Biomedical subjects

K Harms-Ringdahl

Publications and source records attributed to K Harms-Ringdahl.

At least 19 recordsLinked to original sources

PubMed2003

The effect of dance training on joint mobility, muscle flexibility, speed and agility in young cross-country skiers--a prospective controlled intervention study.

We evaluated a short-term (3 months) and a long-term (8 months) effect of dance training on joint mobility and muscle flexibility of the spine, hip and ankle and on speed and agility in young cross-country skiers. Twenty elite cross-country skiers - aged 12-15 years - participated in the study. Five males and five females received dance training (intervention group) and five males and five females did not dance (reference group). Joint mobility and muscle flexibility of the spine, hip and ankle joints were measured using a goniometer, a kyphometer, a measuring tape and a ruler. Two sports-related functional tests - the slalom-test and the hurdle-test - were also performed. These measurements/tests were performed before the start of the dancing period and after 3 and 8 months. The subjects from the intervention group increased their speed with 0.3 s after 3 (P = 0.05) and 8 months (P = 0.02), respectively, when measured with the slalom-test. They also improved their speed and agility according to the hurdle-test after 3 months with 0.8 s (P = 0.000) and 8 months with 0.6 s (P = 0.01). Furthermore, they increased flexion-extension of the thoracic spine with 7.5 degrees after 3 months (P = 0.05) and with 9 degrees degrees after 8 months (P = 0.03) and lateral flexion of the spine with 0.04 m (P = 0.005) and 0.03 m (P = 0.02) after 3 and 8 months, respectively. The reference group was impaired or unchanged in the studied parameters after both 3 and 8 months. We conclude that dance training has a positive effect on speed and agility and on joint mobility and muscle flexibility in flexion-extension and lateral flexion of the spine in young cross-country skiers.

Adolescent↗

PubMed2001

Living with spine-related pain in a changing society--a qualitative study.

PURPOSE: To elucidate life lived with recurrent, spine-related pain and to explore the development from work to disability pension. METHOD: A qualitative design at individual level was chosen. Nineteen people--five on disability pension, four physicians and ten rehabilitation officials--were interviewed. Data were analysed using grounded theory. RESULTS: A process of 'coming to terms with pain' with four phases was identified. During the phases pain had a deteriorating course and was combined with other medical problems. Together with changes on the labour market these factors caused the persons to leave their employment and also hindered reorientation on the labour market. Committed as they were to social norms, the persons found adjustment to a place outside the labour market difficult. CONCLUSIONS: Our findings suggest how recurrent back and neck pain can develop, interact with medical, individual, work-related and structural factors and result in incapacity to work. To avoid this incapacity pain has to be followed and the other factors considered in the design and timing of rehabilitation.

Disability Evaluation↗

PubMed2001

Variability of forces applied by experienced physiotherapists during provocation of the sacroiliac joint.

OBJECTIVE: To evaluate the distribution of total force vector and force components intended for the right and left sacroiliac joint, respectively, during pain-provocation sacroiliac joint tests. DESIGN: Two force plates, each capable of sensing three orthogonal forces, were used in a descriptive study to assess force. BACKGROUND: Studies evaluating the reliability of sacroiliac joint tests have revealed conflicting results and to our knowledge, no studies have evaluated the distribution of forces and their variations. METHODS: Fifteen physiotherapists, experienced in musculoskeletal therapy, performed the distraction test and pressure on apex sacralis on the same healthy person on two occasions. RESULTS: In both tests, the total force vector was less on the force plate closer to the physiotherapist. The vertical force component dominated and was considerably greater than the lateral (examined person supine/prone). The caudal/cranial force component was small. Systematic differences were found for the total force vector and for the lateral and vertical force components between occasions and/or between the force plates. CONCLUSIONS: The consistency of total force vector and force components was incomplete within and between physiotherapists and between occasions. Relevance. The results indicate that forces have to be investigated as the questions still arise of whether the variation in force distribution has any importance in pain response, whether force registration could be a useful pain evaluation instrument, and whether force registration could be a step towards standardising pain-provocation sacroiliac joint tests.

