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Diarbakerli, E., Thoreson, O., Björklund, M., Dahlberg, L. E., Englund, M., Gerdhem, P., . . . Abbott, A. (2024). Swedish musculoskeletal researchers view on a collaborative network and future research priorities in Swedish healthcare. Musculoskeletal Care, 22(1), Article ID e1865.
Open this publication in new window or tab >>Swedish musculoskeletal researchers view on a collaborative network and future research priorities in Swedish healthcare
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2024 (English)In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 22, no 1, article id e1865Article in journal (Refereed) Published
Abstract [en]

Background: Musculoskeletal disorders (MSK) are a global burden causing significant suffering and economic impact. Systematic identification and targeting of research questions of highest interest for stakeholders can aid in improving MSK disorder knowledge and management.

Objective: To obtain Swedish MSK researchers' opinions and views on a collaborative Swedish MSK network (SweMSK) and identify future research areas of importance for Swedish MSK research.

Methods: A web-based survey was conducted July to September 2021 to collect data from 354 Swedish MSK researchers. The survey focused on the need, objectives, and structure of a SweMSK network and identified prioritised areas for future MSK research.

Results: The study included 141 respondents, of which 82 were associate professors or professors. The majority (68%) supported the creation of a new musculoskeletal network. The most supported element was increased collaboration regarding nationwide and multicenter studies. Respondents recommended the creation of a homepage and the establishment of national work groups with different specific interests as the primary elements of a new network.

Conclusion: The results demonstrated a need and desire for increased national research collaboration and the creation of a new musculoskeletal network. The high academic experience and active research participation of the respondents suggest the need for MSK disorder knowledge and management improvement in Sweden. Therefore, the SweMSK network may help facilitate effective collaboration and research efforts that can contribute to the advancement of MSK disorder management and care. This study may provide valuable insights for policymakers, clinicians, and researchers to improve MSK disorder care and management in Sweden.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
clinical study, musculoskeletal, network, pain, researcher, survey
National Category
Orthopaedics Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-221116 (URN)10.1002/msc.1865 (DOI)001158247800001 ()2-s2.0-85184404909 (Scopus ID)
Funder
Swedish Research Council, 2019‐06101
Available from: 2024-02-23 Created: 2024-02-23 Last updated: 2024-02-23Bibliographically approved
Bergqvist, M., Möller, M. C., Björklund, M., Borg, J. & Palmcrantz, S. (2023). The impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training, long-term after stroke—as part of a randomized controlled trial. PLOS ONE, 18(3), Article ID e0281212.
Open this publication in new window or tab >>The impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training, long-term after stroke—as part of a randomized controlled trial
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2023 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 3, article id e0281212Article in journal (Refereed) Published
Abstract [en]

Introduction: Visuospatial and executive impairments have been associated with poor activity performance sub-acute after stroke. Potential associations long-term and in relation to outcome of rehabilitation interventions need further exploration.

Aims: To explore associations between visuospatial and executive function and 1) activity performance (mobility, self-care and domestic life) and 2) outcome after 6 weeks of conventional gait training and/or robotic gait training, long term (1–10 years) after stroke.

Methods: Participants (n = 45), living with stroke affecting walking ability and who could perform the items assessing visuospatial/executive function included in the Montreal Cognitive Assessment (MoCA Vis/Ex) were included as part of a randomized controlled trial. Executive function was evaluated using ratings by significant others according to the Dysexecutive Questionnaire (DEX); activity performance using 6-minute walk test (6MWT), 10-meter walk test (10MWT), Berg balance scale, Functional Ambulation Categories, Barthel Index and Stroke Impact Scale.

Results: MoCA Vis/Ex was significantly associated with baseline activity performance, long-term after stroke (r = .34-.69, p < .05). In the conventional gait training group, MoCA Vis/Ex explained 34% of the variance in 6MWT after the six-week intervention (p = 0.017) and 31% (p = 0.032) at the 6 month follow up, which indicate that a higher MoCA Vis/Ex score enhanced the improvement. The robotic gait training group presented no significant associations between MoCA Vis/Ex and 6MWT indicating that visuospatial/executive function did not affect outcome. Rated executive function (DEX) presented no significant associations to activity performance or outcome after gait training.

