shh.sePublications
Change search
Refine search result
1 - 49 of 49
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1. Aboagye, Emmanuel
    et al.
    Lilje, Stina
    Sophiahemmet University.
    Bengtsson, Camilla
    Sophiahemmet University.
    Peterson, Anna
    Sophiahemmet University.
    Persson, Ulf
    Skillgate, Eva
    Sophiahemmet University.
    Manual therapy versus advice to stay active for nonspecific back and/or neck pain: A cost-effectiveness analysis2022In: Chiropractic and Manual Therapies, E-ISSN 2045-709X, Vol. 30, no 1, article id 27Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Low back and neck pain are the most common musculoskeletal disorders worldwide, and imply suffering and substantial societal costs, hence effective interventions are crucial. The aim of this study was to evaluate the cost-effectiveness of manual therapy compared with advice to stay active for working age persons with nonspecific back and/or neck pain.

    METHODS: The two interventions were: a maximum of 6 manual therapy sessions within 6 weeks, including spinal manipulation/mobilization, massage and stretching, performed by a naprapath (index group), respectively information from a physician on the importance to stay active and on how to cope with pain, according to evidence-based advice, at 2 occasions within 3 weeks (control group). A cost-effectiveness analysis with a societal perspective was performed alongside a randomized controlled trial including 409 persons followed for one year, in 2005. The outcomes were health-related Quality of Life (QoL) encoded from the SF-36 and pain intensity. Direct and indirect costs were calculated based on intervention and medication costs and sickness absence data. An incremental cost per health related QoL was calculated, and sensitivity analyses were performed.

    RESULTS: The difference in QoL gains was 0.007 (95% CI - 0.010 to 0.023) and the mean improvement in pain intensity was 0.6 (95% CI 0.068-1.065) in favor of manual therapy after one year. Concerning the QoL outcome, the differences in mean cost per person was estimated at - 437 EUR (95% CI - 1302 to 371) and for the pain outcome the difference was - 635 EUR (95% CI - 1587 to 246) in favor of manual therapy. The results indicate that manual therapy achieves better outcomes at lower costs compared with advice to stay active. The sensitivity analyses were consistent with the main results.

    CONCLUSIONS: Our results indicate that manual therapy for nonspecific back and/or neck pain is slightly less costly and more beneficial than advice to stay active for this sample of working age persons. Since manual therapy treatment is at least as cost-effective as evidence-based advice from a physician, it may be recommended for neck and low back pain. Further health economic studies that may confirm those findings are warranted. Trial registration Current Controlled Trials ISRCTN56954776. Retrospectively registered 12 September 2006, http://www.isrctn.com/ISRCTN56954776 .

    Download full text (pdf)
    fulltext
  • 2.
    Asker, Martin
    et al.
    Sophiahemmet University.
    Hägglund, Martin
    Waldén, Markus
    Källberg, Henrik
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Reducing the risk of shoulder and knee injuries in adolescent handball players: A three-armed cluster randomised controlled trial2022Conference paper (Other academic)
  • 3.
    Asker, Martin
    et al.
    Sophiahemmet University.
    Hägglund, Martin
    Waldén, Markus
    Källberg, Henrik
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    The effect of shoulder and knee exercise programmes on the risk of shoulder and knee injuries in adolescent elite handball players: A three-armed cluster randomised controlled trial2022In: Sports Medicine - Open, ISSN 2199-1170, Vol. 8, no 1, article id 91Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The risk of injury in adolescent handball is high, and shoulder and knee injuries are among the most frequent and burdensome. The Swedish Knee Control programme reduced the risk of anterior cruciate ligament injuries in female youth football players and traumatic knee injuries in male and female youth floorball players. However, to date, Knee Control has not been evaluated in an elite youth sport setting. The literature on the prevention of shoulder injuries in sport is scarce, and there are to our knowledge no previous studies evaluating the preventative efficacy of injury prevention exercise programmes (IPEPs) on shoulder injuries in adolescent handball players.

    OBJECTIVES: To study the preventive efficacy of IPEPs on shoulder and knee injuries in adolescent elite handball players.

    METHODS: Eighteen Swedish handball-profiled secondary schools (clusters) with players aged 15-19 years, 54% males were randomised into either the Shoulder Group or Knee Group (interventions) or a Control Group. Players in the Shoulder Group were instructed to perform the Shoulder Control programme, and  players in the Knee Group to perform the Knee Control programme, three times per week during May 2018 to May 2019. Control Group players continued their usual training. Outcomes were shoulder and knee injuries defined by the Oslo Sports Trauma Research Center Overuse Injury Questionnaire. Intention-to-treat analyses were performed using Cox regression models with hazard rate ratios (HRRs) with corresponding 95% confidence intervals (CI).

    RESULTS: Six clusters (199 players) in the Shoulder Group, six clusters (216 players) in the Knee Group and six clusters (212 players) in the Control Group were included. There were 100 shoulder injuries and 156 knee injuries. The Shoulder Group had a 56% lower shoulder injury rate, HRR 0.44 (95% CI 0.29 to 0.68), and the Knee Group had a 31% lower knee injury rate, HRR 0.69 (95% CI 0.49 to 0.97) than the Control Group. The absolute risk reduction was 11% and 8%, and the number needed to treat was 9 and 13, respectively.

    CONCLUSIONS: Adolescent elite handball players who performed the Shoulder Control and the Knee Control programmes had a lower risk of shoulder and knee injuries, respectively, than players who continued their usual training. Further research on how these two programmes can be combined to reduce knee and shoulder injuries in a time effective way is warranted. Trial registration ISRCTN15946352. Key points The burden of knee and shoulder injuries in handball is high. The Shoulder Control programme reduces the risk and overall burden of shoulder injuries in adolescent elite handball players. The Knee Control programme reduces the risk and overall burden of knee injuries in adolescent elite handball players.

    Download full text (pdf)
    fulltext
  • 4. Asker, Martin
    et al.
    Waldén, Markus
    Källberg, Henrik
    Holm, Lena W
    Skillgate, Eva
    Sophiahemmet University.
    Preseason clinical shoulder test results and shoulder injury rate in adolescent elite handball players: a prospective study2020In: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 50, no 2, p. 67-74Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN: Prospective cohort study.

