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  • 151.
    Flodgren, G
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Hedelin, R
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Henriksson-Larsén, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Bone mineral density in flatwater sprint kayakers.1999Ingår i: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 64, nr 5, s. 374-379Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 152.
    Flodgren, G
    et al.
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Heiden, M
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin.
    Lyskov, E
    Crenshaw, A G
    Characterization of a laboratory model of computer mouse use - applications for studying risk factors for musculoskeletal disorders.2007Ingår i: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 38, nr 2, s. 213-218Artikel i tidskrift (Refereegranskat)
  • 153.
    Flodgren, Gerd
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Effects of low-load repetitive work and mental load on sensitising substances and metabolism in the trapezius muscle2007Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Low-load repetitive work (LLRW) and mental load are important risk factors for the development of workrelated muscle pain. The link between these risk factors and the development of pain is still not understood, but stimulation of chemo-sensitive receptors in the muscle probably plays an important role. It has been suggested that sensitising substances may accumulate in the muscle during LLRW, especially when combined with mental load.

    The overall purpose of this thesis was to try to shed some light on the effects of LLRW on the concentration of sensitising substances (glutamate, prostaglandin E2 (PGE2), norepinephrine (NE)) and on metabolism (lactate, pyruvate and oxygenation) in the trapezius muscle of healthy controls (CON) and subjects with trapezius myalgia (TM).

    A first step was to investigate whether females with TM exhibit higher absolute concentrations of glutamate and PGE2 in the affected muscle during rest. Using Microdialysis (MD) females with TM and asymptomatic controls were studied during four hours of rest. [Glutamate] and [PGE2] during rest did not differ between groups.

    A second step was to investigate, in a simulated occupational setting, the effects of LLRW on the concentration of sensitising substances and metabolism in the trapezius muscle of TM and CON, and whether increased work duration resulted in a progressive effect. Asymptomatic females were studied during baseline rest, 30 versus 60 min work and recovery, using MD and near infrared spectroscopy (NIRS). Subjects with TM were studied during baseline rest, 30 min work and recovery. [Glutamate] and [lactate] increased in response to work, but not progressively with increased work duration. [Glutamate] was at all time points significantly lower in TM. [PGE2]and oxygenation remained unchanged during work for CON, while for TM oxygenation decreased significantly during work. In TM [pyruvate] increased during both work and recovery, and a significant interaction between groups was found for [pyruvate] during recovery; while moderately increased in CON it increased progressively in TM.

    The effects of LLRW with and without superimposed mental load on intramuscular [NE], muscle activity and oxygen saturation in the trapezius were also investigated and compared. Using MD, electromyography and NIRS, healthy females were studied on two occasions; during 30 min LLRW and during 30 min LLRW with superimposed mental load. During work [NE], and muscle activity, were increased, while oxygenation decreased, but no differences between occasions. However, recovery of [NE] to baseline was slower after LLRW with superimposed mental load. The findings of the present thesis suggest: (i) no inflammation, or increased interstitial [glutamate] in TM; (ii) LLRW causes an increased anaerobic metabolism in both TM and CON; (iii) no effect of work duration was found; (iv) a significant difference in the effects of LLRW on the interstitial milieu of the trapezius muscle in TM as compared to CON; (v) LLRW causes a significant increase in [NE], but superimposed mental load does not cause a further increase; (vi) LLRW with a superimposed mental load may result in a slower recovery to baseline [NE] as compared with LLRW alone.

  • 154.
    Flodgren, Gerd
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Crenshaw, AG
    Hellström, FB
    Fahlström, M
    Effects of low-load work on sensitising substances and muscle metabolism in trapezius myalgia: determined with microdialysis and near infrared spectroscopyArtikel i tidskrift (Refereegranskat)
  • 155.
    Flodgren, Gerd
    et al.
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Crenshaw, AG
    Hellström, FB
    Fahlström, M
    Effects of low-load work on sensitising substances and muscle metabolism in trapezius myalgia: determined with microdialysis and near infrared spectroscopyArtikel i tidskrift (Refereegranskat)
  • 156.
    Flodgren, Gerd
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Hellström, FB
    Fahlström, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Crenshaw, AG
    Effects of 30 versus 60 minutes of low-load work on intramuscular lactate, pyruvate, glutamate, prostaglandin E2 and oxygenation in the trapezius muscle of healthy females2006Ingår i: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 97, nr 5, s. 557-565Artikel i tidskrift (Refereegranskat)
  • 157.
    Flodgren, Gerd M
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Crenshaw, Albert G
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin. Idrottsmedicin.
    Fahlström, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Hellström, Fredrik B
    Bronemo, Lars
    Djupsjöbacka, Mats
    Glutamate and prostaglandin E2 in the trapezius muscle of female subjects with chronic muscle pain and controls determined by microdialysis.2005Ingår i: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 9, nr 5, s. 511-515Artikel i tidskrift (Refereegranskat)
  • 158.
    Flodgren, Gerd M
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Crenshaw, Albert G
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin. Idrottsmedicin.
    Fahlström, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Hellström, Fredrik B
    Bronemo, Lars
    Djupsjöbacka, Mats
    Glutamate and prostaglandin E2 in the trapezius muscle of female subjects with chronic muscle pain and controls determined by microdialysis.2005Ingår i: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 9, nr 5, s. 511-515Artikel i tidskrift (Refereegranskat)
  • 159.
    Flodgren, Gerd M
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Crenshaw, Albert G
    Hellström, Fredrik
    Fahlström, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Combining microdialysis and near-infrared spectroscopy for studying effects of low-load repetitive work on the intramuscular chemistry in trapezius myalgia.2010Ingår i: Journal of Biomedicine and Biotechnology, ISSN 1110-7243, E-ISSN 1110-7251, Vol. 2010, s. 513803-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Epidemiological research provides strong evidence for a link between repetitive work (RW) and the development of chronic trapezius myalgia (TM). The aims were to further elucidate if an accumulation of sensitising substances or impaired oxygenation is evident in painful muscles during RW. Females with TM (n = 14) were studied during rest, 30 minutes RW and 60 minutes recovery. Microdialysate samples were obtained to determine changes in intramuscular microdialysate (IMMD) [glutamate], [PGE(2)], [lactate], and [pyruvate] (i.e., [concentration]) relative to work. Muscle oxygenation (%StO(2)) was assessed using near-infrared spectroscopy. During work, all investigated substances, except PGE(2), increased significantly: [glutamate] (54%, P < .0001), [lactate] (26%, P < .005), [pyruvate] (19%, P < .0001), while the %StO(2) decreased (P < .05). During recovery [PGE(2)] decreased (P < .005), [lactate] remained increased (P < .001), [pyruvate] increased progressively (P < .0001), and %StO(2) had returned to baseline. Changes in substance concentrations and oxygenation in response to work indicate normal increase in metabolism but no ongoing inflammation in subjects with TM.

