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Biomedical subjects

R Nisell

Publications and source records attributed to R Nisell.

At least 19 recordsLinked to original sources
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

Exercise and variations in neuropeptide concentrations in rheumatoid arthritis.

The aim of the present study was to investigate the influence of an exercise program on neuropeptide concentrations, disease activity, impairments and disabilities in rheumatoid arthritis (RA). Eleven females (median age 60 years, median disease duration 6.5 years, ARA functional classes I or II) exercised 30 min daily for 4 weeks. The urine concentrations of calcitonin gene-related peptide-like immunoreactivity (CGRP-LI) and neuropeptide Y-like immunoreactivity (NPY-LI) were analyzed 1 week prior to exercise start, at exercise start, after 2 and 4 weeks of exercise, and after a 4-week follow-up period. Measurements of disease activity, aerobic capacity, grip force, limb muscle function, and activities of daily living (ADL) were also undertaken. The results indicate a decrease (md 5.64 pM to md 3.48 pM, P</=0.05) of CGRP-LI concentrations after 4 weeks' exercise. NPY-LI concentrations remained unchanged, as did disease activity and aerobic capacity. Muscle function and ADL capacity improved significantly (P</=0.05) after the exercise period. Only the improved grip force remained after the follow-up period. In conclusion the results indicate that decreased CGRP-LI concentration, probably reflecting a decreased sympathetic tone, follows physical exercise and suggest that regular physical activity might be important among individuals with RA to maintain a decreased sympathetic tone and less symptoms from their disease.

Adult↗
PubMed1998

[Pain analysis is vital in rheumatic diseases. The pain is often the patient's worst problem].

The article consists of a synthesis of a rheumatic pain symposium held at the annual meeting of the Swedish Medical Association in 1996. Various aspects of pain in rheumatic diseases were discussed, such as physiological, neurohumoral and neurogenic mechanisms, sensory stimulation treatment, differentiation of mechanical and inflammatory pain, quality enhancement by improved cooperation between primary and tertiary care facilities, pharmacological treatment with (centrally and peripherally acting) opioids, selective cyclo-oxygenase inhibitors, and NMDA (N-methyl-D-aspartate) receptor antagonists. The aim of the symposium, with its focus on the manifest pain problem, was to improve our knowledge and skill in the understanding and treatment of this large patient category. For patients with rheumatic disorders exacerbated by pain problems, as for other patients, a pain diagnosis is of fundamental importance. This can be achieved by analysis of the social, psychological, physiological and medical factors contributing to the cause and degree of pain and to pain behaviour, and of the extent to which the pain may be nociceptive (i.e., inflammatory, mechanical, or ischaemic in origin), neurogenic or idiopathic. Pain analysis should be followed by individualised treatment focused on the patient's most crucial problems, thus enhancing the prospect of optimal treatment outcome.

Analgesia↗
PubMed1998

[Pain analysis is vital in rheumatic diseases. Pain often causes much worry to patients].

The article consists of a synthesis of a rheumatic pain symposium held at the annual meeting of the Swedish Medical Association in 1996. Various aspects of pain in rheumatic diseases were discussed, such as physiological, neurohumoral and neurogenic mechanisms, sensory stimulation treatment, differentiation of mechanical and inflammatory pain, quality enhancement by improved co-operation between primary and tertiary care facilities, pharmacological treatment with (centrally and peripherally acting) opioids, selective cyclo-oxygenase inhibitors, and NMDA (N-methyl-D-aspartate) receptor antagonists. For patients with rheumatic disorders exacerbated by pain problems, as for other patients, a pain diagnosis is of fundamental importance. This can be achieved by analysis of the social, psychological, physiological and medical factors contributing to the cause and degree of pain and to pain behaviour, and of the extent to which the pain may be nociceptive (i.e., inflammatory, mechanical, or ischaemic in origin), neurogenic or idiopathic. Pain analysis should be followed by individualised treatment focused on the patient's most crucial problems, thus enhancing the prospect of optimal treatment outcome.

Analgesics↗
PubMed1995

Validity of five common manual neck pain provoking tests.

