ups, and Biering-Sorensen trunk extensor endurance test. The results showed that adolescents with an ID in general had significantly lower scores in the balance and muscle performance tests. The group with ID did not have a more visually dominated postural control compared to the group without ID. Height, BMI or muscle performance had no strong correlations with balance performance. It appears as if measures to improve balance and strength are required already at a young age for people with an ID. 

  • 3. Blomqvist, Sven
    et al.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Validity and reliability of the Dynamic One Leg Stance (DOLS) in people with vision loss2007In: Advances in physiotherapy, ISSN 1403-8196, Vol. 9, no 3, p. 129-135Article in journal (Refereed)
  • 4.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Skolverket.
    Persson, Elin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundkvist, Hillevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postural stability, physical activity, aerobic capacity and their associations for young people with and without intellectual disabilities2014In: European Journal of Adapted Physical Activity, ISSN 1803-3857, E-ISSN 1803-3857, Vol. 7, no 1, p. 22-30Article in journal (Other academic)
    Abstract [en]

    Previous studies show that people with intellectual disability (ID) appear to have impaired postural stability, a lower level of physical activity, and lower aerobic capacity compared to persons without ID, limitations that could affect their health. This study investigates these physical functions and their associations in a group of young people with ID compared to an age-matched group without ID. In total, this cross-sectional study included 106 high school students (16-20 years): 57 students with mild to moderate ID and 49 agematched students without ID (control group). Tests were performed for postural stability, level of physical activity, and aerobic capacity. Both females and males with ID had significantly lower estimated maximum oxygen uptake (l O2/min) (p< 0.001 for females and p=0.004 for males) and a lower aerobic capacity expressed relative to body weight (ml O2/ kg*min) (p< 0.001 for females and p=0.012 for males) compared to age-matched peers. Analyses of associations were made using the Pearson’s correlation coefficient and multivariate linear regression analysis. No significant associations could be found. Physical status appears impaired for young people with ID and functions, such as postural stability, should be evaluated separately

  • 5.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Skolverket.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postural muscle responses and adaptations to backward platform perturbations in young people with and without intellectual disability2014In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 39, no 3, p. 904-908Article in journal (Refereed)
    Abstract [en]

    This study examines postural muscle responses to backward perturbations in young people with and without intellectual disability (ID). The study included 56 young people with ID and 43 age-matched without ID volunteers. The subjects stood on a platform that was moved backwards in a surface translation. Lower and upper leg muscles and lower back spine muscles were recorded with surface electromyography (EMG). Muscle onset latency, time to peak amplitude (EMG), adaption of muscle responses to repeated perturbations (using IEMG for epochs), and synergies and strategies were assessed. The result showed no differences between the two groups in muscle onset latency, time to peak amplitude, synergies, and strategies. However, young people with ID tended to adapt their IEMG less compared to the controls. These findings suggest that young people with ID have limited ability to adapt their postural muscle responses to repeated perturbations.

  • 6.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Test-retest reliability, smallest real difference and concurrent validity of six different balance tests on young people with mild to moderate intellectual disability2012In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 98, no 4, p. 313-319Article in journal (Refereed)
    Abstract [en]

    Objectives Some studies have reported that people with intellectual disability may have reduced balance ability compared with the population in general. However, none of these studies involved adolescents, and the reliability and validity of balance tests in this population are not known. The purpose of this study was to examine the reliability of six different balance tests and to investigate their concurrent validity.

    Design Test-retest reliability assessment.

    Settings All subjects were recruited from a special school for people with intellectual disability in Bollnas, Sweden.

    Participants Eighty-nine adolescents (35 females and 54 males) with mild to moderate intellectual disability with a mean age of 18 years (range 16 to 20 years).

    Interventions All subjects followed the same test protocol on two occasions within an 11-day period.

    Main outcomes Balance test performances.

