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  • 51.
    Johansson, Roland S
    et al.
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Riso, Ronald
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Bäckström, Lars
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Somatosensory control of precision grip during unpredictable pulling loads. I. Changes in load force amplitude.1992In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 89, no 1, p. 181-191Article in journal (Refereed)
    Abstract [en]

    In manipulating 'passive' objects, for which the physical properties are stable and therefore predictable, information essential for the adaptation of the motor output to the properties of the current object is principally based on 'anticipatory parameter control' using sensorimotor memories, i.e., an internal representation of the object's properties based on previous manipulative experiences. Somatosensory afferent signals only intervene intermittently according to an 'event driven' control policy. The present study is the first in a series concerning the control of precision grip when manipulating 'active' objects that exert unpredictable forces which cannot be adequately represented in a sensorimotor memory. Consequently, the manipulation may be more reliant on a moment-to-moment sensory control. Subjects who were prevented from seeing the hand used the precision grip to restrain a manipulandum with two parallel grip surfaces attached to a force motor which produced distally directed (pulling) loads tangential to the finger tips. The trapezoidal load profiles consisted of a loading phase (4 N/s), plateau phase and an unloading phase (4 N/s) returning the load force to zero. Three force amplitudes were delivered in an unpredictable sequence; 1 N, 2 N and 4 N. In addition, trials with higher load rate (32 N/s) at a low amplitude (0.7 N), were superimposed on various background loads. The movement of the manipulandum, the load forces and grip forces (normal to the grip surfaces) were recorded at each finger. The grip force automatically changed with the load force during the loading and unloading phases. However, the grip responses were initiated after a brief delay. The response to the loading phase was characterized by an initial fast force increase termed the 'catch-up' response, which apparently compensated for the response delay--the grip force adequately matched the current load demands by the end of the catch-up response. In ramps with longer lasting loading phases (amplitude greater than or equal to 2 N) the catch-up response was followed by a 'tracking' response, during which the grip force increased in parallel with load force and maintained an approximately constant force ratio that prevented frictional slips. The grip force during the hold phase was linearly related to the load force, with an intercept close to the grip force used prior to the loading. Likewise, the grip force responses evoked by the fast loadings superimposed on existing loads followed the same linear relationship.(ABSTRACT TRUNCATED AT 400 WORDS)

  • 52. Klein, C S
    et al.
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Thomas, C K
    Fatigue properties of human thenar motor units paralysed by chronic spinal cord injury.2006In: The Journal of physiology, ISSN 0022-3751, Vol. 573, no Pt 1, p. 161-71Article in journal (Refereed)
  • 53.
    Lämås, Kristina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindgren, Lenita
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
    Wester, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Does touch massage facilitate recovery after stroke?: A study protocol of a randomized controlled trial2016In: BMC Complementary and Alternative Medicine, ISSN 1472-6882, E-ISSN 1472-6882, Vol. 16, article id 50Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite high quality stroke care, decreased sensorimotor function, anxiety and pain often remain one year after stroke which can lead to impaired health and dependence, as well as higher healthcare costs. Touch massage (TM) has been proven to decrease anxiety and pain, and improve quality of health in other conditions of reduced health, where reduced anxiety seems to be the most pronounced benefit. Thus there are reasons to believe that TM may also reduce anxiety and pain, and improve quality of life after stroke. Further, several studies indicate that somatosensory stimulation can increase sensorimotor function, and it seems feasible to believe that TM could increase independence after stroke. In this study we will evaluate effects of TM after stroke compared to sham treatment.

    METHODS: This is a prospective randomized open-labelled control trial with blinded evaluation (PROBE-design). Fifty patients with stroke admitted to stroke units will be randomized (1:1) to either a TM intervention or a non-active transcutaneous electrical nerve stimulation (non-TENS) control group. Ten sessions of 30 min treatments (TM or control) will be administered during two weeks. Assessment of status according to the International Classification of Functioning, Disability and Health (ICF), including body function, activity, and participation. Assessment of body function will include anxiety, pain, and stress response (heart rate variability and salivary cortisol), where anxiety is the primary outcome. Activity will be assessed by means of sensorimotor function and disability, and participation by means of health-related quality of life. Assessments will be made at baseline, after one week of treatment, after two weeks of treatment, and finally a follow-up after two months. The trial has been approved by the Regional Ethical Review Board.

    DISCUSSION: TM seems to decrease anxiety and pain, increase health-related quality of life, and improve sensorimotor functions after stroke, but the field is largely unexplored. Considering the documented pleasant effects of massage in general, absence of reported adverse effects, and potential effects in relation to stroke, it is essential to evaluate effects of TM during the sub-acute phase after stroke. The results of this project will hopefully provide important knowledge for evidence-based care.

    TRIAL REGISTRATION: ClinicalTrials.gov: NTC01883947.

  • 54.
    Macefield, Vaughan G
    et al.
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Johansson, Roland S
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Control of grip force during restraint of an object held between finger and thumb: responses of cutaneous afferents from the digits1996In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 108, no 1, p. 155-171Article in journal (Refereed)
    Abstract [en]

    Unexpected pulling and pushing loads exerted by an object held with a precision grip evoke automatic and graded increases in the grip force (normal to the grip surfaces) that prevent escape of the object; unloading elicits a decrease in grip force. Anesthesia of the digital nerves has shown that these grip reactions depend on sensory signals from the digits. In the present study we assessed the capacity of tactile afferents from the digits to trigger and scale the evoked grip responses. Using tungsten microelectrodes inserted percutaneously into the median nerve of awake human subjects, unitary recordings were made from ten FA I and 13 FA II rapidly adapting afferents, and 12 SA I and 18 SA II slowly adapting afferents. While the subject held a manipulandum between a finger and the thumb, tangential load forces were applied to the receptor-bearing digit (index, middle, or ring finger or thumb) as trapezoidal load-force profiles with a plateau amplitude of 0.5-2.0 N and rates of loading and unloading at 2-8 N/s, or as "step-loads" of 0.5 N delivered at 32 N/s. Such load trials were delivered in both the distal (pulling) and proximal (pushing) direction. FA I afferents responded consistently to the load forces, being recruited during the loading and unloading phases. During the loading ramp the ensemble discharge of the FA I afferents reflected the first time-derivative of the load force (i.e., the load-force rate). These afferents were relatively insensitive to the subject's grip force responses. However, high static finger forces appeared to suppress excitation of these afferents during the unloading phase. The FA II afferents were largely insensitive to the load trials: only with the step-loads did some afferents respond. Both classes of SA afferents were sensitive to load force and grip force, and discharge rates were graded by the rate of loading. The firing of the SA I afferents appeared to be relatively more influenced by the subject's grip-force response than the discharge of the SA II afferents, which were more influenced by the load-force stimulus. The direction in which the tangential load force was applied to the skin influenced the firing of most afferents and in particular the SA II afferents. Individual afferents within each class (except for the FA IIs) responded to the loading ramp before the onset of the subject's grip response and may thus be responsible for initiating the automatic increase in grip force. However, nearly half of the FA I afferents recruited by the load trials responded to the loading phase early enough to trigger the subject's grip-force response, whereas only ca. one-fifth of the SA Is and SA IIs did so. These observations, together with the high density of FA I receptors in the digits, might place the FA I afferents in a unique position to convey the information required to initiate and scale the reactive grip-force responses to the imposed load forces.