Adult↗

PubMed2001

Reliability of sports related functional tests with emphasis on speed and agility in young athletes.

The aim of the present investigation was to test the reliability of two sports related functional tests, a speed test (slalom-test) and an agility test (hurdle-test). Eleven athletes aged 11 years (8 boys, 3 girls) participated voluntarily in the study. All subjects completed four different test sessions for both the slalom-test and the hurdle-test using six standard track hurdles placed at 2-m intervals along a 12-m length of track. There were no significant differences between testing sessions for either the slalom-test (P=0.99) or the hurdle-test (P=0.96), showing no systematic variation between test times. The intraclass correlation coefficients were 0.96 and 0.90 respectively, indicating a good reliability. We conclude that the slalom-test and the hurdle-test are reliable sports related functional tests for measuring speed and agility in groups of young athletic individuals.

Child↗

PubMed2001

Mobility, muscular strength and endurance in the cervical spine in Swedish Air Force pilots.

PURPOSE: Muscle strength, endurance and range of movement of the cervical spine in a group of Swedish Air Force jet pilots (AF) and in a reference group of conscripts doing their military service (RG) were compared. METHODS: We tested 30 (AF) 24-42 yr and 33 (RG) 19-22 yr. A questionnaire was used to document complaints. Maximum voluntary isometric muscle strength of the flexor and extensor muscles of the cervical spine and sub-maximum isometric endurance in the flexor and extensor muscles were measured. RESULTS: Eleven AF (37%) and four RG (12%) had experienced discomfort in the neck within the previous year. The pilots' flexor and extensor muscle strength (47 Nm and 65 Nm) was superior to that of the conscripts (36 Nm and 59 Nm) (p = 0.0001, p = < 0.05, respectively). However, the RG group had greater isometric endurance in the flexor muscles than AF (p = < 0.05) and greater neck rotation (p = <0.005). There was no difference between the two groups in the other variables. CONCLUSION: Differences between the groups with regard to muscle strength and endurance might depend on variations in work-related physical muscle strain, and/or differences in fiber composition in the muscles, which might be reflected by pilot selection procedures.

Adult↗

PubMed2000

Between-days reliability of subjective and objective assessments of back extensor muscle fatigue in subjects without lower-back pain.

BACKGROUND: It is important to evaluate the reliability of common used methods of examining muscle fatigue from the lower back since the methods are used in patient evaluation. METHODS: To establish between-days reliability, ten subjects without lower-back pain performed a Sorensen test, a prone test for back extensor muscles against gravity, on three separate days. EMG was recorded from the L1 and L5 of the back extensor muscles. Fatigue was subjectively rated using a Borg CR-10 scale. Intraclass correlation coefficient, standard error of measurement and coefficient of variation were calculated from a one-way ANOVA. Percent agreement was also calculated. RESULTS: The study revealed good reliability for the slope for the total time (ICC 0.65-0.90), the initial and end median frequency (ICC 0.75-0.89), median frequencies at Borg ratings of three (ICC 0.63-0.88), five (ICC 0.62-0.84) and seven (ICC 0.67-0. 87), endurance time (ICC 0.89). The Borg ratings of the first minute agreed better than those of the second and the third. The Borg ratings at the second and the third test agreed to 40-80%, indicating a need for a practice session. CONCLUSION: The protocol used for assessing fatigue in the back extensor muscles proved to be reliable and is recommended for further use.

Adult↗

PubMed2000

Rehabilitation of neck-shoulder pain in women industrial workers: a randomized trial comparing isometric shoulder endurance training with isometric shoulder strength training.