  • 160.
    Forsgren, Sture
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Bjur, Dennis
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Rantapää-Dahlqvist, Solbritt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Reumatologi.
    Norrgård, Örjan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Dalén, Tore
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Danielson, Patrik
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Novel information on the non-neuronal cholinergic system in orthopedics provides new possible treatment strategies for inflammatory and degenerative diseases2009Ingår i: Orthopedic Reviews, ISSN 2035-8237, Vol. 1, nr 1, s. 39-46Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Anti-cholinergic agents are used in thetreatment of several pathological conditions.Therapy regimens aimed at up-regulatingcholinergic functions, such as treatment withacetylcholinesterase inhibitors, are also currentlyprescribed. It is now known that not onlyis there a neuronal cholinergic system but alsoa non-neuronal cholinergic system in variousparts of the body. Therefore, interference withthe effects of acetylcholine (ACh) broughtabout by the local production and release ofACh should also be considered. Locally producedACh may have proliferative, angiogenic,wound-healing, and immunomodulatory functions.Interestingly, cholinergic stimulationmay lead to anti-inflammatory effects. Withinthis review, new findings for the locomotorsystem of a more widespread non-neuronalcholinergic system than previously expectedwill be discussed in relation to possible newtreatment strategies. The conditions discussedare painful and degenerative tendon disease(tendinopathy/tendinosis), rheumatoid arthritis,and osteoarthritis.

  • 161.
    Forsgren, Sture
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Bjur, Dennis
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Danielson, Patrik
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Den kroniskt smärtande senan - histopatologi.2007Ingår i: Idrottsskador - frontlinjen inom behandling och rehablitering, s. 267-274Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    I denna artikel belyses de morfologiska förändringar man ser i Achilles- och patellarsena vid tendinos. Fokus riktas inte minst på nya fynd avseende utseenden för sencellerna (tenocyterna). Vidare ges en kortfattad beskrivning av vad man idag känner till avseende nervrelaterade aspekter för dessa senor hos människa. Det är sannolikt att kunskap om dessa är viktig för att man rätt ska förstå de smärtsymptom som föreligger vid tendinos och även de effekter som nyare tids behandlingar har vid dessa kroniska smärttillstånd.

  • 162.
    Forsgren, Sture
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Bjur, Dennis
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Danielson, Patrik
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Förändringar i kroniskt smärtande sena.2006Ingår i: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 25, nr 3, s. 8-10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Vad känner man till om de förändringar som sker i en kroniskt smärtande sena?

    Hur ser sencellerna ut och hur påverkas nerverna vid tendinos? I denna sammanställning kommer de förändringar man ser i Akilles- och patellarsena vid tendinos att belysas. Fokus riktas inte minst på nya fynd avseende utseenden för sencellerna (tenocyterna). Vidare ges en kortfattad beskrivning av vad man idag känner till avseende nervrelaterade aspekter för dessa senor hos människa. Det är sannolikt att kunskap om dessa är viktig för att man rätt ska förstå de smärtsymptom som föreligger vid tendinos och även de effekter som nyare tids behandlingar har vid dessa kroniska smärttillstånd.

  • 163.
    Forsgren, Sture
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Danielson, Patrik
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi. Anatomi.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Vascular NK-1 receptor occurrence in normal and chronic painful Achilles and patellar tendons: studies on chemically unfixed as well as fixed specimens.2005Ingår i: Regulatory Peptides, ISSN 0167-0115, E-ISSN 1873-1686, Vol. 126, nr 3, s. 173-181Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    It is not known as to whether the Achilles and patellar tendons contain neurokinin-1 (NK-1) receptors. This is a drawback when considering the fact that pain symptoms are frequent in these and as recent studies show that the pain symptoms might be cured via interference with blood vessel function. In the present study, the human Achilles and patellar tendons were examined concerning immunohistochemical expression of the NK-1 receptor. Chemically unfixed and fixed specimens, TRITC and PAP stainings and a battery of NK-1 receptor antibodies, including antibodies against the C-terminus and the N-terminal region, were utilized. NK-1 receptor immunoreaction could be detected in inner parts of the walls of large blood vessels and in the walls of small blood vessels. To some extent, NK-1 immunoreaction was also detectable in small nerve fascicles and in tenocytes. It was found to be of utmost importance to apply both chemically unfixed and fixed specimens. The use of chemically unfixed tissue was found advantageous in order to depict the immunoreactions in the blood vessel walls. The observations represent new findings and are of relevance as substance P (SP) is known to be of importance where neurogenic angiogenesis contributes to diseases and as SP on the whole has profound effects concerning blood vessel regulation.

  • 164.
    Forsgren, Sture
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Spang, Christoph
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    In mid-portion Achilles tendinosis the plantaris tendon shows the same tendinosis-like morphological features and expression of the non-neuronal cholinergic system as the Achilles tendon itself2013Ingår i: International journal of experimental pathology (Print), ISSN 0959-9673, E-ISSN 1365-2613, Vol. 94, nr 4, s. A3-A3Artikel i tidskrift (Övrigt vetenskapligt)
  • 165.
    Gaida, J
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi. School of Primary Health Care, Monash University, Melbourne, Australia.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Forsgren, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Cook, J
    School of Primary Health Care, Monash University, Melbourne, Australia.
    Decreased tumour necrosis factor alpha (tnf-a) in serum of patients with achilles tendinopathy: further evidence against the role of inflammation in the chronic stage2014Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 48, nr 7, s. 597-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Altered expression of several cytokines and growth factors has been shown in biopsies of tendinopathy tissue. Biopsy studies are however challenged by capacity to obtain i) healthy tissue for comparison, ii) multiple samples to monitor cytokine dynamics, and iii) tissue from recent onset tendinopathy. An alternative is to study cytokines in blood samples. Whether cytokines in blood samples reflect tissue levels and the degree of tendinopathy is unknown.

    OBJECTIVE: To measure serum concentration of six cytokines and growth factors suggested to have a role in tendon response to load among individuals with chronic Achilles tendinopathy and controls.

    DESIGN: In this cross-sectional study, serum cytokine concentrations were measured from fasting blood samples on the BioPlex-200.

    SETTING: Sports Medicine Unit, Umeå University.

    PARTICIPANTS: Participants were recreationally active individuals. Achilles tendinopathy (n=22) was diagnosed on clinical criteria and confirmed with ultrasound examination. The control group (n=10) had no history of tendon pain and had normal ultrasound findings.

    INDEPENDENT VARIABLES: Serum concentration of tumour necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), basic fibroblast growth factor (bFGF), platelet derived growth factor BB (PDGF-BB), interferon gamma (IFN-γ), and vascular-derived endothelial growth factor (VEGF) were the independent variables.