    BACKGROUND: Shoulder injuries are common in handball. Shoulder weakness, scapular dyskinesia and range of motion (ROM) deficits are associated with shoulder injury in adults, but studies of adolescent players are scarce.

    OBJECTIVE: To investigate if elite adolescent female and male handball players with shoulder muscle weakness, deficits in shoulder rotation ROM or joint position sense (JPS), or scapular dyskinesia in preseason have an increased shoulder injury rate compared to players not having these characteristics.

    METHODS: 341 uninjured players (452 player-seasons, 50% females) had isometric external rotational (IER), internal rotational (IIR), abduction (IABD) and eccentric external rotational (EER) shoulder strength, shoulder ROM, JPS, and scapular dyskinesia measured during pre-season. Players were monitored weekly regarding match- and training hours and shoulder injuries during one or two seasons. We used multivariable Cox proportional hazard models to calculate hazard rate ratios (HRR) related to the first injury with 95% confidence intervals (95% CI).

    RESULTS: 48 new shoulder injuries were reported during the two seasons. In females, the HRR for IER was 2.37 (95% CI 1.03-5.44), for IIR 2.44 (95% CI 1.06-5.61), and for scapular dyskinesia 1.53 (95% CI 0.36-6.52). In males, the HRR for IER was 1.02 (95% CI 0.44-2.36), for IIR 0.74 (95% CI 0.31-1.75), and for scapular dyskinesia 3.43 (95% CI 1.49-7.92). There were no associations between new shoulder injuries and deficits in ROM or JPS.

    CONCLUSION: In adolescent elite handball, male players with pre-season scapula dyskinesia, and female players with pre-season internal or external rotation shoulder weakness, had an increased shoulder injury rate. J Orthop Sports Phys Ther, Epub 27 Nov 2019. doi:10.2519/jospt.2020.9044.

  • 5.
    Berglöf, Mida
    et al.
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Hägglund, Martin
    Asker, Martin
    Sophiahemmet University.
    Increased adherence to injury prevention exercise programs in adolescent handball: Cohort study of 3219 player seasons2023Conference paper (Other academic)
  • 6.
    Berglöf, Mida
    et al.
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Hägglund, Martin
    Asker, Martin
    Sophiahemmet University.
    Increased adherence to injury prevention exercise programs in adolescent handball: Cohort study of 3219 player seasons2023Conference paper (Refereed)
  • 7. Bohman, Tony
    et al.
    Holm, Lena W
    Hallqvist, Johan
    Pico-Espinosa, Oscar J
    Skillgate, Eva
    Sophiahemmet University.
    Healthy lifestyle behaviour and risk of long-duration troublesome neck pain among men and women with occasional neck pain: results from the Stockholm public health cohort2019In: BMJ Open, E-ISSN 2044-6055, Vol. 9, no 11, article id e031078Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The effect of a healthy lifestyle on the prognosis of neck pain is unknown. This study aimed to investigate if a healthy lifestyle behaviour influences the risk of long-duration troublesome neck pain among men and women with occasional neck pain.

    DESIGN: Longitudinal cohort study.

    SETTINGS: General population, and a subsample of the working population, in Stockholm County, Sweden.

    PARTICIPANTS: This study involved 5342 men and 7298 women, age 18 to 84, from the Stockholm Public Health Cohort, reporting occasional neck pain at baseline in 2006.

    MEASURES: Baseline information about leisure physical activity, smoking, alcohol consumption and consumption of fruits and vegetables were dichotomised into recommendations for healthy/not healthy behaviour. The exposure, a healthy lifestyle behaviour, was categorised into four levels according to the number of healthy behaviours (HB) met. Generalised linear models were applied to assess the exposure on the outcome long-duration troublesome neck pain (activity-limiting neck pain ≥2 days/week during the past 6 months), at follow-up in 2010.

    RESULTS: The adjusted risk of long-duration troublesome neck pain decreased with increasing adherence to a healthy lifestyle behaviour among both men and women (trend test: p<0.05). Compared with the reference category, none or one HB, the risk decreased by 24% (risk ratio 0.76, 95% CI 0.58 to 0.98) among men and by 34% (0.66, 0.54 to 0.81) among women, with three or four HBs. The same comparison showed an absolute reduction of the outcome by 3% in men (risk difference -0.03, 95% CI -0.05 to -0.01) and 5% in women (-0.05,-0.08 to -0.03). Similar results were found in the working population subsample.

    CONCLUSION: Adhering to a healthy lifestyle behaviour decreased the risk of long-duration troublesome neck pain among men and women with occasional neck pain. The results add to previous research and supports the importance of promoting a healthy lifestyle behaviour.

    Download full text (pdf)
    fulltext
  • 8. Bohman, Tony
    et al.
    Holm, Lena W
    Lekander, Mats
    Hallqvist, Johan
    Skillgate, Eva
    Sophiahemmet University.
    Influence of work ability and smoking on the prognosis of long-duration activity-limiting neck/back pain: A cohort study of a Swedish working population2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 4, article id e054512Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Long-duration activity-limiting neck/back pain is common, but the knowledge of what work and lifestyle factors that influence the prognosis is sparse. The objective was therefore to evaluate if two factors, good self-perceived work ability and no daily smoking, are associated with a favourable prognosis of long-duration activity-limiting neck/back pain in a working population, and if these exposures have a synergistic prognostic effect.

    DESIGN: A prospective cohort study based on three subsamples from the Stockholm Public Health Cohort.

    SETTINGS: A working population in Stockholm County, Sweden.

    PARTICIPANTS: Individuals, 18-61 years old, reporting long-duration activity-limiting neck/back pain the previous 6 months at baseline in 2010 (n=5177).

    MEASURES: The exposures were: self-perceived work ability (categorised into good, moderate and poor) and daily smoking (no/yes). The outcome in 2014 was 'absence of long-duration activity-limiting neck/back pain' the previous 6 months representing a favourable prognosis of reported problems at baseline in 2010. Risk ratios (RRs) and risk differences (RDs) with 95% CI was estimated by general linear regressions, and the synergistic effect was estimated by the synergy index (SI) with 95% CI.