    Results Intraclass correlation coefficients greater than 0.80 were achieved for four of the balance tests: Extended Timed Up and Go Test, Modified Functional Reach Test, One-leg Stance Test and Force Platform Test. The smallest real differences ranged from 12% to 40%; less than 20% is considered to be low. Concurrent validity among these balance tests varied between no and low correlation.

    Conclusion The results indicate that these tests could be used to evaluate changes in balance ability over time in people with mild to moderate intellectual disability. The low concurrent validity illustrates the importance of knowing more about the influence of various sensory subsystems that are significant for balance among adolescents with intellectual disability.

    (C) 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  • 7.
    Larsson, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Blomqvist, Sven
    Gävle Högskola.
    Muscle function among healthy adult athletes before and after a postural balance training period2016In: Jacobs Journal of Sports Medicine, Vol. 3, no 2, article id 021Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 8.
    Lundell, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Holmner, Åsa
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Telehealthcare in COPD: a systematic review and meta-analysis on physical outcomes and dyspnea2015In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 109, no 1, p. 11-26Article, review/survey (Refereed)
    Abstract [en]

    Background: Only a minority of patients with chronic obstructive pulmonary disease (COPD) have access to pulmonary rehabilitation (PR). Home-based solutions such as telehealthcare, have been used in efforts to make PR more available. The aim of this systematic review was to investigate the effects of telehealthcare on physical activity level, physical capacity and dyspnea in patients with COPD, and to describe the interventions used. 

    Methods: Randomized controlled trials were identified through database searches, reference lists and included authors. Articles were reviewed based on eligibility criteria by three authors. Risk of bias was assessed by two authors. Standardized mean differences (SMD) or mean differences (MD) with 95% CI were calculated. Forest plots were used to present data visually.

    Results: Nine studies (982 patients) were included. For physical activity level, there was a significant effect favoring telehealthcare (MD, 64.7 min; 95% CI, 54.4-74.9). No difference between groups was found for physical capacity (MD, -1.3 m; 95% CI, -8.1-5.5) and dyspnea (SMD, 0.088; 95% CI, -0.056-0.233). Telehealthcare was promoted through phone calls, websites or mobile phones, often combined with education and/or exercise training. Comparators were ordinary care, exercise training and/or education. 

    Conclusions: The use of telehealthcare may lead to improvements in physical activity level, although the results should be interpreted with caution given the heterogeneity in studies. This is an important area of research and further studies of the effect of telehealthcare for patients with COPD would be beneficial.

  • 9.
    Lundell, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tistad, Malin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. School of Education, Health and Social Studies, Dalarna University, Sweden.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wiklund, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Holmner, Åsa
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Building COPD care on shaky ground: a mixed methods study from Swedish primary care professional perspective2017In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, article id 467Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 10. Milosavljevic, Stephan
    et al.
    Bagheri, Nasser
    Vasiljev, Radivoj M
    McBride, David I
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Does daily exposure to whole-body vibration and mechanical shock relate to the prevalence of low back and neck pain in a rural workforce?2012In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 56, no 1, p. 10-17Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To determine whether whole-body vibration (WBV) and mechanical shock exposure from quad bike use are associated with the prevalence of neck and low back pain (LBP) in New Zealand farmers and rural workers.

    METHODS: Full-day WBV and mechanical shock exposures were gathered from 130 farmers and rural workers. Participants were surveyed for a history of neck or LBP in the past 7 days and in the past 12 months. Anthropometric, personal, and workplace data were also gathered.

    RESULTS: Physical exposures (mechanical shocks), employee status, and low levels of workplace satisfaction are all significantly associated with the 12-month prevalence of LBP in this rural workforce that regularly use quad bikes. Both vibration and mechanical shock exposure were strongly associated with 12-month prevalence of neck pain. The 7-day prevalence of neck pain showed a non-significant association with mechanical shock and vibration.

    CONCLUSIONS: Knowledge of these findings will be valuable information for those who teach and advise on safe driving techniques for such vehicles in the rural workplace where reduction of physical exposures and injury rates is of high importance.