Conclusion: Visuospatial/executive function may significantly affect activity performance and the outcome of rehabilitation interventions for impaired mobility long-term after stroke and should be considered in the planning of such interventions. Patients with severely impaired visuospatial/executive function may benefit from robotic gait training since improvement was seen irrespective of visuospatial/executive function. These results may guide future larger studies on interventions targeting long-term walking ability and activity performance.

Place, publisher, year, edition, pages
Public Library of Science, 2023
National Category
Physiotherapy Neurology
Identifiers
urn:nbn:se:umu:diva-205802 (URN)10.1371/journal.pone.0281212 (DOI)000949067800050 ()36893079 (PubMedID)2-s2.0-85149781296 (Scopus ID)
Funder
Swedish Research CouncilRegion StockholmThe Swedish Brain FoundationPromobilia foundationThe Swedish Stroke Association
Available from: 2023-03-20 Created: 2023-03-20 Last updated: 2023-09-05Bibliographically approved
Grinberg, A., Strong, A., Strandberg, J., Selling, J., Liebermann, D. G., Björklund, M. & Häger, C. (2022). An electroencephalography-based approach to evaluate movement-related anxiety in physically active adults and following anterior cruciate ligament injury. In: : . Paper presented at Society for Neuroscience 2022 Meeting, San Diego, Carliforna, USA, November 12-16, 2022. , Article ID 84186.
Open this publication in new window or tab >>An electroencephalography-based approach to evaluate movement-related anxiety in physically active adults and following anterior cruciate ligament injury
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2022 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: Psychophysiological consequences often persist following musculoskeletal trauma and can result in vastly decreased quality of life. Re-injury anxiety is particularly common among individuals following anterior cruciate ligament (ACL) injury. Existing assessments of re-injury anxiety are, however, restricted to subjective suboptimal questionnaires, which may result in under-reporting and thus poorer injury management. We propose a novel approach to objectively quantify arousal response to movement-related anxiety. A new experimental paradigm was implemented to induce and record a conditioned electrophysiological response to a sudden perturbation, experienced to be potentially injurious.

Objective: To explore the feasibility of detecting anxiety-associated electrocortical response and to evaluate its discriminative ability between asymptomatic individuals and those who had experienced an ACL injury.

Methods: Physically-active asymptomatic persons and individuals post-ACL reconstruction stood blindfolded on a perturbation platform capable of generating high-acceleration translations (1.5 m/s2). Auditory stimuli were repeatedly presented in four-second intervals, as either low- or high-frequency tones. Half of the high-frequency tones were followed 1.5 seconds later by a destabilizing perturbation in one of eight randomized directions. The two tone conditions were thus termed ‘Neutral’ and ‘Anxiety’, as the high-frequency tone was intended to invoke an arousal response in anticipation of a potential perturbation. Event-related potentials (ERP) were computed for nine electrodes by averaging 100 Neutral and 100 Anxiety trials. Significant ERP components were identified using functional data analysis. Paired difference-waves’ amplitudes (Neutral - Anxiety) were compared between groups.

Results: ERP correlates of anxiety were detected for both groups in frontal and central midline locations, with an observable contingent negative variation (CNV) from 500 ms post-stimulus in Anxiety compared with Neutral trials. This ERP component is reflective of a threat-induced arousal response, associated with attention and expectancy of an anxiety-relevant event. Preliminary data indicate no group differences in CNV amplitudes.

Conclusions: Objective evaluation of an arousal response to movement-related anxiety was found to be feasible, resulting in a threat-induced CNV. Further investigation will elucidate the discriminative power of such an approach to differentiate between individuals with high and low re-injury anxiety, as well as potential associations with existing patient-reported outcome measures.

National Category
Health Sciences Psychology
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-223317 (URN)
Conference
Society for Neuroscience 2022 Meeting, San Diego, Carliforna, USA, November 12-16, 2022
Available from: 2024-04-12 Created: 2024-04-12 Last updated: 2024-04-15Bibliographically approved
Diarbakerli, E., Thoreson, O., Björklund, M., Dahlberg, L. E., Englund, M., Gerdhem, P., . . . Abbott, A. (2022). Learning from the past to plan for the future: a scoping review of musculoskeletal clinical research in Sweden 2010-2020. Upsala Journal of Medical Sciences, 127(1), Article ID e8709.
Open this publication in new window or tab >>Learning from the past to plan for the future: a scoping review of musculoskeletal clinical research in Sweden 2010-2020
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2022 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 127, no 1, article id e8709Article, review/survey (Refereed) Published
Abstract [en]

Background: The aims of this study are to 1) determine the scope of musculoskeletal (MSK)-related clinical research in Sweden; 2) collate the amount of first-tier funding received; 3) discuss strategies and infrastructure supporting future MSK clinical trials in Sweden.