    RESULTS: Participants with moderate or good work ability, respectively, had an adjusted RR for a favourable prognosis of 1.37 (95% CI 1.11 to 1.69), and 1.80 (1.49 to 2.17) in comparison with participants with poor work ability. The corresponding adjusted RD were 0.07 (0.02 to 0.11) and 0.17 (0.12 to 0.22). Participants not smoking on daily basis had an adjusted RR of 1.21 (1.02 to 1.42), and an adjusted RD of 0.05 (0.01 to 0.10) for a favourable outcome compared with daily smokers. The adjusted SI was 0.92 (0.60 to 1.43).

    CONCLUSION: For participants with long-duration activity-limiting neck/back pain, moderate or good self-perceived work ability and not being a daily smoker were associated with a favourable prognosis but having both exposures seemed to have no synergistic prognostic effect.

    Download full text (pdf)
    fulltext
  • 9. de Zoete, Annemarie
    et al.
    Rubinstein, Sidney M
    de Boer, Michiel R
    Ostelo, Raymond
    Underwood, Martin
    Hayden, Jill A
    Buffart, Laurien M
    van Tulder, Maurits W
    The effect of spinal manipulative therapy on pain relief and function in patients with chronic low back pain: An individual participant data meta-analysis2021In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 112, p. 121-134, article id S0031-9406(21)00025-0Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A 2019 review concluded that spinal manipulative therapy (SMT) results in similar benefit compared to other interventions for chronic low back pain (LBP). Compared to traditional aggregate analyses individual participant data (IPD) meta-analyses allows for a more precise estimate of the treatment effect.

    PURPOSE: To assess the effect of SMT on pain and function for chronic LBP in a IPD meta-analysis.

    DATA SOURCES: Electronic databases from 2000 until April 2016, and reference lists of eligible trials and related reviews.

    STUDY SELECTION: Randomized controlled trials (RCT) examining the effect of SMT in adults with chronic LBP compared to any comparator.

    DATA EXTRACTION AND DATA SYNTHESIS: We contacted authors from eligible trials. Two review authors independently conducted the study selection and risk of bias. We used GRADE to assess the quality of the evidence. A one-stage mixed model analysis was conducted. Negative point estimates of the mean difference (MD) or standardized mean difference (SMD) favors SMT.

    RESULTS: Of the 42 RCTs fulfilling the inclusion criteria, we obtained IPD from 21 (n=4223). Most trials (s=12, n=2249) compared SMT to recommended interventions. There is moderate quality evidence that SMT vs recommended interventions resulted in similar outcomes on pain (MD -3.0, 95%CI: -6.9 to 0.9, 10 trials, 1922 participants) and functional status at one month (SMD: -0.2, 95% CI -0.4 to 0.0, 10 trials, 1939 participants). Effects at other follow-up measurements were similar. Results for other comparisons (SMT vs non-recommended interventions; SMT as adjuvant therapy; mobilization vs manipulation) showed similar findings. SMT vs sham SMT analysis was not performed, because we only had data from one study. Sensitivity analyses confirmed these findings.

    LIMITATIONS: Only 50% of the eligible trials were included.

    CONCLUSIONS: Sufficient evidence suggest that SMT provides similar outcomes to recommended interventions, for pain relief and improvement of functional status. SMT would appear to be a good option for the treatment of chronic LBP. Systematic Review Registration Number PROSPERO CRD42015025714.

    Download full text (pdf)
    fulltext
  • 10.
    Edlund, Klara
    et al.
    Sophiahemmet University.
    Johansson, Fred
    Sophiahemmet University.
    Lindroth, Rebecca
    Bergman, Louise
    Sundberg, Tobias
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Body image and compulsive exercise: Are there associations with depression among university students?2022In: Eating and Weight Disorders, ISSN 1124-4909, E-ISSN 1590-1262, Vol. 27, no 7, p. 2397-2405Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Mental health problems among university students have been reported to be significantly increasing and suggested to be associated with college drop-out. Body dissatisfaction and compulsive exercise are both constructs relevant for mental health problems in general and eating disorders in particular. This study examined associations between body dissatisfaction, compulsive exercise and self-reported symptoms of depression among Swedish university students.

    METHODS: Participants (n = 4262) are students in an ongoing cohort study, and data from the baseline assessment were used. Four linear regression models were built to explore the associations between body dissatisfaction, compulsive weight control exercise and depressive symptoms.

    RESULTS: Our findings showed that females reported higher levels of body dissatisfaction than males. Body dissatisfaction and compulsive exercise were associated with self-reported symptoms of depression in this non-clinical population. Results showed that compulsive exercise was negatively associated with reported symptoms of depression, while body dissatisfaction was positively associated with symptoms of depression.

    CONCLUSION: In line with previous research, there was a gender difference in body dissatisfaction where females displayed higher levels of dissatisfaction than males.  Body dissatisfaction was  positively associated with reported symptoms of depression, suggesting support of previous research indicating body dissatisfaction to increase mental health problems. Compulsive exercise was negatively associated with symptoms of depression suggesting a behavior negatively reinforced, supporting both constructs to be of interest for reported symptoms of depression in a non-clinical population of Swedish university students.

    LEVEL OF EVIDENCE: III, cohort study.

    TRIAL REGISTRATION: http://clinicaltrials.gov/ID : NCT04465435.

    Download full text (pdf)
    fulltext
  • 11.
    Edlund, Klara
    et al.
    Sophiahemmet University.
    Sundberg, Tobias
    Sophiahemmet University.
    Johansson, Fred
    Sophiahemmet University.
    Onell, Clara
    Sophiahemmet University.
    Rudman, Ann
    Holm, Lena W
    Sophiahemmet University.
    Grotle, Margreth
    Jensen, Irene
    Côté, Pierre
    Skillgate, Eva
    Sophiahemmet University.
    Sustainable UNiversity Life (SUN) study: Protocol for a prospective cohort study of modifiable risk and prognostic factors for mental health problems and musculoskeletal pain among university students2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 4, article id e056489Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Mental health problems and musculoskeletal pain are common health problems among young adults including students. Little is known about the aetiology and prognosis of these problems in university students. We aim to determine the role of personal, sociodemographic, academic and environmental factors for risk and prognosis of symptoms of depression, anxiety and stress as well as musculoskeletal pain in university students. The constructs that will be studied are based on the biopsychosocial model and psychopathology associated with disabling pain. This model acknowledges illness to consist of interrelated mechanisms categorised into biological, psychological, environmental and social cues.