  • 55.
    Markström, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Schelin, Lina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Elite women athletes with superior knee function present similar dynamic knee stability, although different movement strategies, when compared to controls2018In: 23rd annual Congress of the European College of Sport Science: Sport Science at the cutting edge, Dublin, July 4-7, 2018, 2018Conference paper (Refereed)
  • 56.
    Markström, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Schelin, Lina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Similar dynamic knee stability but different movement strategies and between-leg asymmetries for hip and knee joints for ACL-reconstructed persons relative to knee-healthy controls2018In: 8th World Congress of Biomechanics, Dublin, July 8-12, 2018, 2018Conference paper (Refereed)
  • 57.
    Markström, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Schelin, Lina
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Dynamic knee control and movement strategies in athletes and non‐athletes in side hops: implications for knee injury2019In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 29, no 8, p. 1181-1189Article in journal (Refereed)
    Abstract [en]

    Athletes exposed to rapid maneuvers need a high level of dynamic knee stability and robustness, while also controlling whole body movement, to decrease the risk of non‐contact knee injury. The effects of high‐level athletic training on such measures of movement control have not, however, been thoroughly evaluated. This study investigated whether elite athletes (who regularly perform knee‐specific neuromuscular training) show greater dynamic knee robustness and/or different movement strategies than non‐athletic controls, in relation to overall knee function. Thirty‐nine women (19 athletes, 20 controls) performed standardized rebound side hops (SRSH) while a motion capture system synchronized with two force plates registered three‐dimensional trunk, hip, and knee joint angles and moments. Dynamic knee robustness was evaluated using finite helical axis (FHA) inclination angles extracted from knee rotation intervals of 10°, analyzed with independent t tests. Angle and moment curves were analyzed with inferential methods for functional data. Athletes had superior knee function (less laxity, greater hop performances, and strength) but presented similar FHA inclination angles to controls. Movement strategies during the landing phase differed; athletes presented larger (a) hip flexion angles (during 9%‐29% of the phase), (b) hip adduction moments (59%‐99%), (c) hip internal rotation moments (83%‐89%), and (d) knee flexion moments (79%‐93%). Thus, elite athletes may have a greater ability than non‐athletes to keep the knee robust while performing SRSH more efficiently through increased engagement of the hip. However, dynamic knee robustness associated with lower FHA inclination angles still show room for improvement, thus possibly decreasing knee injury risk.

  • 58.
    Markström, Jonas L.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Schelin, Lina
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Individuals with anterior cruciate ligament reconstruction adopt different movement strategies but display robust knees during side hop landingsManuscript (preprint) (Other academic)
  • 59.
    Markström, Jonas L.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Schelin, Lina
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A novel standardised side hop test reliably evaluates landing mechanics for anterior cruciate ligament reconstructed persons and controls2018In: Sports Biomechanics, ISSN 1476-3141, E-ISSN 1752-6116Article in journal (Refereed)
    Abstract [en]

    We propose a novel one-leg standardised rebound side-hop test (SRSH) specifically designed for detailed analysis of landing mechanics. Anterior cruciate ligament reconstructed persons (ACLR, n = 30) and healthy-knee controls (CTRL, n = 30) were tested for within-session and test-retest (CTRL only, n = 25) reliability and agreement. Trunk, hip and knee angles and moments in sagittal, frontal, and transversal planes during landing, including time to stabilisation (TTS), were evaluated using intra-class correlations (ICCs), average within-person standard deviations (SW) and minimal differences. Excellent within-session reliability were found for angles in both groups (most ICCs > 0.90, SW ≤ 5°), and excellent to good for moments (most ICCs > 0.80, SW ≤ 0.34 Nm/kg). Only knee internal rotation moment showed poor reliability (ICC < 0.4). Test-retest results were excellent to fair for all angles and moments (ICCs 0.47–0.91, SW < 5° and ≤ 0.25 Nm/kg), except for peak trunk lateral bending angle and knee internal rotation moment. TTS showed excellent to fair within-session reliability but poor test-retest results. These results, with a few exceptions, suggest promising potential of evaluating landing mechanics during the SRSH for ACLR and CTRL, and emphasise the importance of joint-specific movement control variables in standardised tasks.

  • 60.
    Markström, Jonas L.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Schelin, Lina
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A comparison of knee joint kinematics and kinetics during landings in three one-leg hop tests (hop for distance, vertical hop and side hop) performed by female elite floorball athletes2016In: XXI ISEK Congress: Bridges to Innovation, 2016Conference paper (Refereed)
  • 61.
    Markström, Jonas L.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    ACL-reconstructed and ACL-deficient individuals show differentiated trunk, hip, and knee kinematics during vertical hops more than 20 years post-injury2018In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 26, no 2, p. 358-367Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Little is known regarding movement strategies in the long term following injury of the anterior cruciate ligament (ACL), and even less about comparisons of reconstructed and deficient knees in relation to healthy controls. The present purpose was to compare trunk, hip, and knee kinematics during a one-leg vertical hop (VH) ~20 years post-ACL injury between persons treated with surgery and physiotherapy (ACLR), solely physiotherapy (ACLPT), and controls (CTRL). Between-leg kinematic differences within groups were also investigated.

