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  • 301.
    Nordström, Peter
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Neovius, Martin
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Early and rapid bone mineral density loss of the proximal femur in men.2007In: J Clin Endocrinol Metab, ISSN 0021-972X, Vol. 92, no 5, p. 1902-8Article in journal (Refereed)
  • 302.
    Nordström, Peter
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Hälsosamt fet av träning2011In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, no 1, p. 66-68Article in journal (Other academic)
  • 303.
    Nordström, Peter
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Eriksson, Marie
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Wahlund, Lars-Olof
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Risk factors in late adolescence for young-onset dementia in men: a nationwide cohort study2013In: JAMA internal medicine, ISSN 2168-6114, Vol. 173, no 17, p. 1612-1618Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE: Young-onset dementia (YOD), that is, dementia diagnosed before 65 years of age, has been related to genetic mutations in affected families. The identification of other risk factors could improve the understanding of this heterogeneous group of syndromes.

    OBJECTIVE: To evaluate risk factors in late adolescence for the development of YOD later in life.

    DESIGN: We identified the study cohort from the Swedish Military Service Conscription Register from January 1, 1969, through December 31, 1979. Potential risk factors, such as cognitive function and different physical characteristics, were assessed at conscription. We collected other risk factors, including dementia in parents, through national register linkage.

    PARTICIPANTS: All Swedish men conscripted for mandatory military service (n = 488 484) with a mean age of 18 years.

    SETTING: Predominantly Swedish men born from January 1, 1950, through December 31, 1960.

    EXPOSURE: Potential risk factors for dementia based on those found in previous studies, data available, and quality of register data.

    MAIN OUTCOMES AND MEASURE: All forms of YOD.

    RESULTS: During a median follow-up of 37 years, 487 men were diagnosed as having YOD at a median age of 54 years. In multivariate Cox regression analysis, significant risk factors (all P < .05) for YOD included alcohol intoxication (hazard ratio, 4.82 [95% CI, 3.83-6.05]); population-attributable risk, 0.28), stroke (2.96 [2.02-4.35]; 0.04), use of antipsychotics (2.75 [2.09-3.60]; 0.12), depression (1.89 [1.53-2.34]; 0.28), father's dementia (1.65 [1.22-2.24]; 0.04), drug intoxication other than alcohol (1.54 [1.06-2.24]; 0.03), low cognitive function at conscription (1.26 per 1-SD decrease [1.14-1.40]; 0.29), low height at conscription (1.16 per 1-SD decrease [1.04-1.29]; 0.16), and high systolic blood pressure at conscription (0.90 per 1-SD decrease [0.82-0.99]; 0.06). The population-attributable risk associated with all 9 risk factors was 68%. Men with at least 2 of these risk factors and in the lowest third of overall cognitive function were found to have a 20-fold increased risk of YOD during follow-up (hazard ratio, 20.38 [95% CI, 13.64-30.44]).

    CONCLUSIONS AND RELEVANCE: In this nationwide cohort, 9 independent risk factors were identified that accounted for most cases of YOD in men. These risk factors were multiplicative, most were potentially modifiable, and most could be traced to adolescence, suggesting excellent opportunities for early prevention.

  • 304.
    Nordström, Peter
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Pettersson, Ulrika
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Type of physical activity, muscle strength, and pubertal stage as determinants of bone mineral density and bone area in adolescent boys.1998In: Journal of Bone and Mineral Research, ISSN 0884-0431, E-ISSN 1523-4681, Vol. 13, no 7, p. 1141-8Article in journal (Refereed)
    Abstract [en]

    The present study was conducted to evaluate the influence of different types of weight-bearing physical activity, muscle strength, and puberty on bone mineral density (BMD, g/cm2) and bone area in adolescent boys. Three different groups were investigated. The first group consisted of 12 adolescent badminton players (age 17.0 +/- 0.8 years) training for 5.2 +/- 1.9 h/week. The second group consisted of 28 ice hockey players (age 16.9 +/- 0.3 years) training for 8.5 +/- 2.2 h/week. The third group consisted of 24 controls (age 16.8 +/- 0.3 years) training for 1.4 +/- 1.4h/week. The groups were matched for age, height, and pubertal stage. BMD, bone mineral content (BMC, g), and the bone area of the total body, lumbar spine, hip, femur and tibia diaphyses, distal femur, proximal tibia, and humerus were measured using dual-energy X-absorptiometry. When adjusting for the difference in body weight between the groups, the badminton players were found to have significantly higher BMD (p < 0.05) of the trochanter and distal femur compared with the ice hockey players despite a significantly lower weekly average training. The badminton players had higher BMD compared with the control with the control group at all weight-bearing BMD sites, except at the diaphyses of the femur and tibia and lumbar spine. The independent predictors of bone density were estimated by adjusting BMC for the bone area in a multivariate analysis among all subjects (n = 64). Accordingly, the bone density of all sites except the spine was significantly related to muscle strength and height, and the bone density of the total body, neck, trochanter, distal femur, and proximal tibia was significantly related to type of physical activity (beta = 0.09-0.33, p < 0.05). The bone area values at different sites were strongly related to muscle strength and height and less strongly related to the type of physical activity and pubertal stage. In conclusion, it seems that during late puberty in adolescent boys the type of weight-bearing physical activity is an important determinant of bone density, while the bone area is largely determined by parameters related to body size. The higher BMD at weight-bearing sites in badminton players compared with ice hockey players, despite significantly less average weekly training, indicates that physical activity including jumps in unusual directions has a great osteogenic potential.

  • 305.
    Nordström, Peter
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Sievänen, Harri
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Pedersen, Nancy L
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    High physical fitness in young adulthood reduces the risk of fractures later in life in men: a nationwide cohort study2013In: Journal of Bone and Mineral Research, ISSN 0884-0431, E-ISSN 1523-4681, Vol. 28, no 5, p. 1061-1067Article in journal (Refereed)
    Abstract [en]

    A few studies indicate that self reported physical activity is associated with the risk of fractures in middle-aged and elderly men. We investigated whether objectively measured physical fitness in young adulthood was associated with the risk of low-energy fractures later in life in men. Aerobic capacity and isometric muscle strength were measured in 435445 Swedish men that conscripted for military service from 1969-1978. Incident fractures were searched in national registers. During a median follow-up period of 35 years (range, 11-41 years), 8 030 subjects sustained at least one fracture, increasing the risk of death 1.8 times (95% CI = 1.6-2.0) during follow up. When comparing men in the lowest and highest decile of physical fitness, the risk of a fracture was 1.8 times higher (95% CI = 1.6-2.1) and that of hip fracture was 2.7 times higher (95% CI = 1.6-4.7). The risk of fracture was also 1.4-1.5 times higher when comparing the extreme deciles of muscle strength (p < 0.001 for all). In a subcohort of 1009 twin pairs, up to 22% of the variation in physical fitness and 27-39% of the variation in muscle strength was attributable to environmental factors unique to one twin, e.g. physical activity. In conclusion, low aerobic capacity and muscle strength in young adulthood are associated with an increased risk of low-energy fractures later in life, while a low-energy fracture is associated with an increased risk of death already in middle-aged men.

  • 306.
    Nyberg, Andre
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Jonsson, Per
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Limited scientific evidence supports the use of conservative treatment interventions for pain and function in patients with subacromial impingement syndrome: randomized control trials2010In: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 15, no 6, p. 436-452Article in journal (Refereed)
    Abstract [en]

    Background: Different conservative treatment interventions are often used to decrease pain and improve function in patients with subacromial impingement syndrome (SAIS). However, the current evidence to support the use of these interventions has not been established.

    Objectives: To determine the evidence for conservative treatment interventions regarding pain and function compared to any intervention for SAIS patients.

    Methods: A systematic review of randomized controlled trials, published in English between 1 January 1999 and 31 May 2010, was performed using PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library and manual searching. The methodological quality (PEDro scale) and evidence grade (SBU) were rated. Eight studies were of high quality, four were medium quality, and eight were low quality. Various conservative treatment interventions were evaluated: acupuncture, electrotherapy modalities, exercises, mixed modalities, changing posture, and use of a functional brace.

    Results: Limited scientific evidence (LSE) indicates positive effects of exercise and mixed modalities regarding pain and function and high-intensity laser therapy (HILT) regarding pain in SAIS patients. LSE also indicate no effect of electrotherapy modalities, apart from HILT, as treatment for SAIS.