    METHODS AND ANALYSIS: This cohort study aims to recruit around 5000 Swedish full-time students. Data will be collected using five online surveys during one academic year. A subgroup (n=1851) of the cohort, recruited before the COVID-19 pandemic, receive weekly text messages with three short questions assessing mood, worry and pain, sent through the web-based platform SMS-track . Statistical analyses will include Kaplan-Meier estimates, Cox regression analyses, multinomial logistic regression analyses and generalised estimating equations. We will assess effect measure modification when relevant and conduct sensitivity analyses to assess the impact of lost to follow-up.

    PROTOCOL AMENDMENTS: Due to opportunity and timing of the study, with relevance to the outbreak of the COVID-19 pandemic, this study further aims to address mental health problems, musculoskeletal pain and lifestyle in university students before and during the pandemic.

    ETHICS AND DISSEMINATION: The Sustainable UNiversity Life study was approved by the Swedish ethics authority (2019-03276; 2020-01449). Results will be disseminated through peer-reviewed research papers, reports, research conferences, student theses and stakeholder communications.

    TRIAL REGISTRATION NUMBER: NCT04465435.

    Download full text (pdf)
    fulltext
  • 12.
    Fältström, Anne
    et al.
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Tranaeus, Ulrika
    Weiss, Nathan
    Sophiahemmet University.
    Källberg, Henrik
    Sophiahemmet University.
    Lyberg, Victor
    Sophiahemmet University.
    Nomme, Mathias
    Thome, Nicolai
    Omsland, Truls
    Pedersen, Eirik
    Hägglund, Martin
    Waldén, Markus
    Asker, Martin
    Sophiahemmet University.
    Normative values and changes in range of motion, strength, and functional performance over 1 year in adolescent female football players: Data from 418 players in the Karolinska football Injury Cohort study.2022In: Physical Therapy in Sport, ISSN 1466-853X, E-ISSN 1873-1600, Vol. 58, p. 106-116, article id S1466-853X(22)00135-3Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study normative values of range of motion (ROM), strength, and functional performance and investigate changes over 1 year in adolescent female football players.

    DESIGN: Cross-sectional.

    PARTICIPANTS: 418 adolescent female football players aged 12-17 years.

    MAIN OUTCOME MEASURES: The physical characteristic assessments included (1) ROM assessment of the trunk, hips, and ankles; (2) strength measures (maximal isometric and eccentric strength for the trunk, hips, and knees, and strength endurance for the neck, back, trunk and calves), and (3) functional performance (the one-leg long box jump test and the square hop test).

    RESULTS: Older players were stronger, but not when normalized to body weight. Only small differences in ROM regarding age were found. ROM increased over 1 year in most measurements with the largest change in hip external rotation, which increased by 6-7° (Cohen's d = 0.83-0.87). Hip (d = 0.28-1.07) and knee (d = 0.38-0.53) muscle strength and the square hop test (d = 0.71-0.99) improved over 1 year.

    CONCLUSIONS: Normative values for ROM and strength assessments of neck, back, trunk, hips, knees, calves and ankles are presented for adolescent female football players. Generally, fluctuations in ROM were small with little clinical meaning, whereas strength improved over 1 year.

    Download full text (pdf)
    fulltext
  • 13.
    Fältström, Anne
    et al.
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Weiss, Nathan
    Sophiahemmet University.
    Källberg, Henrik
    Sophiahemmet University.
    Lyberg, Victor
    Sophiahemmet University.
    Waldén, Markus
    Hägglund, Martin
    Asker, Martin
    Sophiahemmet University.
    Tranaeus, Ulrika
    Lifestyle characteristics in adolescent female football players: Data from the Karolinska football Injury Cohort2022In: BMC Sports Science, Medicine & Rehabilitation, ISSN 2052-1847, Vol. 14, no 1, p. 212-, article id 212Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Normative values of lifestyle characteristics in adolescent female football players may be used by clinicians and coaches to take actions because the potential important for well-being, performance on the pitch, and risk of injury. The aim was to report descriptive characteristics of lifestyle factors in adolescent female football players and potential changes over 1 year.

    METHODS: We included 419 adolescent competitive female football players from 12 clubs and 27 teams (age 14 ± 1 years, range 12-17 years) and 286 were followed over 1 year. The players completed an extensive questionnaire regarding demographics, football-related factors, and lifestyle factors including tobacco consumption, alcohol use, medicine intake, eating and sleeping habits, well-being, stress, coping, and passion. Baseline data are presented for the total cohort and separately for 4 age groups (12, 13, 14, and 15-17 years).

    RESULTS: 12% skipped breakfast, 8% skipped lunch and 11% used protein supplements several days per week. 16% slept less than 8 h/night, 8% had impaired sleep with daytime consequences, and 22% stated that they were tired in daily activities several days per week. 32% experienced stress some or most days/week and 24% were classified as having psychological distress. Medicine intake (23% vs. 34%), skipping breakfast or lunch several days per week (10% vs. 47% and 20 vs. 33%), tiredness (20% vs. 27%), stress (26% vs. 40%), and psychological distress (27% vs. 37%) increased significantly (P = 0.031 to < 0.001) at the 1-year follow-up.

    CONCLUSION: Many adolescent female football players skip breakfast and lunch, have insufficient sleep, experience stress and are classified as having psychological distress. These factors increased over 1 year.

    Download full text (pdf)
    fulltext
  • 14. Holm, Lena W
    et al.
    Bohman, Tony
    Lekander, Mats
    Magnusson, C
    Skillgate, Eva
    Sophiahemmet University.
    Risk of transition from occasional neck/back pain to long-duration activity limiting neck/back pain: A cohort study on the influence of poor work ability and sleep disturbances in the working population in Stockholm County2020In: BMJ Open, E-ISSN 2044-6055, Vol. 10, no 6, article id e033946Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The prevalence of neck/back pain (NBP) is high worldwide. Limited number of studies have investigated workers with occasional NBP regarding the risk of developing long-duration activity limiting NBP (LNBP). The objectives were to assess (1) the effect of poor work ability and sleep disturbances in persons with occasional NBP on the risk of LNBP, and (2) the interaction effect of these exposures.

    DESIGN: Cohort study based on three subsamples from the Stockholm Public Health Cohort.

    SETTINGS: The working population in Stockholm County.

