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  • 1.
    Aasa, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi. Norrlandsklinikens hälsocentral, Umeå, Sweden.
    Berglund, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Aasa, Ulrika
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain: a randomized controlled trial2015Ingår i: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 45, nr 2, s. 77-85Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study Design Randomized controlled trial. Background Low back pain is a common disorder. Patients with low back pain frequently have aberrant and pain-provocative movement patterns that often are addressed with motor control exercises. Objective To compare the effects of low-load motor control (LMC) exercise and those of a high-load lifting (HLL) exercise. Methods Seventy participants with recurrent low back pain, who were diagnosed with nociceptive mechanical pain as their dominating pain pattern, were randomized to either LMC or HLL exercise treatments. Participants were offered 12 treatment sessions over an 8-week period. All participants were also provided with education regarding pain mechanisms. Methods Participants were assessed prior to and following treatment. The primary outcome measures were activity (the Patient-Specific Functional Scale) and average pain intensity over the last 7 days (visual analog scale). The secondary outcome measure was a physical performance test battery that included 1 strength, 3 endurance, and 7 movement control tests for the lumbopelvic region. Results Both interventions resulted in significant within-group improvements in pain intensity, strength, and endurance. The LMC group showed significantly greater improvement on the Patient-Specific Functional Scale (4.2 points) compared with the HLL group (2.5 points) (P<.001). There were no significant between-group differences in pain intensity (P = .505), strength, and 1 of the 3 endurance tests. However, the LMC group showed an increase (from 2.9 to 5.9) on the movement control test subscale, whereas the HLL group showed no change (from 3.9 to 3.1) (P<.001). Conclusion An LMC intervention may result in superior outcomes in activity, movement control, and muscle endurance compared to an HLL intervention, but not in pain intensity, strength, or endurance.

  • 2.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering. Umeå universitet, Samhällsvetenskapliga fakulteten, Idrottshögskolan vid Umeå universitet.
    Berglund, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering. Umeå universitet, Samhällsvetenskapliga fakulteten, Idrottshögskolan vid Umeå universitet.
    A descriptive analysis of functional impairments and patho-anatomical findings in eight powerlifters2020Ingår i: Journal of Sports Medicine and Physical Fitness, ISSN 0022-4707, E-ISSN 1827-1928, Vol. 60, nr 4, s. 582-593Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Low back pain (LBP) is a common pain problem in powerlifters. There is a lack of evidence to guide powerlifters and health-care professionals in understanding the role of powerlifting in the development of LBP and treatment of injuries in powerlifters. This study aimed to describe functional impairments and patho-anatomical findings in eight powerlifters with and without LBP. METHODS: First, four powerlifters with LBP were recruited. Each powerlifter was then matched with a pain-free lifter (Control) by age, Body Mass Index and competition weight class. They all performed physical performance tests and were examined with magnetic resonance imaging. Four weeks prior to the examination the powerlifters also recorded training load. Powerlifters with LBP were also examined by a physiotherapist in order to define their pain and impairments. RESULTS: The four male powerlifters with LBP had a nociceptive pain associated with non-ideal squatting technique, higher flexibility in their lumbar spine than in their hips and patho-anatomical findings such as degenerated discs (four), spondylolysis (one) and spinal stenosis (one). However, the controls also showed similar functional impairments and patho-anatomical findings. CONCLUSIONS: Powerlifters with and without LBP show similar functional impairments and patho-anatomical findings. However, powerlifters' LBP seems associated with pain during movement and loading of the lumbar spine. The association and causation between specific functional impairments, patho-anatomical findings and LBP in powerlifters has to be further investigated in studies including more participants.

  • 3.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Paulin, Johan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Madison, Guy
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Correspondence between physical self-concept and participation in, and fitness change after, bi-weekly body conditioning classes in sedentary women2017Ingår i: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 31, nr 2, s. 451-461Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aims of the study were (1) to investigate the effects of participation in low impact body conditioning classes on physical fitness in sedentary women at different ages and (2) to examine the correspondence between physical self-concept and participation in, and fitness change after, the participation. Ninety-two sedentary women (mean age 44.2 years) participated in 11-weeks of bi-weekly classes that included cardiovascular, strength, core, endurance and mobility exercises, all performed in synchrony with music. Cardiorespiratory fitness, maximal lifting strength, mobility and balance tests were performed pre- and post the exercise period and the short-form Physical Self-Description Questionnaire (PSDQ-S) was completed. Zero-order Spearman correlation analyses showed that women who rated the PSDQ-S dimension Sport competence higher participated in a larger number of sessions (rs=0.24, p=0.040). At post-tests, all participants had increased their balance, the participants aged 20-34 years had increased their lifting strength, and the participants aged 35-65 years had increased their cardiorespiratory fitness and mobility. Most PSDQ-S dimensions did not affect performance change, but the perception of being physically active was related to increased cardiovascular fitness. We conclude that women with a sedentary lifestyle who wish to increase their physical capacity benefit from music exercise and that inquiries about perceived sport competence and physical activity can improve recommendations made by strength and conditioning professionals.

  • 4. Abat, F
    et al.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin. Alfredson Tendon Clinic Inc, Umeå, Sweden; Pure Sports Medicine Clinic, ISEH, UCLH, London, UK.
    Cucchiarini, M
    Madry, H
    Marmotti, A
    Mouton, C
    Oliveira, J M
    Pereira, H
    Peretti, G M
    Spang, Christoph
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Stephen, J
    van Bergen, C J A
    de Girolamo, L
    Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part II2018Ingår i: Journal of experimental orthopaedics, ISSN 2197-1153, Vol. 5, nr 38Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The treatment of painful chronic tendinopathy is challenging. Multiple non-invasive and tendon-invasive methods are used. When traditional non-invasive treatments fail, the injections of platelet-rich plasma autologous blood or cortisone have become increasingly favored. However, there is little scientific evidence from human studies supporting injection treatment. As the last resort, intra- or peritendinous open or endoscopic surgery are employed even though these also show varying results. This ESSKA basic science committee current concepts review follows the first part on the biology, biomechanics and anatomy of tendinopathies, to provide a comprehensive overview of the latest treatment options for tendinopathy as reported in the literature.

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  • 5.
    Abat, Ferran
    et al.
    ReSport Clinic Barcelona, Blanquerna-Ramon Llull University School of Health Science, Rosselló, Barcelona, Spain.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin.
    Sonosurgery ultrasound-guided arthroscopic shaving for the treatment of patellar tendinopathy when conservative treatment fails2023Ingår i: Anterior knee pain and patellar instability / [ed] Vicente Sanchis-Alfonso, Cham: Springer Nature, 2023, 3, s. 403-413Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    Proximal patellar Tendinopathy, commonly denominated as Jumper´s Knee, is widely considered to be a challenge to treat (Abat et al. in J Exp Orthop. 3:34, 2016). The treatment of patellar tendinopathy focuses on reducing if not eliminating the pain and improving function. At present, there are a several distinct treatments oriented to that end, and a “gold-standard” treatment might be in sight. (Abat F, Alfredson H, Cucchiarini M, Madry H, Marmotti A, Mouton C, Oliveira JM, Pereira H, Peretti GM, Spang C, Stephen J, van Bergen CJA, de Girolamo L. Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part II: treatment options. J Exp Orthop. 2018 Sep 24;5(1):38. https://doi.org/10.1186/s40634-018-0145-5.)

  • 6.
    Abat, Ferran
    et al.
    Department of Sports Orthopaedic, ReSport Clinic Barcelona, Barcelona, Spain.
    Maffulli, Nicola
    Centre for Sports and Exercise Medicine, Queen Mary University of London Barts and The London School of Medicine, London, United Kingdom.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin.
    Lopez-Vidriero, E.
    Department of Orthopaedic, International Sports Medicine Clinic and Ibermutuamur Sevilla, Sevilla, Spain.
    Myers, C.
    Complete Physio, Tendon Performance, Sports Medicine Ultrasound Group (SMUG), London, United Kingdom.
    Gomes, S.
    Department of MSK Radiology, Clinica do Dragao Espregueira Mendes Sports Centre – FIFA Medical Centre of Excellence, Porto, Portugal.
    Chan, O.
    Department of MSK Radiology, BMI London Independent Hospital, London, United Kingdom.
    Clinical utility of diagnostic ultrasound in athletes with tendinopathy (ICL 22)2016Ingår i: Esska instructional course lecture book: Barcelona 2016 / [ed] Roland Becker; Gino M.M.J. Kerkhoffs; Pablo E. Gelber; Matteo Denti; Romain Seil, Springer Berlin/Heidelberg, 2016, s. 217-223Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    Chronic painful tendinopathy is common in elite and recreational athletes and in sedentary subjects; all may have to stop or decrease their level of physical activity [1, 2]. Midportion Achilles tendinopathy and for the younger and heavy loading population also patellar tendinopathy are problematic injuries. However, recent research on innervation patterns histopathology and pain mechanisms in Achilles and patellar tendons has led to an increased knowledge about the chronic painful tendon [3–6].