    Conclusions: The lack of high quality interventions limits the ability to draw conclusions regarding efficacy from several of the included studies. However, exercise may be as efficient as surgery, manual therapy in combination with exercise seems to be more effective than exercise alone and high-dose exercises seem to be more effective than low-dose exercises. Furthermore, there is contradictory evidence to support the use of acupuncture.

  • 307.
    Olinder, Sandra
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Förbättrad balans hos kvinnliga innebandyspelare efter fem veckors balansträning i relation till skaderisk.: En kombinerad litteraturstudie och empirisk studie2012Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: Balance is a complicated term which includes a static, dynamic and functional part. These parts have, during a long period of time, been included into the existing training programs through several different balance exercises, which aim to prevent sports injuries mostly focused on the knee and ankle. In floorball these injuries are common and a sports injury prevention program is required.

    Purpose: The purpose is to explain the balance term and relate it to injury prevention training and the existing theories. A second purpose is to see whether five weeks of balance training increases the balance ability in female floorball players and thereby increase the test values in the two tests.

    Method: Twenty female floorball players participated in the study and were divided into a training group and a control group. They performed a Star excursion balance test (SEBT) and a Multiple single leg hop stabilization test (MSLHST) before and after a five week training period, containing exercises of balance.

    Results: The training group showed improvement after the training period, however only one significant result was found. The control group showed no improvements, rather the opposite in some parts of the tests.

    Conclusions: The results indicate that there could be an injury preventive effect coming from balance training, but the training program and the tests have to be customized to suit the training group. Nevertheless, balance training should be recommended as a compliment to the ordinary training session.  

  • 308.
    Olsson, Carl-Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Nyberg, Lars
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology. Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Brain simulation of action may be grounded in physical experience2011In: Neurocase, ISSN 1355-4794, E-ISSN 1465-3656, Vol. 17, no 6, p. 501-505Article in journal (Refereed)
    Abstract [en]

    An intriguing quality of our brain is that when actions are imagined, corresponding brain regions are recruited as when the actions are actually performed. It has been hypothesized that the similarity between real and simulated actions depends on the nature of motor representations. Here we tested this hypothesis by examining S.D., who never used her legs but is an elite wheel chair athlete. Controls recruited motor brain regions during imagery of stair walking and frontal regions during imagery of wheel chair slalom. S.D. showed the opposite pattern. Thus, brain simulation of actions may be grounded in specific physical experiences.

  • 309. Ovchinnikova, Olga
    et al.
    Gylfe, Åsa
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Clinical Bacteriology.
    Bailey, Leslie
    Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Rudling, Mats
    Jung, Christian
    Bergström, Sven
    Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
    Waldenström, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Hansson, Göran K
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Osteoprotegerin promotes fibrous cap formation in atherosclerotic lesions of ApoE-deficient mice--brief report.2009In: Arteriosclerosis, Thrombosis and Vascular Biology, ISSN 1079-5642, E-ISSN 1524-4636, Vol. 29, no 10, p. 1478-1480Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Osteoprotegerin (OPG) is a tumor necrosis factor receptor-related cytokine, initially found to inhibit osteoclastogenesis. In the present study we investigated the effect of OPG treatment on atherosclerosis. METHODS AND RESULTS: Hypercholesterolemic apoe(-/-) mice were treated with recombinant 15 mg/kg OPG or vehicle injections twice a week for 10 consecutive weeks. Mice treated with OPG showed increased amounts of smooth muscle cells and collagen within the atherosclerotic lesions. OPG treatment did not affect atherosclerotic lesion size (8.2% versus 7.6%) or total vessel area but led to a 250% increase in lesion collagen, formation of mature collagen fibers in subendothelial fibrous caps, and upregulated mRNA for lysyl oxidase that promotes collagen crosslinking. In cell culture studies, OPG promoted cell proliferation in rat aortic smooth muscle cells. In contrast, OPG treatment did not affect markers of vascular or systemic inflammation. CONCLUSIONS: OPG treatment promotes smooth muscle accumulation, collagen fiber formation, and development of fibrous caps but does not affect inflammatory properties of atherosclerotic lesions. Its effects may contribute to plaque stabilization.

  • 310.
    Persson, Emelie
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Evaluation of Military strength ability tests based on content validity index.2012Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Physical strength ability tests are widely used in the Military branch to evaluate soldiers’ ability to complete occupational tasks, screen for injuries as well as prevent disorders. Five common occupational tasks are identified: lifting, walking while holding an object in your hands, walking with equipment attached to the body, climbing and digging. Unfortunately several physical tests are made on weak scientific bases and therefore the validity of these tests are not known. The purpose of this study is to determine, based on expert opinions on the military tests used by NATO and Sweden which tests that are most relevant for military armed forces.

    Method: Eight experts were selected to judge the content validity of 30 strength ability tests.  I-Content Validity Index (I-CVI) was used to calculate the experts’ ratings. The I-CVI described the content validity of each test.

    Results: Several commonly used tests were not considered content valid based on the experts judgment. The results also indicated suitable tests for each military task, to be tested in future studies.

    Conclusion: The study suggests a lack of valid strength tests for military physical work capacity. Further studies should be made to create an occupation relevant test battery.

  • 311.
    Persson, Jens
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Are VO2 max and body composition predicting factors for the risk of obtaining injuries when playing ice hockey ?2012Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 312.
    Pettersson, Sofia
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    The presence of the relative age effect in Swedish elite level female soccer players2012Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    A great extent of research has been put into the subject of the relative age effect, proving its existence among a number of sports, among which soccer is one of the most researched. However previous studies have mainly been focusing on male athletes and almost completely neglected female athletes. Therefore the aim of this study was to investigate if the relative age effect is present among Swedish elite-level, female soccer players, using the highest league and the national team as a sample. No presence of the relative age effect was shown for either of the two samples (p=0,43 and p=0,71 for the National team, p=0,42 and p=0,51 for “Damallsvenskan”), a result well in line with the author’s hypothesis. The results are suggested to be the fruit of a number of different factors, most notably the combination of the pubertal differences of females compared to males and the lack of intense competition in early ages along with sociological aspects.

  • 313.
    Pettersson, Ulrika
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Benmassa hos kvinnliga löpare med menstruationsrubbningar1997In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 6, no 2, p. 30-32Article in journal (Other academic)
  • 314.
    Pettersson, Ulrika
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Bone mass in the young athlete1999Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Bone mass and bone size accumulate during childhood and adolescence and peak in the twenties. The obtained peak bone mass has been suggested to be a major determinant of bone mass even in the very elderly. Although, genetic factors are the main determinants, environmental and lifestyle factors also play a crucial role in modulating maximal bone mass. Assessing these lifestyle factors would be of great importance for the intervention strategies against osteoporosis.  

    The first aim of this thesis was to compare the bone mass and bone size in male and female young adults on a high level of physical activity with males or females on a low level of physical activity. Furthermore, it also aimed to investigate the influence of pubertal maturity, menstrual disturbances, and different body constitutional factors on bone mass and size during adolescence and young adulthood.  

    The female activity groups consisted of cross-county skiers, soccer players, and rope skippers. Compared to their age-matched inactive controls, all these athletic groups demonstrated a significantly higher bone mineral density (BMD) at those sites subjected to the sport-specific loading. Rope-skipping, a very high impact activity was associated with a higher bone size, preferentially in the lower extremity, suggesting an effect of weight-bearing activity also on bone geometry. The effect of menstrual disturbances was evaluated in a group of long-distance runners, where amenorrheic runners had significantly lower BMD in both trabecular and also cortical bone in the lower extremity compared to eumenorrheic runners, suggesting that weight-bearing activity cannot compensate for the shortfall of reduced estrogen levels.  

    The male activity groups consisted of ice hockey players and badminton players. Compared to their age-matched controls, both athletic groups demonstrated a significantly higher BMD at those sites subjected to the sport-specific loading. Especially badminton was associated with a high BMD, suggesting that physical activity, including jumps in unusual directions has a great osteogenic potential.  

    The main determinants of BMD in both male and females were, except for type of physical activity, activity, muscle strength, height, and different body constitutional factors. However, the relationships with muscle strength and body constitution were somewhat weaker in the athletic groups, especially in the males, indicating that impact forces may be of greater importance in regulating bone mass in highly trained athletes. Yet bone size was largely determined by parameters related to body size and less strongly to physical activity. In a prospective study on adolescent boys, the changes in bone mass during late puberty were mainly accounted for by growth and development, including height and pubertal maturation, and less to physical activity level. Thus, the osteogenic effect from physical activity seems to be of importance for bone mass achievement predominantly before late puberty.