OBJECTIVES: To study whether isometric shoulder endurance was more advantageous than isometric shoulder strength training in reducing pain and perceived exertion and to increase shoulder function through improved muscle endurance and strength. DESIGN: Randomized trial. SETTING: Three occupational health care centers. PARTICIPANTS: Women industrial workers with nonspecific neck-shoulder pain. The International Classification of Diseases, 10th Revision (ICD-10) diagnosis was "cervicobrachial syndrome" (M53.1). Thirty-eight patients completed the isometric shoulder endurance training and 31 patients completed the isometric shoulder strength training. INTERVENTION: Twelve weeks of training. MAIN OUTCOME MEASURES: Self-reported pain and rating of perceived exertion (RPE), arm motion performance test, shoulder muscle strength, shoulder muscle endurance, and shoulder functional tests, as well as follow-up after supervised training had ended. RESULTS: The isometric shoulder strength training resulted in an almost one-scale step decrease in RPE at work and a 5% to 15% improvement of arm motion performance compared with the endurance training. The isometric shoulder strength training more effectively improved left side shoulder abduction strength (p < .026), but no major differences were found for the other strength measurements. The isometric shoulder endurance training was not more successful than the strength training in the endurance test (p .51 to .81). CONCLUSIONS: Physical training programs for neck-shoulder pain may include isometric shoulder muscular strength exercise in addition to isometric shoulder endurance training, rather than endurance training only.

Exercise Therapy↗

PubMed1999

A physiotherapy test package for assessing back and neck dysfunction--discriminative ability for patients versus healthy control subjects.

BACKGROUND AND PURPOSE: A physiotherapy test package of 10 tests designed for assessing dysfunction due to back or neck pain was tested for its ability to discriminate between back- or neck-pain sufferers and healthy control subjects. Twenty-seven patients and 26 healthy control subjects participated in the study. METHOD: Fifteen patients suffering from back or neck pain and 15 matched healthy control subjects were assessed using the package to compare the results between the groups. The results from a further 12 back- or neck-pain sufferers and 11 unmatched healthy control subjects were analysed with respect to sensitivity and specificity, cluster formation and correlation with ratings of pain and perceived exertion. RESULTS: The differences in the test results for the patients and the matched healthy control subjects were highly significant in all variables but one. High sensitivity for cut-off points of clinical relevance was found in all variables but one, whereas specificity was moderate in most variables. CONCLUSIONS: Despite the small sample size, the significant differences between patients and healthy control subjects, with the sensitivity and specificity figures, suggest that the content validity of the test package is satisfactory.

Adult↗

PubMed1999

Back pain in women post-partum is not a unitary concept.

BACKGROUND AND PURPOSE: At least half of all pregnant women experience back pain at some time during pregnancy and some of them also have persisting back pain post-partum. The aim of the present study was to identify and classify back problems in women post-partum by use of different pain provocation tests and define their relationship to spinal sagittal configuration and mobility. METHOD: One hundred and nineteen women with back pain persisting two months after delivery were interviewed and examined, on average 7.2 months post-partum. Ten clinical pain provocation tests were performed. The first was performed to identify hip pain, the second to identify radiating pain and the other eight tests were performed to provoke pain in the areas of the posterior pelvic/sacroiliac joints, the symphysis pubis and the lumbar spine. The spinal sagittal configuration and mobility were measured in the thoracic and lumbar spine, respectively, with Debrunner's kyphometer (Protek AG, Berne, Switzerland). RESULTS: Twenty-seven per cent of women had pain in the area of the posterior pelvic/sacroiliac joints, 18% in the area of the lumbar spine, 39% both in the area of the posterior pelvic/sacroiliac joints and in the lumbar spine, and in 16% no pain could be provoked. There were no statistically significant differences between the four groups with respect to the spinal sagittal configuration or the mobility in the thoracic or lumbar spine. CONCLUSIONS: Back pain post-partum is not a unitary concept. Based on the clinical tests, women with back pain post-partum can be separated into groups with different pain localizations. The measuring of the spinal sagittal configuration and mobility did not help to further identify or classify post-partum back pain.

Adult↗

PubMed1999

Intra- and inter-rater reliability of an 11-test package for assessing dysfunction due to back or neck pain.