    MAIN OUTCOME MEASUREMENTS: A diagnosis of Achilles tendinopathy (yes/no) was defined as the key outcome variable prior to data collection.

    RESULTS: TNF-α concentration was lower in the tendinopathy group than the control group (P=.018); there were no other group differences.

    CONCLUSIONS: The observations indicate a lowering of the TNF-α concentration in the chronic phase of Achilles tendinopathy. As TNF-α levels are elevated in chronic inflammatory conditions, this reinforces that chronic Achilles tendinopathy is not an inflammatory disorder. Collecting a blood sample to study disease biomarkers leaves the tendon intact and therefore this design can be used to study cytokine dynamics with multiple sampling during disease progression and recovery.

  • 166.
    Gaida, James E.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi. University of Canberra Research Institute for Sport and Exercise (UCRISE); Discipline of Physiotherapy, University of Canberra.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering. Institute of Sport Exercise and Health, University College Hospital London.
    Forsgren, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Cook, Jill L.
    A pilot study on biomarkers for tendinopathy: lower levels of serum TNF-alpha and other cytokines in females but not males with Achilles tendinopathy2016Ingår i: BMC Sports Science Medicine and Rehabilitation, ISSN 2052-1847, Vol. 8, artikel-id 5Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Achilles tendinopathy is a painful musculoskeletal condition that is common among athletes, and which limits training capacity and competitive performance. The lack of biomarkers for tendinopathy limits research into risk factors and also the evaluation of new treatments. Cytokines and growth factors involved in regulating the response of tendon cells to mechanical load have potential as biomarkers for tendinopathy. Methods: This case-control study compared serum concentration of cytokines and growth factors (TNF-alpha, IL-1 beta, bFGF, PDFG-BB, IFN-gamma, VEGF) between individuals with chronic Achilles tendinopathy and controls. These were measured in fasting serum from 22 individuals with chronic Achilles tendinopathy and 10 healthy controls. Results were analysed in relation to gender and physical activity pattern. Results: TNF-alpha concentration was lower in the entire tendinopathy group compared with the entire control group; none of the other cytokines were significantly different. TNF-alpha levels were nevertheless highly correlated with the other cytokines measured, in most of the subgroups. Analysed by gender, TNF-alpha and PDGF-BB concentrations were lower in the female tendinopathy group but not the male tendinopathy group. A trend was seen for lower IL-1 beta in the female tendinopathy group. Physical activity was correlated with TNF-alpha, PDGF-BB and IL-1 beta to varying extents for control subgroups, but not for the female tendinopathy group. No correlations were seen with BMI or duration of symptoms. Conclusions: This pilot study indicates a lower level of TNF-alpha and PDGF-BB, and to some extent IL-1 beta among females, but not males, in the chronic phase of Achilles tendinopathy. It is suggested that future studies on tendinopathy biomarkers analyse male and female data separately. The lack of correlation between cytokine level and physical activity in the female tendinopathy group warrants further study.

  • 167. Gaida, James E
    et al.
    Alfredson, Håkan
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Kiss, Zoltan S
    Bass, Shona L
    Cook, Jill L
    Asymptomatic Achilles tendon pathology is associated with a central fat distribution in men and a peripheral fat distribution in women: a cross sectional study of 298 individuals.2010Ingår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 11, nr 41, s. 1-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Adiposity is a modifiable factor that has been implicated in tendinopathy. As tendon pain reduces physical activity levels and can lead to weight gain, associations between tendon pathology and adiposity must be studied in individuals without tendon pain. Therefore, the purpose of this study was to determine whether fat distribution was associated with asymptomatic Achilles tendon pathology. METHODS: The Achilles tendons of 298 individuals were categorised as normal or pathological using diagnostic ultrasound. Fat distribution was determined using anthropometry (waist circumference, waist hip ratio [WHR]) and dual-energy x-ray absorptiometry. RESULTS: Asymptomatic Achilles tendon pathology was more evident in men (13%) than women (5%) (p = 0.007). Men with tendon pathology were older (50.9 +/- 10.4, 36.3 +/- 11.3, p < 0.001), had greater WHR (0.926 +/- 0.091, 0.875 +/- 0.065, p = 0.039), higher android/gynoid fat mass ratio (0.616 +/- 0.186, 0.519 +/- 0.142, p = 0.014) and higher upper-body/lower body fat mass ratio (2.346 +/- 0.630, 2.022 +/- 0.467, p = 0.013). Men older than 40 years with a waist circumference >83 cm had the greatest prevalence of tendon pathology (33%). Women with tendon pathology were older (47.4 +/- 10.0, 36.0 +/- 10.3, p = 0.008), had less total fat (17196 +/- 3173 g, 21626 +/- 7882 g, p = 0.009), trunk fat (7367 +/- 1662 g, 10087 +/- 4152 g, p = 0.003) and android fat (1117 +/- 324 g, 1616 +/- 811 g, p = 0.005). They had lower central/peripheral fat mass ratios (0.711 +/- 0.321 g, 0.922 +/- 0.194 g, p = 0.004) than women with normal tendons. Women with tendon pathology were more often menopausal (63%, 13%, p = 0.002). CONCLUSIONS: Men with Achilles tendon pathology were older and had a central fat distribution. Women with tendon pathology were older and had a peripheral fat distribution. An interaction between age and waist circumference was observed among men.

  • 168.
    Gaida, James Edmund
    et al.
    School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, AUSTRALIA.
    Alfredson, Lotta
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Kiss, Zoltan Steven
    Victoria House Medical Imaging, Prahran, Victoria, AUSTRALIA.
    Wilson, Andrew Michael
    Department of Medicine, St Vincent's Hospital, University of Melbourne, Fitzroy, Victoria, AUSTRALIA.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Cook, Jill Leigh
    Centre for Physical Activity and Nutrition Research, Deakin University, Burwood, Victoria, AUSTRALIA.
    Dyslipidemia in Achilles tendinopathy is characteristic of insulin resistance2009Ingår i: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 41, nr 6, s. 1194-1197Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    UNLABELLED: Overuse is considered to be a main causative factor for tendinopathies; however, recent reports indicate that tendinopathy is also common among both overweight and inactive individuals. These factors are associated with abdominal obesity, dyslipidemia, hypertension, and insulin resistance. We hypothesized that these features would be associated with tendinopathy.

    PURPOSE: To compare lipid profile between participants with Achilles tendinopathy and matched controls.

    METHODS: Fasting serum lipids were measured among 60 participants with chronic painful midportion Achilles tendinopathy (54% male) and 60 control subjects matched for gender, age (+/-10 yr), and body mass index (+/-2 kg x m(-2)).