  • 315.
    Pettersson, Ulrika
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Fysisk aktivitet hos ungdomar och framtida risk för besnkörhet.2000In: Svensk Idrottsmedicin, ISSN 1103-7652, no 1, p. 7-9Article in journal (Other academic)
  • 316.
    Pettersson, Ulrika
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Styrketräning och påvarkan av benmassa2001In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 10, no 3, p. 38-42Article in journal (Other academic)
  • 317.
    Pettersson, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Alfredson, Håkan
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Bone mass in female cross-country skiers: relationship between muscle strength and different BMD sites.2000In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 67, no 3, p. 199-206Article in journal (Refereed)
    Abstract [en]

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

  • 318.
    Pettersson, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Nilsson, Martin
    Institutionen för Internmedicin, Sahlgrenska Universitetssjukhus.
    Sundh, Valter
    Institutionen för Geriatrik, Sahlgrenska Universitetssjukhus.
    Mellström, Dan
    Göteborgs universitet och Institutionen för Internmedicin, Sahlgrenska Universitetssjukhus.
    Lorentzon, Mattias
    Göteborgs universitet och Institutionen för Internmedicin, Sahlgrenska Universitetssjukhus.
    Physical activity is the strongest predictor of calcaneal peak bone mass in young Swedish men2010In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 21, no 3, p. 447-455Article in journal (Refereed)
    Abstract [en]

    In a highly representative sample of young adult Swedish men (n = 2,384), we demonstrate that physical activity during childhood and adolescence was the strongest predictor of calcaneal bone mineral density (BMD), and that peak bone mass was reached at this site at the age of 18 years.

    INTRODUCTION: The purpose of the present study was to determine if physical activity during growth is associated with peak calcaneal BMD in a large, highly representative cohort of young Swedish men.

    METHODS: In this study, 2,384 men, 18.3 +/- 0.3 (mean +/- SD) years old, were included from a population attending the mandatory tests for selection to compulsory military service in Sweden. BMD (g/cm(2)) of the calcaneus was measured using dual-energy X-ray absorptiometry. Training habits were investigated using a standardized questionnaire.

    RESULTS: Regression analysis (with age, height, weight, smoking, and calcium intake as covariates) demonstrated that history of regular physical activity was the strongest predictor and could explain 10.1% of the variation in BMD (standardized beta = 0.31, p < 0.001). A regression model with quadratic age effect revealed maximum BMD at 18.4 years.

    CONCLUSIONS: We found that history of physical activity during growth was the strongest predictor of peak calcaneal BMD in young men.

  • 319.
    Pettersson, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Alfredson, Håkan
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsen, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Effect of high impact activity on bone mass and size in adolescent females: A comparative study between two different types of sports.2000In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 67, no 3, p. 207-214Article in journal (Refereed)
    Abstract [en]

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

  • 320.
    Pettersson, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lorentzon, R
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    A comparison of bone mineral density and muscle strength in young male adults with different exercise level.1999In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 64, no 6, p. 490-8Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate any differences in bone mass at different sites between young adults subjected to a high physical activity and a group of young adults with a low level of physical activity. In addition, we compared the relationship among bone mass, muscle strength, and body constitution in these two groups. The reference group consisted of 20 men, age 24.6 +/- 2.3 years, not training for more than 3 hours per week. The ice hockey players consisted of 20 players, age 23.4 +/- 4.9 years, from an ice hockey team in the second highest national Swedish league, training for about 10 hours per week. The groups were matched according to age, height, and weight. Areal bone mineral density (BMD) was measured in total body, head, humerus, spine, pelvis, femur, femoral neck, Ward's triangle, trochanter, femur diaphysis, proximal tibia, and tibia diaphysis using dual energy X-ray absorptiometry. BMD was significantly higher in the total body (8.1%), humerus (11.4%), spine (12.7%), pelvis (12.4%), femoral neck (10.3%), femur (7.4%), proximal tibia (9.8%), and tibia diaphysis (7.5%) in the high activity group. Fat mass was significantly lower in the high activity group (18.7%). The high activity group also had a significantly higher lean body mass (5.4%) and a significantly higher isokinetic muscle strength of the quadriceps muscle compared with the reference group. In the reference group, there was a general strong independent relationship between muscle strength of the thigh and all BMD sites, except for the head, tibia diaphysis, and proximal tibia. Furthermore, in the same group, body mass index (BMI) independently predicted pelvis BMD. On the contrary, in the high activity group, muscle strength did not predict any BMD site at all. In the same group, body constitutional parameters (weight, height, and fat mass) independently predicted pelvis BMD, and BMI was shown to be an independent predictor of humerus BMD. The differences in BMD between the groups seem to be site-specific and may be associated with the type and magnitude of loading during off season training and preferentially during ice hockey. High physical activity seems to weaken the relationship between BMD and muscle strength. Hence, impact forces may be of greater importance in regulating bone mass than muscle strength in itself in highly trained athletes.

  • 321.
    Pettersson, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Ahlénius, Gerd-Marie
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Henriksson-Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Low bone mass density at multiple skeletal sites, including the appendicular skeleton in amenorrheic runners1999In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 64, no 2, p. 117-125Article in journal (Refereed)
    Abstract [en]

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

  • 322.
    Piedrahita, Hugo
    et al.
    Luleå University of Technology Human Work Sciences Department 97187 Luleå Sweden.
    Oksa, Juha
    Finnish Institute of Occupational Health Physical Work Capacity Team 90220 Oulu Finland.
    Rintamäki, Hannu
    Finnish Institute of Occupational Health Physical Work Capacity Team 90220 Oulu Finland.
    Malm, Christer
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Effect of local leg cooling on upper limb trajectories and muscle function and whole body dynamic balance2009In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 105, no 3, p. 429-438Article in journal (Refereed)
    Abstract [en]

    This study was designed to find out if local leg cooling affects muscle function and trajectories of the upper limb during repetitive light work as well as capability to maintain dynamic balance. Nine healthy female subjects performed repetitive lifting task with right hand for 60 min while standing in front of a table with six target angles (30 degrees -220 degrees ) and with the legs inside a container with 15 degrees C cold water (Cold condition, C) or without water (Normal condition, N). Muscle temperature of the medial aspect of the gastrocnemius, rectal, and skin temperatures were measured continuously. The trajectories of the right upper limb were recorded with a 3D motion analysis system. Muscular strain (averaged EMG, a-EMG) and EMG gaps in eight muscles of the right upper limb were measured. End point excursion depicting the ability to maintain dynamic balance was measured before and after each experiment. Leg cooling decreased significantly (P < 0.05) the muscle and the mean skin temperature in C compared with N (6.7 and 2.2 degrees C, respectively). No marked changes in the trajectories or EMG activity were observed between the different environmental conditions. The end point excursion was significantly (P < 0.05) reduced in C compared with N and a positive correlation between excursion and muscle temperature was found at the end of the working period in C. In conclusion, local leg cooling did not affect upper limb muscle function or trajectories, but ability to maintain dynamic balance was reduced.

  • 323.
    Pietilä Holmner, Elisabeth
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Fahlström, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    The effects of interdisciplinary team assessment and a rehabilitation program for patients with chronic pain2013In: American Journal of Physical Medicine & Rehabilitation, ISSN 0894-9115, E-ISSN 1537-7385, Vol. 92, no 1, p. 77-83Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to evaluate the effects of interdisciplinary team assessment and a 4-wk rehabilitation program in chronic pain patients.

    Design: This was a longitudinal cohort study evaluating interdisciplinary pain rehabilitation measures in a specialist care setting. A total of 93 women (42.2 +/- 9.5 yrs) with chronic musculoskeletal pain (median pain duration, 8 yrs) were evaluated at assessment and at the start and end of the rehabilitation program. Pain intensity measured with a visual analog scale, pain dimensions measured with the Multidimensional Pain Inventory, and anxiety and depression measured with the Hospital Anxiety and Depression Scale were registered.

    Results: The participants exhibited significantly improved results of pain and pain-related measures. The results were seen both after the short-term intervention in the form of the interdisciplinary assessment and after the 4-wk rehabilitation program. The improvements seen after the assessment were not related to specific interventions, such as change of medication, and therefore seem to be a result of the interdisciplinary assessment concept as such.