  • 11. Milosavljevic, Stephan
    et al.
    Bergman, Frida
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Carman, Allan B
    All-terrain vehicle use in agriculture: Exposure to whole body vibration and mechanical shock2010In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 41, no 4, p. 530-535Article in journal (Refereed)
    Abstract [en]

    Whole body vibration (WBV) and mechanical shock were measured in 12 New Zealand farmers during their daily use of all-terrain vehicles (ATVs). As per the International Organization for Standardization (ISO) guidelines for WBV exposure, frequencies between 0 and 100Hz were recorded via a seat-pad tri-axial accelerometer during 20min of ATV use. The farmers were also surveyed to estimate seasonal variation in daily ATV usage as well as 7-day and 12-month prevalence of spinal pain. Frequency-weighted vibration exposure and total riding time were calculated to determine the daily vibration dose value (VDV). The daily VDV of 16.6m/s(1.75) was in excess of the 9.1m/s(1.75) action limit set by ISO guidelines suggesting an increased risk of low back injury from such exposure. However, the mean shock factor R, representing cumulative adverse health effects, was 0.31 indicating that these farmers were not exposed to excessive doses of mechanical shock. Extrapolation of daily VDV data to estimated seasonal variations of farmers in ATV riding time demonstrated that all participants would exceed the ISO recommended maximum permissible limits during the spring lambing season, as compared to lower exposures calculated for summer, autumn and winter. Low back pain was the most commonly reported complaint for both 7 day (50%) and 12 month prevalence (67%), followed by the neck (17% and 42%) and the upper back (17% and 25%) respectively. The results demonstrate high levels of vibration exposure within New Zealand farmers and practical recommendations are needed to reduce their exposure to WBV.

  • 12. Milosavljevic, Stephan
    et al.
    Mani, Ramakrishnan
    Ribeiro, Daniel Cury
    Vasiljev, Radivoj
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Exploring how anthropometric, vehicle and workplace factors influence whole-body vibration exposures during on-farm use of a quad bike2012In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 42, no 4, p. 392-396Article in journal (Refereed)
    Abstract [en]

    The primary aim of this study is to determine whether a combination of body height, terrain and vehicle mechanical factors confound for the effect of body mass on WBV exposure while using a quad bike under normal rural working conditions. A seat pad mounted triaxial accelerometer and data logger recorded full work day vibration and shock data from 130 New Zealand rural workers. Personal, vehicle and workplace characteristics were gathered using a modified version of the Whole Body Vibration Health Surveillance Questionnaire. Whole-body vibrations were analysed in accordance with the ISO 2631-1 and ISO 2631-5 standards and it is presented as one hour vibration dose value in the Z-direction (1 h VDVZ). Body mass did not demonstrate any significant bivariate association (P > 0.20) with I h VDVZ. However BMI, body height, vehicle weight, sheep farm, dairy farm, 2 shock absorber solid axle rear suspension, flat farmland and engine capacity (cc) all demonstrated threshold bivariate associations (P <= 0.20) with 1 h VDVZ. Body mass, body height, 2 shock absorber solid rear axle suspension, and working on a sheep farm created the strongest multiple regression model explaining 16% of variance in VDVZ. Relevance to industry: The influence of driver's body mass on vibration exposure is strongly influenced by work environment and vehicle mechanical factors and this should be taken in to consideration for research that explores exposures and/or designing seating and suspension systems to attenuate vibration exposures in small on-farm vehicles. (C) 2012 Elsevier B.V. All rights reserved.