    RESULTS: The participants with Achilles tendinopathy showed evidence of underlying dyslipidemia. They had higher triglyceride (TG) levels (P = 0.039), lower %HDL-C (P = 0.016), higher TG/HDL-C ratio (P = 0.036), and elevated apolipoprotein B concentration (P = 0.017) in comparison to the well-matched control group.

    CONCLUSIONS: This pattern of dyslipidemia is characteristic of the dyslipidemia displayed by individuals with insulin resistance and is common in the metabolic syndrome. Two additional aspects of tendinopathy research support a connection with the metabolic syndrome. First, tendinopathy has been associated with greater waist circumference, as has the metabolic syndrome. Second, insulin resistance has been associated with fat deposition in muscle (primarily intracellular), whereas fat deposition in tendon has been found among those with tendon pain.If tendinopathy is confirmed to be associated with dyslipidemia and the metabolic syndrome in larger studies, it may be appropriate to redefine our concept of tendinopathy to that of a cardiovascular disease (CVD). In this case, we may be able to draw considerably on CVD research to improve our understanding of tendinopathy, and perhaps treating CVD risk factors will improve the treatment of tendinopathy.

  • 169.
    Gaida, James Edmund
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Bagge, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Purdam, Craig
    Cook, Jill
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Forsgren, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Evidence of the TNF-α system in the human Achilles tendon: expression of TNF-α and TNF receptor at both protein and mRNA levels in the tenocytes2012Ingår i: Cells Tissues Organs, ISSN 1422-6405, E-ISSN 1422-6421, Vol. 196, nr 4, s. 339-352Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Understanding adaption to load is essential for prevention and treatment of tendinopathy/tendinosis. Cytokine release in response to load is one mechanism involved in mechanotransduction. The cytokine tumor necrosis factor alpha (TNF-α) is implicated in tendinosis and can induce apoptotic effects via tumor necrosis factor receptor 1 (TNFR1). The complete absence of information concerning the TNF-α system in Achilles tendon is a limitation as mid-portion Achilles tendinosis is very frequent. Purpose: To examine expression patterns of TNF-α and its two receptors (TNFR1 and TNFR2) in human Achilles tendinosis and control tissue and to biochemically confirm the presence of TNF-α in tendinosis tissue. Methods: TNF-α and TNFR1 mRNA were detected via in situ hybridization. TNF-α, TNFR1, and TNFR2 were demonstrated immunohistochemically. Apoptosis markers were utilized. ELISA was used to detect TNF-α. Results: TNF-α and TNFR1 mRNA was detected in tenocytes of both tendinosis and control tendons. Tenocytes from both groups displayed specific immunoreactions for TNF-α, TNFR1, and TNFR2. The widened/rounded tenocytes of tendinosis samples exhibited the most intense immunoreactions. Apoptosis was detected in only a subpopulation of the tenocytes in tendinosis tissue. TNF-α was measurable in tendinosis tissue. Inflammatory cells were not seen. Conclusion: This is the first evidence of the existence of the TNF-α system in the human Achilles tendon. Findings are confirmed at mRNA and protein levels as well as biochemically. The TNF-α system was in principle confined to the tenocytes. The connection between tenocyte morphology and the expression pattern of TNF-α, TNFR1, and TNFR2 suggests that the TNF-α system may be involved in tenocyte activation in Achilles tendinosis.

  • 170.
    Gilenstam, Kajsa
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Idrottsmedicin. Umeå universitet, Samhällsvetenskaplig fakultet, Umeå centrum för genusstudier (UCGS).
    Gender and physiology in ice hockey: a multidimensional study2009Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Background That men are prioritised over women has been called the “gender regime in sport”, and has in part been explained by the gender difference in performance. However, gender differences in physical performance between women and men can be debated to depend on how comparisons are made and on the fact that there are many different confounders that may influence the results. Even if attempts are made to overcome this and the groups of women and men are stated to be matched, there are still often differences in training experience in years, or differences in training load. Women tend to have less experience in ice hockey in relation to age and differences in training conditions have also been reported. The aim of this thesis was to investigate how female and male ice hockey players position themselves in their sport and to visualise the interactions between society and biology that may affect performance.

    Theoretical approach and methods Harding’s three perspectives (Symbolic, Structural and Individual) were applied on information from team administration as well as on results from questionnaires, semi-structured interviews, and tests of puck velocity, anthropometrics, body composition, isokinetic muscle strength, ergospirometry and on-ice tests from female and male ice hockey players.

    Results Vast differences in structural conditions were found, for example in hockey history and in the financial situation within the teams and both women and men were aware of the gender differences in structural conditions. However these differences were not even considered when comparisons of the ice hockey performance of women and men were made. Nine out of ten female players increased puck velocity when a more flexible stick and a lighter puck were used thus indicating that poorly adjusted equipment may affect performance. Male ice hockey players were taller, heavier and stronger, had more lean body mass and a higher aerobic capacity compared to the women in absolute values as well as in relation to body weight. However, the differences diminished or disappeared when the values were expressed in relation to lean body mass. Men had higher expectations on their situation as athletes and the interviewed women described men’s ice hockey as superior to theirs and consequently male ice hockey players deserved better conditions.

    Conclusions The views of women and men may affect structural conditions in sport which in turn may affect possibilities in sport for the individual. Gender differences in conditions thus risk confirming the traditional views of femininity and masculinity. However, by moving outside the normal gender boundaries individuals may change the traditional views of femininity and masculinity.

  • 171.
    Gilenstam, Kajsa
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Gender in ice hockey: Women in a male territory2010Ingår i: Sport and discrimination in Europe / [ed] William Gasparini and Clotilde Talleu, Strasbourg: Council of Europe Publishing , 2010, s. 51-56Kapitel i bok, del av antologi (Övrig (populärvetenskap, debatt, mm))
  • 172.
    Gilenstam, Kajsa
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Idrottens struktur - natur eller kultur?: Ett exempel från ishockey2011Ingår i: För barnets bästa: En antologi om idrott ur ett barnrättsperspektiv / [ed] Johan R Norberg och Johan Pihlblad, Stockholm: SISU Idrottsböcker , 2011, 1, s. 29-38Kapitel i bok, del av antologi (Övrig (populärvetenskap, debatt, mm))
  • 173.
    Gilenstam, Kajsa
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Hammarström, Anne
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Henriksson-Larsén, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Gendered expectations and structural conditions in ice hockeyIngår i: Research Quarterly for Exercise and Sport, ISSN 0270-1367, E-ISSN 2168-3824Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 174.
    Gilenstam, Kajsa
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Henriksson-Larsén, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Karp, Staffan
    Thorsen, Kim
    Tunga puckar och låga förväntningar - blindskär i damhockeyns utveckling2010Ingår i: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 19, nr 1, s. 46-50Artikel i tidskrift (Övrigt vetenskapligt)
  • 175.
    Gilenstam, Kajsa
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Henriksson-Larsén, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Thorsen, Kim
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Influence of stick stiffness and puck weight on puck velocity during slap shots in women's ice hockey2009Ingår i: Sports Engineering, ISSN 1369-7072, E-ISSN 1460-2687, Vol. 11, nr 3, s. 103-107Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 176.
    Gilenstam, Kajsa
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Karp, Staffan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Pedagogiska institutionen.
    Henriksson-Larsén, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Gender in ice hockey: women in a male territory2008Ingår i: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 18, nr 2, s. 235-249Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