BACKGROUND AND PURPOSE: The intra- and inter-rater reliability of 11 tests assembled by physiotherapists for clinical purposes was investigated. Forty-five patients and 23 healthy volunteers participated in the study. METHOD: Twenty-one patients were tested simultaneously and independently by two physiotherapists to determine inter-rater reliability for two raters. Twenty-four patients and 11 healthy volunteers were tested by one physiotherapist three times in a week to determine intra-rater reliability over time. Twelve healthy volunteers were tested by three different physiotherapists in a week to determine inter-rater reliability for three raters. RESULTS: Inter-rater agreement for two simultaneous raters was clinically acceptable. Repeatability on three test occasions was clinically acceptable in six of the 11 tests. There were no systematic differences between occasions. CONCLUSIONS: Intra- and inter-rater reliability was acceptable for six of the 11 tests in the form described here: three gait tests, two functional lifting tests and a functional muscular endurance test in the right leg. If these tests are to be used as outcome measures, account must be taken of the size of the typical fluctuation in measurements shown. The repeatability figures given may be used as guidelines for interpreting the clinical value of possible changes in test values.

Adult↗

PubMed1999

Correlation between electromyographic spectral changes and subjective assessment of lumbar muscle fatigue in subjects without pain from the lower back.

OBJECTIVE: The purpose of this study was to correlate objective measurements of muscle fatigue in the lower back to the subject's own assessment of fatigue. DESIGN: Muscle fatigue in the lower back was assessed in healthy subjects using electromyography (EMG), endurance time and the Borg scale. BACKGROUND: Muscle fatigue, measured with EMG and endurance time, in the lower back, is significant for patients with pain in the lower back. METHODS: Fifty healthy subjects participated. EMG was detected from the lumbar extensor muscles during a modified Sørensen's test, an isometric contraction for the back extensors until exhaustion. During the test, subjects rated their subjective fatigue on a Borg CR-10 scale. RESULTS: Borg scale ratings correlated with endurance time (0.68) and EMG median- and mean power frequency slopes (0.41-0.50). At a Borg rating of 3, median- and mean power frequency and endurance time were reduced by 30%. At a Borg rating of 5, median- and mean power frequency and endurance time were reduced by 50%. At a Borg rating of 7, median- and mean power frequency and endurance time were reduced by 60-70%. CONCLUSIONS: Significant correlation between the Borg scale, EMG and endurance time suggests a close relationship between subjective and objective assessment of muscle fatigue.

Adult↗

PubMed1998

Simultaneous Ashworth measurements and electromyographic recordings in tetraplegic patients.

OBJECTIVE: A recent prevalence study of 353 spinal cord injured (SCI) individuals in the greater Stockholm area showed problematic spasticity in 30% of this population. To treat spasticity, the evaluation becomes crucial. The modified Ashworth scale (MAS) is the clinically most-used scale to grade degree of spasticity. This study evaluated whether the MAS correlated with electromyographic (EMG) recordings of muscle activity. STUDY DESIGN: This cross-sectional study was performed at an outpatient clinic that has the responsibility to do a standardized, yearly follow-up of all SCI patients in the greater Stockholm area. Thirty-eight SCI individuals met the inclusion criteria; 15 of the 38 were randomly selected for the study. They were all motor-complete tetraplegic men; mean age was 33 years and mean time since injury was 9 years. Spasticity evaluation was performed by flexing and extending the knees during simultaneous EMG recordings and MAS assessment of the thigh muscle activity. RESULTS: Eighty percent of the individual EMG recordings correlated significantly with the corresponding Ashworth measurements. The spastic resistance, as measured both clinically and electromyographically, was stronger and lasted longer during extension than flexion movements. Spearman coefficients for correlation of quantitative spasticity measures with MAS grades were calculated. EMG and clinical measures of spasticity were more closely correlated for flexion movements. Among EMG parameters, duration of movement-associated electrical activity invariably correlated significantly with the MAS grades (p < .05). Furthermore, Ashworth measurements of movement-associated spasticity showed a positive correlation with the EMG parameters mean, peak, and start to peak of electrical activity. Each increasing grade on the MAS corresponded to increasing myoelectric activity levels for each movement. CONCLUSION: EMG parameters were significantly positively correlated with simultaneous MAS measurements of the spastic muscle contraction. The Ashworth scale may therefore accurately reflect the movement-provoked spasticity in motor-complete tetraplegic patients.