    Conclusions: Both interdisciplinary assessment and rehabilitation program seem to be effective in chronic pain rehabilitation, at least for women. Further studies are needed to investigate potential sex differences, as well as content and duration for optimal pain rehabilitation programs.

  • 324. Pilyavskii, Alexander I
    et al.
    Maisky, Vladimir A
    Kalezic, Ivana
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Ljubisavljevic, Milos
    Centre for Musculoskeletal Research, National Institute for Working Life - Umeå.
    Kostyukov, Alexander I
    Windhorst, Uwe
    Centre for Musculoskeletal Research, National Institute for Working Life - Umeå.
    Johansson, Håkan
    Centre for Musculoskeletal Research, National Institute for Working Life - Umeå.
    c-fos expression and NADPH-d reactivity in spinal neurons after fatiguing stimulation of hindlimb muscles in the rat2001In: Brain Research, ISSN 0006-8993, E-ISSN 1872-6240, Vol. 923, no 1-2, p. 91-102Article in journal (Refereed)
    Abstract [en]

    The distribution of Fos-immunoreactive (Fos-ir) and nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d)-reactive neurons in the rat lumbar spinal cord was examined following muscle fatigue caused by intermittent high-rate (100 s(-1)) electrical stimulation of the triceps surae muscle or the ventral root L5 (VRL5) for 30 min. Following both types of stimulation, the fatigue-related c-fos gene expression was more extensive in the L2-L5 segments on the stimulated side, and the majority of Fos-ir neurons were concentrated in the dorsal horn. After direct muscle stimulation, the highest number of Fos-ir neurons were detected in two regions: layer 5, and superficial layers (1 and 2(o)), although many labeled cells were also found in layers 3, 4, 6, and 7. In response to VRL5 stimulation, the maximal density of Fos-ir neurons was detected in the middle and lateral parts of layers 1 and 2(o), the zone of termination of high-threshold muscle afferents(.) Statistically significant prevalence of Fos-ir cell number was also found in layers 5 and 7 on the stimulated side. A few Fos-ir neurons were detected in the ventral horn (layer 8 and area 10) on both sides. The lamellar distribution of NADPH-d-reactive neurons was similar over all experimental groups of animals. In the L3-L6 segments, such reactive cells were arranged in two distinct regions: dorsal horn (layers 2(i), 3, and 5) and area 10; in the L1 and L2 segments, an additional cluster of NADPH-d positive cells was found in the intermediolateral cell column (IML). Double-labeled cells were not detected. We suggest that c-fos expression in response to muscle fatigue reveals activity of functionally different types of spinal neurons which could operate together with NOS-containing cells in pre-motoneuronal networks to modulate the motoneuron output.

  • 325.
    Purdam, C R
    et al.
    Department of Physical Therapies, Australian Institute of Sport, Belconnen, Australia.
    Jonsson, Per
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Alfredson, Håkan
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Cook, J L
    La Trobe University Musculoskeletal Research Centre, Victoria, Australia.
    Khan, K M
    Department of Family Practice and School of Human Kinetics, University of British Columbia, Canada.
    A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy2004In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 38, no 4, p. 395-397Article in journal (Refereed)
    Abstract [en]

    Objectives: This non-randomised pilot study investigated the effect of eccentric quadriceps training on 17 patients (22 tendons) with painful chronic patellar tendinopathy.

    Methods: Two different eccentric exercise regimens were used by subjects with a long duration of pain with activity (more than six months). (a) Nine consecutive patients (10 tendons; eight men, one woman; mean age 22 years) performed eccentric exercise with the ankle joint in a standard (foot flat) position. (b) Eight patients (12 tendons; five men, three women; mean age 28 years) performed eccentric training standing on a 25° decline board, designed to increase load on the knee extensor mechanism. The eccentric training was performed twice daily, with three sets of 15 repetitions, for 12 weeks. Primary outcome measures were (a) 100 mm visual analogue scale (VAS), where the subject recorded the amount of pain during activity, and (b) return to previous activity. Follow up was at 12 weeks, with a further limited follow up at 15 months.

    Results: Good clinical results were obtained in the group who trained on the decline board, with six patients (nine tendons) returning to sport and showing a significantly reduced amount of pain over the 12 week period. Mean VAS scores fell from 74.2 to 28.5 (p  =  0.004). At 15 months, four patients (five tendons) reported satisfactory results (mean VAS 26.2). In the standard squat group the results were poor, with only one athlete returning to previous activity. Mean VAS scores in this group were 79.0 at baseline and 72.3 at 12 weeks (p  =  0.144).

    Conclusion: In a small group of patients with patellar tendinopathy, eccentric squats on a decline board produced encouraging results in terms of pain reduction and return to function in the short term. Eccentric exercise using standard single leg squats in a similar sized group appeared to be a less effective form of rehabilitation in reducing pain and returning subjects to previous levels of activity.

     

  • 326. Rabago, D
    et al.
    Best, T M
    Zgierska, A E
    Zeisig, Eva
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Ryan, M
    Crane, D
    A systematic review of four injection therapies for lateral epicondylosis: prolotherapy, polidocanol, whole blood and platelet-rich plasma2009In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 43, no 7, p. 471-481Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVE: To appraise existing evidence for prolotherapy, polidocanol, autologous whole blood and platelet-rich plasma injection therapies for lateral epicondylosis (LE). DESIGN: Systematic review. DATA SOURCES: Medline, Embase, CINAHL, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine. Search strategy: names and descriptors of the therapies and LE. STUDY SELECTION: All human studies assessing the four therapies for LE. MAIN RESULTS: Results of five prospective case series and four controlled trials (three prolotherapy, two polidocanol, three autologous whole blood and one platelet-rich plasma) suggest each of the four therapies is effective for LE. In follow-up periods ranging from 9 to 108 weeks, studies reported sustained, statistically significant (p<0.05) improvement in visual analogue scale primary outcome pain score measures and disease-specific questionnaires; relative effect sizes ranged from 51% to 94%; Cohen's d ranged from 0.68 to 6.68. Secondary outcomes also improved, including biomechanical elbow function assessment (polidocanol and prolotherapy), presence of abnormalities and increased vascularity on ultrasound (autologous whole blood and polidocanol). Subjects reported satisfaction with therapies on single-item assessments. All studies were limited by small sample size. CONCLUSIONS: There is strong pilot-level evidence supporting the use of prolotherapy, polidocanol, autologous whole blood and platelet-rich plasma injections in the treatment of LE. Rigorous studies of sufficient sample size, assessing these injection therapies using validated clinical, radiological and biomechanical measures, and tissue injury/healing-responsive biomarkers, are needed to determine long-term effectiveness and safety, and whether these techniques can play a definitive role in the management of LE and other tendinopathies.

  • 327.
    Radovanovic, S.
    et al.
    Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Sports Medicine.
    Korotkov, A.
    Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Sports Medicine.
    Johansson, H.
    Ljubisavljevic, M.
    Lyskov, E.
    Thunberg, J.
    Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Sports Medicine.
    Kataeva, G.
    Danko, S.
    Roudas, M.
    Pakhomov, S.
    Medvedev, S.
    Comparison of brain activity during different types of proprioceptive inputs: a positron emission tomography study2002In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 143, no 3, p. 276-285Article in journal (Refereed)
    Abstract [en]

    It has been shown that the primary and secondary somatosensory cortex, as well as the supplementary motor area (SMA), are involved in central processing of proprioceptive signals during passive and active arm movements. However, it is not clear whether different cortical areas are involved in processing of different proprioceptive inputs (skin, joint, muscle receptors), what their relative contributions might be, where kinesthetic sensations are formed within the CNS, and how they interact when the full peripheral proprioceptive machinery acts. In this study we investigated the representation of the brain structures involved in the perception of passive limb movement and illusory movement generated by muscle tendon vibration. Changes in cortical activity as indicated by changes in regional cerebral blood flow (rCBF) were measured using positron emission tomography (PET). Twelve subjects were studied under four conditions: (1) passive flexion-extension movement (PM) of the left forearm; (2) induced illusions of movements (VI) similar to the real PM, induced by alternating vibration of biceps and triceps tendons (70-80 Hz) at the elbow; (3) alternating vibration of biceps and triceps tendons (with 20-50 Hz) without induced kinesthetic illusions (VN); and (4) rest condition (RE). The results show different patterns of cortex activation. In general, the activation during passive movement was higher in comparison with both kinds of vibration, and activation during vibrations with induced illusions of movement was more prominent than during vibrations without induced illusions. When the PM condition was contrasted with the other conditions we found the following areas of activation -- the primary motor (MI) and somatosensory area (SI), the SMA and the supplementary somatosensory area (SSA). In conditions where passive movements and illusory movements were contrasted with rest, some temporal areas, namely primary and associative auditory cortex, were activated, as well as secondary somatosensory cortex (SII). Our data show that different proprioceptive inputs, which induce sensation of movement, are associated with differently located activation patterns in the SI/MI and SMA areas of the cortex. In general, the comparison of activation intensities under different functional conditions indicates the involvement of SII in stimulus perception generation and of the SI/MI and SMA areas in the processing of proprioceptive input. Activation of the primary and secondary auditory cortex might reflect the interaction between somatosensory and auditory systems in movement sense generation. SSA might also be involved in movement sense generation and/or maintenance.