  • 177.
    Gilenstam, Kajsa M.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Thorsen, Kim
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Henriksson-Larsén, Karin B.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Physiological Correlates of Skating Performance in Women's and Men's Ice Hockey2011Ingår i: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 25, nr 8, s. 2133-2142Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 178.
    Gisslèn, Karl
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Gyulai, C
    Söderman, Kerstin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    High prevalence of jumper's knee and sonographic changes in Swedish elite junior volleyball players compared to matched controls.2005Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, ISSN 1473-0480, Vol. 39, nr 5, s. 298-301Artikel i tidskrift (Refereegranskat)
  • 179.
    Gisslén, Karl
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Neovascularisation and pain in jumper's knee: a prospective clinical and sonographic study in elite junior volleyball players.2005Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 39, nr 7, s. 423-428Artikel i tidskrift (Refereegranskat)
  • 180.
    Gisslén, Karl
    et al.
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Gyulai, Csaba
    Nordström, Peter
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Alfredson, Håkan
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Normal clinical and ultrasound findings indicate a low risk to sustain jumper's knee patellar tendinopathy: a longitudinal study on Swedish elite junior volleyball players.2007Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 41, nr 4, s. 253-258Artikel i tidskrift (Refereegranskat)
  • 181.
    Gisslén, Karl
    et al.
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Ohberg, Lars
    Umeå universitet, Medicinsk fakultet, Strålningsvetenskaper, Diagnostisk radiologi.
    Alfredson, Håkan
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Is the chronic painful tendinosis tendon a strong tendon?: a case study involving an Olympic weightlifter with chronic painful Jumper's knee.2006Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 14, nr 9, s. 897-902Artikel i tidskrift (Refereegranskat)
  • 182.
    Gustafsson, Helena
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Nordström, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Strahle, Stefan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Nordström, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Parkinsons Disease: A population-based investigation of life satisfaction and employment2015Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, nr 1, s. 45-51Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective:

    To investigate relationships between individuals' socioeconomic situations and quality of life in working-aged subjects with Parkinson's disease.

    Methods:

    A population-based cohort comprising 1,432 people with Parkinson's disease and 1,135 matched controls, who responded to a questionnaire. Logistic regression analysis was performed to identify factors associated with life satisfaction and likelihood of employment.

    Results:

    In multivariate analyses, Parkinson's disease was associated with an increased risk of dissatisfaction with life (odds ratio (OR) = 5.4, 95% confidence interval (95% CI) = 4.2-7.1) and reduced likelihood of employment (OR = 0.30, 95% CI = 0.25-0.37). Employers' support was associated with greater likelihood of employment (p < 0.001). Twenty-four percent of people with Parkinson's disease for ≥ 10 years remained employed and 6% worked full-time. People with Parkinson's disease also more frequently experienced work demands that exceeded their capacity; this factor and unemployment independently correlated with greater risk of dissatisfaction with life (both p < 0.05).

    Conclusion:

    People with Parkinson's disease have an increased risk of dissatisfaction with life. Employment situation is important for general life satisfaction among working-aged individuals. People with Parkinson's disease appear to find it difficult to meet the challenge of achieving a balanced employment situation.

  • 183.
    Hadrevi, Jenny
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Ca 2+ regulatory proteins of muscle contraction: a possible marker of chronic muscle myalgia2014Konferensbidrag (Refereegranskat)
    Abstract [en]

    Aim of Investigation

    Work related illnesses are one of the main reasons for sick-leave in the western world. One of the most common is pain and discomfort in the neck-shoulder region affecting the trapezius muscle, trapezius myalgia (TM). Patients suffering from work related chronic trapezius myalgia experience muscle stiffness, weakness and tension. The biochemical mechanisms behind these sensations are not yet known. Recent proteomic screening results indicate an increased abundance of the calcium regulatory fast myosin light chains in myalgic muscle suggesting an altered contractibility in the myalgic trapezius. To characterize a general increase of Ca2+ in the myalgic muscle the expression level of sarco/endoplasmic reticulum Ca2+-ATPase, (SERCA-1) was analyzed. The aim of this study was to compare the level of Ca2+ regulated proteins in cleaners with trapezius myalgia (TM) and cleaners without trapezius myalgia (CON) and to verify a possible difference in phosphorylation of the contractile regulatory myosin light chains.

    Methods

    Two-dimensional gel electrophoresis was used to separate proteins of interest. The proteomic correlation pattern of the myosin light chain proteins and the differences between healthy and myalgic muscle were investigated using a multivariate Partial Least Square Discriminant Analysis (PLS-DA). Phosphorylations of the fast regulatory myosin light chains were analyzed using serine and tyrosin antibodies. The characterization of myosin isoforms was performed using advanced Orbitrap LC-MS/MS. The expression level of SERCA-1 was analyzed in muscle biopsies from 11 professional cleaners with TM and 11 CON using Simple western size assay (Peggy, Protein simple, CA, US)

    Results

    The detected systematic differences between myosin light chain proteins showed according to the PLS-DA analysis that the fast regulatory light chains were generally more abundant in the MYA group. Ten protein spots were identified as different myosin light chains isoforms according to the amino acid sequencing. Phosphorylated serine was detected in 6 of the isoforms, though there were no differences in amount of phosphorylation between spots. The expression level of Serca-1 was significantly (p = 0.017) higher in TM subjects compared to the CON.

    Conclusions

    There is a higher abundance of fast contracting calcium regulatory myosin light chains in muscle experiencing chronic myalgia. This increased abundance of the regulatory fast myosin light chains supports the previously presented results showing an altered contractibility of the myalgic trapezius muscle. Our results show no difference in phosphorylation between the different spots contradictory to previously published results; suggesting phosphorylation of the protein being the reason for the separation of spots on the two dimensional gels. Instead our results show the spots to have different amino acid sequences. The actual function of the detected myosin light chain proteins remains to be elucidated. The increased abundance of fast contracting regulatory light chains together with the significantly increased abundance of Serca-1 proteins in the MYA muscle supports a higher abundance of Ca2+ in the myalgic muscle. The increased abundance of Serca-1 might be an indication of an adaptation due to peripheral sensitization or increased neuronal signaling altering the contrability of the muscle.       

     

    Acknowledgments

    Supported by Postdoctoral Grant from Swedish Research Council for Health, Working Life and Welfare (Forte) 2013-1259 and Medical Research Council of Southeast Sweden (FORSS-159031,LIO-35923, SC-2013-00395-36).