Methods: A systematic scoping review protocol was applied in PubMed, Scopus, and SweCRIS databases. The articles were examined, and data were extracted in multiple stages by three blinded authors.

Results: The search strategy resulted in 3,025 publications from 479 Swedish-affiliated authors. Primary health care was the basis for 14% of the publications, 84% from secondary health care, and 2% from occupational health care with a similar proportional distribution of first-tier research grant financing. Approximately one in six publications were randomized controlled trials (RCTs), while the majority were of observational cohort design. The majority of publications in primary and occupational health care were related to pain disorders (51 and 67%, respectively), especially diagnosis, prognosis, and healthcare organizational-related interventions (34%) and rehabilitation (15%) with similar proportional distribution of first-tier research grant financing. In secondary health care, rheumatic inflammatory disorder-related publications were most prevalent (30%), most frequently concerning diagnosis, prognosis, and healthcare organizational-related interventions (20%), attracting approximately half of all first-tier funding. Publications related to degenerative joint disorders (25%), fractures (16%), and joint, tendon, and muscle injuries (13%) frequently concerned surgical and other orthopedic-related interventions (16, 6, and 8%, respectively). Pain disorder-related publications (10%) as well as bone health and osteoporosis-related publications (4%) most frequently concerned diagnosis, prognosis, and healthcare organizational-related interventions (5 and 3%, respectively).

Conclusions: Swedish-affiliated MSK disorder research 2010-2020 was predominantly observational cohort rather than RCT based. There was skewed first-tier funding allocation considering prevalence/incidence and burden of disease. Use of infrastructure supporting register-based RCTs, placebo-controlled RCTs, and hybrid effectiveness-implementation studies on prevention and clinical intervention is important strategies for the future in all healthcare sectors.

Place, publisher, year, edition, pages
Upsala medical society, 2022
Keywords
clinical research, Musculoskeletal disorders, occupational health care, primary health care, research design, research funding, secondary health care, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-201253 (URN)10.48101/ujms.v127.8709 (DOI)000879744700001 ()36337277 (PubMedID)2-s2.0-85141355356 (Scopus ID)
Funder
Swedish Research Council, 2019-06101
Available from: 2022-12-05 Created: 2022-12-05 Last updated: 2022-12-05Bibliographically approved
Arumugam, A., Björklund, M., Mikko, S. & Häger, C. K. (2021). Effects of neuromuscular training on knee proprioception in individuals with anterior cruciate ligament injury: A systematic review and GRADE evidence synthesis. BMJ Open, 11(5), Article ID e049226.
Open this publication in new window or tab >>Effects of neuromuscular training on knee proprioception in individuals with anterior cruciate ligament injury: A systematic review and GRADE evidence synthesis
2021 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 5, article id e049226Article, review/survey (Refereed) Published
Abstract [en]

Objective: To systematically review and summarise the evidence for the effects of neuromuscular training compared with any other therapy (conventional training/sham) on knee proprioception following anterior cruciate ligament (ACL) injury.

Design: Systematic Review.

Data sources: PubMed, CINAHL, SPORTDiscus, AMED, Scopus and Physical Education Index were searched from inception to February 2020.

Eligibility criteria: Randomised controlled trials (RCTs) and controlled clinical trials investigating the effects of neuromuscular training on knee-specific proprioception tests following a unilateral ACL injury were included.

Data extraction and synthesis: Two reviewers independently screened and extracted data and assessed risk of bias of the eligible studies using the Cochrane risk of bias 2 tool. Overall certainty in evidence was determined using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool.

Results: Of 2706 articles retrieved, only 9 RCTs, comprising 327 individuals with an ACL reconstruction (ACLR), met the inclusion criteria. Neuromuscular training interventions varied across studies: whole body vibration therapy, Nintendo-Wii-Fit training, balance training, sport-specific exercises, backward walking, etc. Outcome measures included joint position sense (JPS; n=7), thresholds to detect passive motion (TTDPM; n=3) or quadriceps force control (QFC; n=1). Overall, between-group mean differences indicated inconsistent findings with an increase or decrease of errors associated with JPS by ≤2°, TTDPM by ≤1.5° and QFC by ≤6 Nm in the ACLR knee following neuromuscular training. Owing to serious concerns with three or more GRADE domains (risk of bias, inconsistency, indirectness or imprecision associated with the findings) for each outcome of interest across studies, the certainty of evidence was very low.