  • 13. Milosavljevic, Stephan
    et al.
    McBride, David I.
    Bagheri, Nasser
    Vasiljev, Radivoj M.
    Carman, Allan B.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Moore, Dave
    Factors associated with quad bike loss of control events in agriculture2011In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 41, no 3, p. 317-321Article in journal (Refereed)
    Abstract [en]

    Objective: To determine personal and workplace factors associated with quad bike loss of control events (LCEs) on New Zealand farms. Methods: Rural community databases were used to sample 130 farmers and farm employees (workers). Fieldwork and survey investigated for prevalence of LCEs; farm type; farm terrain; personal measures; and vehicle driving exposures. Results: Seventy nine workers (61%) described a total of 200 LCEs. Increased driver height, increased body mass, non-flat farm terrain, increased driving speed and distance, and greater whole body vibration exposure were significantly associated with LCEs. Conclusions: Taller and heavier drivers of quad bikes should be particularly vigilant for risk of an ICE. Vehicle speed, distance driven and choice of driving routes over difficult terrain are potentially modifiable factors which have behavioural components and should be considered as management strategies for reducing risk of on-farm quad bike LCEs. Relevance to industry: Quad bike accidents are a considerable problem in agriculture. This research has identified a number of physical and driving factors that should be considered in the management strategies for reducing risk of on-farm quad bike accidents. (C) 2011 Elsevier B.V. All rights reserved.

  • 14. Milosavljevic, Stephan
    et al.
    McBride, David I
    Bagheri, Nasser
    Vasiljev, Radivoj M
    Mani, Ramakrishnan
    Carman, Allan B
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Exposure to whole-body vibration and mechanical shock: a field study of quad bike use in agriculture2011In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 55, no 3, p. 286-295Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The purpose of this study was to determine exposure to whole-body vibration (WBV) and mechanical shock in rural workers who use quad bikes and to explore how personal, physical, and workplace characteristics influence exposure.

    METHODS: A seat pad mounted triaxial accelerometer and data logger recorded full workday vibration and shock data from 130 New Zealand rural workers. Personal, physical, and workplace characteristics were gathered using a modified version of the Whole Body Vibration Health Surveillance Questionnaire. WBVs and mechanical shocks were analysed in accordance with the International Standardization for Organization (ISO 2631-1 and ISO 2631-5) standards and are presented as vibration dose value (VDV) and mechanical shock (S(ed)) exposures.

    RESULTS: VDV(Z) consistently exceeded European Union (Guide to good practice on whole body vibration. Directive 2002/44/EC on minimum health and safety, European Commission Directorate General Employment, Social Affairs and Equal Opportunities. 2006) guideline exposure action thresholds with some workers exceeding exposure limit thresholds. Exposure to mechanical shock was also evident. Increasing age had the strongest (negative) association with vibration and shock exposure with body mass index (BMI) having a similar but weaker effect. Age, daily driving duration, dairy farming, and use of two rear shock absorbers created the strongest multivariate model explaining 33% of variance in VDV(Z). Only age and dairy farming combined to explain 17% of the variance for daily mechanical shock. Twelve-month prevalence for low back pain was highest at 57.7% and lowest for upper back pain (13.8%).

    CONCLUSIONS: Personal (age and BMI), physical (shock absorbers and velocity), and workplace characteristics (driving duration and dairy farming) suggest that a mix of engineered workplace and behavioural interventions is required to reduce this level of exposure to vibration and shock.

  • 15.
    Rehn, B
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Nilsson, T
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Lundström, R
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Hagberg, M
    Burström, L
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Neck pain combined with arm pain among professional drivers of forest machines and the association with whole-body vibration exposure.2009In: Ergonomics, ISSN 1366-5847, Vol. 52, no 10, p. 1240-7Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate the existence of neck pain and arm pain among professional forest machine drivers and to find out if pain were related to their whole-body vibration (WBV) exposure. A self-administered questionnaire was sent to 529 forest machine drivers in northern Sweden and the response was 63%. Two pain groups were formed; 1) neck pain; 2) neck pain combined with arm pain. From WBV exposure data (recent measurements made according to ISO 2631-1, available information from reports) and from the self-administered questionnaire, 14 various WBV exposure/dose measures were calculated for each driver. The prevalence of neck pain reported both for the previous 12 months and for the previous 7 d was 34% and more than half of them reported neck pain combined with pain in one or both arms. Analysis showed no significant association between neck pain and high WBV exposure; however, cases with neck pain more often experienced shocks and jolts in the vehicle as uncomfortable. There was no significant association between the 14 WBV measures and type of neck pain (neck pain vs. neck pain combined with arm pain). It seems as if characteristics of WBV exposure can explain neither existence nor the type of neck pain amongst professional drivers of forest machines. The logging industry is important for several industrialised countries. Drivers of forest machines frequently report neuromusculoskeletal pain from the neck. The type of neck pain is important for the decision of treatment modality and may be associated with exposure characteristics at work.