  • 7.
    Adam, Eriksson
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin.
    Victoria, Olofsson
    Smålagsspel för unga fotbollsspelare: yttre fysisk belastning och motivation.2021Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Fotboll är en högintensiv sport med intermittent arbete och har höga krav på den aeroba förmågan. För att utveckla den aeroba förmågan hos fotbollsspelare används ofta small sided games (SSG). Träningsmetoden liknar match men spelas på mindre yta med färre spelare. I ett idrottssammanhang visar tidigare forskning på samband mellan inre motivation och större upplevd glädje till aktiviteten, så även uthållighet i att utföra aktiviteter till hands. Detta kan komma att påverka idrottares utveckling samt prestation. Studien jämförde yttre fysisk belastning (Total distans (TD), sprintlöpningar (SL), höghastighetslöpningar (HHL), accelerationer (ACC) och deaccelerationer (DEC) i SGG mellan olika planstorlekar och antal spelare. Vidare undersöktes om spelarnas typ av motivation skiljde sig mellan uppläggen, samt om samband mellan motivationsformerna och yttre fysisk belastning fanns. Sjutton fotbollsspelare (18 ± 1 år) från ett pojklag deltog i studien. Global Positioning System data samlades in via Polar Team Pro applikation som tilldelades av fotbollsklubben. Planstorlek för uppläggen var 7 mot 7(7vs7); 50m x 35-45m, 4 mot 4(4vs4); 32m x 20m. Distansen var längre i SSG 7vs7 än i SSG 4vs4 (p <0.05), spelare gjorde även fler accelerationer (p <0.05) såväl som deaccelerationer (p <0.05) i SSG 7vs7. En enkät baserad på Situational Motivation Scale (SIMS) användes för att identifiera spelarnas motivationsform; Inre motivation, identifierad reglering, extern reglering och amotivation. Resultatet visade inga signifikanta skillnader i motivationsform mellan SSG 7vs7 och SSG 4vs4. Resultatet visade ett signifikant negativt samband mellan amotivation och TD i SSG 7vs7, samt ett mellan identifierad reglering och SL i SSG 7vs7. Studien visar att olika upplägg av smålagsspel påverkar den yttre fysiska belastningen hos unga fotbollsspelare på olika sätt samt att spelarnas motivationsform kan påverka utfallet av träningen och utvecklingen. Vidare krävs mer forskning på unga fotbollsspelare för att säkerställa pålitliga resultat.  

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  • 8.
    Aghababa, Alireza
    et al.
    Sport Psychology Department, Sport Sciences Research Institute, Tehran, Iran.
    Rohani, Hadi
    Exercise Physiology Department, Sport Sciences Research Institute, Tehran, Iran.
    Nabilpoor, Maghsood
    Sport Sciences, International University, Qazvin, Iran.
    Theos, Apostolos
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin.
    Derek, Kingsley
    Exercise Physiology Department, Cardiovascular Dynamics Laboratory, Ohio, United States.
    Shahidi, Seyed Houtan
    Sport Coaching Department, Gedik University, İstanbul, Turkey.
    Effects of COVID-19 on physical activity and mood in the middle-aged people: Concerns and strategies2022Ingår i: Turkish Journal of Sports Medicine, ISSN 1300-0551, Vol. 57, nr 1, s. 38-43Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To assess the impact of coronavirus on the physical activity levels before and during self-quarantine, and the effect of self-isolation on the total mood status of Iranian citizens during the covid-19 pandemic. 

    Material and Methods: A national sample of 2359 middle-aged (M age=42.8±5.3 years, n=1183,50.1%, male; n=1148, 48.7% female) Iranian completed an online questionnaire that assessed changes in daily physical activity behavior and mood status from March 20th to April 20th, 2020. The questionnaire implemented to collect the total duration, intensity, and frequency of physical activity and their psychological mood condition via the BRUMS Mood Scale.

    Results: There were significant differences between physical activity frequency, duration, and intensity before and during the coronavirus pandemic. There was no significant difference between the total mood conditions between the sex categories. The main key finding of the current study is that the total physical activity participation behavior of our middle-aged populations has decreased meaningfully.

    Conclusion: The present study has provided important approaches that should be implemented to promote the engagement of middle-aged adults in physical activity. Therefore, based on scientific evidence, maintaining a regular physical activity routine regarding world health organization guidelines is a key strategy for physical health.

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  • 9.
    Agvald, Liv
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Fysisk aktivitetsnivå hos barn i årskurs 3: En accelerometerstudie2018Självständigt arbete på avancerad nivå (magisterexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Introduktion: Vikten av fysisk aktivitet är väl utredd, men kunskapsunderlaget om hur aktiva våra yngre barn är idag är fortfarande tunt. Tri-accelerometer har visat sig vara en valid metod att mäta aktivitet hos barn.

    Syfte: Syftet med studien är att undersöka och kartlägga den totala fysiska aktivitetsnivån under en veckas tid hos barn i årskurs tre på en skola i norra Sverige. Ytterligare syfte är att se hur stor andel av barnen som når upp till rekommenderad dos av daglig aktivitet, samt om det finns någon signifikant skillnad i aktivitetsnivå sett utifrån kön eller deltagande i organiserad idrott eller ej.

    Metod: Fyrtio barn deltog i studien. Deltagarnas aktivitet registrerades under en veckas tid genom en tri-accelerometer. Ett kortare frågeformulär angående deras fysiska aktivitet besvarades även.

    Resultat: Ingen signifikant skillnad avseende kön eller deltagande i organiserad idrott eller ej kunde påvisas. 39 av 40 deltagare nådde upp till rekommenderad dos av daglig aktivitet.

    Diskussion: Utifrån studien så förefaller barn i årskurs tre vara tillräckligt aktiva för att uppnå kraven på daglig aktivitetsdos, ett positivt resultat då larmrapporter om alltmer stillasittande förekommer. Större och djupare studier behövs för att se om dessa resultat stämmer i ett större sammanhang.

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  • 10.
    Ahlsved, Kaj
    Umeå universitet, Humanistiska fakulteten, Institutionen för kultur- och medievetenskaper. Åbo Akademi, Åbo, Finland.
    Velocipedmusik från stålhästens decennium - hur lät den?2023Ingår i: Toiminta soi, ISSN 2737-016XArtikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

    På 1890-talet var intresset för cykling stort i Finland. Intresset avspeglades även i musikkulturen eftersom det började komponeras musik med cykeltema. Endast en liten del av den musiken har getts ut kommersiellt i Finland. Kaj Ahlsved har grävt i arkiven och i samarbete med musiker levandegjort musiken så som den finns nertecknad i version för hornensemble i Finlands armés stämböcker. Hur lät ”cykelmusiken”, vem komponerade den och varför?  

  • 11.
    Albertsson, Sandra
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Juntunen, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Styrketräningsadaption: Aminosyrafördelning och intracellulär signalering2013Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Muscle mass regulation is responsive to a variety of stimuli, whereas amino acids and resistance exercise are two major regulators. Protein accretion occurs when the rate of protein synthesis exceeds the rate of protein degradation. It has long been recognized that both amino acid and resistance exercise effect protein synthesis and protein degradation, although the effect of varying distribution of amino acids remain unknown. The intracellular pathways by which protein synthesis are activated is complex. The purpose of this essay is to elucidate if there exist any scientific rationale to spread the amino acid intake over the day, with the purpose to maximize muscle protein accretion in response to resistance exercise. Furthermore , we intend to describe how amino acids and resistance exercise effect the molecular pathways that regulate protein synthesis, with the main focus on pathways that activate and are activated by mTOR.

    Studies that examine acute effects on protein synthesis or protein balance after resistance exercise and amino acid intake support the notion that there may be an advantage to spread the amino acid intake over the day, since the synthetic response to amino acids are transient. However, studies examining the effect of different meal frequencies on protein accretion and /or training results fail to support this notion. Both amino acids and resistance exercise seems to independently activate the intracellular pathways that regulate protein synthesis, with the effect being greatest when both are combined. The regulation also seems to be dependent on exercise intensity and volume, age of test subjects, contraction type and muscle fiber type. Furthermore, some researchers have found correlations between activation of these pathways and resistance exercise-induced muscle gain and strength gain.

  • 12.
    Alfredson, Hakan
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB). ISEH, UCLH, London, UK.
    Persistent pain in the Achilles midportion?: Consider the plantaris tendon as a possible culprit!2017Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 51, nr 10, s. 833-834Artikel, forskningsöversikt (Refereegranskat)
  • 13.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin. Alfredson Tendon Clinic Inc., Umeå, Sweden; Pure Sports Medicine, London, England.
    Achilles and patellar tendon operations performed in local anestesia2018Ingår i: American journal of Anesthesiology and Pain medicine, ISSN 2640-5377, Vol. 1, nr 1, s. 001-002Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    From 20 years of research on innervation patterns and pain mechanisms in chronic painful Achilles and patellar tendinopathy, we have learned that the nerves are located outside the affected tendon. With this background we use local anestetics in combination with Adrenaline when these patients are surgical treated. We have now more than 15 years of experience in treating Achilles tendinopathy, and 10 years of experience in treating patellar tendinopaty, in local anesthesia alone. I will present the scientific background and practi-cal techniques to use local anesthesia for treatment of chronic painful Achilles and patellar tendinopathy.

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  • 14.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Can specific treatment prevent progressive tendon degeneration?2011Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 45, nr 4, s. 334-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Tendon degeneration is generally believed to be irreversible.

    Objective To use ultrasound to study the Achilles midportion tendon structure and thickness before and after treatment of chronic painful tendinosis.

    Design Prospective study.

    Patients and interventions Middle aged patients on varying activity levels, having midportion chronic Achilles tendinosis, were followed with ultrasound examinations before and after treatment with eccentric training, sclerosing polidocanol injections and surgical scraping.

    Outcome measurements Tendon thickness and structure.

    Results 89 patients successfully treated (pain-free during tendon loading) with eccentric training (n=22), sclerosing polidocanol injections (n=38) and surgical scraping (n=29), had a significantly thinner Achilles midportion and a more normal tendon structure, after compared to before, treatment.