  • 328.
    Renström, Frida
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Payne, Felicity
    Metabolic Disease Group, The Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Brito, Ema C
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Barroso, Ines
    Metabolic Disease Group, The Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Franks, Paul W
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Replication and extension of genome-wide association study results for obesity in 4,923 adults from Northern Sweden.2009In: Human Molecular Genetics, ISSN 0964-6906, E-ISSN 1460-2083, Vol. 18, no 8, p. 1489-1496Article in journal (Refereed)
    Abstract [en]

    Recent genome-wide association studies (GWAS) have identified multiple risk loci for common obesity (FTO, MC4R, TMEM18, GNPDA2, SH2B1, KCTD15, MTCH2, NEGR1, and PCSK1). Here we extend those studies by examining associations with adiposity and type 2 diabetes in Swedish adults. The nine single nucleotide polymorphisms (SNPs) were genotyped in 3,885 non-diabetic and 1,038 diabetic individuals with available measures of height, weight and BMI. Adipose mass and distribution was objectively assessed using dual energy X-ray absorptiometry (DEXA) in a sub-group of non-diabetics (n=2,206). In models with adipose mass traits, BMI or obesity as outcomes, the most strongly associated SNP was FTO rs1121980 (P<0.001). Five other SNPs (SH2B1 rs7498665, MTCH2 rs4752856, MC4R rs17782313, NEGR1 rs2815752, and GNPDA2 rs10938397) were significantly associated with obesity. To summarize the overall genetic burden, a weighted risk score comprising a subset of SNPs was constructed; those in the top quintile of the score were heavier (+2.6kg) and had more total (+2.4kg), gynoid (+191g), and abdominal (+136g) adipose tissue than those in the lowest quintile (all P<0.001). The genetic burden score significantly increased diabetes risk, with those in the highest quintile (n=193/594 cases/controls) being at 1.55-fold (95% CI: 1.21-1.99; P<0.0001) greater risk of type 2 diabetes than those in the lowest quintile (n=130/655 cases/controls). In summary, we have statistically replicated six of the previously associated obese-risk loci and our results suggest that the weight-inducing effects of these variants are explained largely by increased adipose accumulation.

  • 329.
    Rova, Anton
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Effects of long term supplementation of anabolic androgen steroids on skeletal muscle structural and non-structural proteins2013Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Testosterone and other anabolic androgen steroids (AAS) are widely used by both professional and amateur athletes, aiming at enhancing muscle strength, thus improved exercise performance. However, to our knowledge very few studies have been performed to investigate the long term effects of AAS on muscle protein metabolism. This study will evaluate the cellular expression and localization of four proteins after long term (5 to 15 years) supplementation of AAS, in muscle biopsies from strength athletes. HSPB1 and PGM-1 were selected for further study since they were registered in proteomics as proteins with significant different abundance between doped and clean athletes. In addition, two well-known muscle structural proteins, desmin and F-actin were also evaluated together with the two novel proteins, using immunohistochemistry (IHC) method. No obvious changes in distribution or location of either HSPB1 or PGM-1 were observed in longitudinal sections from doped biopsies, indicating that both proteins were not affected by AAS doping. Considering that PGM-1 is a metabolic related protein in muscle cells, long term AAS doping may not induce metabolic changes focally in muscle fibers. HSPB1 were not affected in areas with irregular staining for the two structural proteins, indicating that HSPB1 was not obviously structural relevant, but more prone to be a metabolism protein. AAS doping did induce focal changes in desmin and F-actin, may suggesting muscular remodeling at Z-disc level.

  • 330.
    Ruergård, Anna
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    US and CD-guided surgical scraping and plantaris tendon removal for midportion Achilles tendinopathy: -a one year follow up2013Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Treatment with Ultrasound (US) and Color Doppler (CD)-guided surgical scraping has shown good short-term clinical results in patients with chronic painful midportion Achilles tendinopathy. The objetives was to prospectively follow the patients 1-year after surgery. Sixty-four tendons in 47 patients (28 men and 19 women, mean age 52 +/-12 years) on different activity levels were operated with US+CD-guided surgical scraping, 17 bilaterally. In 43/64 tendons there was also removal of the plantaris tendon. Questionnaires evaluating activity level, VAS for pain during activity, satisfaction with treatment result, improvement after surgery and the SF-36 score (quality of life), were used before and 1-year after surgery. At the one year follow up, the median VAS for pain during tendon loading activity had decreased from 67 (95% CI 61-73) before surgery to 10,5 (95% CI 5-16) after surgery (p<0.001) All patients were satisfied with the result and had returned to full tendon loading activity. There were no complications. The SF-36 score had improved significantly, both physical and psychological parameters. In conclusion the 1-year perspective, US+CD-guided surgical scraping, often combined with plantaris tendon removal, seems to be a good treatment for patients with chronic painful midportion Achilles tendinopathy.

  • 331.
    Ruergård, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Andersson, Lisa
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Effekter av fysisk aktivitet på psykisk ohälsa hos unga kvinnor2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Among young adults and especially women, psychological issues are common phenomena in the society such as depression, anxiety and stress. Research has shown that physical activity can be a complement for anti-depressant medication. The aim of this review is to examine previous research to find out how physical activity can provide positive effects on overall mood state in particular young women's psychological health. The results of this review is that there are support in the literature of young women that physical activity may enhance mood in studies of depression and anxiety symptoms and small support for the effects on reducing stress. Physical activity with both high intensity and low intensity has shown to have positive effects on depression and anxiety, but the physical activity has to be regular for long-term effects. The frequency of 2-3 times per week provide effects on mood in studies. In the research area of physiological mechanisms that may reduce depression, anxiety and stress it is not enough research done on young women to provide enough evidence of what the mechanism is behind the effect of the psychological effect of exercise, not in the research done on cortisol, serotonin and Brain Derived Neurotrophic Factor (BDNF). Physical activity should be better explored as a possibility as a treatment and prevention for depression and other psychological health problems with larger test groups and with separate groups for women and men. Also there are lack of studies done that compare different physical activity and intensity, duration and times per week.

  • 332. Sahlin, Kent
    et al.
    Fernström, Maria
    Svensson, Michael
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Tonkonogi, Michail
    No evidence of an intracellular lactate shuttle in rat skeletal muscle.2002In: Journal of Physiology, ISSN 0022-3751, E-ISSN 1469-7793, Vol. 541, no Pt 2, p. 569-74Article in journal (Refereed)
    Abstract [en]

    The concerted view is that cytosolic pyruvate is transferred into mitochondria and after oxidative decarboxylation further metabolized in the tricarboxylic acid cycle. Recently this view has been challenged. Based on experimental evidence from rat skeletal muscle it has been concluded that mitochondria predominantly oxidize lactate in vivo and that this constitutes part of an 'intracellular lactate shuttle'. This view appears to be gaining acceptance in the scientific community and due to its conceptual importance, confirmation by independent experiments is required. We have repeated the experiments in mitochondria isolated from rat soleus muscle. Contrary to the previously published findings we cannot find any mitochondrial respiration with lactate. Analysis of lactate dehydrogenase (LDH) by spectrophotometry demonstrated that the activity in the mitochondrial fraction was only 0.7 % of total activity. However, even when external LDH was added to mitochondria, there were no signs of respiration with lactate. In the presence of conditions where lactate is converted to pyruvate (external additions of both LDH and NAD(+)), mitochondrial oxygen consumption increased. Furthermore, we provide theoretical evidence that direct mitochondrial lactate oxidation is energetically unlikely. Based on the present data we conclude that direct mitochondrial lactate oxidation does not occur in skeletal muscle. The presence of an 'intracellular lactate shuttle' can therefore be questioned.