    METHODS: Sixty-six persons who suffered unilateral ACL injury on average 23 ± 2 years ago (32 ACLR, 34 ACLPT) and 33 controls performed the VH. Peak trunk, hip, and knee angles during Take-off and Landing phases recorded with a 3D motion capture system were analysed with multivariate statistics.

    RESULTS: Significant group effects during both Take-off and Landing were found, with ACLPT differing from CTRL in Take-off with a combination of less knee flexion and knee internal rotation, and from both ACLR and CTRL in Landing with less hip and knee flexion, knee internal rotation, and greater hip adduction. ACLR also presented different kinematics to ACLPT and CTRL in Take-off with a combination of greater trunk flexion, hip flexion, hip internal rotation, and less knee abduction, and in Landing with greater trunk flexion and hip internal rotation. Further, different kinematics and hop height were found between legs within groups in both Take-off and Landing for both ACL groups, but not for CTRL.

    CONCLUSION: Different kinematics for the injured leg for both ACL groups compared to CTRL and between treatment groups, as well as between legs within treatment groups, indicate long-term consequences of injury. Compensatory mechanisms for knee protection seem to prevail over time irrespective of initial treatment, possibly increasing the risk of re-injury and triggering the development of osteoarthritis. Detailed investigation of movement strategies during the VH provides important information and a more comprehensive evaluation of knee function than merely hop height. More attention should also be given to the trunk and hip in clinics when evaluating movement strategies after ACL injury.

    LEVEL OF EVIDENCE: Prospective cohort study, Level II.

  • 62.
    Markström, Jonas L.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    One-leg lateral side-hops induce greater demands on knee landing control than hops in other directions as demonstrated in athletic and non-athletic females with or without injury of the anterior cruciate ligamentManuscript (preprint) (Other academic)
  • 63.
    Markström, Jonas L.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A kinematic analysis of one-leg vertical jump on average 23 years after injury of the anterior cruciate ligament2015In: Gait & Posture: 24th Annual Meeting of ESMAC 2015 Abstracts, 2015, Vol. 42, p. 1-2, article id Session OS01 Best-Paper-Session - OutcomesConference paper (Refereed)
  • 64.
    Markström, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Different dynamic knee stability and frontal plane kinematics and kinetics between landings in common one-leg hops for ACL-reconstructed women and knee-healthy controls2018In: 8th World Congress of Biomechanics, Dublin, July 8-12, 2018, 2018Conference paper (Refereed)
  • 65. Moorhead, A
    et al.
    Liddle, D
    Hurley-Osing, D
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Baxter, D
    McDonough, S
    Physical activity monitoring in healthy adults2007Conference paper (Other academic)
  • 66. Mulligan, Hilda
    et al.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hale, Leigh
    Thomas, David
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Promoting physical activity for people with neurological disability: perspectives and experiences of physiotherapists2011In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 27, no 6, p. 399-410Article in journal (Refereed)
    Abstract [en]

    Both New Zealand and Sweden have health and disability policies that promote recreational exercise within society for people with disability. Despite these policies, levels of physical activity by people with disability in these countries are low. Physiotherapists are equipped to assist people with disabling conditions into physical activity. This qualitative study explored the perspectives and experiences of physiotherapists in New Zealand and Sweden toward promoting physically active recreation for adults with chronic neurological conditions. Nine physiotherapists who worked with adults with neurological disability in a range of long-term rehabilitation and community (home) health services were interviewed and the data analysed for themes. The physiotherapists described innovative and resourceful expertise to assist patients to be physically active. However, they perceived a lack of support for their work from within the health system and a lack of knowledge of disability issues within the recreational arena, both of which they perceived hindered their promotion of physical activity for people with neurological disability. Physiotherapists feel unable to fully support health and disability policies for the promotion of physically active recreation for people with neurological conditions, because of perceived constraints from within the recreational arena and their own health systems. If these constraints were addressed, then physiotherapists could be better agents to promote physical activity for people with neurological conditions.

  • 67. Naili, J E
    et al.
    Esbjörnsson, A C
    Hedström, M
    Wretenberg, P
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Broström, E W
    Utvärdering av funktion före och efter total höftledsplastik hos personer med höftledsartros2014Conference paper (Other academic)
  • 68. Naili, J E
    et al.
    Esbjörnsson, A C
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Quantifying function before and after total joint replacement surgery in patients with hip osteoarthritis2014Conference paper (Other academic)
  • 69. Naili, J E
    et al.
    Esbjörnsson, A C
    Iversen, M D
    Schwartz, M H
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Broström, E W
    Quantifying function before and after total joint replacement surgery in patients with hip osteoarthritis.2014Conference paper (Other academic)
  • 70. Naili, J. E.
    et al.
    Iversen, M. D.
    Esbjörnsson, A. -C
    Hedström, M.
    Schwartz, M. H.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Broström, E. W.
    Challenging the effect of hip and knee replacement for osteoarthritis: a prospective one year follow-up study of 64 patients evaluating function and gait dynamics2016In: Osteoarthritis and Cartilage, ISSN 1063-4584, E-ISSN 1522-9653, Vol. 24, p. S111-S111Article in journal (Other academic)
  • 71. Naili, Josefine E
    et al.
    Iversen, Maura D.
    Esbjörnsson, Anna-Clara
    Hedström, Margareta
    Schwartz, Michael H.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Broström, Eva W.
    Deficits in functional performance and gait one year after total knee arthroplasty despite improved self-reported function2017In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 25, no 11, p. 3378-3386Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The current literature lacks sufficient information about improvements in gait patterns and function after total knee arthroplasty (TKA) and whether patients return to full function. This study evaluated change in gait, performance-based function, and self-reported function 1 year after TKA in patients with symptomatic knee osteoarthritis and how these aspects interrelate.

    METHODS: A total of 28 patients (64 % female) with knee osteoarthritis, with a mean age of 66 (±7) years, and 25 age- and gender-matched controls participated in this prospective cohort study. Three-dimensional gait analysis generated comprehensive measures of kinematic and kinetic gait deviations, respectively. Participants completed the Five Times Sit-to-Stand (5STS) test, and the self-reported questionnaire Knee Injury and Osteoarthritis Outcome Score (KOOS), at baseline prior to surgery and 1 year after TKA.