    PARTICIPANTS: Persons aged 18-60 years, reporting occasional NBP the past 6 months at baseline year 2010 (n=16 460).

    MEASURES: Work ability was assessed with items from the Work Ability Index, perceived mental and/or physical work ability. Sleep disturbances were self-reported current mild/severe disturbances. The outcome in year 2014 was reporting NBP the previous 6 months, occurring ≥couple of days per week and resulting in decreased work ability/restricted other daily activities. The additive effect of having both poor work ability and sleep disturbances was modelled with a dummy variable, including both exposures. Poisson log-linear regression was used to calculate risk ratios (RRs) and 95% CIs.

    RESULTS: At follow-up, 9% had developed LNBP. Poor work ability and sleep disturbances were independent risk factors for LNBP; adjusted RR 1.7 (95% CI: 1.4 to 2.0) and 1.4 (95% CI: 1.2 to 1.5), respectively. No additive interaction was observed.

    CONCLUSION: Workers with occasional NBP who have poor work ability and/or sleep disturbances are at risk of developing LNBP. Having both conditions does not exceed additive risk.

    Download full text (pdf)
    fulltext
  • 15. Holm, Lena W
    et al.
    Onell, Clara
    Sophiahemmet University.
    Carlseus, Martin
    Ekwurtzel, Robin
    Holmertz, Olle
    Bohman, Tony
    Skillgate, Eva
    Sophiahemmet University.
    Vigorous regular leisure-time physical activity is associated with a clinically important improvement in back pain: A secondary analysis of randomized controlled trials2021In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 22, no 1, article id 857Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Neck and back pain are musculoskeletal conditions with serious individual and societal consequences. Current evidence about the prognostic value for neck and back pain is limited and conflicting. This prospective cohort study aimed to assess the association between leisure-time physical activity (LPA) and improvement of neck and/or back pain in a working population receiving manual therapy or general care in one of two randomized controlled trials (RCTs).

    METHODS: Analyses of data from two RCTs evaluating the effect of manual therapies for neck and/or back pain was conducted. Participants (n = 1 464) answered questionnaires about frequency and effort level of LPA at baseline. LPA on moderate or vigorous levels was compared to no or low/irregular moderate and vigorous levels. Pain intensity was assessed with numerical scales at baseline and 3-, 6-, and 12-month follow-up. The outcome was minimal clinically important improvement in pain intensity, defined as ≥2 points improvement in mean pain intensity at follow-up. Crude- and adjusted risk ratios (RR) with 95% confidence intervals (CI) were calculated with Poisson regression analysis and stratified by pain location.

    RESULTS: Participants with neck and/or back pain performing vigorous LPA showed a minimal clinically important improvement after 12 months compared to the control group; RR 1.35 (95% CI; 1.06-1.73). No effect was observed at 3 or 6 months. Moderate LPA did not improve pain intensity in any follow-up. Stratified analyses revealed that the effect of vigorous LPA at 12 months in back pain was RR 1.83 (95% CI; 1.26-2.66) and neck pain RR 1.06 (95% CI; 0.75-1.49).

    CONCLUSIONS: Persons with neck and/or back pain receiving manual therapy or general evidence-based care have greater chance of improvement after 12 months if they prior to treatment frequently practice vigorous LPA. When analyzed separately, the effect was only present for back pain.

    TRIAL REGISTRATION: Registration in Current Controlled Trials (ISRCTN), Stockholm Manual Intervention Trial (MINT), ISRCTN92249294 BJORN-trial, ISRCTN56954776.

    Download full text (pdf)
    fulltext
  • 16.
    Johansson, Fred
    et al.
    Sophiahemmet University.
    Billquist, Jessica
    Andreasson, Hanna
    Jensen, Irene
    Onell, Clara
    Sophiahemmet University.
    Berman, Anne H
    Skillgate, Eva
    Sophiahemmet University.
    Study environment and the incidence of mental health problems and activity-limiting musculoskeletal problems among university students: The SUN cohort study2023In: BMJ Open, E-ISSN 2044-6055, Vol. 13, no 9, article id e072178Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To determine the association between different aspects of study environment and the incidence of mental health problems and activity-limiting musculoskeletal problems.

    DESIGN, SETTING AND PARTICIPANTS: We recruited a cohort of 4262 Swedish university students of whom 2503 (59%) were without moderate or worse mental health problems and 2871 (67%) without activity-limiting musculoskeletal problems at baseline. The participants were followed at five time points over 1 year using web surveys.

    EXPOSURES: Self-rated discrimination, high study pace, low social cohesion and poor physical environment measured at baseline.

    OUTCOMES: Self-rated mental health problems defined as scoring above cut-off on any of the subscales of the Depression, Anxiety and Stress Scale. Self-rated activity-limiting musculoskeletal problems in any body location assessed by the Nordic Musculoskeletal Questionnaire.

    STATISTICAL ANALYSIS: Discrete survival-time analysis was used to estimate the hazard rate ratio (HR) of each exposure-outcome combination while adjusting for gender, age, living situation, education type, year of studies, place of birth and parental education as potential confounders.

    RESULTS: For discrimination, adjusted HRs were 1.75 (95% CI 1.40 to 2.19) for mental health problems and 1.39 (95% CI 1.12 to 1.72) for activity-limiting musculoskeletal problems. For high study pace, adjusted HRs were 1.70 (95% CI 1.48 to 1.94) for mental health problems and 1.25 (95% CI 1.09 to 1.43) for activity-limiting musculoskeletal problems. For low social cohesion, adjusted HRs were 1.51 (95% CI 1.29 to 1.77) for mental health problems and 1.08 (95% CI 0.93 to 1.25) for activity-limiting musculoskeletal problems. For perceived poor physical study environment, adjusted HRs were 1.20 (95% CI 0.99 to 1.45) for mental health problems and 1.20 (95% CI 1.01 to 1.43) for activity-limiting musculoskeletal problems.

    CONCLUSIONS: Several aspects of the study environment were associated with the incidence of mental health problems and activity-limiting musculoskeletal problems in this sample of Swedish university students.