    Conclusion For the Achilles midportion, tendon degeneration might not be irreversible. The findings indicate a possible regeneration potential.

  • 15.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Eccentric calf muscle training: the story2010Ingår i: Sportverletzung, Sportschaden, ISSN 0932-0555, E-ISSN 1439-1236, Vol. 24, nr 4, s. 188-189Artikel i tidskrift (Refereegranskat)
  • 16.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering. 2Institute of Sport, Exercise and Health, University College London Hospitals, London, UK.
    Low recurrence rate after mini surgery outside the tendon combined with short rehabilitation in patients with midportion Achilles tendinopathy2016Ingår i: Open Access Journal of Sports Medicine, E-ISSN 1179-1543, Vol. 7, s. 51-54Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There is a general opinion that a structured and specific rehabilitation is needed after treatment of midportion Achilles tendinopathy to minimize recurrence of the condition. There is sparse knowledge about the recurrence rates in large patient materials after specific treatments for midportion Achilles tendinopathy.

    Aim: This study aimed to investigate the recurrence rates in a large number of patients with chronic painful midportion Achilles tendinopathy that had been surgically treated with the ultrasound (US) and Doppler (DP)-guided mini-surgical scraping technique. Postoperatively, a relatively simple rehabilitation protocol, including a range of movement exercises and gradually increased walking and biking before allowing free activity, was used.

    Materials and methods: From a database, information about the recurrence rates after US + DP-guided mini-surgical scraping, performed by a single surgeon on 519 tendons with US + DP-verified chronic painful midportion Achilles tendinopathy, was obtained.

    Results: Recurrence of painful midportion Achilles tendinopathy was found in 26 of 519 (5%) operated tendons, 13 from women and 13 from men. In 13 tendons, a close by located plantaris tendon was extirpated during the reoperation.

    Conclusion: In this large material on patients treated with US + DP-guided mini-surgical scraping for midportion Achilles tendinopathy, there were few recurrences, although only a simple and nonspecific rehabilitation protocol was used.

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  • 17.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Midportion Achilles tendinosis and the plantaris tendon2011Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 45, nr 13, s. 1023-1025Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: When re-operating patients with midportion Achilles tendinosis, having had a poor effect of ultrasound (US) and Doppler-guided scraping, the author found the involvement of the plantaris tendon to be a likely reason for the poor result. The aim of this study was to investigate the occurrence of a plantaris tendon in close relation to the Achilles tendon in consecutive patients with midportion Achilles tendinosis undergoing treatment with US and Doppler-guided scraping.

    Material and methods: This study includes 73 consecutive tendons with chronic painful midportion Achilles tendinosis, where US+Doppler examination showed thickening, irregular tendon structure, hypo-echoic regions, and localised high blood flow outside and inside the ventral Achilles midportion. The tendons were treated with US+Doppler-guided scraping, via a medial incision. If there was a plantaris tendon located in close relation to the medial Achilles, it was extirpated.

    Results: An invaginated, or ‘close by located’, enlarged plantaris tendon was found in 58 of 73 (80%) tendons. Preliminary clinical results of the combined procedure, US + Doppler-guided surgical scraping and extirpation of the plantaris tendon, are very promising.

    Conclusions: A thickened plantaris tendon located in close relation to the medial Achilles seems common in patients with chronic painful midportion tendinosis. The role of the plantaris tendon in midportion Achilles tendinosis needs to be further evaluated and should be kept in mind when treating this condition.

  • 18.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Reply to the letter from Dr. Karsten Knobloch regarding our article "Sclerosing injections to treat midportion Achilles tendinosis: a randomized controlled study evaluating two different concentrations of polidocanol"2009Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 17, nr 1, s. 113-114Artikel i tidskrift (Övrigt vetenskapligt)
  • 19.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin. National Institute for Working Life, University of Umeå , 901 87, Umeå, Sweden .
    Strategies in treatment of tendon overuse injury. The chronic painful tendon.2006Ingår i: European Journal of Sport Science, ISSN 1746-1391, E-ISSN 1536-7290, Vol. 6, nr 2, s. 81-85Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The etiology and pathogenesis to chronic tendon pain is unknown, and treatment is known to be difficult. Treatment is often based on opinions and not findings in scientific studies. Recent research, using the intra-tendinous microdialysis technique, has shown that in chronic painful Achilles-, patellar-, and extensor carpi radialis brevis (ECRB) tendons, there were no signs (normal Prostaglandin-2 levels) of a so-called chemical inflammation. Furthermore, in biopsies from chronic painful Achilles tendons, pro-inflammatory cytokines were not up-regulated, again showing the absence of an intra-tendinous inflammation. Consequently, if the purpose is to treat a chemical inflammation, there is no science backing up for treatment of theses conditions with anti-inflammatory agents (NSAIDs, corticosteroidal injections). Interestingly, Substance-P (SP) and Calcitonin Gene Regulated Peptide (CGRP) nerves have been demonstrated in close relation to vessels in biopsies from these chronic painful tendons, indicating the existence of a possible so-called neurogenic inflammation. Using ultrasonography (US) + color Doppler (CD), and immunhistochemical analyses of biopsies, a vasculo/neural (SP- and CGRP-nerves) ingrowth in the chronic painful tendinosis tendon, but not in the pain-free normal tendon, has recently been found. A specially designed treatment, using US- and CD-guided injections of the sclerosing agent Polidocanol, targeting the neovessels outside the tendon, has in pilot studies on chronic painful Achilles-, and patellar tendons been shown to cure the tendon pain in the majority of patients. A recent randomized double-blind study, verified the importance of injecting the sclerosing substance Polidocanol.

  • 20.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Ultrasound and Doppler-guided mini-surgery to treat midportion Achilles tendinosis: results of a large material and a randomised study comparing two scraping techniques.2011Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 45, nr 5, s. 407-410Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Treatment based on ultrasound (US) and colour Doppler (CD) findings in midportion Achilles tendinosis has shown promising results. In a randomised study on a small patient material, similar short-term clinical results were demonstrated with surgery outside the tendon and sclerosing polidocanol injections, but surgical treatment led to a faster return to activity.

    OBJECTIVE: To evaluate the clinical results of US and CD-guided mini-surgery (scraping) outside the ventral tendon in a larger patient material and, in a randomised study, compare two different techniques for surgical scraping.

    MATERIAL AND METHODS: 103 patients (66 men, 37 women), mean age 43 years (range 24-77), with midportion tendinosis in 125 Achilles tendons were included. Patients from a large group (88 tendons), and a randomised study (37 tendons), were in local anaesthesia treated with a US and CD-guided new surgical approach outside the ventral tendon. All patients in the large group, and one arm of the randomised study, were treated open with a scalpel, while the other arm of the randomised study were treated percutaneously. Pain during Achilles tendon loading activity (Visual Analogue Scale (VAS)), and satisfaction with treatment, were evaluated.

    RESULTS: Before surgery, the mean VAS was 73. After surgery (follow-up mean 18 months, range 6-33), the mean VAS was 3 in 111 tendons (89%) from satisfied patients back in full Achilles tendon loading activity. In the randomised study, there were no significant differences in the results between open treatment with a scalpel and percutaneous treatment with a needle.

    CONCLUSIONS: US and CD-guided scraping show good short-term results in midportion Achilles tendinosis.

  • 21.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Where to now with Achilles tendon treatment?2011Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 45, nr 5, s. 386-386Artikel i tidskrift (Refereegranskat)
  • 22.
    Alfredson, Håkan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin.
    Masci, Lorenzo
    Institute of Sports Exercise and Health, University College Hospital London, London, United Kingdom; Sports & Exercise Medicine, Queen Mary University of London, London, United Kingdom.
    Spang, Christoph
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi. Private Orthopaedic Spine Center, Würzburg, Germany.
    Is There a Relationship Between Quadriceps Tendinopathy and Suprapatellar Plica? An Observational Case Series2022Ingår i: International Medical Case Reports Journal, E-ISSN 1179-142X, Vol. 15, s. 81-84Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Chronic painful quadriceps tendinopathy is a relatively rare condition known to be difficult to manage. Conservative management is first-line treatment and if that fails open intra-tendinous revision surgery followed by a long rehabilitation period is used. There is sparse research on etiology and new treatment methods. This observational study aimed to evaluate the intra-articular findings in patients with chronic painful quadriceps tendinopathy resistant to conservative management.

    Patients and Methods: Seven male athletes (mean age 33 years, range 22–40) suffering from chronic painful quadriceps tendinopathy in altogether 10 tendons, not responding to conservative management including heavy strength training, were included. Clinical examination and ultrasound scanning were used for diagnosis. Arthroscopy was used for evaluation of the inside of the knee.

    Results: In all 10 knees, there were obliterating major plica formations in the suprapatellar pouch.

    Conclusion: Obliterating plica formations in the suprapatellar pouch may be involved in the aetiology and pathology in quadriceps tendinopathy.

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  • 23.
    Alfredson, Håkan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin. Institute of Sports Exercise and Health, University College Hospital London, London, United Kingdom.
    Masci, Lorenzo
    Institute of Sports Exercise and Health, University College Hospital London, London, United Kingdom; Sports and Exercise Medicine, Queen Mary University of London, London, United Kingdom.
    Spang, Christoph
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi. Private Orthopaedic Spine Center Dr. Alfen, Würzburg, Germany.
    Sharp pain in a normal Achilles tendon of a professional female football player was related to a plantaris tendon in a rare position: a case report2021Ingår i: Journal of Medical Case Reports, E-ISSN 1752-1947, Vol. 15, nr 1, artikel-id 513Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Plantaris tendinopathy and plantaris-associated Achilles tendinopathy can be responsible for chronic pain in the Achilles tendon midportion, often accompanied by medial tenderness. As conservative treatments are less successful for this patient group, proper diagnosis is important for decision making. This report presents a case with plantaris tendinopathy in a rare (superficial) location.