     

     

     

  • 184.
    Hadrevi, Jenny
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Hellström, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Kieselbach, Thomas
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Malm, Christer
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Pedrosa-Domellöf, Fatima
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB). Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Oftalmiatrik.
    Protein differences between human trapezius and vastus lateralis muscles determined with a proteomic approach2011Ingår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 12, nr 181, s. 11-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The trapezius muscle is a neck muscle that is susceptible to chronic pain conditions associated with repetitive tasks, commonly referred to as chronic work-related myalgia, hence making the trapezius a muscle of clinical interest. To provide a basis for further investigations of the proteomic traits of the trapezius muscle in disease, two-dimensional difference gel electrophoresis (2D-DIGE) was performed on the healthy trapezius using vastus lateralis as a reference. To obtain as much information as possible from the vast proteomic data set, both one-way ANOVA, with and without false discovery rate (FDR) correlation, and partial least square projection to latent structures with discriminant analysis (PLS-DA) were combined to compare the outcome of the analysis.

    Results: The trapezius and vastus lateralis showed significant differences in metabolic, contractile and regulatory proteins, with different results depending on choice of statistical approach and pre-processing technique. Using the standard method, FDR correlated one-way ANOVA, 42 protein spots differed significantly in abundance between the two muscles. Complementary analysis using immunohistochemistry and western blot confirmed the results from the 2D-DIGE analysis.

    Conclusions: The proteomic approach used in the present study combining 2D-DIGE and multivariate modelling provided a more comprehensive comparison of the protein profiles of the human trapezius and vastus lateralis muscle, than previously possible to obtain with immunohistochemistry or SDS-PAGE alone. Although 2D-DIGE has inherent limitations it is particularly useful to comprehensively screen for important structural and metabolic proteins, and appears to be a promising tool for future studies of patients suffering from chronic work related myalgia or other muscle diseases.

  • 185.
    Hadrévi, Jenny
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    New Aspects on Chronic Trapezius Myalgia: Contribution of Metabolomics and Proteomics2014Ingår i: Journal of Musculoskeletal Pain, ISSN 1058-2452, E-ISSN 1540-7012, Vol. 22, nr 4, s. 382-388Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Several hypotheses regarding the underlying mechanisms and the maintenance behind chronic work-related musculoskeletal disorders have been presented. Chronic low load work and psychosocial stress is believed to be the underlying causes to these pain conditions. The recent application of comprehensive screening methods: omnics methods; to this field of research could contribute to current knowledge regarding the pathophysiology of these disorders. The pathophysiological mechanisms behind chronic trapezius myalgia are discussed in the context of new findings obtained with proteomic and metabolomic methods. Proteins and metabolites which differ in abundance between healthy muscle and muscle suffering from chronic trapezius myalgia are presented. Primarily, the pathways and effects of the proteins and metabolites found in three recently published papers are discussed. Proteomics and metabolomics are efficient screening methods enabling the presentation of potential biomarkers and pathophysiological mechanisms explaining the pathophysiology of chronic work-related trapezius myalgia. The previous findings detecting systematic differences of proteins and metabolites when comparing chronic myalgic muscle to healthy muscle, indicating a higher glycogen metabolism, increased muscle turnover and increased neuronal signalling in the myalgic muscle, are discussed in this review.

  • 186. Hakkarainen, J
    et al.
    Toivanen, M
    Leinonen, A
    Frängsmyr, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Strömberg, Nicklas
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Lapinjoki, S
    Nassif, X
    Tikkanen-Kaukanen, C
    Human and bovine milk oligosaccharides inhibit Neisseria meningitidis pili attachment in vitro.2005Ingår i: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 135, nr 10, s. 2445-2448Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Milk oligosaccharides have been shown to interfere with adhesion of many pathogens to host mucosal surfaces. Characterization of the adhesion mechanisms of the bacteria to host cell surface is needed to develop novel functional food, infant formulas, and anti-infective drugs. Adhesion of Neisseria meningitidis, a human specific pathogen causing meningitis and septicemia, is not completely understood but is mediated by type IV pili. Here, we developed a microtiter well pili binding assay to investigate the binding activities of N. meningitidis isolated type IV pili to different glycoproteins. Pili binding activities to bovine thyroglobulin and human salivary agglutinin but not to chicken ovalbumin were present. Inhibition of these binding activities was demonstrated by fractionated human or bovine milk oligosaccharides. The binding of neisserial pili to bovine thyroglobulin was most effective and was clearly inhibited by human milk neutral or bovine milk acidic oligosaccharides.

  • 187. Hamberg, Jern
    et al.
    Björklund, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Nordgren, Bengt
    Sahlstedt, Bo
    Stretchability of the rectus femoris muscle: investigation of validity and intratester reliability of two methods including x-ray analysis of pelvic tilt.1993Ingår i: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 74, nr 3, s. 263-270Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Validity and intratester reliability of two test methods designed to identify stretchability of the rectus femoris muscle (RFM) was investigated, combined with x-ray analysis of pelvic tilt in the sagittal plane. The first method is commonly used in clinical practice. The second is a new technique supposed to tilt the pelvis posteriorly and thus further separate the origin and insertion of the muscle. Investigation of validity and intratester reliability of the two methods was made by testing and retesting a random sample of 71 persons. The tests were performed with an equipment that automatically recorded the angle of knee flexion from a previously determined applied torque, indicating the end point of motion for that particular subject. Angle of knee flexion and subjective estimation of pain sensation due to stretch were recorded at each measurement. The pelvic tilt-analysis consisted of test-retest reliability of x-ray measurements, comparison between the methods in both starting and final position, and x-ray and electronic goniometer measurements. All applied torques were measured with a strain gauge. Two out of three criteria of validity favored the new method and the third pointed out the two methods as equal. The two methods as well as the x-ray measurements showed high reliability, and the hypothesis of a more posterior tilted pelvis in the new method was confirmed. The electronic goniometer was less sensitive than x-ray, but proposed to analyse pelvic tilt clinically. Methodology procedures for joint angle measurements are discussed.