  • 16.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Clinical exercise pathophysiology for physical therapy: Examination, testing, and exercise prescription for movement-related disorders2017In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 19, no 2, p. 116-116Article, book review (Other academic)
  • 17.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Musculoskeletal disorders and whole-body vibration exposure among professional drivers of all-terrain vehicles2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Musculoskeletal disorders are common among professional driver groups. Ergonomic risk factors at work are often suggested as causative, aggravating or preserving. The general aim with this thesis is to investigate the association between musculoskeletal disorders and physical exposure with special with special focus on whole-body vibration (WBV), among professional drivers of all-terrain vehicles (ATVs). Drivers of ATVs are expsosed to high magnitudes of WBV and shock. This thesis included drivers of forest machines, snowgroomers and snowmobiles. A cross-sectional study revealed that ATV drivers had an increased risk of musculoskeletal symptoms in the neck-shoulder and thoracic regions, even after adjusting for age, smoking habits and psychosocial stress. Prevalence rates were in the range of 1.5-2.9 (CI:1.2-5.2) compared to an age-matched group from the general population. No group of ATV drivers had a significantly increased risk of low back pain. Trend analysis showed no association between symptoms and exposure time. A clinical investigation of a subgroup found that it was for ATV drivers with neck pain to have assymetrical and focal neuropathies, pure or in mix with a nociceptive disorder, in the neck and upper extremities (47-79%), which was in contrast to referents with neck pain who had more nociceptive disorders (27% prevalence of neuropathy). Two studies measured characteristics of seated WBV exposure in forest machines (forwarders), snowgroomers and snowmobiles. The magnitudes of WBV in ATVs, measured and analyzed according to ISO 2631-1, were between 0.5-3.5 m/s2 (frequency weighted vector sum), which was considered high compared to limits suggested by the international standard ISO 2631-1 and the physical agent directive from the Euoropean Union (0.5 m/s2, rms). Drivers of ATVs were exposed to horizontally directed WBV and shocks. Non-neutral neck postures are ergonomic risk factors that occured infrequently and with short duration. The magnitude of seated WBV in forwarder vehicles varied substantiálly depending on model, terrain condition and driver. This may result in different conclusions regarding health risk assessments. The main conclusion from this thesis is that musculoskeletal symptoms and disorders in the neck and upper extremities, among drivers of ATVs, may be a result of long-time exposure to shock-type and horisozontally oriented seated WBV.

  • 18.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Occurence and type of neck pain among drivers of forest machines and the sociation with whole-body vibration exposere2007In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 93, p. S323-Article in journal (Refereed)
  • 19.
    Rehn, Börje
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Blomqvist, Sven
    Gävle Högskola.
    Fysisk aktivitet och hälsa för personer med utvecklingsstörning: Forskning pågår2015In: Fysioterapi, ISSN 1653-5804, Vol. 1, p. 26-32Article, review/survey (Other academic)
    Abstract [sv]

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

  • 20.
    Rehn, Börje
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hedlund, Mattias
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sandlund, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Flippade klassrum om människokroppens funktion för fysioterapeutstudenter2017Conference paper (Other (popular science, discussion, etc.))
    Abstract [sv]

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

  • 21.
    Rehn, Börje
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lidström, J
    Skoglund, J
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effects on leg muscular performance from whole-body vibration exercise: a systematic review.2007In: Scandinavian journal of medicine & science in sports, ISSN 0905-7188, Vol. 17, no 1, p. 2-11Article in journal (Refereed)
  • 22.
    Rehn, Börje
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Leif
    Umeå University, Faculty of Science and Technology, Mathematical statistics.
    Liljellind, Ingrid
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Variation in exposure to whole-body vibration for operators of forwarder vehicles - aspects on measurement strategies and prevention2005In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 35, no 9, p. 831-842Article in journal (Refereed)
    Abstract [en]