    Case presentation: This article describes a pain history and treatment timeline of a professional Swedish female soccer player (32 years old, Northern European ethnicity, white) who suffered from sharp pain in the Achilles tendon midportion and tenderness on the medial and superficial side for about 2 years. Conservative treatments, including eccentric exercises, were not successful and, to some extent, even caused additional irritation in that region. Ultrasound showed a wide and thick plantaris tendon located on the superficial side of the Achilles tendon midportion. The patient was surgically treated with local removal of the plantaris tendon. After surgery there was a relatively quick (4–6 weeks) rehabilitation, with immediate weight bearing, gradual increased loading, and return to running activities after 4 weeks. At follow-up at 8 weeks, the patient was running and had not experienced any further episodes of sharp pain during change of direction or sprinting.

    Conclusions: The plantaris tendon should be considered as a possible source of Achilles tendon pain. This case study demonstrates that the plantaris tendon can be found in unexpected (superficial) positions and needs to be carefully visualized during clinical and imaging examinations.

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  • 24.
    Alfredson, Håkan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin. ISEH, UCLH, London, UK; Pure Sports Medicine Clinic, London, UK.
    Masci, Lorenzo
    Spang, Christoph
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Surgical plantaris tendon removal for patients with plantaris tendon-related pain only and a normal Achilles tendon: a case series2018Ingår i: BMJ Open Sport & Exercise Medicine, ISSN 2055-7647, Vol. 4, nr 1, artikel-id e000462Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Surgical removal of the plantaris tendon can cure plantaris-associated Achilles tendinopathy, a condition in which Achilles and plantaris tendinopathy coexist. However, rare cases with plantaris tendinopathy alone are often misdiagnosed due to a normal Achilles tendon.

    Design and setting: Prospective case series study at one centre.

    Participants: Ten consecutive patients (9 men and one woman, mean age 35 years, range 19–67) with plantaris tendon-related pain alone in altogether 13 tendons were included. All had had a long duration (median 10 months, range 3 months to 10 years) of pain symptoms on the medial side of the Achilles tendon mid-portion. Preoperative ultrasound showed thickened plantaris tendon but a normal Achilles tendon.

    Interventions: Operative treatment consisting of ultrasound-guided excision of the plantaris tendon.

    Primary and secondary outcome measures: Scores from Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A)were taken preoperatively and postoperatively (median duration 10 months). Patient satisfaction and time until full return to sports activity level was asked by a questionnaire.

    Results: The VISA-A scores increased from 61 (range 45–81) preoperatively to 97 (range 94–100) postoperatively (p<0.01). Follow-up results at 10 months (range 7–72 months) on 9/10 patients showed full satisfaction and return to their preinjury sports or recreational activity

    Conclusion: The plantaris tendon should be kept in mind when evaluating painful conditions in the Achilles tendon region, especially when no Achilles tendinopathy is present. Excision of the plantaris tendon via a minor surgical procedure in local anaesthesia results in a good outcome.

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  • 25.
    Alfredson, Håkan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin. Institute of Sports, Exercise and Health, University College Hospital, London, UK.
    Masci, Lorenzo
    Department of Sports and Exercise Medicine, Queen Mary University, London, United Kingdom.
    Spang, Christoph
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi. Research Unit, Orthopaedic Spine Center, Dr. Alfen, Würzburg, Germany.
    Ultrasound and surgical inspection of plantaris tendon involvement in chronic painful insertional Achilles tendinopathy: A case series2021Ingår i: BMJ Open Sport and Exercise Medicine, ISSN 2055-7647, Vol. 7, nr 1, artikel-id e000979Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Chronic painful insertional Achilles tendinopathy is known to be difficult to manage. The diagnosis is not always easy because multiple different tissues can be involved. The plantaris tendon has recently been described to frequently be involved in chronic painful mid-portion Achilles tendinopathy. This study aimed to evaluate possible plantaris tendon involvement in patients with chronic painful insertional Achilles tendinopathy.

    Methods: Ninety-nine consecutive patients (74 males, 25 females) with a mean age of 40 years (range 24-64) who were surgically treated for insertional Achilles tendinopathy, were included. Clinical examination, ultrasound (US)+Doppler examination, and surgical findings were used to evaluate plantaris tendon involvement.

    Results: In 48/99 patients, there were clinical symptoms of plantaris tendon involvement with pain and tenderness located medially at the Achilles tendon insertion. In all these cases, surgical findings showed a thick and wide plantaris tendon together with a richly vascularised fatty infiltration between the plantaris and Achilles tendon. US examination suspected plantaris involvement in 32/48 patients.

    Conclusion: Plantaris tendon involvement can potentially be part of the pathology in chronic painful insertional Achilles tendinopathy and should be considered for diagnosis and treatment when there is distinct and focal medial pain and tenderness.

    Level of evidence: IV case series.

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  • 26.
    Alfredson, Håkan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Masci, Lorenzo
    Öhberg, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Diagnostisk radiologi.
    Partial midportion Achilles tendon ruptures: new sonographic findings helpful for diagnosis.2011Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 45, nr 5, s. 429-432Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Partial Achilles tendon ruptures are not always easy to diagnose. A history including a sudden onset of pain, and/or relative weakness in plantar flexion force, are indicators. The most loaded side of the Achilles tendon is the dorsal side (skin side). OBJECTIVE: To evaluate the ultrasound (US) and Doppler (CD) findings in patients with a suspected partial rupture in the Achilles tendon. Material and METHODS: Seventeen patients (16 men and 1 woman) with a mean age of 36 years (range 23-71) were examined clinically and by US+CD because of midportion Achilles tendon pain. There was an acute onset in 14/17 patients, and all had painful weakness during tendon loading activity. RESULTS: In all patients the US examination showed a partial Achilles tendon rupture, presented as a disrupted dorsal (skin side) tendon line and an irregular tendon structure mainly located in the dorsal and mid-tendon. The size of the rupture varied from 1/3 to 2/3 of the tendon thickness. In the dorsal part of the tendon, corresponding to the region with disrupted tendon line and irregular structure, CD examination showed high blood flow-most often of a longitudinal character. Six of the patients were surgically treated, and macroscopical examination verified the ultrasound findings, showing disruption on the dorsal side, and a partial rupture in the dorsal and mid- tendon. CONCLUSIONS: Ultrasound and Doppler examination can be helpful tools to diagnose partial midportion Achilles tendon ruptures. The characteristic findings of a disrupted dorsal tendon line, and high blood flow in the structurally abnormal dorsal tendon, indicate a partial rupture.

  • 27.
    Alfredson, Håkan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin. Alfredson Tendon Clinic, Capio Ortho Center Skåne, Malmö, Sweden.
    Roberts, David
    Capio Ortho Center Skåne, Malmö, Sweden.
    Spang, Christoph
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi. Institute for Sports Science, Würzburg University, Würzburg, Germany; Private Orthopaedic Spine Center, Würzburg, Germany.
    Waldén, Markus
    Capio Ortho Center Skåne, Malmö, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Ultrasound- and doppler-Guided WALANT arthroscopic surgery for patellar tendinopathy with Partial Rupture in Elite Athletes: a 2-Year follow-up of a prospective case series2024Ingår i: Medicina, ISSN 1010-660X, E-ISSN 1648-9144, Vol. 60, nr 4, artikel-id 541Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and Objectives: Patellar tendinopathy is difficult to treat, and when combined with partial rupture, there are additional challenges. The aim of this study was to evaluate the subjective outcome and return-to-sport status after ultrasound (US)- and colour doppler (CD)-guided wide awake local anaesthetic no tourniquet (WALANT) arthroscopic shaving in elite athletes.

    Material and Methods: Thirty Swedish and international elite athletes (27 males) with a long duration (>1 year) of persistent painful patellar tendinopathy in 35 patellar tendons, not responding to non-surgical treatment, were included. All patients were treated with the same protocol of arthroscopic shaving, including bone removal and debridement of partial rupture, followed by at least 3 months of structured rehabilitation. The VISA-P score and a study-specific questionnaire evaluating physical activity level and subjective satisfaction with the treatment were used for evaluation.

    Results: At the 2-year follow-up (mean 23, range 8–38 months), 25/30 patients (29/35 tendons) were satisfied with the treatment result and had returned to their pre-injury sport. The mean VISA-P score increased from 37 (range 7–69) before surgery to 80 (range 44–100) after surgery (p < 0.05). There was one drop-out (one tendon). There were no complications.

    Conclusions: US- and CD-guided WALANT arthroscopic shaving for persistent painful patellar tendinopathy, including bone removal and debridement of partial rupture, followed by structured rehabilitation showed good clinical results in the majority of the elite-level athletes.

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  • 28.
    Alfredson, Håkan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin. ISEH, UCLH, London, UK; Pure Sports Medicine Clinic, London, UK.
    Spang, Christoph
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB). Dr Alfen, Orthopedic Spine Center, 97080 Würzburg, Germany.
    Clinical presentation and surgical management of chronic Achilles tendon disorders: a retrospective observation on a set of consecutive patients being operated by the same orthopedic surgeon2018Ingår i: Foot and Ankle Surgery, ISSN 1268-7731, E-ISSN 1460-9584, Vol. 24, nr 6, s. 490-494Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Non-invasive treatment is not always successful in patients with Achilles tendon disorders, and surgical treatment is instituted as the next step. There is sparse knowledge about the diagnoses, pain levels before surgery, surgically confirmed pathologies and postoperative complications in large patient groups.