    RESULTS: Kinetic gait deviations of both the operated and non-operated limb persisted in patients with knee osteoarthritis at 1 year after surgery, while kinematic gait patterns were comparable to controls. Performance on the 5STS and KOOS scores in patients with knee osteoarthritis improved significantly 1 year after surgery (effect size 0.5-1.5), but did not reach the level of controls. Ten patients with knee osteoarthritis (36 %) exceeded the minimally detectable change on the 5STS.

    CONCLUSION: Measures of overall gait patterns and the 5STS revealed improvements in function 1 year after TKA, but were not restored to the level of healthy controls. Based on change in 5STS performance, we identified patients with substantial improvements in gait patterns. Self-reported measures of function could not detect differences between patients improving in 5STS performance and those who did not. These findings highlight the use of the 5STS in clinical practice since improvement on this test seems to follow the reduction in gait pattern deviations.

    LEVEL OF EVIDENCE: II.

  • 72. Naili, Josefine
    et al.
    Esbjörnsson, Anna-Clara
    Iversen, Maura
    Schwarz, Michael
    Hedström, Margareta
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Broström, Eva
    The impact of symptomatic knee osteoarthritis on gait pattern and its association with performance-based measures and patient-reported outcomes2017In: Knee (Oxford), ISSN 0968-0160, E-ISSN 1873-5800, Vol. 24, no 3, p. 536-546Article in journal (Refereed)
    Abstract [en]

    Background: Limited knowledge exists regarding the impact of symptomatic knee osteoarthritis (OA) on the overall gait pattern; and whether gait deviations are associated with performance based measures (PBMs) and patient-reported outcomes (PROs). This cross-sectional study evaluated overall gait patterns in patients with knee OA using the Gait Deviation Index for kinematics (GDI) and kinetics (GDI-kinetic), and explored associations between gait deviations, PBMs, and PROs. Methods: Forty patients with knee OA and 25 age and gender-matched controls underwent three-dimensional gait analysis. Participants performed the Timed Up and Go (TUG), Five Times Sit-to-Stand (5STS), and Single Limb Mini Squat (SLMS) tests and completed a disease specific PRO. Associations between gait deviations, PBMs, and PROs were assessed by Pearson's correlation and multiple linear regression. Results: Patients with OA demonstrated significantly lower GDI and GDI-kinetic scores of the OA and contralateral limbs compared to controls; with GDI-kinetic scores on the contralateral limb more impacted than the OA limb. On the contralateral limb, GDI-kinetic score significantly correlated with TUG (r = -0.42) and 5STS (r = -033), while on the OA limb with TUG (r = -0.68), 5STS (r = -0.38), SLMS (r = -0.38), activities of daily living (r = -0.35) and Knee-related Quality of Life (r = -035). No significant associations existed between kinematic GDI scores, PBMs and PROs. Conclusion: The overall gait pattern, as represented by GDI and GDI-kinetic scores, in patients with symptomatic knee OA is affected both on the painful OA limb and the contralateral limb. The GDI and GDI-kinetic scores provide different information regarding function that is not revealed by PBMs or PROs.

  • 73. Pini, Alessa
    et al.
    Abramowicz, Konrad
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hébert-Losier, Kim
    Schelin, Lina
    Strandberg, Johan
    Vantini, Simone
    Anterior Cruciate Ligament Rupture: Functional Data Analysis of Knee Motion2014In: 47-th Scientific Meeting of the Italian Statistical Society: Proceedings / [ed] S. Cabras, T. Di Battista, W. Racugno, Caligari: CUEC , 2014Conference paper (Other academic)
  • 74. Pollick, Frank E
    et al.
    Chizk, Chris
    Häger-Ross, Charlotte
    Center for visual science, University of Rochester.
    Hayhoe, Mary
    Implicit accuracy constraints in two-fingered grasps of viritual objects with haptic feedback2001In: Haptic human-computer interaction: first international workshop, Glasgow, UK, August 31-September 1, 2000, proceedings / [ed] Brewster, Stephen & Murray-Smith, Roderick, NewYork: Springer-Verlag New York, 2001, 1, p. 98-107Chapter in book (Refereed)
  • 75.
    Rudolfsson, Thomas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Djupsjöbacka, Mats
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effects of neck coordination exercise on sensorimotor function in chronic neck pain: A randomized controlled trial.2014In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 9, p. 908-914Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the effect of neck coordination exercise on sensorimotor function in women with neck pain compared with best-available treatment and sham treatment.

    DESIGN: Observer-blinded randomized controlled trial with short-term and 6-month follow-ups.

    SUBJECTS: Women with chronic non-specific neck pain were randomized to 3 groups: neck coordination exercise with a novel training device; strength training for the neck and shoulders; or massage. Each group had 36 participants.

    METHODS: The intervention period was 11 weeks with 22 individually supervised sessions. Primary outcomes were postural sway measures and precision of goal-directed arm movements. Secondary outcomes were range of motion for the neck, peak speed of axial rotation, and neck pain. A repeated measures multivariate analysis of variance (MANOVA) was conducted separately on the primary outcomes for the short-term and 6-month evaluations and on the sensorimotor secondary outcomes for the 6-month effect. The 6-month effect on pain was analysed with a repeated measures analysis of variance (ANOVA).

    RESULTS: No significant treatment effects in favour of neck coordination exercise were found for short-term or 6-month evaluations.

    CONCLUSION: Neck coordination exercise is no better than strength training and massage in improving sensorimotor function. Further research should investigate the use of cut-offs for sensorimotor dysfunctions prior to proprioceptive or coordinative training.

  • 76.
    Röijezon, Ulrik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, University of Gävle, Sweden; Alfta Research Foundation, Alfta, Sweden .
    Djupsjöbacka, Mats
    Centre for Musculoskeletal Research, University of Gävle, Sweden.
    Björklund, Martin
    Centre for Musculoskeletal Research, University of Gävle, Sweden; Alfta Research Foundation, Alfta, Sweden.
    Häger Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Science and Technology, Centre for Biomedical Engineering and Physics (CMTF). Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Liebermann, Dario
    Sackler Faculty of Medicine, Tel Aviv University, Israel.
    Kinematics of fast cervical rotations in persons with chronic neck pain: a cross-sectional and reliability study2010In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 11, p. 222-Article in journal (Other academic)
    Abstract [en]

    Background

    Assessment of sensorimotor function is useful for classification and treatment evaluation of neck pain disorders. Several studies have investigated various aspects of cervical motor functions. Most of these have involved slow or self-paced movements, while few have investigated fast cervical movements. Moreover, the reliability of assessment of fast cervical axial rotation has, to our knowledge, not been evaluated before.