    Exposure to whole-body vibration (WBV) may cause health problems, e.g. lumbago. The risk will depend on intensity and duration. Exposure to WBV in vehicles varies due to several factors as the vehicle type, the terrain condition, the driver, the speed etc. To estimate the health risk, the measurement strategy has to consider this variation. Furthermore, to understand the importance of different preventive strategies, the cause of the variation has to be known. The objective of this study was to describe variation in exposure to seated WBV during occupational operation of forwarder vehicles and to investigate sources for variation. WBV was measured in 10 various terrain types for seven forwarders operated by 11 drivers. For each driver there were between four and 35 measurements. The measurement periods varied between 0.2 and 34 min. The vibration total value (av) and total vibration dose value (VDVt) were determined. Results showed that WBV exposure varied considerably and that this variation could result in different conclusions regarding health risk assessments. The highest magnitudes were achieved during travelling activities. During travelling empty, variations in av were significantly dependent upon forwarder model and terrain type. No significant predictor for variation in VDVt was however found for travelling empty. During travelling loaded the forwarder model and operator were the most important predictors for variation in av. Variation in VDVt was also dependent on the forwarder model during travelling loaded.

  • 23.
    Rehn, Börje
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Bergdahl, Ingvar A
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Ahlgren, Chrisitina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    From, Carin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sundelin, Gunnnevi
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Musculoskeletal symptoms among drivers of all-terrain vehicles2002In: Journal of Sound and Vibration, ISSN 0022-460X, E-ISSN 1095-8568, Vol. 253, no 1, p. 21-29Article in journal (Refereed)
    Abstract [en]

    The aim of this cross-sectional study was to characterize the risk of experiencing musculoskeletal symptoms in the region of the neck, shoulders and upper and lower back for professional drivers of various categories of all-terrain vehicles and to assess the association between symptoms and duration of exposure to whole-body vibration (WBV) and shock from driving all-terrain vehicles. The study group consisted of 215 drivers of forest machines, 137 drivers of snowmobiles and 79 drivers of snowgroomers and a control group of 167 men randomly selected from the general population. The subjects were all from one of the four most northern counties in Sweden and they were all men. Musculoskeletal symptoms were assessed by use of a standardized questionnaire. In addition, the questionnaire held items about the driving time with all-terrain vehicles and a subjective estimation of exposure to unpleasant movements (shock, jolt, irregular sway). The job strain was measured according to Karasek's demands/control model. The prevalence ratios were adjusted for age, smoking and job strain. Among drivers, significantly increased prevalence ratios within the range of 1∂5–2·9 were revealed for symptoms from the neck–shoulder and thoracic regions during the previous year. None of the driver categories had a statistically significantly increased risk of low back pain. Forest vehicles were those most reported to cause unpleasant movements. In conclusion, drivers of all-terrain vehicles exhibit an increased risk of symptoms of musculoskeletal disorders in the neck–shoulder and thoracic regions. The increased risk is suggested to be related to physical factors such as exposure to whole-body vibration (WBV) and shock, static overload or extreme body postures. However, since symptoms of low back pain were not significantly increased, it appears that factors other than WBV would explain the occurrence of symptoms in the group of all-terrain drivers.