  • 333.
    Salman, Ali Faleh
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Jämförelse av skador mellan manliga och kvinnliga handbollsspelare i junior- och seniorlag2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Physical activity is important in human life at any age, but unfortunately, many injuries happen during times of practicing sports. Sports injuries account for about 16% of all recorded injuries in emergency departments in Sweden. Injuries are a major issue in most team sports; therefore, all sport teams work on having prevention of injuries. Handball is a tough sport with a lot of clash among the players that causes several injuries.

    The purpose of this study is to compare injuries between male and female handball players in the senior and junior teams, to see how much age and gender may affect the injury incidence.

    This thesis has studied handball injuries by choosing and examining random patterns from Swedish handball teams in various levels of senior and junior teams of both sexes. The Survey has been done in spring 2012, and I have personally designed the questionnaire. The study comprised of 226 players, including 128 seniors (53 women and 75 men) and 98 juniors (47 women and 51 men).

     

    The total number of the injured players was (145), and according to their responses of the survey, the total number of injuries was (220), meaning that 64% of the players were injured at least once during the season 2011-2012.  Handball injuries are divided into two types: acute injuries and overloading injuries, and they can fall during training and matches.

     

    Finally, I conclude that there are no significant differences detected between the different groups of age and gender concerning injuries, locations of injuries, types of injuries (acute or overload), times of injury (trainings or matches) and periods of absence from trainings and matches, in Swedish teams of handball. However, the distribution of males are statistically different, p <0.05. That there are fewer injuries among seniors than juniors leading to absence 8-30 days from the times of matches and training, and more injuries among seniors leading to the absence>30days. Therefore, I which proves no differences between genders and ages in injuries.

  • 334.
    Sandgren, Evelina
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Pulsmätning och beräkning av speltid som metod för att kartlägga intensiteten under en innebandymatch: En pilotstudie2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    INTRODUCTION: Even though floorball has become a popular team sport there are very little research on the physical demands that the floorball players requires. By characterizing the playing time, work intensity, and time for recovery during a game, the training could be optimized.

    AIM: The aim of this study was to determine if heart rate monitoring and calculation of playing time could be used to characterize the players work intensity during a floorball game by measuring playing time, time for recovery and heart rate.

    METHODS: One female floorball team (playing in the Swedish division 1) consisted by 14 players (17, 6 ± 0, 7 years, 167, 8 ± 6,4 cm,  60,4 ± 6,9 kg) participated in the study. During two games the player’s heart rate were measured by Polar team ² system and the games were recorded with a video camera (Go Pro Hero 3. To determine the player’s maximum heart rate, which was needed to calculate the intensity level, the player’s preformed a Yo-yo intermittent recovery test- level 1. Playing time during the games was analyzed by watching the videos and values for heart rate and work intensity were measured by Polar Team² software.

    RESULTS: Total effective playing time was approximately 21 minutes, a substitution about 49 seconds and the time for recovery between substitutions about two minutes and twenty seconds. Time spent in intensity zone 91-100% of max was about twenty minutes and time spent in intensity zone 51-60% of max was about four minutes. Time spent in the intensity zones in-between (61-90% of max) was about 56 minutes.

    CONCLUSIONS: Heart rate monitoring and calculation of playing time are, together with measuring for example movement patterns and distance, good tools for characterizing work intensity during a floor ball game, although level of intensity should be calculated as percentage of the heart reserve and it should be measured both for effective playing time and for the whole game.

    Key words: match analysis, heart rate monitoring, intensity, playing time

     

  • 335.
    Sandgren, Evelina
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Karlsson, Mia
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Yu, Ji-Guo
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Correlation analysis between soccer game world ranking and player league distribution2013In: Sport and Art, ISSN 2331-6233, Vol. 1, no 2, p. 34-40Article in journal (Refereed)
    Abstract [en]

    Nowadays professional soccer player trading between clubs/leagues is very common. Soccer players could be employed in foreign clubs/leagues, but when international competitive events come, the elite players are recruited to compose a national team. One can expect that the higher ranking of a national team, the more players are employed by the top soccer leagues. However, the relationship between the two issues has never been studied early. In the study, seven national soccer teams were selected from a list of the world top 35 soccer teams of year 2010[created by the Federation of International Football Association (FIFA)]. The 7 teams are Spain, England, Argentina, Germany, USA, Ghana and Sweden, across the full range of the list, thus, representing different levels of the world. On basis of the position of the 7 teams in the world ranking, an order ranking for the 7 teams was created. To identify player distribution of the 7 teams in different quality/level of soccer leagues, a league ranking including the top 25 soccer leagues in the world created by the International Federation of Football History and Statistics (IFFHS) was used. For each of the 7 teams, its player distribution in different soccer leagues was classified. On basis of the league ranking and the number of player(s) of each team in different leagues, calculated team point was calculated for each team. According to the amount of the calculated point, a calculated team ranking was obtained. Correlation analysis was performed between the two rankings: the order ranking and the calculated team ranking. The results showed a high and positive correlation between the two variables. We concluded that the more players are employed in higher ranking leagues the higher world ranking of a national team.

  • 336.
    Sandlund, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Centre for Musculoskeletal Research, University of Gävle; Alfta Research Foundation, Alfta.
    Djupsjöbacka, Mats
    Centre for Musculoskeletal Research, University of Gävle.
    Ryhed, Bengt
    Alfta Research Foundation, Alfta.
    Hamberg, Jern
    Alfta Research Foundation, Alfta.
    Björklund, Martin
    Centre for Musculoskeletal Research, University of Gävle; Alfta Research Foundation, Alfta.
    Predictive and discriminative value of shoulder proprioception tests for patients with whiplash-associated disorders2006In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 38, no 1, p. 44-49Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate whether patients suffering from whiplash-associated disorders have impaired shoulder proprioception and whether the acuity of shoulder proprioception is reflected in the patients’ symptoms and self-rated function.

    Design: A comparative group design, including a correlation design for the patient group.

    Subjects: Patients with chronic whiplash-associated disorders (n/37) and healthy subjects (n/41). The groups were matched for age and gender.

    Methods: All subjects underwent a shoulder proprioception test involving active ipsilateral arm position-matching. Group difference was evaluated by multiple analysis of variance and analysis of variance. The patient group completed questionnaires addressing functioning and health and performed pain ratings. Associations between proprioceptive acuity and selfrated functioning and symptoms were studied by correlation and regression analyses.

    Results: The patient group showed significantly lower acuity of shoulder proprioception. Moderate correlations were found between proprioceptive acuity and questionnaire scores representing physical functioning, so that low proprioceptive acuity was associated with low self-rated physical functioning. Scores representing pain-intensity did not correlate with proprioceptive acuity.

    Conclusion: The results show that, at the group level, patients with whiplash-associated disorders have impaired shoulder proprioception. The clinical relevance of this finding is strongly supported by the association between shoulder proprioceptive acuity and self-rated functioning in the patient group.

  • 337.
    Sandlund, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Centre for Musculoskeletal Research, University of Gävle, Gävle; Alfta Research Foundation, Alfta, Sweden.
    Röijezon, Ulrik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, University of Gävle, Gävle; Alfta Research Foundation, Alfta, Sweden.
    Björklund, Martin
    Centre for Musculoskeletal Research, University of Gävle, Gävle; Alfta Research Foundation, Alfta, Sweden.
    Djupsjöbacka, Mats
    Centre for Musculoskeletal Research, University of Gävle, Gävle.
    Acuity of goal-directed arm movements to visible targets in chronic neck pain2008In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 40, no 5, p. 366-374Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate end-point acuity in goal-directed arm movements in subjects with chronic neck pain, while taking the trade-off between speed and accuracy into account, and to evaluate associations between reduced acuity and self-rated characteristics.

    Design: Single-blinded, controlled, comparative group study.

    Subjects: Forty-five subjects with chronic non-traumatic, non-specific neck pain (n = 24) and whiplash-associated disorders (n = 21). Healthy subjects served as controls (n = 22). The groups were age- and sex-matched.