    Methods

    Cervical kinematics was assessed during fast axial head rotations in 118 women with chronic nonspecific neck pain (NS) and compared to 49 healthy controls (CON). The relationship between cervical kinematics and symptoms, self-rated functioning and fear of movement was evaluated in the NS group. A sub-sample of 16 NS and 16 CON was re-tested after one week to assess the reliability of kinematic variables. Six cervical kinematic variables were calculated: peak speed, range of movement, conjunct movements and three variables related to the shape of the speed profile.

    Results

    Together, peak speed and conjunct movements had a sensitivity of 76% and a specificity of 78% in discriminating between NS and CON, of which the major part could be attributed to peak speed (NS: 226 ± 88 °/s and CON: 348 ± 92 °/s, p < 0.01). Peak speed was slower in NS compared to healthy controls and even slower in NS with comorbidity of low-back pain. Associations were found between reduced peak speed and self-rated difficulties with running, performing head movements, car driving, sleeping and pain. Peak speed showed reasonably high reliability, while the reliability for conjunct movements was poor.

    Conclusions

    Peak speed of fast cervical axial rotations is reduced in people with chronic neck pain, and even further reduced in subjects with concomitant low back pain. Fast cervical rotation test seems to be a reliable and valid tool for assessment of neck pain disorders on group level, while a rather large between subject variation and overlap between groups calls for caution in the interpretation of individual assessments.

  • 77.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Dock, Katarina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Häger, Charlotte K
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindh Waterworth, Eva
    Umeå University, Faculty of Social Sciences, Department of Informatics.
    Motion interactive video games in home training for children with cerebral palsy: parents' perceptions2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 11, p. 925-933Article in journal (Refereed)
    Abstract [en]

    Purpose: To explore parents' perceptions of using low-cost motion interactive video games as home training for their children with mild/moderate cerebral palsy.

    Method: Semi-structured interviews were carried out with parents from 15 families after participation in an intervention where motion interactive games were used daily in home training for their child. A qualitative content analysis approach was applied.

    Results: The parents' perception of the training was very positive. They expressed the view that motion interactive video games may promote positive experiences of physical training in rehabilitation, where the social aspects of gaming were especially valued. Further, the parents experienced less need to take on coaching while gaming stimulated independent training. However, there was a desire for more controlled and individualized games to better challenge the specific rehabilitative need of each child.

    Conclusions: Low-cost motion interactive games may provide increased motivation and social interaction to home training and promote independent training with reduced coaching efforts for the parents. In future designs of interactive games for rehabilitation purposes, it is important to preserve the motivational and social features of games while optimizing the individualized physical exercise.

  • 78.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Domellöf, Erik
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effect of practice with motion interactive video games on goal-directed arm movements in children with cerebral palsy: a kinematic evaluationManuscript (preprint) (Other academic)
    Abstract [en]

    Objective: The aim of the present study was to evaluate the quality of goal-directed arm movements in children with cerebral palsy after four weeks of daily practice with motion interactive games, and to explore and compare the applicability of various kinematic parameters in a virtual context compared to a situation with real objects.

    Methods: Fifteen children with CP, 6-16 years, practiced with the EyeToyâ for PlayStation2â in their homes during four weeks. Before and after the intervention kinematics and kinetics were captured with a five camera motion analysis system (Proreflex, Qualisys AB, Gothenburg, Sweden) and a force plate. The children performed arm movements towards both virtual and real targets.

    Results: The children used a more economic reaching strategy with shorter Centre of pressure paths, improved Movement precision, and reduced variability in Maximal shoulder angles during play after practice. Transfer of improved motor control to goal-directed arm movements towards real targets was also indicated by increased Movement smoothness, and while reaching with the non-dominant side, reduced Centre of pressure paths path. The spatiotemporal characteristics proved complex to interpret in terms of improved motor control.

    Conclusions: When taking the constraints of the tasks into account the relevant kinematic parameters explored support the conclusion that practice with motion interactive games resulted in an improved motor control. The results of this study illuminate the importance of considering both the nature of the task and the context in which movements are performed when selecting and interpreting kinematic parameters.

  • 79.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Domellöf, Erik
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Training of goal directed arm movements with motion interactive video games in children with cerebral palsy: a kinematic evaluation2014In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 17, no 5, p. 318-326Article in journal (Refereed)
    Abstract [en]

    Objective: The main aim of this study was to evaluate the quality of goal-directed arm movements in 15 children with cerebral palsy (CP) following four weeks of home-based training with motion interactive video games. A further aim was to investigate the applicability and characteristics of kinematic parameters in a virtual context in comparison to a physical context.

    Method: Kinematics and kinetics were captured while the children performed arm movements directed towards both virtual and physical targets.

    Results: The children’s movement precision improved, their centre of pressure paths decreased, as did the variability in maximal shoulder angles when reaching for virtual objects. Transfer to a situation with physical targets was mainly indicated by increased movement smoothness.

    Conclusion: Training with motion interactive games seems to improve arm motor control in children with CP. The results highlight the importance of considering both the context and the task itself when investigating kinematic parameters.

  • 80.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Domellöf, Erik
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Low-cost motion interactive video games in home training for children with cerebral palsy: A kinematic evaluation2011In: 2011 International Conference on Virtual Rehabilitation, ICVR / [ed] Daniel Thalmann, IEEE conference proceedings, 2011Conference paper (Refereed)
    Abstract [en]

    3D motion analysis was applied to assess goal-directed arm movements in 15 children with cerebral palsy (CP) before and after four weeks of home training with low-cost motion interactive video games. The results indicated that the children improved movement precision when playing the virtual games, improved movement smoothness when reaching for real targets, and reduced the involvement of the trunk especially when reaching with the non-dominant side. © 2011 IEEE.