  • 24.
    Rehn, Börje
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundström, Ronny
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Tor
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Bergdahl, Ingvar
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Ahlgren, Christin
    From, C
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Symptoms of musculoskeletal disorders among drivers of all-terrain vehicles in northern Sweden2005In: Noise and Vibration Worldwide, ISSN 0957-4565, Vol. 36, no 1, p. 13-18Article in journal (Refereed)
  • 25.
    Rehn, Börje
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nilsson, Peter
    Norgren, Martin
    Effects of whole-body vibration exercise on human bone density - systematic review2008In: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, ISSN 10833196, Vol. 13, no 6, p. 427-433Article in journal (Refereed)
  • 26.
    Rehn, Börje
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Neuromusculoskeletal disorders in the neck and upper extremities among drivers of all-terrain vehicles - a case series.2004In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 5, no 1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The purpose of this study was to investigate whether professional drivers of all-terrain vehicles (ATVs) with neck pain have a different array of neuromusculoskeletal disorders in the neck and upper extremities than a referent group with neck pain from the general population. It is hypothesized that exposure to shock-type vibration and unfavorable working postures in ATVs have the capacity to cause peripheral nervous lesions. METHODS: This study was based on a case series analyzed according to a case-case comparison design. The study population consisted of 60 male subjects, including professional drivers of forest machines (n = 15), snowmobiles (n = 15), snowgroomers (n = 15) and referents from the general population (n = 15) all of whom had reported neck pain in a questionnaire and underwent an extensive physical examination of the neck and upper extremities. Based on symptom history, symptoms and signs, and in some cases chemical, electroneurographical and radiological findings, subjects were classified as having a nociceptive or neuropathic disorder or a mix of these types. RESULTS: The occurrence of asymmetrical and focal neuropathies (peripheral nervous lesion), pure or in a mix with a nociceptive disorder was common among cases in the ATV driver groups (47%-79%). This contrasted with the referents that were less often classified as having asymmetrical and focal neuropathy (27%), but instead had more nociceptive disorders. The difference was most pronounced among drivers of snowgroomers, while drivers of forest machines were more frequently classified as having a nociceptive disorder originating in the muscles. CONCLUSION: This study found a high prevalence of assymetrical and focal neuropathies among drivers with pain in the neck, operating various ATVs. It seems as if exposure to shock-type whole-body vibration (WBV) and appurtenant unfavorable postures in ATVs may be associated to peripheral nervous lesions.

  • 27.
    Rehn, Börje
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Olofsson, Bodil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Whole-body vibration exposure and non-neutral neck postures during occupational use of all-terrain vehicles.2005In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 49, no 3, p. 267-275Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The purpose of this study was to characterize whole-body vibration (WBV) exposure from various all-terrain vehicles (ATVs) like snowgroomers, snowmobiles and forwarders, and to investigate how frequently the drivers' cervical spine is positioned in a non-neutral rotational position during operation. METHODS: Field measurements of WBV were measured according to the international standard ISO 2631-1 in 19 ATVs. Simultaneous recordings of frequency and duration of rotational neck movements exceeding 15 degrees were achieved through an observational method, PEOflex. RESULTS: The sum of the vectors of frequency-weighted r.m.s. acceleration varied between 0.5 and 3.5 m s(-2), which meant that for most vehicles they exceeded the action value stated by the European Union (0.5 m s(r.m.s.)(-2)). In general, snowmobiles achieved the highest vibration total value. The dominant vibration direction for the snowmobile was the x-axis but the z-axis also had relatively high vibration dose values and maximal transient vibration values. The z-axis was the dominant vibration direction for the snowgroomer and the y-axis for the forwarder. Frequency and duration of non-neutral rotational neck postures were relatively low for all driver categories. CONCLUSIONS: Vibration magnitudes in ATVs are considerably high than the EU's action value and the health guidance caution zones in ISO 2631-1. The dominant vibration direction varies depending on the machine type. Duration and frequency of non-neutral rotational positions do not seem to constitute single ergonomic risk factors for musculoskeletal symptoms in the neck among professional drivers of ATVs. However, synergistic effects with other factors are conceivable.