Adult↗

PubMed1998

Properties of person hoist spreader bars and their influence on sitting/lifting position.

The purpose of this study is to analyse mechanical lifts with regard to how the spreader bar design, e.g. frontal length, height and sagittal depth, affects sitting positions and safety during lift and transfer. The seven spreader bars available on the Swedish market had two-point to four-point suspensions. Twelve subjects were photographed individually sitting in each of three types of sling: divided, one-piece with divided leg support, and one-piece. All the slings had significant effects on all specific sitting aspects. However, the spreader bar design only affected the sitting position in the hoist. A long (0.62 m) spreader bar gave a relatively upright sitting position. A deep (0.18 m) spreader bar gave a backward inclination. For all specific sitting aspects, there was a significant interaction between slings and spreader bars. This study demonstrates that the design of the spreader bar, as well as that of the sling, is of decisive importance for the sitting position during lifting.

Biomechanical Phenomena↗

PubMed1998

Effects of static and dynamic shoulder rotator exercises in women with rheumatoid arthritis: a randomised comparison of impairment, disability, handicap, and health.

The aim was to compare static and dynamic shoulder rotator endurance training in a group of women with mild rheumatoid arthritis and to see whether such training could influence impairment, disability, and handicap. The effects on general health were also studied. Patients were randomly assigned to a static (n = 17) (average age 59, median disease duration 7) or a dynamic training group (n = 20) (average age 56, median disease duration 10.5). Measurements were taken at the start, 10 weeks later when the training period was finished, and after a further 10 weeks. After the training both groups had fewer swollen joints in the upper extremity and less shoulder-arm pain. The dynamic group patients also improved according to the physical and overall dimensions of the Sickness Impact Profile. As impairment and aspects of disability and handicap were influenced by training but not by the patients' opinions regarding perceived disease activity and health, these relationships must be studied further.

Adult↗

PubMed1998

Lift/transfer and technical aids for persons with severe acquired brain injury. An inventory of problems.

A questionnaire about assistive devices for lift and transfer was distributed to all individuals evaluated at the Solberga Project outpatient service unit, a regional centre for long-term follow-up of severely brain injured persons in the Greater Stockholm area. The target group was 60 severely brain injured adults, of whom 57 (30 women and 27 men) answered a questionnaire created by one of the authors. The causes of injury in the study population were trauma (n = 27), cerebrovascular accident (n = 19), anoxia (n = 10) and other (n = 1). Thirty-two persons were quadriplegic after the injury and 21 were hemiplegic. More than half (33/57) reported problems with all five defined lift and transfer situations. Most (42/44) reported problems getting in and out of their wheelchairs. Technical aids were seldom used; 24 persons did not use any aids at all. The most commonly used aid was an adjustable bed. Most of the technical aids were used when the individual also had personal assistance. The persons who managed lift and transfer by themselves used few aids. It is reasonable to assume that severely brain injured individuals would be involved in more activities if they used technical aids more readily.

Activities of Daily Living↗

PubMed1997

Relationship between subjective neck disorders and cervical spine mobility and motion-related pain in male machine operators.