  • 188.
    Hammarström, Anne
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Johansson, Klara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Annandale, Ellen
    Ahlgren, Christina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Aléx, Lena
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Christianson, Monica
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Elwer, Sofia
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Eriksson, Carola
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Fjellman-Wiklund, Anncristine
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Gilenstam, Kajsa
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Gustafsson, Per E.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Harryson, Lisa
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Lehti, Arja
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Stenberg, Gunilla
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Verdonk, Petra
    Central gender theoretical concepts in health research: the state of the art2014Ingår i: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 68, nr 2, s. 185-190Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Despite increasing awareness of the importance of gender perspectives in health science, there is conceptual confusion regarding the meaning and the use of central gender theoretical concepts. We argue that it is essential to clarify how central concepts are used within gender theory and how to apply them to health research. We identify six gender theoretical concepts as central and interlinked-but problematic and ambiguous in health science: sex, gender, intersectionality, embodiment, gender equity and gender equality. Our recommendations are that: the concepts sex and gender can benefit from a gender relational theoretical approach (ie, a focus on social processes and structures) but with additional attention to the interrelations between sex and gender; intersectionality should go beyond additive analyses to study complex intersections between the major factors which potentially influence health and ensure that gendered power relations and social context are included; we need to be aware of the various meanings given to embodiment, which achieve an integration of gender and health and attend to different levels of analyses to varying degrees; and appreciate that gender equality concerns absence of discrimination between women and men while gender equity focuses on women's and men's health needs, whether similar or different. We conclude that there is a constant need to justify and clarify our use of these concepts in order to advance gender theoretical development. Our analysis is an invitation for dialogue but also a call to make more effective use of the knowledge base which has already developed among gender theorists in health sciences in the manner proposed in this paper.

  • 189.
    Hassler, Sven
    et al.
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Sjölander, Per
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Johansson, Robert
    Umeå universitet, Medicinsk fakultet, Strålningsvetenskaper, Onkologi.
    Grönberg, Henrik
    Umeå universitet, Medicinsk fakultet, Strålningsvetenskaper, Onkologi.
    Damber, Lena
    Umeå universitet, Medicinsk fakultet, Strålningsvetenskaper, Onkologi.
    Fatal accidents and suicide among reindeer-herding Sami in Sweden2004Ingår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 63 Suppl 2, s. 384-388Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Over the last decades, reindeer-herding management has experienced dramatic changes, e.g. increased motorization and socio-economic pressure. The aim of the present study was to investigate whether these changes have increased the risk of fatal, work-related accidents and suicide between 1961 and 2000. STUDY DESIGN AND METHODS: A cohort containing 7,482 members of reindeer-herding Sami families was extracted from national population registers. Information on fatal accidents and suicide was obtained from the Swedish Causes of Death Register, and compared to the expected number of deaths in a demographically matched control population of non-Sami. RESULTS: The male reindeer herding Sami showed a significantly increased risk of dying from accidents such as vehicle accidents and poisoning. No significant increased risk of suicide was observed. A comparison between the periods of 1961-1980 and 1981-2000 showed non-significant differences in risk, although a trend towards increased risks was observed for most types of external causes of death except suicide. CONCLUSIONS: It is suggested that the increased socio-economic pressure and the extensive use of terrain vehicles have increased the risk for fatal accidents among Swedish reindeer herders, and that commercial reindeer management is one of the most dangerous occupations in Sweden.

  • 190.
    Hedelin, R
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Bjerle, P
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Henriksson-Larsén, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Heart rate variability in athletes: relationship with central and peripheral performance.2001Ingår i: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 33, nr 8, s. 1394-1398Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 191.
    Hedelin, R
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Wiklund, U
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Bjerle, P
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Henriksson-Larsén, K
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Pre- and post-season heart rate variability in adolescent cross-country skiers.2000Ingår i: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 10, nr 5, s. 298-303Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

  • 192.
    Hedelin, Rikard
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Kenttä, Göran
    Wiklund, Urban
    Bjerle, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Henriksson-Larsén, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Short-term overtraining: effects on performance, circulatory responses, and heart rate variability.2000Ingår i: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 32, nr 8, s. 1480-1484Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 193.
    Hedelin, Rikard
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Wiklund, Urban
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Radiofysik.
    Bjerle, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Henriksson-Larsén, K
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Cardiac autonomic imbalance in an overtrained athlete.2000Ingår i: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 32, nr 9, s. 1531-1533Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 194. Hellsten, Y
    et al.
    Svensson, M
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Sjödin, B
    Smith, S
    Christensen, A
    Richter, E A
    Bangsbo, J
    Allantoin formation and urate and glutathione exchange in human muscle during submaximal exercise.2001Ingår i: Free Radical Biology & Medicine, ISSN 0891-5849, E-ISSN 1873-4596, Vol. 31, nr 11, s. 1313-22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Seven males performed two exhaustive cycling bouts (EX1 and EX2) at a work-rate of 90% of maximal oxygen uptake, separated by 60 min. During EX1 there was a significant accumulation of urate (from 0.16 +/- 0.02 to 0.27 +/- 0.03 micromol/kg d.w.) and allantoin (from 0.39 +/- 0.05 to 0.69 +/- 0.14 micromol/kg d.w.) in the muscle. An uptake of urate was observed in early recovery from EX1 (0-9 min: 486 +/- 136 micromol; p <.05). There was no exchange of total glutathione or cysteine over the muscle either during or after exercise, and muscle and plasma total glutathione remained unaltered (p <.05). The glycogen levels were lowered by 40% at the onset of EX2, yet the level of oxidative stress in EX1 and EX2 was similar as evidenced by a similar increase in muscle allantoin in both exercise bouts. The data suggest that urate is utilized as antioxidant in human skeletal muscle and that reactive oxygen species are formed in muscle during intense submaximal exercise. No net exchange of glutathione appears to occur over the muscle either at rest, during exercise or in recovery. Moreover, when an exhaustive exercise bout is repeated with lowered glycogen levels, the level of oxidative stress is not different than that of the first bout.

  • 195.
    Henriksson, Sofie
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Does the test results measured with Neurocom Balance Master change after concussion in ice hockey players?: A retrospective study of Ice Hockey Players2012Självständigt arbete på avancerad nivå (magisterexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Ice hockey is a high velocity, full body contact sport with great risk of injuries. Concussion is a frequent and common injury in ice hockey. The present study aimed to examine the test results measured with Neurocom Balance Master after concussion in elite ice hockey players. The unilateral stance (US) and limits of stability (LOS) were performed preseason and in the event of concussion 24 hours, 7 days, 14 days and 21 days post injury. 107 male ice hockey players from one elite Swedish team during the seasons 2002/2003 – 2011/2012 where recruited for the study. ANOVA analysis of matched pair test and log test and OPLS-DA modeling and univariate scaled data was performed on the results. The results indicate that both the US and LOS test were not specific enough to predict further concussion and no significance was found when comparing baseline test with tests values after concussion. Perhaps were balance deficits so mild that the tests could not detect them or perhaps was balance was not affected in any higher degree. Except for the movement velocity (MVL) in the LOS test (P < 0,0031*),  indicating that players were not fully recovered 7 days post injury, proposing a possible impact at the high-level central nervous system after concussion.