    Aims: To study the diagnoses, pain scores before surgery, macroscopic surgical findings and postoperative complications in a series of patients treated for Achilles disorders.

    Material and methods: One surgeon operated on 771 Achilles tendons of 481 men and 290 women during a 10-year period. The clinically and ultrasound confirmed diagnoses, pre-operative pain and functional scores (Visual Analogue Scale, VAS, range 0-100; Victorian Institute Sports Tendon Assessment - Achilles questionnaire, VISA-A), macroscopic findings during surgery and postoperative complications, were retrospectively collected from a database.

    Results: Clinically, by ultrasound and during surgery midportion Achilles tendinopathy was confirmed in 519 (67%) patients, 41% of them had a thickened plantaris tendon located close the Achilles tendon. Partial midportion rupture was found in 31 (4%) patients, chronic midportion rupture in 12 (2%) patients and insertional Achilles tendinopathy, including superficial and retro-calcaneal bursitis, Haglund deformity, distal Achilles tendinopathy, plantaris tendon pathology, and bone spurs, in 209 (27%) patients. The mean pre-operative pain scores for midportion Achilles tendinopathy were 73 (VAS) and 45 (VISA-A), and for insertional Achilles tendinopathy 77 (VAS) and 39 (VISA-A). For midportion Achilles tendinopathy there were 14 (3%), and for insertional Achilles tendinopathy 10 (5%), postoperative complications.

    Conclusions: Patients presenting high pain scores from midportion Achilles tendinopathy were the most common. Plantaris tendon involvement is a frequent observation. For insertional Achilles tendinopathy the combination of pathology in the subcutaneous and retrocalcaneal bursa, a Haglund deformity and distal Achilles tendinopathy/tendinosis was most frequent. 

  • 29.
    Alfredson, Håkan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Spang, Christoph
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Forsgren, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Unilateral surgical treatment for patients with midportion Achilles tendinopathy may result in bilateral recovery2014Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 48, nr 19, s. 1421-1424Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Bilateral midportion Achilles tendinopathy/tendinosis is not unusual, and treatment of both sides is often carried out. Experiments in animals suggest of the potential involvement of central neuronal mechanisms in Achilles tendinosis. OBJECTIVES: To evaluate the outcome of surgery for Achilles tendinopathy. METHODS: This observational study included 13 patients (7 men and 6 women, mean age 53 years) with a long duration (6-120 months) of chronic painful bilateral midportion Achilles tendinopathy. The most painful side at the time for investigation was selected to be operated on first. Treatment was ultrasound-guided and Doppler-guided scraping procedure outside the ventral part of the tendon under local anaesthetic. The patients started walking on the first day after surgery. Follow-ups were conducted and the primary outcome was pain by visual analogue scale. In an additional part of the study, specimens from Achilles and plantaris tendons in three patients with bilateral Achilles tendinosis were examined. RESULTS: Short-term follow-ups showed postoperative improvement on the non-operated side as well as the operated side in 11 of 13 patients. Final follow-up after 37 (mean) months showed significant pain relief and patient satisfaction on both sides for these 11 patients. In 2 of 13 patients operation on the other, initially non-operated side, was instituted due to persisting pain. Morphologically, it was found that there were similar morphological effects, and immunohistochemical patterns of enzyme involved in signal substance production, bilaterally. CONCLUSION: Unilateral treatment with a scraping operation can have benefits contralaterally; the clinical implication is that unilateral surgery may be a logical first treatment in cases of bilateral Achilles tendinopathy.

  • 30.
    Alfredson, Håkan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Tol, Johannes
    Sports Medicine Physician Aspetar Qatar Orthopaedic and Sports Medicine Hosptial Doha, Qatar.
    de-Vos, Robert-Jan
    Erasmus Medical Centre and The Hague Medical Centre Rotterdam, The Netherlands.
    Chronic pain in the Achilles tendon2013Ingår i: Aspetar Sports Medicine Journal, Vol. 2, nr 1, s. 18-22Artikel i tidskrift (Övrigt vetenskapligt)
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  • 31.
    Alfredson, Håkan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin. Capio Ortho Center Skåne, Malmö, Sweden.
    Waldén, Markus
    Capio Ortho Center Skåne, Malmö, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Roberts, David
    Capio Ortho Center Skåne, Malmö, Sweden.
    Spang, Christoph
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi. Department of Sports Science, University of Würzburg, Sanderring, Germany.
    Combined midportion achilles and plantaris tendinopathy: a 1-year follow-up study after ultrasound and color-doppler-guided walant surgery in a private setting in Southern Sweden2023Ingår i: Medicina, ISSN 1010-660X, E-ISSN 1648-9144, Vol. 59, nr 3, artikel-id 438Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and Objectives: Chronic painful midportion Achilles combined with plantaris tendinopathy can be a troublesome condition to treat. The objective was to prospectively follow patients subjected to ultrasound (US)- and color doppler (CD)-guided wide awake, local anesthetic, no-tourniquet (WALANT) surgery in a private setting.

    Material and Methods: Twenty-six Swedish patients (17 men and 9 women, mean age 50 years (range 29-62)) and eight international male patients (mean age of 38 years (range 25-71)) with combined midportion Achilles and plantaris tendinopathy in 45 tendons altogether were included. All patients had had >6 months of pain and had tried non-surgical treatment with eccentric training, without effect. US + CD-guided surgical scraping of the ventral Achilles tendon and plantaris removal under local anesthesia was performed on all patients. A 4-6-week rehabilitation protocol with an immediate full-weight-bearing tendon loading regime was used. The VISA-A score and a study-specific questionnaire evaluating physical activity level and subjective satisfaction with the treatment were used for evaluation.

    Results: At the 1-year follow-up, 32/34 patients (43 tendons) were satisfied with the treatment result and had returned to their pre-injury Achilles tendon loading activity. There were two dropouts (two tendons). For the Swedish patients, the mean VISA-A score increased from 34 (0-64) before surgery to 93 (61-100) after surgery (p < 0.001). There were two complications, one wound rupture and one superficial skin infection.

    Conclusions: For patients suffering from painful midportion Achilles tendinopathy and plantaris tendinopathy, US + CD-guided surgical Achilles tendon scraping and plantaris tendon removal showed a high satisfaction rate and good functional results 1 year after surgery.

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  • 32.
    Alfredson, Håkan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin. Alfredson Tendon Clinic, Capio Ortho Center Skåne, Malmö, Sweden.
    Waldén, Markus
    Capio Ortho Center Skåne, Malmö, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Roberts, David
    Capio Ortho Center Skåne, Malmö, Sweden.
    Spang, Christoph
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi. Private Orthopaedic Spine Center, Würzburg, Germany; Institute for Sports Science, Würzburg University, Würzburg, Germany.
    Tendinopathic plantaris but normal achilles tendon found in about one-fifth of patients not responding to conservative achilles tendon management: results from a prospective walant surgical case series on 105 tendons2024Ingår i: Open Access Journal of Sports Medicine, E-ISSN 1179-1543, Vol. 15, s. 41-45Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Midportion Achilles tendinopathy is a relatively common condition. This study aimed to investigate the presence of a normal Achilles tendon, but a tendinopathic plantaris tendon, in a large and consecutive prospective sample of patients referred to a specialised tendon clinic for midportion Achilles tendon pain not responding to non-surgical treatment.

    Patients and Methods: A total of 105 consecutive tendons were operated on in 81 patients (62 males) suffering from painful midportion Achilles tendon pain. Clinical examination, ultrasound (US) and colour Doppler (CD) examination, and wide awake local anaesthetic no tourniquet (WALANT) surgery were performed in all patients.

    Results: For 19/105 (18%) tendons from 14 patients, clinical examination suspected plantaris tendinopathy alone as there was a distinct tenderness on the medial side, but no thickening of the Achilles tendon. US examination followed by surgery confirmed the diagnosis.

    Conclusion: Midportion Achilles tendon pain is not always related to Achilles tendinopathy since pain related to the plantaris tendon alone was found in almost every fifth patient. Consequently, there is an obvious need for proper examination to identify the pain source and establish a correct diagnosis before treatment.

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  • 33.
    Alm, Petter
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Evaluation of Physiological Characters in Mixed Martial Arts Athletes2012Självständigt arbete på avancerad nivå (magisterexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Abstract

    Introduction: MMA is a relatively new sport and is a mixture of many different martial arts. Currently, studies on the physiological characters of MMA athletes are very limited. The present study is mainly interested in evaluation of MMA athletes with respect to the aerobic and anaerobic capacity.

    Method and materials: 5 male pro MMA athletes were recruited for the study. VO2max and anaerobic threshold measured with different methods were evaluated on treadmill and arm cycle. Muscle strength and power was evaluated through measurement of squat jump, counter movement jump, counter movement jump with arm swing, maximum clean, maximum deadlift and maximum reps of vertical sit-ups. Body composition including bone mineral density, muscle mass and fat mass were also measured.  All the above measurements were performed twice with one year in between. Personal competition records expressed as percentage of win in total competition during the past year or the whole years before each test occasion were also calculated. 

    Result: except for a lower relative VO2max (both on treadmill and arm cycle) and [La] 0min after treadmill test, none of the measurements on absolute VO2max, anaerobic thresholdor body composition showed significant difference in values between the two test occasions. A tendency of decrease in muscle strength/power was observed in the second occasion, where the lower squat jump (cm) and counter movement jump with arm swing (cm/kg) were significant.