Conclusions: The heterogeneity of interventions, methodological limitations, inconsistency of effects (on JPS/TTDPM/QFC) preclude recommendation of one optimal neuromuscular training intervention for improving proprioception following ACL injury in clinical practice. There is a need for methodologically robust RCTs with homogenous populations with ACL injury (managed conservatively or with reconstruction), novel/well-designed neuromuscular training and valid proprioception assessments, which also seem to be lacking.

PROSPERO registration number CRD42018107349.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2021
Keywords
knee, orthopaedic sports trauma, rehabilitation medicine, sports medicine
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-183724 (URN)10.1136/bmjopen-2021-049226 (DOI)000729767000012 ()34006560 (PubMedID)2-s2.0-85106149490 (Scopus ID)
Available from: 2021-05-31 Created: 2021-05-31 Last updated: 2024-03-14Bibliographically approved
Degerstedt, F., Björklund, M., Keisu, B.-I. & Enberg, B. (2021). Unequal physical activity among children with cerebral palsy in Sweden: A national registry study. Health Science Reports, 4(3), Article ID e342.
Open this publication in new window or tab >>Unequal physical activity among children with cerebral palsy in Sweden: A national registry study
2021 (English)In: Health Science Reports, E-ISSN 2398-8835, Vol. 4, no 3, article id e342Article in journal (Refereed) Published
Abstract [en]

Aim: To examine the extent to which sex, country of birth, and functional aspects influence participation in physical education and physical leisure activity among children with cerebral palsy (CP) in Sweden.

Methods: This national cross-sectional registry study included children with CP aged 6 to 18 years who participated in the Swedish national quality registry, the Cerebral Palsy Follow-up Program, CPUP, in 2015. Comparisons and associations between sex, country of birth, and functional aspects and physical leisure/physical education were examined using chi-squared and multivariable logistic regression analysis.

Results: The study included 1935 children. Of them, 1625 (87%) reported participating in physical education and 989 (53%) reported participating in physical leisure activity. Children born in Sweden had higher odds of participating in physical education (OR: 1.99; 95% CI: 1.20-3.28) and physical leisure activity (OR: 2.51; 95% CI: 1.70-3.72) compared with children born outside Europe. Greater impairment of gross motor function was associated with lower participation levels. Boys participated slightly more frequently in leisure activities than girls.

Conclusion: Enhancing social inclusion with regard to disability, birth country, and sex are important and achievable goals for policymakers and practitioners for promoting participation in physical activity for children and adolescents with CP.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
inequality, leisure, norms, physical education, youth
National Category
Gender Studies Physiotherapy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-186647 (URN)10.1002/hsr2.342 (DOI)000700814100054 ()34401523 (PubMedID)2-s2.0-85115821642 (Scopus ID)
Available from: 2021-08-16 Created: 2021-08-16 Last updated: 2023-09-05Bibliographically approved
Degerstedt, F., Enberg, B., Keisu, B.-I. & Björklund, M. (2020). Inequity in physiotherapeutic interventions for children with Cerebral Palsy in Sweden: a national registry study. Acta Paediatrica, 109(4), 774-782
Open this publication in new window or tab >>Inequity in physiotherapeutic interventions for children with Cerebral Palsy in Sweden: a national registry study
2020 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 109, no 4, p. 774-782Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to investigate the distribution of physiotherapeutic interventions for children with Cerebral Palsy in Sweden from an equity perspective, considering sex, country of birth and geographical region.

Method: This national cross‐sectional registry study includes children with Cerebral Palsy aged 0‐18 years who participated in 2015 in the Swedish national quality registry, the Cerebral Palsy follow‐up programme, CPUP. Comparisons and associations between physiotherapeutic interventions and sex, country of birth and geographical regions were conducted using chi‐square and logistic regression analysis, controlling for cognitive level, level of motor function, age group and dominating symptom.

Results: Of the 2855 participants, 2201 (79%) had received physiotherapy. Children born in Sweden had 1.60 times higher odds (95% CI 1.10‐2.33) of receiving physiotherapy compared with children born in foreign countries. Distribution of physiotherapeutic interventions differed significantly between geographical regions. No associations between sex and physiotherapeutic interventions were observed.