    Methods: Subjects performed fast and accurate pointing movements to a visual target. Group differences in end-point variability, controlled for peak velocity, were evaluated. Associations between end-point variability and self-rated symptoms, functioning, self-efficacy and kinesiophobia were analysed.

    Results: End-point acuity, controlled for peak velocity, was reduced for both neck-pain groups. Similar spatial error patterns across all groups indicated no direction-specific reduction. For both neck-pain groups, associations were found between end-point acuity and neck movement deficits, physical functioning and, in whiplash, also balance and pain.

    Conclusion: Acuity of goal-directed arm movements can be reduced in chronic neck pain. Associations between acuity and self-rated characteristics support the clinical validity of the results and indicate that impaired neck function contributes to reduced end-point acuity. The results can be of importance for characterization and rehabilitation of neck disorders.

  • 338.
    Sandow, Joel
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lundström, Peter
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Olsson, Carl-Johan
    Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    När kroppen lider blir huvudet dumt2011In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 20, no 1, p. 50-53Article in journal (Other academic)
    Abstract [sv]

    Fysisk trötthet påverkar kognitiva funktioner negativt på olika sätt. På kort sikt drabbas det episodiska minnet. På lång sikt blir de exekutiva funktionerna sämre. För att undvika enkla misstag bör till exempel skidåkare och orienterare noggrant planera de moment av träningen som är mer kognitiva.

  • 339.
    Sandström, Torbjörn
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Niemelä, Maria
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    A Brief Review of Effective Training for Optimizing Muscle Power in Vertical Jumping2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Power is important in many sports where force need to be applied in high velocities or short time. Power is also important for the elderly for maintaining active daily activities. In recent years, much research on power training has been performed, especially concerning the method of power training. In 2009, The American College of Sports Medicine released a recommendation for power training. However, the ACSM recommendation did not specify the training method. The purpose of this review was to investigate if the ACSM recommendation is suitable for power training in the lower body using vertical jump as the evaluating method. Literature search was performed in the database of PubMed and relevant articles cited by the searched articles were also included in this review. Reviewing the studies showed that the numbers of repetitions and sets in the power training interventions were inconsistent and no definitive conclusion could be made. However, studies where the greatest power improvement was achieved used approximately the same numbers of reps (5-7) and sets (6-7) as ACSM’s recommendations. The results indicate that the guidelines of ACSM needs a minor adjustment with respect to reps and sets: extending the number of reps and sets to seven instead of the current recommendation of 3-6. Regarding frequency, two sessions per week were superior compared with three sessions per week.

  • 340.
    Scott, Alex
    et al.
    University of British Columbia.
    Docking, Sean
    Monash University, Melbourne.
    Vicenzino, Bill
    University of Queensland, Brisbane.
    Alfredson, Håkan
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Zwerver, Johannes
    University Medical Center Groningen, Center for Sports Medicine, Groningen.
    Lundgreen, Kirsten
    Oslo Sports Trauma Research Center.
    Finlay, Oliver
    Lee Valley Athletics Centre and Hospital of St John and St Elizabeth, London.
    Pollock, Noel
    e and Hospital of St John and St Elizabeth, London.
    Cook, Jill L.
    Monash University, Melbourne.
    Fearon, Angela
    University of British Columbia.
    Purdam, Craig R.
    Australian Institute of Sport, Canberra.
    Hoens, Alison
    Physiotherapy Association of British Columbia, Vancouver Coastal Health and Research Institute, University of British Columbia, Vancouver.
    Rees, Jonathan D.
    Goetz, Thomas J.
    University of Queensland, Brisbane.
    Danielson, Patrik
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Sports and exercise-related tendinopathies: a review of selected topical issues by participants of the second International Scientific Tendinopathy Symposium (ISTS) Vancouver 20122013In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 47, no 9, p. 536-+Article in journal (Refereed)
    Abstract [en]

    In September 2010, the first International Scientific Tendinopathy Symposium (ISTS) was held in Umea, Sweden, to establish a forum for original scientific and clinical insights in this growing field of clinical research and practice. The second ISTS was organised by the same group and held in Vancouver, Canada, in September 2012. This symposium was preceded by a round-table meeting in which the participants engaged in focused discussions, resulting in the following overview of tendinopathy clinical and research issues. This paper is a narrative review and summary developed during and after the second ISTS. The document is designed to highlight some key issues raised at ISTS 2012, and to integrate them into a shared conceptual framework. It should be considered an update and a signposting document rather than a comprehensive review. The document is developed for use by physiotherapists, physicians, athletic trainers, massage therapists and other health professionals as well as team coaches and strength/conditioning managers involved in care of sportspeople or workers with tendinopathy.

  • 341.
    Segerlund, Emilia
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Hammarlund, Emma
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Johansson, Linn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Hur kan reiki healing påverka kroppen fysiologiskt och psykologiskt samt användas som behandlingsmetod i spamiljöer?2012Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    ABSTRAKT

    Syfte: Syftet med examensarbetet är att beskriva reiki healings fysiologiska och psykologiska effekter och hur reiki healing fungerar i praktiken, samt att se om metoden kan användas som en del av behandlingsutbudet på en spa-anläggning.

    Metod: Detta examensarbete grundar sig på vetenskapliga artiklar och litteratur. Artiklarna är hämtade från databaser som PubMed, AMED, web of science och PsycINFO.

    Resultat:Positiva effekter efter reiki healing är sänkt blodtryck, minskad muskelspänning, minskad smärta, ångest, förbättrat sömnmönster, förbättrat gensvar på immunsystemet, stärkt immunförsvar och snabbare läkning, lindrade symptom på depression och stress.

    Slutsats: Reiki healing har både psykologiska och fysiologiska effekter på kroppen. Behandlingen kan även bli en del av utbudet på en spa-anläggning då reiki healingens effekter liknar bland annat massagens som är en del av utbudet.

    Sökord: reiki, reiki healing, wellness, bloodpressure, puls, stress och terapeutic touch. Limits för sökningen: human, English, published in last 10years och all adults 19+ years.

  • 342.
    Sens, Eric
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Riskfaktorer för Skador inom herr-innebandy: En studie på Funktionell screening och skaderegistrering2012Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

     

    Ur ett folkhälsoperspektiv är fördelarna med idrott och fysisk aktivitet uppenbara, frågan vi behöver ställa oss är om de positiva effekterna står över riskerna för skador och handikapp på lång sikt. Forskning har visat på att riskfaktorer för idrottsskador kan identifieras hos individen och förebyggas med hjälp av träning. Syftet med denna studie är att undersöka samband mellan brister i styrka samt rörlighet och skadeincidens hos manliga innebandyspelare.

     

    Metod: Till denna studie valdes 18 manliga innebandyspelare ut varav 15 av dem (18,6 ± 3,3 år, medel vikt 81,5 ± 7,2 kg) fullföljde hela studien. Samtliga spelare tillhörde ett svenskt division 1 lag. Testerna som genomfördes var knäböj (1RM), utfallssteg, höftlyft och plankan vilka hade till syfte att identifiera brister i styrka, stabilitet samt utförande. Rörlighetstester användes för att undersöka Hamstrings-, Gastrocnemius- och Illiopsoas rörlighet. Efter testerna gjordes en uppföljning under 54 dagar där skador registrerades. De registrerade skadorna sammanställdes och jämfördes mot testresultaten.

     

    Resultat:. Denna studie visade inte på några signifikanta samband mellan testerna och skadeincidens. Ett fynd uppmärksammades dock, det visade sig att gruppen med skadade spelare hade kortare erfarenhet av styrketräning med fria vikter jämfört med den oskadade gruppen (p=0,005). Under studiens gång registrerades sju stycken skador registrerades

     

    Konklusion: Även om denna studie inte lyckades att hitta några samband mellan bristfälliga resultat i styrka och rörlighet relaterat skadeincidens så har tidigare studier visat på att det finns relevanta tester som kan belysa riskfaktorer för skador. Framtida studier bör fokusera på tester som är mer komplexa och innehåller moment som balans och koordination, vilket kan vara riskfaktorer för skada inom manlig innebandy.