    Conclusion: the MMA athletes have reached their physiological capacity needed for the sport or did not prioritized their strength and conditioning training high enough to improve them further.

  • 34.
    Alm, Petter
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Yu, Ji-Guo
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Physiological characters in mixed martial arts2013Ingår i: American Journal of Sports Science, ISSN 2330-8540, Vol. 1, nr 2, s. 12-17Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Mixed martial arts (MMA) is a relatively new sport and is a mixture of many different martial arts. Currently, study on the physiological characters in the sport is very limited. The present study evaluated the physiological characters in 5 active male MMA athletes at two occasions with one year between. Aerobic- and anaerobic capacity were estimated through measurement of VO2max and anaerobic threshold using both treadmill running and arm cycling. Muscle strength was evaluated through series measurements. Body composition and personal competition records were also examined. The subjects presented above average aerobic capacity, but rather high anaerobic capacity and threshold levels compared with other similar sports. No significant difference in VO2max, anaerobic threshold or body composition was observed between the two test occasions, despite a decreased tendency in muscle strength/power in the second test compared to the first. The results were interpreted to indicate either the MMA athletes had reached the physiological requirements for MMA or the one year physical training was inefficient in further improving the parameters.                                              

  • 35.
    Almgren, Simon
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Danielsson, Andreas
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Påverkan av Muskeltrötthet på Motorisk Kontroll hos Kvinnliga Innebandyspelare2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Non-contact injuries are a big part of overall injuries in floorball. Deficits in motor control due to muscle fatigue may be a factor that causes non-contact injuries. We analyzed movement changes with The Functional Movement ScreenTM (FMS) with and without muscle fatigue on women floorball players. Method: A pilot study with a cross-sectional structure. FMS test was used to measure changes in movements and to reach fatigue a 5-10 min running ramp protocol on treadmill was used. The borg RPE-scale was used to measure perceived exhaustion. Participants: Seven female floorball players playing in teams at the highest two leagues in Sweden. The participants age was 19.7 (±SD 3,2) years, length 166.4 cm (±SD 7,2) and weight 63.1 kg (±SD 4,5). Results: Through observations of the participants we noted a different movement pattern while obtaining muscle fatigue. The results of FMS total score shows no significant difference (p=0,504) before and after the VO2max running test. The FMS results from exercises that includes the lower extremities (deep squat, hurdle step, in-line lunge and straight leg raise) does not either confirm a significant difference (p=0,132). Discussion: Our subjective analyze of the movements confirms a different movement strategy with and without muscle fatigue. The non-parametric statistical analyze does not confirm this change in movements as significant. The Functional Movement Screen might not be a good tool to measure changes in movement because the movement change has to be in a specific criteria to get a lower point. Even though we saw a different movement strategy after the ramp running test, the deficit in movements was not in the specific criteria that was necessary to get a lower point. Conclusion: Through the test results and our observations we conclude that movement pattern change after an exercise that causes fatigue, does not completely show how much the movement patterns changes and what the consequences are. More research has to be done in this area to confirm such results.

  • 36.
    Alvehus, Malin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Boman, Niklas
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Söderlund, Karin
    Svensson, Michael B.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Buren, Jonas
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Metabolic adaptations in skeletal muscle, adipose tissue, and whole-body oxidative capacity in response to resistance training2014Ingår i: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 114, nr 7, s. 1463-1471Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The effects of resistance training on mitochondrial biogenesis and oxidative capacity in skeletal muscle are not fully characterized, and even less is known about alterations in adipose tissue. We aimed to investigate adaptations in oxidative metabolism in skeletal muscle and adipose tissue after 8 weeks of heavy resistance training in apparently healthy young men. Expression of genes linked to oxidative metabolism in the skeletal muscle and adipose tissue was assessed before and after the training program. Body composition, peak oxygen uptake (VO2 peak), fat oxidation, activity of mitochondrial enzyme in muscle, and serum adiponectin levels were also determined before and after resistance training. In muscle, the expression of the genes AdipoR1 and COX4 increased after resistance training (9 and 13 %, respectively), whereas the expression levels of the genes PGC-1 alpha, SIRT1, TFAM, CPT1b, and FNDC5 did not change. In adipose tissue, the expression of the genes SIRT1 and CPT1b decreased after training (20 and 23 %, respectively). There was an increase in lean mass (from 59.7 +/- A 6.1 to 61.9 +/- A 6.2 kg), VO2 peak (from 49.7 +/- A 5.5 to 56.3 +/- A 5.0 ml/kg/min), and fat oxidation (from 6.8 +/- A 2.1 to 9.1 +/- A 2.7 mg/kg fat-free mass/min) after training, whereas serum adiponectin levels decreased significantly and enzyme activity of citrate synthase and 3-hydroxyacyl-CoA dehydrogenase did not change. Despite significant increases in VO2 peak, fat oxidation, and lean mass following resistance training, the total effect on gene expression and enzyme activity linked to oxidative metabolism was moderate.

  • 37. Aman, Malin
    et al.
    Forssblad, Magnus
    Henriksson-Larsén, Karin
    Insurance claims data: a possible solution for a national sports injury surveillance system? An evaluation of data information against ASIDD and consensus statements on sports injury surveillance2014Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 4, nr 6, artikel-id e005056Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Before preventive actions can be suggested for sports injuries at the national level, a solid surveillance system is required in order to study their epidemiology, risk factors and mechanisms. There are guidelines for sports injury data collection and classifications in the literature for that purpose. In Sweden, 90% of all athletes (57/70 sports federations) are insured with the same insurance company and data from their database could be a foundation for studies on acute sports injuries at the national level.

    OBJECTIVE: To evaluate the usefulness of sports injury insurance claims data in sports injury surveillance at the national level.

    METHOD: A database with 27 947 injuries was exported to an Excel file. Access to the corresponding text files was also obtained. Data were reviewed on available information, missing information and dropouts. Comparison with ASIDD (Australian Sports Injury Data Dictionary) and existing consensus statements in the literature (football (soccer), rugby union, tennis, cricket and thoroughbred horse racing) was performed in a structured manner.

    RESULT: Comparison with ASIDD showed that 93% of the suggested data items were present in the database to at least some extent. Compliance with the consensus statements was generally high (13/18). Almost all claims (83%) contained text information concerning the injury.

    CONCLUSIONS: Relatively high-quality sports injury data can be obtained from a specific insurance company at the national level in Sweden. The database has the potential to be a solid base for research on acute sports injuries in different sports at the national level.

  • 38.
    Anckarman, Erika
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Den framgångsrika personliga tränaren: En kvalitativ studie om klienters upplevelse av vilka egenskaper och faktorer som är viktiga för personliga tränare2016Självständigt arbete på avancerad nivå (magisterexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Fitnessbranschen har under senare tid expanderat snabbt och PT erbjuds idag på de flesta anläggningar. Träning med PT har positiva effekter fysiskt men även på beteenden kopplat till träning. För ett positiv utfall av träningen krävs det en god interaktion mellan klient och coach.

    Syfte: Syftet med studien var att undersöka vad klienter som tränar eller har tränat med en PT det senaste året anser är viktiga egenskaper och faktorer hos en PT.

    Design och metod: Studien har en kvalitativ deskriptiv design. Datainsamling genomfördes med hjälp av semistrukturerade intervjuer. Kvalitativ innehållsanalys användes för databearbetning.

    Resultat: Vid dataanalysen framkom 3 teman, 6 kategorier och 17 subkategorier. De teman och kategorier som framkom var:

    Framstå som kompetent - Utseende och uppvisad erfarenhet, Ge känsla av bred kunskap Coachingstil- Närvaro här och nu, Individanpassning Pedagogiska strategier - Verktyg för att uppnå resultat, Trygghetsskapande

    Konklusion: Bakgrundsinformation om alla PT bör finnas tillgänglig på hemsida eller anläggning i syfte att klienten ska kunna välja sin en PT utifrån deras personliga önskemål. Detta skulle kunna skapa goda grundförutsättningar för en fungerande arbetsallians. Forskning inom detta område är begränsat och det är därför av intresse att fler större studier genomförs. 

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  • 39.
    Anderback, Nanny-Maja
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Öling, Kajsa
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Kan fysisk aktivitet under graviditeten reducera graviditetsrelaterade besvär?2017Självständigt arbete på grundnivå (kandidatexamen), 180 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Många kvinnor är gravida i en eller flera perioder under sitt liv. Under denna tid har studier visat att kvinnor tenderar att bli fysiskt inaktiva. Med en graviditet kommer också en ökad risk för andra sjukdomar och besvär, såsom graviditetsdiabetes och övervikt. Vissa av dessa besvär har kunnat förebyggas med hjälp av fysisk aktivitet. Traditionellt har det funnits en uppfattning om att fysisk aktivitet innebär risker både för den gravida kvinnan och för fostret. Idag finns dock en mer liberal syn på fysisk aktivitet under graviditet men forskningen är fortfarande bristfällig.

    Syfte: Vårt syfte med denna litteraturstudie är att studera effekter av fysisk aktivitet under graviditet på graviditetsrelaterade besvär.

    Resultat: Vår studie har visat att det finns positiva effekter av fysisk aktivitet under graviditet framförallt på graviditetsrelaterade besvär som ländryggssmärta, bäckenbottendysfunktion, trötthet, graviditetsdiabetes och övervikt samt vissa positiva tendenser på preeklampsi, ödem och bäckensmärta.