Conclusion: The results of this study indicate inequity in care in Sweden towards children with Cerebral Palsy born in other counties. Further, physiotherapeutic interventions were not equally distributed in different geographical regions of Sweden. Knowledge of inequity is crucial in order to address the problem.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
adolescents, cerebral palsy, CPUP, inequity, physiotherapy
National Category
Physiotherapy Gender Studies Pediatrics
Identifiers
urn:nbn:se:umu:diva-163637 (URN)10.1111/apa.14980 (DOI)000488167100001 ()31435959 (PubMedID)2-s2.0-85073965380 (Scopus ID)
Available from: 2019-10-01 Created: 2019-10-01 Last updated: 2023-05-10Bibliographically approved
Bohman, T., Bottai, M. & Björklund, M. (2019). Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain: a longitudinal cohort study. BMJ Open, 9(4), Article ID e024557.
Open this publication in new window or tab >>Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain: a longitudinal cohort study
2019 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 9, no 4, article id e024557Article in journal (Refereed) Published
Abstract [en]

Objectives: To develop predictive models for short-term and long-term clinically important improvement in women with non-specific chronic disabling neck pain during the clinical course of physiotherapy.

Design: Longitudinal cohort study based on data from a randomised controlled trial evaluating short-term and long-term effects on sensorimotor function over 11 weeks of physiotherapy.

Participants and settings: Eighty-nine women aged 31–65 years with non-specific chronic disabling neck pain from Gävle, Sweden.

Measures: The outcome, clinically important improvement, was measured with the Patient Global Impression of Change Scale (PGICS) and the Neck Disability Index (NDI), assessed by self-administered questionnaires at 3, 9 and 15 months from the start of the interventions (baseline). Twelve baseline prognostic factors were considered in the analyses. The predictive models were built using random-effects logistic regression. The predictive ability of the models was measured by the area under the receiver operating characteristic curve (AUC). Internal validity was assessed with cross-validation using the bootstrap resampling technique.

Results: Factors included in the final PGICS model were neck disability and age, and in the NDI model, neck disability, depression and catastrophising. In both models, the odds for short-term and long-term improvement increased with higher baseline neck disability, while the odds decreased with increasing age (PGICS model), and with increasing level of depression (NDI model). In the NDI model, higher baseline levels of catastrophising indicated increased odds for short-term improvement and decreased odds for long-term improvement. Both models showed acceptable predictive validity with an AUC of 0.64 (95% CI 0.55 to 0.73) and 0.67 (95% CI 0.59 to 0.75), respectively.

Conclusion: Age, neck disability and psychological factors seem to be important predictors of improvement, and may inform clinical decisions about physiotherapy in women with chronic neck pain. Before using the developed predictive models in clinical practice, however, they should be validated in other populations and tested in clinical settings.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-161460 (URN)10.1136/bmjopen-2018-024557 (DOI)000471157200062 ()31023751 (PubMedID)2-s2.0-85065220930 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2006-1162Länsförsäkringar AB, 51-1010/06
Available from: 2019-07-09 Created: 2019-07-09 Last updated: 2023-08-28Bibliographically approved
Hallman, D. M., Holtermann, A., Björklund, M., Gupta, N. & Norregaard Rasmussen, C. D. (2019). Sick leave due to musculoskeletal pain: determinants of distinct trajectories over 1 year. International Archives of Occupational and Environmental Health, 92(8), 1099-1108
Open this publication in new window or tab >>Sick leave due to musculoskeletal pain: determinants of distinct trajectories over 1 year
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2019 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 92, no 8, p. 1099-1108Article in journal (Refereed) Published
Abstract [en]

Purpose: This study aimed to identify sub-groups of workers with different trajectories of sick leave due to musculoskeletal pain over 1 year, and to investigate the extent to which the identified trajectories are associated with personal, occupational, lifestyle, and pain-related factors at baseline.

Methods: Data on 981 blue- and white-collar workers were analyzed in the DPHACTO cohort (2012-2014). The number of days on sick leave due to pain was reported using text messages at 4-week intervals across 1 year. Latent class growth analysis was used to distinguish sub-groups with different trajectories of sick leave. A web-based questionnaire at baseline was used to assess personal, occupational (physical and psychosocial), lifestyle, and pain-related factors. Multinomial regression models were constructed to determine associations between baseline factors and trajectories of sick leave (referencing no sick leave), with adjustment for potential confounders.