    Download full text (pdf)
    fulltext
  • 17.
    Johansson, Fred
    et al.
    Sophiahemmet University.
    Côté, Pierre
    Hogg-Johnson, Sheilah
    Rudman, Ann
    Holm, Lena W
    Grotle, Margreth
    Jensen, Irene
    Sundberg, Tobias
    Sophiahemmet University.
    Edlund, Klara
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Depression, anxiety and stress among Swedish university students before and during six months of the COVID-19 pandemic: A cohort study2021In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 49, no 7, p. 741-749, article id 14034948211015814Article in journal (Refereed)
    Abstract [en]

    AIMS: The COVID-19 pandemic has had a profound effect on societies and citizens worldwide, raising concerns about potential mental health impacts. We aimed to describe trajectories of depression, anxiety and stress symptoms during the COVID-19 outbreak compared to before the outbreak, and to determine if trajectories were modified by pre-pandemic loneliness, poor sleep quality and mental health problems.

    METHODS: We conducted a cohort study with 1836 Swedish university students entering the study before 13 March 2020, the onset of the pandemic, with follow-ups within three (FU1) and six months (FU2) of the outbreak. Generalized Estimating Equations were used to estimate mean differences in symptom levels over time-periods, and to estimate potential effect modifications.

    RESULTS: We found small differences in mean levels of the depression, anxiety and stress scale (DASS-21) over time. Compared to before the pandemic, depression increased by 0.25 points of 21 (95% CI: 0.04 to -0.45) at FU1 and decreased by 0.75/21 (95% CI:-0.97 to -0.53) at FU2. Anxiety decreased from baseline to FU1 by 0.09/21 (95% CI: -0.24 to -0.07) and by 0.77/21 (95% CI: -0.93 to -0.61) to FU2. Stress decreased from baseline to FU1 by 0.30/21 (95% CI: -0.52 to -0.09) and by 1.32/21 (95% CI: -1.55 to -1.09) to FU2. Students with pre-pandemic loneliness, poor sleep quality or pre-pandemic mental health problems did not have worse trajectories of mean mental health symptoms.

    CONCLUSIONS: Symptom levels were relatively stable during the first three months of the pandemic, while there was a slight decrease during the summer months, probably due to seasonality effects.

    Download full text (pdf)
    fulltext
  • 18.
    Johansson, Fred
    et al.
    Sophiahemmet University.
    Côté, Pierre
    Hogg-Johnson, Sheilah
    Skillgate, Eva
    Sophiahemmet University.
    Depression, anxiety and stress among Swedish university students during the second and third waves of COVID-19: A cohort study2021In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 49, no 7, p. 750-754, article id 14034948211031402Article in journal (Refereed)
    Abstract [en]

    AIMS: This study aims to describe the mean trajectories of depression, anxiety and stress symptoms among Swedish university students before and during the second and third waves of the COVID-19 pandemic.

    METHODS: We recruited 1835 participants in September 2020, of whom 81% provided follow-ups in December 2020-January 2021 and 77% provided follow-ups in March-April 2021. The short-form Depression, Anxiety and Stress Scale was used to measure mental health symptoms. Generalized estimating equations were used to estimate the mean differences in symptom levels over the three time periods.

    RESULTS: Compared with September, mean depression was 0.91 points of 21 higher (95% confidence interval (CI) 0.70-1.13) in December 2020-January 2021 and 0.66 points higher (95% CI 0.43-.88) in March-April 2021. Anxiety levels were 0.20 points higher (95% CI 0.05-0.34) in December 2020-January 2021 and 0.17 points higher (95% CI 0.02-0.33) in March-April 2021. Stress levels were 0.21 points higher (95% CI 0.00-0.41) in December 2020-January 2021 and 0.16 points lower (95% CI -0.38 to 0.05) in March-April 2021.

    CONCLUSIONS: Our results indicate relatively stable levels of mental health among Swedish university students during the second and third waves of COVID-19 compared with before the second wave. Mean depression symptom scores increased slightly, but the importance of this small increase is uncertain.

    Download full text (pdf)
    fulltext
  • 19.
    Johansson, Fred
    et al.
    Sophiahemmet University.
    Côté, Pierre
    Onell, Clara
    Sophiahemmet University.
    Källberg, Henrik
    Sophiahemmet University.
    Sundberg, Tobias
    Sophiahemmet University.
    Edlund, Klara
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Strengths of associations between depressive symptoms and loneliness, perfectionistic concerns, risky alcohol use and physical activity across levels of sleep quality in Swedish university students: A cross-sectional study2023In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 32, no 2, article id e13745Article in journal (Refereed)
    Abstract [en]

    Previous research shows that sleep quality may interact with some other predictors of depression, such that poor sleep could strengthen the association between these factors and depression. We aimed to determine the presence of statistical interactions between sleep quality and loneliness, risky alcohol use, perfectionistic concerns and/or physical inactivity in relation to depressive symptoms. Further, we aimed to describe the functional form of the statistical interactions and associations. We used a cross-sectional design and included 4262 Swedish university students. All measures were self-reported, sleep quality was measured with the Pittsburgh Sleep Quality Index, and depressive symptoms with the short-form Depression, Anxiety and Stress Scale. Regression models of increasing complexity (linear and non-linear, with and without interactions) were compared to determine the presence of associations and statistical interactions, and to explore the best functional form for these associations and interactions. Out-of-sample R2 from repeated cross-validation was used to select the final models. We found that sleep quality was associated with depressive symptoms in all final models. Sleep quality showed a linear interaction with perfectionistic concerns in relation to depressive symptoms, such that perfectionistic concerns were more strongly associated with depressive symptoms when sleep quality was poor. Loneliness, risky alcohol use and physical inactivity were non-linearly associated with depressive symptoms but did not interact with sleep quality. We concluded that out of the four examined variables, only perfectionistic concerns interacted with sleep quality in relation to depressive symptoms. This interaction was weak and explained little of the overall variance in depressive symptoms.