    Konklusion: Positiva effekter har framkommit men inga tydliga rekommendationer finns, därför behövs ytterligare studier. Många studier har metodologiska brister och därför behövs fler RCT studier på de graviditetsrelaterade besvären för att få konsensus om vilken typ av fysisk aktivitet, duration, intensitet samt frekvens under graviditet som är gynnsamt för de besvär vi studerat.

  • 40.
    Andersson, Annie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Björkén, Rebecca
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Kan fysisk aktivitet och kost ha en positiv inverkan på fysiska och psykiska subkliniska menstruella besvär?2018Självständigt arbete på grundnivå (kandidatexamen), 180 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Introduktion: Många kvinnor påverkas negativt av fysiska och psykiska besvär under sin menstruationscykel. Det råder idag stor kunskapsbrist om hur subkliniska menstruella besvär som kraftig menstruationssmärta, riklig menstruationsblödning, premenstruellt syndrom, premenstruellt dysforiskt syndrom, oregelbunden menstruation och menstruationsbortfall kan lindras utan att använda läkemedel. Fysisk aktivitet och kost har visats ge stora hälsoeffekter vid många sjukdomar och besvär och därför var syftet att undersöka om det även ger positiva hälsoeffekter vid menstruella besvär.

    Syfte: Syftet med litteraturstudien var att studera om fysisk aktivitet och kost kan minska fysiska och psykiska subkliniska menstruella besvär och därigenom ge ökat välmående.

    Metod: Sökt i Pubmed med sökorden subkliniska besvär i relation till fysisk aktivitet respektive kost hos fertila tränade och otränade kvinnor utan inverkan av hormonella preventivmedel.

    Resultat: Studien har visat vissa belägg för att fysisk aktivitet och kost kan lindra några subkliniska menstruella besvär. Premenstruellt syndrom (PMS) kan främst lindras genom lugna, meditativa aktiviteter. Vidare sågs god effekt på PMS av mindre men fler måltider med komplexa kolhydrater, samt intag av vitaminer och mineraler. Yoga har även visats minska menstruationssmärta, och allmän fysisk aktivitet har visat antydan till att förbättra menstruationens regelbundenhet. För att undvika oregelbunden menstruation eller menstruationsuppehåll behövs adekvat energiintag. Övriga subkliniska menstruella besvär saknade tydliga rekommendationer.

    Konklusion: Studien har visat att fysisk aktivitet och kost kan ha positiva effekter på vissa menstruella subkliniska besvär. För kvinnor med PMS verkar lugna, meditativa former av fysisk aktivitet kunna lindra syndromet. Yoga och fysisk aktivitet har även visats minska dysmenorré. Tillräckligt energiintag är essentiellt för att undvika oregelbunden och utebliven menstruation. Ytterligare studier behövs inom området för att säkerställa resultat och ge generella rekommendationer.

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  • 41.
    Andersson, Anton
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin.
    Radiell eller fokuserad stötvågsbehandling vid akillestendinopati: En systematisk litteraturöversikt2021Självständigt arbete på avancerad nivå (magisterexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syftet med denna systematiska litteraturöversikt var att jämföra radiell mot fokuserad stötvågsbehandling samt att undersöka effekten utav stötvågsbehandling för att reducera smärta och återfå fysisk funktion vid Akillestendinopati. Litteraturöversikten har följt checklistan PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis). Inklusionskriterier till litteraturöversikten är utformade efter PICO (population, intervention, control, outcome) och databaser som använts är PubMed, SPORTDiscus, CINAHL, Scopus och Web of Science. Data har analyserats narrativt och tillförlitligheten hos utfallen har bedömts med GRADE.Sju studier inkluderades till litteraturöversikten varav fyra studier som utfört radiell och tre studier som utfört fokuserad stötvågsbehandling som intervention. En signifikant skillnad för smärtreduktion sågs i två av studierna för båda behandlingarna. När radiell stötvågsbehandling användes hade interventionsgrupperna en högre smärtreduktion än kontrollgrupperna och när fokuserad stötvågsbehandling användes hade kontrollgrupperna en högre smärtreduktion än interventionsgrupperna. En signifikant skillnad för återställande utav den fysiska funktionen i ankeln sågs i tre studier för radiell stötvågsbehandling och två studier för fokuserad stötvågsbehandling. Där radiell stötvågsbehandling användes hade interventionsgrupperna en större ökad fysisk funktion än kontrollgrupperna och där fokuserad stötvågsbehandling användes hade kontrollgrupperna en större ökad fysisk funktion än interventionsgrupperna.Radiell stötvågsbehandling verkar kunna fungera för att reducera smärta och öka fysisk funktion vid Akillestendinopati. Tillförlitligheten för utfallen vid fokuserad stötvågsbehandling är för låg för att kunna dra någon slutsats om vilken typ av stötvågsbehandling som är mest effektiv. Ifall det varit känt vilken typ av stötvågsbehandling som ger bäst resultat hade det varit en bra vägledning för vårdpersonal som arbetar med stötvågsbehandling.

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  • 42.
    Andersson, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    The feasibility of using a training- and injury log to quantify training load and injury incidence in powerlifting2018Självständigt arbete på avancerad nivå (magisterexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Little is known about injuries and risk factors in powerlifting. In other sports, training load is an important factor that influences injury risk. However, no method to quantify training load in powerlifting exist.Objectives:

    The purpose of this study was to assess whether a standardised training and injury log is a feasible method to quantify training load and to prospectively record injuries.Method:The study was conducted in two phases with 7 respectively 8 powerlifters in each phase. In phase 1, the powerlifters logged their injuries and training for four weeks and then answered a feasibility questionnaire. Based on the results from the questionnaire, updates in the training and injury log were made and the powerlifters in phase 2 logged their training and injuries using the updated version and answered the same questionnaire as the powerlifters in phase 1.

    Results:

    It was possible to extract data and make calculations on training load based on the variables used in the training log and it was possible to calculate injury incidence and prevalence. Also, 9/12 powerlifters stated that they could use this standardised method for a period of at least 6 months.

    Conclusion:

    In conclusion, this standardised training and injury log seems to be a method to quantify training load and injuries in powerlifting. Further studies are needed to investigate the relationship between training load and injuries in powerlifting.

  • 43.
    Andersson, Gustav
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Backman, Ludvig
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Scott, Alexander
    Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health and Research Institute, Vancouver, British Columbia, Canada.
    Lorentzon, Ronny
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Forsgren, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Danielson, Patrik
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Substance P accelerates hypercellularity and angiogenesis in tendon tissue and enhances paratendinitis in response to Achilles tendon overuse in a tendinopathy model2011Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 45, nr 13, s. 1017-1022Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Tenocytes produce substance P (SP) and its receptor (neurokinin-1 receptor (NK-1R) is expressed throughout the tendon tissue, expecially in patients with tendinopathy and tissue changes (tendinosis) including hypercellularity and vascular proliferation. Considering the known effects of SP, one might ask whether SP contributes to these canges.

    Objectives To test whether development of tendinosislike changes (hypercellularity and angiogenesis) is accelerated during a 1-week course of ecercise with local administration of SP in an establish Achilles tendinopathy model.

    Methods Rabbits were subjected to a protocol of Achilles tendon overuse for 1 week, in conjunction with SP injections in the paratenon. Exercised control animals received NaCl injections or no injections, and unexercised, uninjected controls were also used. Tenocyte number and vascular density, as well as paratendinous inflammation, were evaluated. Immunohistochemistry and in sity hybridisation to detect NK-1R were conducted.

    Results There was a significant increase in tenocyte number in the SP-injected and NaCl-injected groups compared with both unexercised and exercised, uninjected controls. Tendon blood vessels increased in number in the SP-injected group compared with unexercised controls, a finding not seen in NaCl-injected controls or in uninjected, exercised animals. Paratendinous inflammation was more pronounced in the SP-injected group than in the NaCl controls. NK-1R was detected in blood vessel walls, nerves, inflammatory cells and tenocytes.

    Conclusions SP accelerated the development of tendinosis-like changes in the rabbit. Achilles tendon, which supports theories of a potential role of SP in tendinosis development; a fact of clinical interest since SP effects can be effectively blocked. The angiogenic response to SP injections seems related to parateninitis.

  • 44.
    Andersson, Hannes
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Gröntvedt, John
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Effekten av 8-veckors medicinbollsträning på smashhastighet hos badmintonspelare2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 45.
    Andersson, Helena
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Caspers, Andreas
    Center for Health and Performance, University of Gothenburg, Gothenburg, Sweden; Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Godhe, Manne
    Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Helge, Torbjörn
    Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Eriksen, Julia
    Department of Medicine, Geriatrics and Acute Medicine, Östra Sjukhuset, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Fransson, Dan
    Center for Health and Performance, University of Gothenburg, Gothenburg, Sweden; Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Börjesson, Mats
    Center for Health and Performance, University of Gothenburg, Gothenburg, Sweden; Department of Medicine, Geriatrics and Acute Medicine, Östra Sjukhuset, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, University of Gothenburg Sahlgrenska Academy, Göteborg, Sweden.
    Ekblom-Bak, Elin
    Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Walking football for Health–physiological response to playing and characteristics of the players2023Ingår i: Science and medicine in football, ISSN 2473-3938, E-ISSN 2473-4446Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Walking Football (WF) is one type of recreational football increasing in popularity, targeting older adults. Further knowledge on the intensity and physical workload of WF, characteristics of the players, the social context, and reasons for playing WF is needed. Thus, the aim of the study was to characterize the individuals that regularly play WF and their experience of WF, and the physiological characteristics of the sport. Sixty-three players from three clubs taking part in organised WF in Sweden were included. The players participated in up to four WF-games and underwent performance tests and answered a questionnaire. The participants mean age was 70.9 years, ranging from 63 to 85 years with 71% (n = 27) of the men and 68% (n = 13) of the women having a BMI > 25. Fifty-one percent (n = 27) of the players had hypertension, and 73% (n = 39) regularly used prescription drugs due to illness. During WF, the players covered on average 2,409 m (2,509 m for men and 2,205 m for women, p =.001). Expressed in percentage of their age-estimated maximal heart rate, mean heart rate represented 80 ± 9 and 80 ± 8% of max for men, and 78 ± 9 and 79 ± 9% of max for women in the first and second halves, respectively, hence WF can be considered a moderate intensity activity for older adults. The main reason for WF participation was to socialize. WF includes a considerable number of accelerations and decelerations, making it more energetically and mechanically demanding than walking.