  • 81.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hoshi, Kei
    Umeå University, Faculty of Social Sciences, Department of Informatics.
    Lindh Waterworth, Eva
    Umeå University, Faculty of Social Sciences, Department of Informatics.
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A conceptual framework for design of interactive computer play in rehabilitation of children with sensorimotor disorders2009In: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 14, no 5, p. 348-354Article in journal (Refereed)
  • 82.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindh Waterworth, Eva
    Umeå University, Faculty of Social Sciences, Department of Informatics.
    McDonough, Suzanne
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Interactive games in motor rehabilitation for children with sensor motor disorders2007In: 2007 virtual rehabilitation, New York: IEEE conference proceedings, 2007, p. 78-78Conference paper (Refereed)
    Abstract [en]

    Interactive computer environments may be a good way to make motor practice more fun and motivating for children with sensorimotor disorders. However, appropriate computer environments that could be used for this purpose need to be systematically tested in rehabilitation settings in order to evaluate their impact on motor aspects as well as on motivation and activity levels. This abstract describes pilot data from an ongoing intervention study involving children diagnosed with cerebral palsy. The interactive environment used is the Sony's EyeToy system for PlayStation2. The intervention is evaluated through interviews as well as with activity monitoring and motor assessments, including 3D motion analysis. Here we will report pilot data based on the interviews.

  • 83.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    McDonough, Suzanne
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Interactive computer play in rehabilitation of children with sensorimotor disorders: a systematic review2009In: Developmental medicine and child neurology, ISSN 1469-8749, Vol. 51, no 3, p. 173-179Article in journal (Refereed)
    Abstract [en]

    The aim of this review was to examine systematically the evidence for the application of interactive computer play in the rehabilitation of children with sensorimotor disorders. A literature search of 11 electronic databases was conducted to identify articles published between January 1995 and May 2008. The review was restricted to reports of intervention studies evaluating the impact of interactive computer play on motor rehabilitation in children. For each study the quality of the methods and the strength of the evidence were assessed by two independent reviewers using the guidelines of the American Academy for Cerebral Palsy and Developmental Medicine. A total of 74 articles were identified, of which 16 met the inclusion criteria. Three studies were randomized controlled trials (RCTs) and half were case series or case reports. Areas investigated were movement quality, spatial orientation and mobility, and motivational aspects. Thirteen studies presented positive findings. Two of the three RCTs investigating movement quality and one level III study examining spatial orientation showed no significant improvements. Interactive computer play is a potentially promising tool for the motor rehabilitation of children but the level of evidence is too limited to assess its value fully. Further and more convincing research is needed.

  • 84.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Waterworth, Eva
    Umeå University, Faculty of Social Sciences, Department of Informatics.
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Using motion interactive games to promote physical activity and enhance motor performance in children with cerebral palsy2011In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 14, no 1, p. 15-21Article in journal (Refereed)
    Abstract [en]

    Objective: To explore the feasibility of using low-cost motion interactive games as a home-based intervention for children with cerebral palsy (CP).

    Methods: Fourteen children with CP, 6–16 years old, practiced with the EyeToy for PlayStation2® in their homes during 4 weeks. Outcome measures were physical activity monitors, Movement Assessment Battery for Children-2 (mABC-2), Bruininks-Oseretsky Test of Motor Proficiency (sub-test 5 : 6), 1 Minute Walk Test and gaming diaries.

    Results: Motivation for practice and compliance of training were high. The children's physical activity increased during the intervention and activity monitors were feasible to use, although data loss may be a concern. According to mABC-2 the children's motor performance improved, but there were both floor and ceiling effects. The two additional motor tests showed only non-significant progress.

    Conclusion: It is highly feasible to use motion interactive games in home rehabilitation for children with CP. Specific motor effects need to be further explored.

  • 85.
    Schelin, Lina
    et al.
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ryden, Patrik
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A statistically compiled test battery for feasible evaluation of knee function after rupture of the Anterior Cruciate Ligament - derived from long-term follow-up data.2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 5, article id e0176247Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Clinical test batteries for evaluation of knee function after injury to the Anterior Cruciate Ligament (ACL) should be valid and feasible, while reliably capturing the outcome of rehabilitation. There is currently a lack of consensus as to which of the many available assessment tools for knee function that should be included. The present aim was to use a statistical approach to investigate the contribution of frequently used tests to avoid redundancy, and filter them down to a proposed comprehensive and yet feasible test battery for long-term evaluation after ACL injury.

    METHODS: In total 48 outcome variables related to knee function, all potentially relevant for a long-term follow-up, were included from a cross-sectional study where 70 ACL-injured (17-28 years post injury) individuals were compared to 33 controls. Cluster analysis and logistic regression were used to group variables and identify an optimal test battery, from which a summarized estimator of knee function representing various functional aspects was derived.

    RESULTS: As expected, several variables were strongly correlated, and the variables also fell into logical clusters with higher within-correlation (max ρ = 0.61) than between clusters (max ρ = 0.19). An extracted test battery with just four variables assessing one-leg balance, isokinetic knee extension strength and hop performance (one-leg hop, side hop) were mathematically combined to an estimator of knee function, which acceptably classified ACL-injured individuals and controls. This estimator, derived from objective measures, correlated significantly with self-reported function, e.g. Lysholm score (ρ = 0.66; p<0.001).

    CONCLUSIONS: The proposed test battery, based on a solid statistical approach, includes assessments which are all clinically feasible, while also covering complementary aspects of knee function. Similar test batteries could be determined for earlier phases of ACL rehabilitation or to enable longitudinal monitoring. Such developments, established on a well-grounded consensus of measurements, would facilitate comparisons of studies and enable evidence-based rehabilitation.

  • 86. Seale, Kirsten
    et al.
    Burger, Marilize
    Posthumus, Michael
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Stattin, Evalena
    Nilsson, Kjell G
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Collins, Malcolm
    September, Alison V
    The Apoptosis Pathway and CASP8 Variants Conferring Risk for Acute and Overuse Musculoskeletal Injuries2019In: Journal of Orthopaedic Research, ISSN 0736-0266, E-ISSN 1554-527XArticle in journal (Refereed)
    Abstract [en]