    Download full text (pdf)
    fulltext
  • 20.
    Johansson, Fred
    et al.
    Sophiahemmet University.
    Edlund, Klara
    Sophiahemmet University.
    Sundgot-Borgen, J
    Björklund, C
    Côté, P
    Onell, Clara
    Sophiahemmet University.
    Sundberg, Tobias
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Sexual harassment, sexual violence and subsequent depression and anxiety symptoms among Swedish university students: A cohort studyManuscript (preprint) (Other academic)
  • 21.
    Johansson, Fred
    et al.
    Sophiahemmet University.
    Rozental, Alexander
    Edlund, Klara
    Sophiahemmet University.
    Côté, Pierre
    Sundberg, Tobias
    Sophiahemmet University.
    Onell, Clara
    Sophiahemmet University.
    Rudman, Ann
    Skillgate, Eva
    Sophiahemmet University.
    Associations between procrastination and subsequent health outcomes among university students in Sweden2023In: JAMA Network Open, E-ISSN 2574-3805, Vol. 6, no 1, p. e2249346-, article id e2249346Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE: Procrastination is prevalent among university students and is hypothesized to lead to adverse health outcomes. Previous cross-sectional research suggests that procrastination is associated with mental and physical health outcomes, but longitudinal evidence is currently scarce.

    OBJECTIVE: To evaluate the association between procrastination and subsequent health outcomes among university students in Sweden.

    DESIGN, SETTING, AND PARTICIPANTS: This cohort study was based on the Sustainable University Life study, conducted between August 19, 2019, and December 15, 2021, in which university students recruited from 8 universities in the greater Stockholm area and Örebro were followed up at 5 time points over 1 year. The present study used data on 3525 students from 3 time points to assess whether procrastination was associated with worse health outcomes 9 months later.

    EXPOSURE: Self-reported procrastination, measured using 5 items from the Swedish version of the Pure Procrastination Scale rated on a Likert scale from 1 ("very rarely or does not represent me") to 5 ("very often or always represents me") and summed to give a total procrastination score ranging from 5 to 25.

    MAIN OUTCOMES AND MEASURES: Sixteen self-reported health outcomes were assessed at the 9-month follow-up. These included mental health problems (symptoms of depression, anxiety, and stress), disabling pain (neck and/or upper back, lower back, upper extremities, and lower extremities), unhealthy lifestyle behaviors (poor sleep quality, physical inactivity, tobacco use, cannabis use, alcohol use, and breakfast skipping), psychosocial health factors (loneliness and economic difficulties), and general health.

    RESULTS: The study included 3525 participants (2229 women [63%]; mean [SD] age, 24.8 [6.2] years), with a follow-up rate of 73% (n = 2587) 9 months later. The mean (SD) procrastination score at baseline was 12.9 (5.4). An increase of 1 SD in procrastination was associated with higher mean symptom levels of depression (β, 0.13; 95% CI, 0.09-0.17), anxiety (β, 0.08; 95% CI, 0.04-0.12), and stress (β, 0.11; 95% CI, 0.08-0.15), and having disabling pain in the upper extremities (risk ratio [RR], 1.27; 95% CI, 1.14-1.42), poor sleep quality (RR, 1.09, 95% CI, 1.05-1.14), physical inactivity (RR, 1.07; 95% CI, 1.04-1.11), loneliness (RR, 1.07; 95% CI, 1.02-1.12), and economic difficulties (RR, 1.15, 95% CI, 1.02-1.30) at the 9-month follow-up, after controlling for a large set of potential confounders.

    CONCLUSIONS AND RELEVANCE: This cohort study of Swedish university students suggests that procrastination is associated with subsequent mental health problems, disabling pain, unhealthy lifestyle behaviors, and worse psychosocial health factors. Considering that procrastination is prevalent among university students, these findings may be of importance to enhance the understanding of students' health.

    Download full text (pdf)
    fulltext
  • 22.
    Johansson, Fred
    et al.
    Sophiahemmet University.
    Tranaeus, Ulrika
    Asker, Martin
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Johansson, Fredrik
    Sophiahemmet University.
    Athletic identity and shoulder overuse injury in competitive adolescent tennis players: The Smash cohort study2022In: Frontiers in Sports and Active Living, E-ISSN 2624-9367, Vol. 4, article id 940934Article in journal (Refereed)
    Abstract [en]

    Objectives: Our primary aim was to determine if athletic identity is prospectively associated with shoulder overuse injuries. Secondly, we aimed to determine if athletic identity is prospectively associated with playing through pain and to describe how athletic identity relates to sex, age, playing level, weekly training load, and match volume.

    Methods: A cohort of 269 adolescent tennis players were followed over a period of 52 weeks. Cox regression was used to estimate the hazard rate ratio (HRR) of first-time shoulder overuse injury associated with every 10-unit increase on the Athletic Identity Measurement Scale (AIMS).

    Results: The adjusted HRR of shoulder overuse injury was 0.89 (95% CI: 0.36-2.20) and the odds ratio of playing through pain was 2.41 (95% CI: 0.74-8.96) for every 10 unit increase on AIMS. The level of athletic identity was higher among players at the national level than among players at the regional level and was weakly correlated to weekly hours of tennis matches, tennis training, and fitness training.

    Conclusions: Our results indicate that higher levels of athletic identity may be associated with a lower incidence of shoulder overuse injuries, and potentially with playing through pain, although these results are inconclusive due to wide confidence intervals.

    Download full text (pdf)
    fulltext
  • 23.
    Johansson, Fredrik
    et al.
    Sophiahemmet University.
    Cools, Ann
    Gabbett, Tim
    Fernandez-Fernandez, Jaime
    Skillgate, Eva
    Sophiahemmet University.
    Association between spikes in external training load and shoulder injuries in competitive adolescent tennis players: The SMASH cohort study2022In: Sports Health, ISSN 1941-0921, p. 103-110, article id 19417381211051643Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Few studies have examined the association between the acute:chronic workload ratio (ACWR) and complaints/injuries in young tennis players. Primary aims of this study were to investigate if accumulated external workload "spikes" in ACWR of tennis training, match play, and fitness training, and to see if high or low workload/age ratio were associated with the rate of shoulder complaints/injuries in competitive adolescent tennis players. Additional aims were to report the incidence of complaints/injuries stratified by sex and level of play and to describe shoulder injury characteristics.

    HYPOTHESIS: Rapid increases in external workload are associated with the incidence of shoulder complaints and injuries.

    STUDY DESIGN: A cohort study.

    LEVEL OF EVIDENCE: Level 3.

    METHODS: At baseline, 301 adolescent competitive tennis players, 13 to 19 years, were screened and followed weekly for 52 weeks with questionnaires, in the years 2018 to 2019. Information about time-varying accumulated external workload spikes (uncoupled ACWR >1.3), and workload/age ratio, in 252 uninjured players were used in Cox regression analyses with the outcomes shoulder complaints (≥20) and injuries (≥40) (Oslo Sports Trauma Research Center Overuse Injury Questionnaire).