Results: Four distinct sub-groups were identified, with trajectories of sick leave due to pain ranging from no sick leave (prevalence 76%; average 0.5 days/year) to some days and increasing sick leave due to pain over 1 year (2%; 89 days/year). The increasing trajectory of sick leave was associated with higher perceived physical exertion, more time in manual work, less social community and influence at work, less leisure-time physical activity, smoking, and more severe symptoms (e.g., multisite pain, low back pain intensity, and pain interference).

Conclusions: We identified four distinct trajectories of sick leave due to musculoskeletal pain. The sub-group with increasing sick leave due to pain was associated with several modifiable physical and psychosocial factors at work and outside work, which may have implications for prevention.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Longitudinal, Risk factors, Sickness absence, Workers
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-165468 (URN)10.1007/s00420-019-01447-y (DOI)000492593000003 ()31165308 (PubMedID)2-s2.0-85067077539 (Scopus ID)
Available from: 2019-12-04 Created: 2019-12-04 Last updated: 2023-03-23Bibliographically approved
Svedmark, Å., Björklund, M., Häger, C. K., Nilsson Sommar, J. & Wahlström, J. (2018). Impact of workplace exposure and stress on neck pain and disabilities in women: a longitudinal follow-up after a rehabilitation intervention. Annals of Work Exposures and Health, 62(5), 591-603
Open this publication in new window or tab >>Impact of workplace exposure and stress on neck pain and disabilities in women: a longitudinal follow-up after a rehabilitation intervention
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2018 (English)In: Annals of Work Exposures and Health, ISSN 2398-7308 , E-ISSN 2398-7316 , Vol. 62, no 5, p. 591-603Article in journal (Refereed) Published
Abstract [en]

Introduction: The aim was to evaluate if pain, disability, and work productivity are influenced by physical and psychosocial work exposures as well as by stress, up to 1 year after a randomized controlled trial treatment intervention, and to determine whether any such association differed between treatment and control groups.

Methods: Ninety-seven working women suffering non-specific neck pain (n = 67 treatment group, n = 30 control group) were followed from end of treatment intervention and at 9- and 15-month follow-ups, respectively. Physical and psychosocial exposures, as well as perceived stress, were assessed after the treatment intervention. Pain, neck disability, and work productivity were assessed at baseline, after intervention 3 months later and at 9- and 15-month follow-ups. Longitudinal assessment was conducted using the exposure level at 3 months as predictor of pain, disability, and work productivity at 3, 9, and 15 months, respectively. Mixed models were used to estimate longitudinal associations, accounting for within-individual correlation of repeated outcome measures by incorporation of a random intercept. Age and duration of neck pain were adjusted for in all models. To evaluate group differences, interactions between exposures and treatment groups were estimated.

Results: High perceived stress was associated with more neck pain, more neck disability, and decreased work productivity in both cross-sectional and longitudinal analyses. High ‘control of decision’ was associated with less neck pain, less neck disability, and higher work productivity in cross-sectional analyses but only to less disability and higher productivity in longitudinal analyses. Shoulder/arm load was the only physical exposure variable that was significantly associated with work productivity in the univariate analyses. Only small differences were observed between treatment and control groups.

Conclusion: High perceived stress and low ‘control of decision’ were associated with more neck pain, increased neck disability, and decreased work productivity. Treatment interventions for individuals with neck pain should take into account psychosocial workplace exposures and stress to improve intermediate and long-term results.

Place, publisher, year, edition, pages
Oxford University Press, 2018
Keywords
non-specific neck pain, physiotherapy, shoulder pain, work productivity
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-139392 (URN)10.1093/annweh/wxy018 (DOI)000449420200007 ()29562318 (PubMedID)2-s2.0-85050676120 (Scopus ID)
Funder
AFA Insurance, 090288Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-1403
Available from: 2017-09-11 Created: 2017-09-11 Last updated: 2020-11-25Bibliographically approved
Projects
Forte-centre Working Life: The Body at Work - from problem to potential [2009-01761_Forte]; University of GävleRehabilitation of people with neck pain. Effects of individualized treatment based on prognostic indicators and tests of functioning [2009-01403_Forte]; University of GävleRehabilitering för personer med nackbesvär: Effekter av individanpassad rehabilitering baserad på prognostiska indikatorer och funktionstest [090288]; University of Gävle
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7543-4397

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