STUDY DESIGN: In a single blinded procedure, quantified cervical clinical tests were performed on machine operators with and without subjective reports of neck pain. OBJECTIVES: To evaluate whether subjective reports of neck pain are associated with limited and painful cervical spine mobility. SUMMARY OF BACKGROUND DATA: Spinal motion evaluation and pain rating are commonly used for assessing impairment in patients with spinal disorders. However, it is still unclear how cervical spinal motion and corresponding pain rating are affected by subjective reports of neck pain. METHODS: Forty-nine male forest machine operators completed the Standardized Nordic questionnaire on musculoskeletal symptoms. Maximal voluntary cervical spinal flexion-extension, bilateral axial rotation, and lateral flexion were measured with a goniometer ad modum Myrin, while corresponding pain was rated on Borg's scale. RESULTS: Nineteen men (38.8%) reported no neck pain within the past 12 months, nine men (18.4%) reported pain during the past 12 months (but not during the past 7 days), and 21 men (42.8%) had experienced neck pain during the past 7 days. The results of two of the range-of-motion tests (flexion and left axial rotation) and three of the pain ratings (during flexion, extension, and left axial rotation) differed significantly between men who reported pain the past 7 days and those with no pain, and they correlated significantly with the severity of pain as reported in the questionnaire. CONCLUSIONS: Many forest machine operators reporting neck pain in the Nordic questionnaire did have limited and painful cervical spine mobility. Range-of-motion tests may be useful tools to describe impairment and constitute a basis for assessment for therapeutic interventions.

Adult↗

PubMed1997

Influence of a reduced G-suit pressure schedule on G-duration tolerance using enhanced G-protection ensembles.

BACKGROUND: Reducing pressure to enhanced G-protection ensembles may diminish potential undesirable physiologic effects, as well as improve wear comfort and garment durability. HYPOTHESIS: G-duration tolerance will not be affected by reducing pressure to the Swedish tactical flight combat suit (TFCS). A second objective tested the similarity in G-duration tolerance between the TFCS and Combined Advanced Technology Enhanced Design G-Ensemble (COMBAT EDGE) combined with a prototype enhanced coverage G-suit. METHODS: There were 12 Swedish pilots (mean = 30 yr) who experienced gradual onset (+0.1 G.s-1) runs (GOR) to +9 Gz, rapid (+6 G.s-1) onset runs (ROR) and simulated aerial combat maneuvers (SACM) with +5 to +9 Gz cycles. The GOR and ROR profiles had a sustained times of 60 s after reaching +9 Gz. RESULTS: GOR duration tolerance was statistically decreased (p < 0.01) by the lower pressure (1.1 psig.G-1) when compared to standard pressure (1.5 psig.G-1). No statistical difference between TFCS and COMBAT EDGE was observed during the GOR trials. For all conditions, during the RORs, 90% of the subjects completed at least 30 s at +9 Gz. Many technical or medical difficulties during SACM trials limited statistical treatment of these data. However, no obvious among-condition differences were observed. Noteworthy among SACM trials were those of 3 subjects enduring more than 9 min before stopping; one completing 12.5 min (35 cycles). Neither heart rate, blood pressure, nor perceived exertion data revealed a condition-effect difference. CONCLUSION: Moderately reduced pressure to the extended coverage anti-G suit, combined with positive pressure breathing, may yield decreased G-tolerance results during laboratory evaluation; however, observed differences are sufficiently small they are likely operationally insignificant.

Adult↗

PubMed1997

Shoulder, elbow and wrist movement impairment--predictors of disability in female patients with rheumatoid arthritis.

To explore and describe how shoulder, elbow and wrist movement impairment and age, disease duration, disease activity and shoulder-upper arm pain are associated with disability in rheumatoid arthritis, these variables were investigated in 63 females. Multiple linear regression analysis indicated that limitations in functional shoulder-arm movement and in active wrist motion ranges explained 30-35% of the variation among the patients' results within each of the physical disability instruments used. The Ritchie index for the upper-extremity might be a predictor of disability, explaining 6-28% of the variation within different disability questionnaires, while shoulder tendalgia explained 24% of the variation in shoulder-arm disability. Altogether, however, our predicting variables only explained 11-30% of the variation in shoulder-arm disability and 25-50% of the variation in the other disability areas studied. Thus, other factors not studied here, e.g. muscle strength and hand grip function, and e.g. psychological and social factors are probably also of importance and remain to be elucidated.

Activities of Daily Living↗