The purpose of the present study was to assess five manual tests for pain provocation of the neck to determine their suitability for epidemiological investigations. To 75 randomly selected men, five manual pain-provoking tests were applied in a single-blind design. Prevalence of reported neck dysfunction, sensitivity, specificity, and positive and negative predicted value for each test were calculated. 22 of the 75 reported present neck pain, while the remainder reported freedom from neck pain for at least one year. Palpation over the facet joints in the cervical spine was found to be the most appropriate screening test to corroborate the replies in self-reported questionnaires on dysfunctions of the neck. The outcome of this test was quite consistent with the reported neck pain. The test of the formina intervertebralia and the upper limb tension test caused pain in almost all subjects with reported neck dysfunctions, though not causing referred pain in the arm as an indication of neurogenous tissue origin, as it was aimed to. Neither the neck rotation test nor the active flexion/extension test was sufficiently provocative to confirm the reported neck pain in these subjects, as both were insufficiently sensitive.

Adolescent↗
PubMed1994

Measurement of pain among electricians with neck dysfunction.

The aim of the study was to develop a pain measurement instrument in Swedish intended for use in epidemiological surveys, and to report the pain assessments of individuals in a working population. The focus was on somato-sensory description in relation to work performance. The material comprised 22 randomly selected electricians attending health checkups, and reporting neck pain during the past week. The pain estimations were made in oral interviews using a specially developed questionnaire. Neck extension and hands above shoulder height caused increased neck pain in all the subjects. The quantitative assessments of present pain showed a limited intensity. To describe the pain quality a wide spectrum of words was used as pain descriptors, but five adjectives were preferred. The more the pain was spread on the pain drawing, the more differentiated was the assessment of its quality. The results concluded that the pain assessment instrument might be useful in epidemiological investigations of musculoskeletal neck dysfunctions.

Adolescent↗
PubMed1991

An electromyographic study of dental work.

Musculoskeletal disorders are common among dentists, and have been ascribed to the demands of high precision work and sustained static loading in the neck-shoulder region, combined with a flexed and rotated cervical spine. In order to determine muscular load levels during dentistry, activity in neck, shoulder, and arm muscles was recorded using an electromyography technique (EMG). Normalized mean, median, 10th and 90th percentile EMG amplitude levels (% maximal reference contraction, %max-RVC) were calculated during ordinary dental work. Among the muscles investigated, the trapezius muscle on both sides had the highest mean (the right trapezius 9.0% and the left 7.6% of max-RVC) and 10th percentile amplitude levels (both about 2% of max-RVC). The trapezius muscles showed similar myoelectric activity on the right and left side, probably because of similar muscular static load on the both sides. The right extensor carpi radialis muscle had a significantly higher muscular load level than the left one, possibly due to stabilization demands on the dominant wrist during demanding precision work. The infraspinatus muscle had low activity level on both sides, reflecting that the dentists worked with a small degree of arm elevation and external rotation. The dentistry work thus seems to generate relatively high muscular load on both trapezius and dominant extensor-carpi-radialis, and relatively low load on the infraspinatus muscle.

Adult↗
PubMed1989

Postural stability in stroke patients: vectorial expression of asymmetry, sway activity and relative sequence of reactive forces.

Bilateral force measurements on the supporting limbs in postural sway while standing still were made to evaluate post-cerebral-vascular accident (CVA) patients during rehabilitation. Normal subjects of the same age group were tested as controls. From the force tracings obtained, three oscillation frequencies were identified, with orders of magnitudes of 7, 1 and 0.1 Hz, respectively, of which the middle frequency, i.e. that corresponding to 1 Hz, was selected for subsequent processing and analysis. These included the determination of relative sequence of the force vectors on both feet and evaluation of timings and amplitudes of the waveforms. Weight-bearing imbalance was defined in the vertical direction to express the difference between the average forces supported by each of the legs. In the horizontal plane, two parameters were defined: sway total activity (SA), to represent the vector summation of the absolute values of the horizontal force components acting on both legs; and asymmetry (ASYM) to express the difference in activities between the two legs. The results presented disclose the reactive force patterns acting on each of the legs of post-CVA hemiplegic individuals, in comparison with normal individuals. Although these forces were shown to act synchronously on both legs, they appeared to be asymmetrical in nature, with a typical vectorial pattern for every individual, which generally differed from that of normal subjects. Sway activity was found to be significantly higher in hemiplegics compared with the normal controls.

Adult↗
PubMed1988

Efficiency of pedal forces during ergometer cycling.