    Rotator cuff tendinopathy (RCT), anterior cruciate ligament (ACL) ruptures, and carpal tunnel syndrome (CTS), are examples of chronic (RCT and CTS) and acute (ACL ruptures) musculoskeletal soft tissue injuries. These injuries are multifactorial in nature, with several identified intrinsic and extrinsic risk factors. Previous studies have implicated specific sequence variants within genes encoding structural and regulatory components of the extracellular matrix of tendons and/ligaments to predispose individuals to these injuries. An example, includes the association of sequence variants within the apoptotic regulatory gene, caspase-8 (CASP8) with other musculoskeletal injury phenotypes, such as Achilles tendinopathy. The primary aim of this study was, therefore, to investigate previously implicated DNA sequence variants within CASP8: rs3834129 (ins/del) and rs1045485 (G/C), and the rs13113 (T/A) identified using a whole exome sequencing approach, with risk of musculoskeletal injury phenotypes (RCT, ACL ruptures, and CTS) in three independent studies. In addition, the aim was to implicate a CASP8 genomic interval in the modulation of risk of RCT, ACL ruptures, or CTS. It was found that the AA genotype of CASP8 rs13113 (T/A) was independently associated with increased risk for CTS. In addition, it was found that the del-C haplotype (rs3834129-rs1045485) was significantly associated with non-contact ACL ruptures, which is in alignment with previous research findings. Collectively, the results of this study implicate the apoptosis pathway as biologically significant in the underlying pathogenesis of musculoskeletal injury phenotypes. These findings should be repeated in larger sample cohorts and across different populations.

  • 87. Sole, G
    et al.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, H
    Selling, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Knee kinematics during stair descent more than 20 years following anterior cruciate ligament injury2014Conference paper (Other academic)
  • 88. Sole, Gisela
    et al.
    Pataky, Todd
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Institute of Fiber Engineering, Department of Bioengineering, Shinshu University, Tokida 3-15-1, Ueda, Nagano 386-8567, Japan.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Analysis of three-dimensional knee kinematics during stair descent two decades post-ACL rupture: Data revisited using statistical parametric mapping2017In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 32, p. 44-50Article in journal (Refereed)
    Abstract [en]

    Changes in movement patterns following knee injuries have generally used analyses of pre-defined discrete event-related variables, whereas Statistical Parametric Mapping (SPM) assesses continuous data over time. We applied SPM to test differences for knee trajectories during stair descent between participants with past anterior cruciate ligament (ACL) rupture who underwent reconstruction or only physical therapy compared to healthy controls. Three-dimensional knee joint kinematics during stair descent were registered for 31 subjects with ACL reconstruction (ACLR), 36 subjects with ACL rupture managed with physical therapy only (ACLPT) (∼23years post-injury), and 32 uninjured controls. SPM was used to assess differences between groups for the entire three-component knee trajectory. A significant difference between the three groups was found for the first ∼10% of stance phase. Post-hoc analyses showed between-group differences when comparing the ACLPT to the control groups. Analyses of ACLPT versus control groups for individual vector components suggested a combination of less flexion at initial foot contact, and less adduction during weight acceptance (∼40% of stance). Altered knee kinematics were confirmed during weight acceptance of stair descent for the ACLPT group compared to controls, but not for ACLR group. Further exploration of the use of SPM and agreement with clinical gait assessment is warranted.

  • 89. Sole, Gisela
    et al.
    Ribeiro, Daniel C.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Advances in clinical biomechanics2015In: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 20, no 3, p. 135-136Article in journal (Other academic)
  • 90. Sole, Gisela
    et al.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Knee kinematics during stair descent 20 years following anterior cruciate ligament rupture with and without reconstruction2016In: Clinical Biomechanics, ISSN 0268-0033, E-ISSN 1879-1271, Vol. 32, p. 180-186Article in journal (Refereed)
    Abstract [en]

    Background: Changes and asymmetries for walking gait have been explored extensively following injuries of anterior cruciate ligaments within ten years of injury or reconstruction. We examined longer term knee joint kinematics of reconstructed and non-reconstructed knees during stair descent compared to controls. Methods: Three-dimensional knee kinematics during stair descent were registered for 33 subjects with ACL reconstruction, 36 subjects with ACL rupture managed with physiotherapy only and 31 uninjured controls. Injured subjects were 23.5 (2.1) years following injury. Linear mixed models were used to compare temporal variables and knee kinematics during stance phase between groups and contralateral sides. Findings: Walking speed was slower for the both ACL-injured groups compared to controls and stance duration was longer for the injured than the uninjured sides of the physiotherapy-only group. Compared to controls, the physiotherapy-only group had significantly less adduction at initial foot contact of the injured and uninjured knees. The uninjured side of the physiotherapy-only group also had less flexion than controls at initial foot contact and during weight acceptance. Compared to the surgically-managed group, the injured sides of the physiotherapy-only groups had significantly less adduction at initial contact, peak adduction during weight acceptance, and peak flexion during propulsion. Interpretation: Independent of treatment, altered knee kinematics exist more than 20 years following ACL injury during stair descent. We suggest that future studies investigating short and long-term kinematic outcomes of ACL injury could evaluate stair descent with particular emphasis on weight acceptance of stance, and potential associations to perceived knee function.

  • 91.
    Sommer, Marius
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark.
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Timing Training in Female Soccer Players: Effects on Skilled Movement Performance and Brain Responses2018In: Frontiers in Human Neuroscience, ISSN 1662-5161, E-ISSN 1662-5161, Vol. 12, article id 311Article in journal (Refereed)
    Abstract [en]

    Although trainers and athletes consider “good timing skills” critical for optimal sport performance, little is known in regard to how sport-specific skills may benefit from timing training. Accordingly, this study investigated the effects of timing training on soccer skill performance and the associated changes in functional brain response in elite- and sub-elite female soccer players. Twenty-five players (mean age 19.5 years; active in the highest or second highest divisions in Sweden), were randomly assigned to either an experimental- or a control group. The experimental group (n = 12) was subjected to a 4-week program (12 sessions) of synchronized metronome training (SMT). We evaluated effects on accuracy and variability in a soccer cross-pass task. The associated brain response was captured by functional magnetic resonance imaging (fMRI) while watching videos with soccer-specific actions. SMT improved soccer cross-pass performance, with a significant increase in outcome accuracy, combined with a decrease in outcome variability. SMT further induced changes in the underlying brain response associated with observing a highly familiar soccer-specific action, denoted as decreased activation in the cerebellum post SMT. Finally, decreased cerebellar activation was associated with improved cross-pass performance and sensorimotor synchronization. These findings suggest a more efficient neural recruitment during action observation after SMT. To our knowledge, this is the first controlled study providing behavioral and neurophysiological evidence that timing training may positively influence soccer-skill, while strengthening the action-perception coupling via enhanced sensorimotor synchronization abilities, and thus influencing the underlying brain responses.