  • 28.
    Rehn, Börje
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stenlund, Tobias
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhberg, Fredrik
    Lindroos, Ola
    Lundström, Ronnie
    Analysis of seated postures using orientation sensors2012Conference paper (Refereed)
  • 29.
    Stenlund, Tobias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Neely, Gregory
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Seated postural neck and trunk reactions to sideways perturbations with or without a cognitive task2015In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 25, no 3, p. 548-556Article in journal (Refereed)
    Abstract [en]

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

  • 30.
    Stenlund, Tobias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lindroos, Ola
    Institutionen för skogens biomaterial och teknologi (SBT), Sveriges lantbruksuniversitet, Umeå.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Neely, Gregory
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Adaptation of postural reactions in seated positions and influence of head posture when exposed to a single sideway perturbation: relevance for driving on irregular terrain2016In: Journal of Novel Physiotherapy and Physical Rehabilitation, ISSN 2455-5487, Vol. 3, no 1, p. 022-029Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 31.
    Stenlund, Tobias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Lindroos, Ola
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Neely, Gregory
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Double-sided Mechanical Shocks Provoke Larger Seated Postural Reactions Compared to Single-Sided Mechanical Shocks2018In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 43, no 8, p. E482-E487Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

    LEVEL OF EVIDENCE: 4.

  • 32.
    Stenlund, Tobias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lindroos, Ola
    Dept. of Forest Biomaterials & Technology, Swedish University of Agricultural Sciences, Sweden.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Inter- and intra-tester reliability when measuring seated spinal postures with inertial sensors2014In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 44, no 5, p. 732-738Article in journal (Refereed)
    Abstract [en]

    Prolonged awkward sitting postures may be associated with neck or back pain, but it is often unclear which specific postures cause most problems and which mechanisms that may underlie the pain. In order to increase the knowledge in this field, it seems crucial first of all to be able to analyse, in depth, different seated spinal postures. A problem is however the lack of reliable and direct measurement methods of the posture, especially for sitting. Recently developed systems with inertial sensor attached along the spine have potential for this purpose. The aim of the present study was therefore to test the reliability of using such a system to assess various seated postures. Inter- and intra-tester as well as intra-subject relative reliability was estimated with intra-class correlation coefficient (ICC). Absolute reliability was estimated with standard error of measurement (SEM) and smallest detectable change (SDC). Ten + ten healthy subjects and four testers participated. Three standardised unsupported seated postures (lumbar lordosis, lumbar kyphosis and neutral posture) and two standing postures (neutral and lumbar kyphosis) were evaluated using five sensors attached to the head, the thorax (high and low), the lumbar spine and the pelvis. The ICC for intra-tester reliability ranged from 0.37 to 0.90, SEM 2.5-12.0 degrees, and SDC 7.1-333 degrees where the largest measurement error was from the head. Intra-tester reliability was higher than inter-tester reliability but not as good as intra-subject reliability. The intra-tester absolute reliability was nevertheless not considered sufficient to distinguish smaller differences. The low reliability may depend on inertial sensor size and attachment but also on the tester's accuracy. This study shows that assessing unsupported seated spinal postures with inertial sensors could be performed with higher reliability if done by the same, rather than different, testers. Relevance to industry: Prolonged awkward seated postures at work may be associated with back and neck pain and should therefore be analysed. Inertial sensor units is a promising tool to measure spinal posture. Smaller sensors attached by one skilled tester directly onto the body will most likely improve assessment in the future. (C) 2014 Elsevier B.V. All rights reserved.

  • 33.
    Sundahl, Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Zetterberg, Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Blomqvist, Sven
    Physical activity levels among adolescent and young adult women and men with and without intellectual disability2016In: JARID: Journal of applied research in intellectual disabilities, ISSN 1360-2322, E-ISSN 1468-3148, Vol. 29, no 1, p. 93-98Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 34.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Neuromusculoskeletal symptoms in the trunk and upper extremities among proffessional drivers of all-terrain vehicles in Sweden2007Conference paper (Other academic)
  • 35.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hand-arm vibration syndrome (HAVS) and musculoskeletal symptoms in the neck and the upper limbs in professional drivers of terrain vehicles: a cross sectional study2006In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 37, no 6, p. 793-799Article in journal (Refereed)
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