  • 196.
    Hogstrom, Magnus
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Nordstrom, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Nordstrom, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Retinol, retinol-binding-protein-4, abdominal fat mass, peak bone mineral density and markers of bone metabolism in men: the NO2-studyManuskript (Övrigt vetenskapligt)
  • 197. Hoksrud, Aasne
    et al.
    Ohberg, Lars
    Umeå universitet, Medicinsk fakultet, Strålningsvetenskaper, Diagnostisk radiologi.
    Alfredson, Håkan
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Bahr, Roald
    Ultrasound-guided sclerosis of neovessels in painful chronic patellar tendinopathy: a randomized controlled trial.2006Ingår i: Am J Sports Med, ISSN 0363-5465, Vol. 34, nr 11, s. 1738-46Artikel i tidskrift (Refereegranskat)
  • 198. Hoksrud, Aasne
    et al.
    Öhberg, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Diagnostisk radiologi.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Bahr, Roald
    Color Doppler ultrasound findings in patellar tendinopathy (jumper's knee).2008Ingår i: The American journal of sports medicine, ISSN 1552-3365, Vol. 36, nr 9, s. 1813-1820Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Recent studies have revealed structural changes with neovessels in patients with jumper's knee and Achilles tendinopathy, and treatment with sclerosing injections has shown promising clinical results. PURPOSE: To study the prevalence of neovascularization and structural tendon changes on color Doppler ultrasound examination in elite athletes with clinical symptoms of jumper's knee and to examine the ultrasound characteristics of the tendon after sclerosing injection treatment with polidocanol. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: The authors recruited patients among elite athletes with a clinical diagnosis of jumper's knee who participated in a previous randomized clinical trial. The patients recorded knee function using the Victorian Institute of Sport Assessment score. Patients were examined by color Doppler ultrasound at baseline and, for patients with structural changes and neovascularization who received sclerosing treatment, after treatment. RESULTS: Sixty-three patients (11 women and 52 men) with 79 symptomatic tendons were studied. The ultrasound examination revealed that neovascularization was present in 48 of the 79 tendons (60%). Of 33 patients (43 tendons) who received sclerosing injections, 29 patients (37 tendons, 86%) were examined 37 (19 to 53) weeks after their final sclerosing injections. Of these, 7 tendons (18.9%) had no change in neovascularization after treatment, 21 tendons (56.8%) had less neovascularization, and 9 tendons (24.3%) had more visible neovascularization. There were no significant differences in the change in Victorian Institute of Sport Assessment score between patients who had less, more, or unchanged neovascularization after treatment (analysis of variance, P = .9). CONCLUSION: About two thirds of patients with jumper's knee can be expected to have structural tendon changes with neovascularization. There was no relationship between changes in ultrasound characteristic and knee function after sclerosing treatment.

  • 199.
    Hult, Andreas
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Malm, Christer
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Oldenborg, Per-Arne
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Histologi med cellbiologi.
    Transfusion of cryopreserved human red blood cells into healthy humans is associated with rapid extravascular hemolysis without a proinflammatory cytokine response2013Ingår i: Transfusion, ISSN 0041-1132, E-ISSN 1537-2995, Vol. 53, nr 1, s. 28-33Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Transfusion of stored red blood cells (RBCs) can be associated with adverse side effects. Recent studies in mice transfused with stored RBCs showed that a strong proinflammatory cytokine storm was induced due to extravascular hemolysis already at 2 hours after transfusion. Therefore, we here investigated if transfusion of 2 units of cryopreserved autologous RBCs induced a proinflammatory response in healthy human volunteers.

    STUDY DESIGN AND METHODS: Two units of autologous RBCs, cryopreserved for 16 weeks, were transfused into 10 healthy human volunteers. Serum and blood samples taken at 2 hours before and at 2 and 48 hours after transfusion were analyzed for signs of extravascular hemolysis and the presence of proinflammatory cytokines.

    RESULTS: At 2 hours after transfusion, transferin-bound serum iron, as well as transferin saturation and total bilirubin, were already significantly increased. These measures all returned back toward that in pretransfusion samples at 48 hours after transfusion. No increases in the production of the proinflammatory cytokines interleukin (IL)-1β, IL-6, IL-8, monocyte chemotactic protein-1, macrophage inflammatory protein-1β, or tumor necrosis factor-α were detected at any time point after transfusion.

    CONCLUSION: Although a significant level of extravascular hemolysis already occurred at 2 hours after transfusion of cryopreserved RBCs, there were no signs of proinflammatory cytokine production up to 48 hours after transfusion.

  • 200.
    Högström, Gabriel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Nordström, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Eriksson, Marie
    Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.
    Nordström, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Risk factors assessed in adolescence and the later risk of stroke in men: a 33-year follow-up study2015Ingår i: Cerebrovascular Diseases, ISSN 1015-9770, E-ISSN 1421-9786, Vol. 39, nr 1, s. 63-71Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Stroke is a common cause of death, and a leading contributor to long-term disability. The cost associated with the disease is great. Several modifiable risk factors for stroke have been found in older cohorts; however, no study to date has investigated the effects of these risk factors from late adolescence.

    METHODS: The study cohort comprised 811,579 Swedish men (mean age, 18 years) that participated in the mandatory military conscription service in Sweden between 1969 and 1986. Some risk factors for stroke, such as body mass index, systolic and diastolic blood pressure, and cognitive function, were assessed at conscription. Aerobic fitness was also assessed at conscription, using a braked ergometer cycle test. Other risk factors for stroke, including stroke in subjects' parents, and socioeconomic factors including highest achieved level of education and annual income 15 years after conscription, were collected through national register linkage using the personal identification number. Stroke diagnosis among the study participants was tracked in the National Hospital Discharge Patient Register.

    RESULTS: During a median follow-up period of 33 years 6,180 ischemic strokes and 2,104 hemorrhagic strokes were diagnosed in the cohort at a mean age of 47.9 years. Strong independent risk factors (all p <1.0 × 10-(6)) for ischemic stroke included low aerobic fitness (hazard ratio [HR], 0.84 per standard deviation [SD] increase), high BMI (HR, 1.15 per SD increase), diabetes (HR, 2.85), alcohol intoxication (HR, 1.93), low annual income (HR, 0.85 per SD decrease), and stroke in the mother (HR, 1.31). Similar risk factors were found for hemorrhagic stroke including low aerobic fitness (HR, 0.82 per SD increase), high BMI (HR, 1.18 per SD increase) alcohol intoxication (HR, 2.92), diabetes (HR, 2.06), and low annual income (HR, 0.75). The population attributable risks associated with all evaluated risk factors were 69% for ischemic stroke and 88% for hemorrhagic stroke (p < 0.001 for both).

    CONCLUSIONS: In the present study we have shown that several known risk factors for stroke are present already in late adolescence, and that they are independent of each other. The strongest risk factors were low physical fitness, high BMI, diabetes, low annual income and a maternal history of stroke. Several of the aforementioned risk factors are potentially modifiable.

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