  • 92.
    Sommer, Marius
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Olsson, Carl Johan
    Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Timing training in female soccer players: effects on motor skill and associated changes in functional brain activityManuscript (preprint) (Other academic)
  • 93.
    Sommer, Marius
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Synchronized metronome training induces changes in the kinematic properties of the golf swing2014In: Sports Biomechanics, ISSN 1476-3141, E-ISSN 1752-6116, Vol. 13, no 1, p. 1-16Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to evaluate possible effects of synchronized metronome training (SMT) on movement dynamics during golf swing performance, as captured by kinematic analysis. A one-group, between-test design was applied on thirteen male golfers (27.5 ± 4.6 years old, 12.7 ± 4.9 golf handicap) who completed twelve sessions of SMT over a four week period. Pre- and post-assessments of golf swings made with three different clubs (4-iron, 7-ironand pitching wedge) were performed using a three-dimensional motion capture system. Club peak velocity at three different swing phases andcross-correlation analysis of time-series signals were made on joint couplings(wrist-elbow-shoulder) of both arms, and between joints and the club, during the full golf swing. There were significantly higher cross-correlations between joint-couplings and concomitant changes of the associated phase-shift differences, as well as reduced phase-shift variability at post-test. No significant effect of SMT was found for the club peak velocities. We suggest that domain-general influences of SMT on the underlying brain-based motorcontrol strategies lead to a more coordinated movement pattern of the golf swing performance, which may explain previous observations of significantly improved golf shot accuracy and decreased variability after SMT.

  • 94.
    Srinivasan, Divya
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Increased movement variability in one-leg hops about 20 years after treatment of anterior cruciate ligament injury2018In: Clinical Biomechanics, ISSN 0268-0033, E-ISSN 1879-1271, Vol. 53, p. 37-45Article in journal (Refereed)
    Abstract [en]

    Background: Recent studies highlight the need for understanding movement control of adjacent joints when evaluating knee function following anterior cruciate ligament (ACL) injury. However, while short-term adaptations to lower-extremity joint coupling have been studied, little is known about any potential long-term adaptations in neuromuscular control displayed by ACL-injured individuals. The aim of our study was to determine whether coordination variability of the hip-knee joint couplings during the one-leg hop is altered about 20 years after injury in two ACL-injured groups compared to healthy knee controls.

    Methods: Seventy persons performed one leg hops ~23 years after ACL injury and following different treatments: 33 participants treated with physiotherapy in combination with ACL-reconstruction (ACLR); 37 participants with physiotherapy alone (ACLPT). They were compared to 33 matched controls. A vector coding procedure was used to create joint couplings for knee and hip angles on all the cardinal planes for the Take-off and Landing phases. The standard deviation of each coupling was computed as a measure of coordination variability.

    Findings: Both the ACL groups differed significantly from controls on their injured side with ~50% higher knee abduction-adduction/hip internal-external rotation variability during the Take-off phase; ~33% higher knee abduction-adduction/knee flexion-extension variability and greater knee abduction-adduction/hip flexion-extension variability (ACLR 50%; ACLPT 80%) during the Landing phase. There were no major differences between injured and non-injured sides in any group.

    Interpretation: Increased variability in lower-extremity joint couplings has emerged as a conspicuous feature of ACL injured persons in the very long term compared to non-injured controls, independent of treatment. Further research of the processes leading to alterations in movement variability using longitudinal studies would facilitate better understanding of the functional adaptations leading to knee dysfunction in the short- and long-term after ACL injury.

  • 95.
    Stenlund, Tobias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Neely, Gregory
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Seated postural neck and trunk reactions to sideways perturbations with or without a cognitive task2015In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 25, no 3, p. 548-556Article in journal (Refereed)
    Abstract [en]

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

  • 96.
    Stenlund, Tobias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lindroos, Ola
    Institutionen för skogens biomaterial och teknologi (SBT), Sveriges lantbruksuniversitet, Umeå.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Neely, Gregory
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Adaptation of postural reactions in seated positions and influence of head posture when exposed to a single sideway perturbation: relevance for driving on irregular terrain2016In: Journal of Novel Physiotherapy and Physical Rehabilitation, ISSN 2455-5487, Vol. 3, no 1, p. 022-029Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 97.
    Stenlund, Tobias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Lindroos, Ola
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Neely, Gregory
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Double-sided Mechanical Shocks Provoke Larger Seated Postural Reactions Compared to Single-Sided Mechanical Shocks2018In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 43, no 8, p. E482-E487Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

    LEVEL OF EVIDENCE: 4.

  • 98.
    Stenlund, Tobias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lindroos, Ola
    Dept. of Forest Biomaterials & Technology, Swedish University of Agricultural Sciences, Sweden.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Inter- and intra-tester reliability when measuring seated spinal postures with inertial sensors2014In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 44, no 5, p. 732-738Article in journal (Refereed)
    Abstract [en]

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

  • 99.
    Stensdotter, Ann Katrin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Hodges, P
    Häger Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Quadriceps activity and movement in response to unpredictable sagital support-surface translations2007Conference paper (Other academic)
  • 100.
    Stensdotter, Ann Katrin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Hodges, P W
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Quadriceps activity and movement reactions in response to unpredictable sagittal support-surface translations in women with patellofemoral pain.2008In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 18, no 2, p. 298-307Article in journal (Refereed)
    Abstract [en]

    Patellofemoral pain (PFP) may be related to unfavorable knee joint loading. Delayed and/or reduced activity of vastus medialis obliquus (VMO) and different movement patterns have been identified in individuals with PFP in some studies, whereas other studies have failed to show a difference compared to non-affected controls. The discrepancy between study results may depend on the different tasks that have been investigated. No previous study has investigated these variables in postural responses to unpredictable perturbations in PFP. Whole body three dimensional kinematics and surface EMG of quadriceps muscles activation was studied in postural responses to unpredictable support surface translations in 17 women with PFP who were pain free at the time of testing, and 17 matched healthy controls. The results of the present study showed earlier onset of VMO activity and associated changes in kinematics to anterior platform translation in the PFP subjects. We suggest that the relative timing between the portions quadriceps muscles may be task specific and part of an adapted response in attempt to reduce knee joint loading. This learned response appears to remain even when the pain is no longer present.

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