The aim of this study was to record the forces applied to the pedal during ergometer cycling and to calculate the effectiveness of these force vectors. Six healthy subjects rode a weight-braked bicycle ergometer at different work loads, pedaling rates, saddle heights, and pedal foot positions. The left lower limb and crank motions were recorded by a cinefilm camera and pedal reaction forces by a Kistler force measuring transducer mounted on the left pedal. The force effectiveness was computed as a ratio between the force tangential to instantaneous direction of pedal movement and the resultant force. The mean force efficiency ratio significantly increased by an increase of the ergometer work load or use of the anterior foot position instead of the posterior. It was not significantly changed due to alterations of the pedaling rate or saddle height.

Adult↗
PubMed1987

Patellofemoral joint forces during ergometric cycling.

We estimated the patellofemoral joint forces generated during pedaling on a bicycle ergometer. Our calculations were based on measurements from a force transducer mounted on the pedal, 16-mm cine-film sequences, and biomechanical models of the cycling motion and of the patellofemoral joint. Six healthy male subjects cycled at different work loads, pedaling rates, saddle heights, and pedal foot positions. The maximum patellofemoral compressive force was 905 N (1.3 times body weight [BW]) when cycling with an anterior foot position at 120 W, 60 rpm, and middle saddle height. The mean peak compressive force between the quadriceps tendon and the intercondylar groove was 295 N (0.4 BW), and the patellar-tendon and quadriceps-tendon strain forces were 661 N (0.9 BW) and 938 N (1.3 BW), respectively. The patellofemoral joint forces were increased with increased work load or decreased saddle height. Different pedaling rates or foot positions did not significantly change these forces.

Adult↗
PubMed1986

Power output and work in different muscle groups during ergometer cycling.

The aim of this study was to calculate the magnitude of the instantaneous muscular power output at the hip, knee and ankle joints during ergometer cycling. Six healthy subjects pedalled a weight-braked bicycle ergometer at 120 watts (W) and 60 revolutions per minute (rpm). The subjects were filmed with a cine camera, and pedal reaction forces were recorded from a force transducer mounted in the pedal. The muscular work at the hip, knee and ankle joint was calculated using a model based upon dynamic mechanics described elsewhere. The mean peak concentric power output was, for the hip extensors, 74.4 W, hip flexors, 18.0 W, knee extensors, 110.1 W, knee flexors, 30.0 W and ankle plantar flexors, 59.4 W. At the ankle joint, energy absorption through eccentric plantar flexor action was observed, with a mean peak power of 11.4 W and negative work of 3.4 J for each limb and complete pedal revolution. The energy production relationships between the different major muscle groups were computed and the contributions to the total positive work were: hip extensors, 27%; hip flexors, 4%; knee extensors, 39%; knee flexors, 10%; and ankle plantar flexors 20%.

Adult↗
PubMed1986

Joint forces in extension of the knee. Analysis of a mechanical model.

A two-dimensional model of the tibio-femoral joint was constructed by using the results of cadaver knee dissections together with radiographic landmarks on healthy knees loaded at various angles of flexion. The tibio-femoral compressive force during isometric knee extension had the same magnitude as the patellar tendon force. The tibio-femoral shear force changed direction from posterior at full flexion to anterior when the knee was extended, indicating that high forces may arise in the anterior cruciate was extended, indicating that high forces may arise in the anterior cruciate ligament in the straight knee. Women developed some 20 per cent higher knee joint forces than men for the same extending muscular moment higher knee joint forces than men for the same extending muscular moment, since women's patellar tendon moment arms were found to be shorter. The model presented may be used for quantifying tibio-femoral forces during knee extending activities.

Adult↗
PubMed1986

Shoulder joint load and muscular activity during lifting.

The aim of this study was to investigate load on shoulder joint and muscles in healthy adults during four different ways of lifting a moderate burden (12.8 kg) from floor to table level. The methods used were surface electrode EMG with linear envelope, and calculation of loading moments of force using a static biomechanical model. The shoulder load at the beginning of the lift was lowest for the straight knee lift. The peak load occurred in the late phase of all lifts. On completion of the lift, load and activation were considerably lower when the subject was allowed to step forward before putting the box down. The most activated shoulder muscles were the anterior and lateral parts of the deltoid, and the serratus anterior. Around 80% of the shoulder load moment was caused by the weight of the burden. Some 75% of maximum shoulder strength was required for lifting the burden.

Adult↗