     

    Sökord: innebandy, skador, riskfaktorer, screening

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

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

  • 344.
    Sjölander, Per
    et al.
    Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Sports Medicine.
    Sundberg, Johan
    Spectrum effects of subglottal pressure variation in professional baritone singers.2004In: J Acoust Soc Am, ISSN 0001-4966, Vol. 115, no 3, p. 1270-3Article in journal (Refereed)
  • 345.
    Sjöstedt, Anna
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Testmetodens betydelse för VO2peak och testtid: en jämförelse mellan två kombinationstest2013Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Tests aimed to verify VO2max should consist of incremental loading during 8 to 12 minutes with 3 to 6 minutes at each load. Time at each load during incremental lactate threshold tests should be 3 to 8 minutes. A combination between a VO2max test and a lactate threshold test is time-saving for both athletes and test laboratory. This study compared two types of combined tests with the hypothesis that lower and more frequent increment loading, near/after OBLA 4 mM, results in shorter test duration and that the subjects´ results for VO2peak will be higher. Method: 10 women (age 27.7 ± 6.2) performed two combination tests (A and B). The workload during A was initially 40 W whereupon the workload subsequently increased by 40 W every third minute until exhaustion. B was initially designed as A until the subject was close to OBLA 4 mM, where the subject completed the ongoing interval on which the load increased every 30 seconds with 20 W until exhaustion. No significant difference between A and B for the value of VO2peak (l/min) (p = 0.664), VO2peak (ml/kg/min) (p = 0.578) or for the total testing time (p = 0.300). The results from test A and B performed on trained women reject the tested hypothesis. However, the number of subjects and the fact that the test has not yet been performed in specific sports should be taken into consideration before the hypothesis is completely rejected. The major problem of test B is to decide when to make the change in the test procedure (faster and smaller increments).

    Key Words: VO2max, Lactate, Lactate threshold, Intermittent testing, Incremental test, Hockey, OBLA

  • 346.
    Song, Yafeng
    et al.
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Forsgren, Sture
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Liu, Jing Xia
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Yu, Jiguo
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Stål, Per
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Unilateral muscle overuse causes bilateral changes in muscle fibre composition and vascular supplyManuscript (preprint) (Other academic)
  • 347.
    Song, Yafeng
    et al.
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
    Forsgren, Sture
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
    Liu, Jing-Xia
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
    Yu, Ji-Guo
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Stål, Per
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
    Unilateral muscle overuse causes bilateral changes in muscle fiber composition and vascular supply2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 12, p. e116455-Article in journal (Refereed)
    Abstract [en]

    Unilateral strength training can cause cross-transfer strength effects to the homologous contralateral muscles. However, the impact of the cross-over effects on the muscle tissue is unclear. To test the hypothesis that unilateral muscle overuse causes bilateral alterations in muscle fiber composition and vascular supply, we have used an experimental rabbit model with unilateral unloaded overstrain exercise via electrical muscle stimulation (E/EMS). The soleus (SOL) and gastrocnemius (GA) muscles of both exercised (E) and contralateral non-exercised (NE) legs (n = 24) were morphologically analyzed after 1w, 3w and 6w of EMS. Non-exercised rabbits served as controls (n = 6). After unilateral intervention the muscles of both E and NE legs showed myositis and structural and molecular tissue changes that to various degrees mirrored each other. The fiber area was bilaterally smaller than in controls after 3w of E/EMS in both SOL (E 4420 and NE 4333 µm2 vs. 5183 µm2, p<0.05) and GA (E 3572 and NE 2983 µm2 vs. 4697 µm2, p<0.02) muscles. After 6w of E/EMS, the percentage of slow MyHCI fibers was lower than in controls in the NE legs of SOL (88.1% vs. 98.1%, p<0.009), while the percentage of fast MyHCIIa fibers was higher in the NE legs of GA (25.7% vs. 15.8%, p = 0.02). The number of capillaries around fibers in the E and NE legs was lower (SOL 13% and 15%, respectively, GA 25% and 23%, respectively, p<0.05) than in controls. The overall alterations were more marked in the fast GA muscle than in the slow SOL muscle, which on the other hand showed more histopathological muscle changes. We conclude that unilateral repetitive unloaded overuse exercise via EMS causes myositis and muscle changes in fiber type proportions, fiber area and fiber capillarization not only in the exercised leg, but also in the homologous muscles in the non-exercised leg.

  • 348.
    Song, Yafeng
    et al.
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Forsgren, Sture
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Yu, Jiguo
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Stål, Per
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Effects on contralateral muscles after unilateral electrical muscle stimulation and exercise2012In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 12, p. e52230-Article in journal (Refereed)
    Abstract [en]

    It is well established that unilateral exercise can produce contralateral effects. However, it is unclear whether unilateral exercise that leads to muscle injury and inflammation also affects the homologous contralateral muscles. To test the hypothesis that unilateral muscle injury causes contralateral muscle changes, an experimental rabbit model with unilateral muscle overuse caused by a combination of electrical muscle stimulation and exercise (EMS/E) was used. The soleus and gastrocnemius muscles of both exercised and non-exercised legs were analyzed with enzyme-and immunohistochemical methods after 1, 3 and 6 weeks of repeated EMS/E. After 1 w of unilateral EMS/E there were structural muscle changes such as increased variability in fiber size, fiber splitting, internal myonuclei, necrotic fibers, expression of developmental MyHCs, fibrosis and inflammation in the exercised soleus muscle. Only limited changes were found in the exercised gastrocnemius muscle and in both non-exercised contralateral muscles. After 3 w of EMS/E, muscle fiber changes, presence of developmental MyHCs, inflammation, fibrosis and affections of nerve axons and AChE production were observed bilaterally in both the soleus and gastrocnemius muscles. At 6 w of EMS/E, the severity of these changes significantly increased in the soleus muscles and infiltration of fat was observed bilaterally in both the soleus and the gastrocnemius muscles. The affections of the muscles were in all three experimental groups restricted to focal regions of the muscle samples. We conclude that repetitive unilateral muscle overuse caused by EMS/E overtime leads to both degenerative and regenerative tissue changes and myositis not only in the exercised muscles, but also in the homologous non-exercised muscles of the contralateral leg. Although the mechanism behind the contralateral changes is unclear, we suggest that the nervous system is involved in the cross-transfer effects.

  • 349.
    Song, Yafeng
    et al.
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Stål, Per
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Backman, C
    Yu, Jiguo
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Forsgren, Sture
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Experimental studies favour that tachykinins are involved in the process of myositis and muscle derangement in an overuse animal modelManuscript (preprint) (Other academic)
  • 350.
    Song, Yafeng
    et al.
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Stål, Per S
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Yu, Ji-Guo
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Lorentzon, Ronny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Backman, Clas
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Hand Surgery.
    Forsgren, Sture
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Inhibitors of endopeptidase and angiotensin-converting enzyme lead to an amplification of the morphological changes and an upregulation of the substance P system in a muscle overuse model2014In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 15, p. 126-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: We have previously observed, in studies on an experimental overuse model, that the tachykinin system may be involved in the processes of muscle inflammation (myositis) and other muscle tissue alterations. To further evaluate the significance of tachykinins in these processes, we have used inhibitors of neutral endopeptidase (NEP) and angiotensin-converting enzyme (ACE), substances which are known to terminate the activity of various endogenously produced substances, including tachykinins.

    METHODS: Injections of inhibitors of NEP and ACE, as well as the tachykinin substance P (SP), were given locally outside the tendon of the triceps surae muscle of rabbits subjected to marked overuse of this muscle. A control group was given NaCl injections. Evaluations were made at 1 week, a timepoint of overuse when only mild inflammation and limited changes in the muscle structure are noted in animals not treated with inhibitors. Both the soleus and gastrocnemius muscles were examined morphologically and with immunohistochemistry and enzyme immunoassay (EIA).

    RESULTS: A pronounced inflammation (myositis) and changes in the muscle fiber morphology, including muscle fiber necrosis, occurred in the overused muscles of animals given NEP and ACE inhibitors. The morphological changes were clearly more prominent than for animals subjected to overuse and NaCl injections (NaCl group). A marked SP-like expression, as well as a marked expression of the neurokinin-1 receptor (NK-1R) was found in the affected muscle tissue in response to injections of NEP and ACE inhibitors. The concentration of SP in the muscles was also higher than that for the NaCl group.

    CONCLUSIONS: The observations show that the local injections of NEP and ACE inhibitors led to marked SP-like and NK-1R immunoreactions, increased SP concentrations, and an amplification of the morphological changes in the tissue. The injections of the inhibitors thus led to a more marked myositis process and an upregulation of the SP system. Endogenously produced substances, out of which the tachykinins conform to one substance family, may play a role in mediating effects in the tissue in a muscle that is subjected to pronounced overuse.

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