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  • 46.
    Andersson, Henrik
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Nilsson, Mikael
    INTERNET-BASED MINDFULNESS-ACCEPTANCE-COMMITMENT IN SPORTS: A RANDOMISED CONTROLLED TRIAL2019Självständigt arbete på avancerad nivå (yrkesexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    De psykologiska faktorerna inom idrott är avgörande för prestation och viktiga för att upprätthålla god mental hälsa. Trots detta är ansträngningar för att förbättra dessa faktorer förvånansvärt sällsynta. Det beror bland annat på att det råder ett stigma kring att söka hjälp samt brist på tid och ekonomiska resurser. De senaste decennierna har det genomförts en stor mängd forskning på internetbaserade interventioner. Dessutom har Mindfulness-Acceptance-Commitment approach (MAC) fått en ökad mängd empiriskt stöd gällande förbättring i prestation och mental hälsa inom idrott. Föreliggande studie är den första i sitt slag att undersöka effekten av internetbaserad MAC, vilken genomfördes med det digitala självhjälpsprogrammet ACTSPORT med eller utan feedback. Av 193 deltagare (ålder 18 - 71, i 40 olika sporter på alla nivåer) som randomiserades till tre grupper med feedback, utan feedback eller väntelista, fullföljde 125 deltagare studien. Resultaten visade att deltagare som fullföljde ACTSPORT med feedback upplevde signifikant förbättrad prestation, minskad prestationsångest såväl som förbättrad mental hälsa vilket inkluderade högre livskvalité och minskade depressionssymtom. Detta visade sig kunna prediceras av signifikanta förbättringar i acceptans och dispositionell mindfulness. En större effekt sågs för deltagarna i gruppen med feedback vilket indikerade att ett visst stöd är fördelaktigt. Slutsatser från studien är att internetbaserade interventioner inom idrott kan vara effektiva, tidsbesparande, kostnadseffektiva, flexibla och tillgängliga medel för att både öka prestation och aspekter av mental hälsa.

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    INTERNET-BASED MINDFULNESS-ACCEPTANCE-COMMITMENT IN SPORTS: A RANDOMISED CONTROLLED TRIAL
  • 47.
    Andersson, Isak
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin.
    Occlusion Training as Rehabilitation after ACL-injury: A Review and Meta-analysis2022Självständigt arbete på avancerad nivå (magisterexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [en]

    A common issue after injuries with or without surgery is muscular atrophy. Every year approximately 8000 individuals injure their ACL only in Sweden and 4000 undergo surgery. Rehabilitation usually consists of strength training and 70 % of 1RM is a preferred weightwhen trying to build strength and muscle. This systematic review and meta-analysis were investigating the effect of occlusion training after ACL injury compared to traditional rehabilitation, measured with knee function, muscle strength, pain and muscle mass. In this review PubMed, Cinahl, Sportsmedicine & Education index, Cochrane Library, SportDiscus and Web of Science were used for the database search. Two independent authors performed the selection process, GRADE and risk of bias assessment. A total of nine studies were included for the synthesis where four could be included in the meta-analysis. No significant difference were found in the meta-analysis looking at muscle mass. No meta-analysis could be performed on knee function, muscle strength or knee pain. There was a significant difference in the intervention group performing occlusion training compared to the control group when looking at knee pain and knee function, but could not be verified bymeta-analysis. In conclusion occlusion training compared with traditional rehabilitation occlusion training seem to reduce experienced pain during training, increase knee function, preserve more muscle mass and give similar results in strength after 16 days to 16 weeks post ACLR.

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    fulltext
  • 48.
    Andersson, Linda
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Andersson, Ida
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Samband mellan överkroppsstyrka och prestation i skidspåret hos svenska längdskidåkande juniorer.2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Previous research has identified strength as a key factor for performance in cross-country skiing. The purpose of the present study was to investigate the relationship between upper body strength and performance in swedish junior cross-country skiers. 33 swedish young men and 23 young women age 17,3 ± 1,0 years volunteered to participate in specific tests during a summer training camp were they completed a test battery consisting of bench press and bench pull. The strength variables obtained were correlated with FIS-points (International Ski Federation´s ranking points for distance and sprint performance) used as the performance indicator. Correlations were performed by Spearman´s rank correlation coefficient for all variables. The results showed that FIS-points for sprint correlated significantly with both bench press and bench pull. No significant correlation was found between FIS-points for distance and bench pull. These results may predict performance for cross-country skiers and indicate a justification for increased proportion of strength training. 

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    Samband mellan överkroppsstyrka och prestation
  • 49.
    Andersson, Linnea
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin.
    Rydberg, Caroline
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin.
    TRÄNING OCH UPPLEVELSE AV TRÄNINGSINFORMATION TILL MOTIONSVANA GRAVIDA KVINNOR SOM TRÄNAR PÅ HÖGINTENSIV NIVÅ2019Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Kvinnor tränar mer nu än tidigare och många av dessa blir även gravida. Träning under graviditet har många hälsofördelar. De flesta råd angående träning under graviditet handlar om träning på måttlig intensitet samt motverkande av graviditetskomplikationer. En del kvinnor tränar mer än dessa rekommendationer. Därav finns råd och rekommendationer för elitatleter samt forskning på högintensiv träning under graviditet. Det är dock oklart ifall dessa råd når ut till gravida kvinnor som tränar på högintensiv nivå.

    Syfte: Att undersöka om träningsmängd förändrats under graviditet hos friska kvinnor som tränat på högintensiv nivå innan graviditeten, samt hur kvinnorna upplevt den information om träning de fått under graviditet och var de fått informationen.

    Deltagare: Arton kvinnor (23–37 år) deltog i studien. Inklusionskriterier var förstföderska, gravid i tredje trimestern fram till fyra veckor postpartum, komplikationsfri graviditet och högintensiv träning minst tre gånger per vecka under minst ett år innan och fram till graviditeten, antingen kondition, styrka eller både och.   

    Metod: Deltagarna besvarade en webbenkät med 23 frågor. Frågorna handlade om träningsmängd under graviditet samt den information om träning deltagarna fått under graviditet.

    Resultat: De flesta kvinnorna minskade sin träningsmängd under graviditeten och många av kvinnorna saknade tillräcklig information för att kunna träna på önskad nivå. Information om träning kom främst från barnmorska.

    Konklusion: Träningsmängd hos friska motionsvana gravida kvinnor har minskat under graviditeten samtidigt som kvinnorna saknade tillräcklig träningsinformation. Kvinnorna fick information om träning under graviditet främst från barnmorska. Det går inte att säga om avsaknaden av information har påverkat träningsmängden men det kan vara intressant att undersöka i framtida studier. Fortsatt forskning på högintensiv träning under graviditet behövs för att kunna ge tillräcklig information till högintensivt tränande gravida kvinnor.

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    fulltext
  • 50.
    Andersson, Terese
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Menstruationscykelns och p-pillers påverkan på den fysiska prestationsförmågan2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Effects of Menstrual Cycle and Oral Contraceptives on Sport Performance

    During the menstrual cycle, there is a variation of the female steriod hormones estrogen and progestogen. These hormones has mainly reproduktive functions, but do also affect other physiological systems, which may have an influence on athletic performance. The use of oral contraceptives among female athletes matches the use among the general population. There is a concern among female athletes and there coaches weather oral contraceptives can affect the performance. The purpose of this litterature review is to determine the effect of the menstrual cycle and the use of oral contraceptives on athletic performance. Most studies indicates that neither the aerobic performance or VO₂max changes during the mestrual cycle, but an increase in ventilation during the lutheal phase has been observed. In the lutheal phase, the body temperature is elevated, which can affect the performance negatively during physical activity in hot and humid conditions. Studies evaluating the anaerobic performance shows varied results, which can be explained by few study participants, different study designs and varying definitions of menstrual cycle phase. Some studies that have examined the strength variation have not seen any difference, and others have seen an advantage during the follicular phase, when it also seems to be beneficial to train more strength training to optimize training adaptation. The use of oral contraceptives can affect the body composition of female athletes. Fat mass and BMD can increase, and is seen mainly in athleteswith mestrual dysfunctions. This can be benificial for their health and decrease the risk of injury, but may decrease performace level. The effect of oral contraceptive administration on aerobic capacity, anaerobic capacity and strength are unclear and the research has come up with varying results. Future studies should investigate oneoral contraceptive pill formulation at a time, andalso compare different formulations, to determineif that affect performance in different ways.

    Key words: menstruation, oral contraceptives, female athlete, performance, hormones

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    Menstruationscykelns och p-pillers påverkan på den fysiska prestationsförmågan
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