    RESULTS: For each additional workload spike in tennis training/match play, the hazard rate ratio (HRR) was 1.26 (95% CI, 1.13-1.40) for a shoulder complaint and 1.26 (95% CI, 1.15-1.39) for a shoulder injury. The HRR for fitness training was 1.11 (95% CI, 1.02-1.20) for a shoulder complaint and 1.18 (95% CI, 1.09-1.27) for a shoulder injury. Workload/age ratio was not associated with the rate of shoulder complaints or injuries.

    CONCLUSION: Accumulated external workload spikes of tennis training, match play, and/or fitness training are associated with a higher rate of shoulder complaints and shoulder injuries in competitive adolescent tennis players.

    CLINICAL RELEVANCE: Consistency in training load on a weekly basis is most likely more beneficial for adolescent tennis players regarding shoulder complaints/injuries than a training schedule comprising rapid increases (ie, spikes) in workload.

    Download full text (pdf)
    fulltext
  • 24.
    Johansson, Fredrik
    et al.
    Sophiahemmet University.
    Gabbett, Tim
    Svedmark, Per
    Skillgate, Eva
    Sophiahemmet University.
    External training load and the association with back pain in competitive adolescent tennis players: Results from the SMASH cohort study2022In: Sports Health, ISSN 1941-0921, Vol. 14, no 1, p. 111-118, article id 19417381211051636Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In young tennis players, high loads on the spine and high training volumes in relation to age are associated with a high lifetime prevalence of back pain. The primary aim of this study was to investigate if accumulated external workload "spikes" in the acute:chronic workload ratio (ACWR) of tennis training, match play, and fitness training, and if high or low workload/age ratio were associated with back pain events in competitive adolescent tennis players. Additional aims were to report the incidence of back pain stratified by sex and level of play and to describe the characteristics of players with back pain.

    HYPOTHESIS: Rapid increases in external workload are associated with the incidence of back pain.

    STUDY DESIGN: Cohort study of 198 competitive tennis players, 13 to 19 years, with a weekly follow-up for 52 consecutive weeks.

    LEVEL OF EVIDENCE: Level 3.

    METHODS: Accumulated external workload spikes (uncoupled ACWR >1.3), and the workload/age ratio, were time-varying exposures in Cox regression analyses with the outcome back pain (pain intensity ≥2/10 in the lower back and/or in the upper back/neck with a pain-related disability).

    RESULTS: For each additional workload spike in tennis training/match play, the hazard rate ratio (HRR) was 1.17 (95% CI, 1.06-1.28) for back pain. The corresponding HRR for fitness training was 1.13 (95% CI, 1.05-1.22). Training workload/age ratio was not related to back pain.

    CONCLUSION: Accumulated external workload spikes of tennis training, match play, and/or fitness training are associated with a higher rate of back pain events in competitive adolescent tennis players.

    CLINICAL RELEVANCE: Back pain is a troublesome clinical problem that may affect the performance of talented young tennis players. Structuring the training schedule to minimize rapid increases (ie, spikes) of training load on a weekly basis may enhance performance and reduce back pain in adolescent tennis players.

    Download full text (pdf)
    fulltext
  • 25.
    Johansson, Fredrik
    et al.
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Gabbett, Tim
    Fernandez, Jaime
    Cools, Ann
    Workload and shoulder injuries in adolescent competitive Swedish tennis players: The SMASH cohort study2020Conference paper (Other academic)
  • 26.
    Larsson, Kristina
    et al.
    Sophiahemmet University.
    Onell, Clara
    Sophiahemmet University.
    Edlund, Klara
    Sophiahemmet University.
    Källberg, Henrik
    Sophiahemmet University.
    Holm, Lena W
    Sundberg, Tobias
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Lifestyle behaviors in Swedish university students before and during the first six months of the COVID-19 pandemic: A cohort study2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 1207Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Changes in Swedish university students' lifestyle behaviors during the COVID-19 pandemic are unknown. This study aimed to assess physical activity, sitting time, meal frequency and risk substance use (alcohol, tobacco, and illicit use of drugs) in Swedish university students before and during the first six months of the COVID-19 pandemic, for all and stratified by age and sex.

    METHODS: Data were obtained from the Sustainable University Life cohort study in which web-based surveys were sent to university students repeatedly for one year. Baseline assessment (before the pandemic) was between August 2019-March 2020, follow-up 1 (FU1) between March-June 2020, and follow-up 2 (FU2) between June-September 2020. Participants reported weekly minutes of physical activity, daily sitting hours, meal frequency by weekly intake of different meals, and motivation for eating irregularly, if so. Also, harmful use of alcohol, tobacco and illicit drugs was assessed. Population means and differences with 95% confidence intervals (95% CI) in lifestyle behaviors between time points were calculated with Generalized Estimating Equations.

    RESULTS: 1877 students (73% women, mean age 26.5 years) answered the baseline survey. Weekly exercise decreased by -5.7 min (95% CI: -10.0, -1.5) and -7.7 min (95% CI: -12.6, -2.8) between baseline and FU1 and FU2, respectively. Weekly daily activities increased by 5.6 min (95% CI: 0.3, 11.7) and 14.2 min (95% CI: 7.9, 20.5) between baseline and FU1 and FU2. Daily sitting time decreased by -1.4 h (95% CI: -1.7, -1.2) between baseline and FU2. Breakfast intake increased by 0.2 days per week (95% CI: 0.1, 0.3) between baseline and FU2. Lunch intake decreased by -0.2 days per week (95% CI: -0.2, -0.1) between baseline and FU1 and by -0.2 days per week (95% CI: -0.3, -0.0) between baseline and FU2. Dinner intake decreased by -0.1 days per week (95% CI: -0.2, -0.0) between baseline and both FU1 and FU2. Only minor differences in risk substance use were observed. Similar changes were observed in analyses stratified by age and sex.

    CONCLUSIONS: Lifestyle behaviors in Swedish university students slightly improved during the first six months of the COVID-19 pandemic compared to before.

    TRIAL REGISTRATION: ClinicalTrials.gov, NCT04465435 . 10/07/2020.

    Download full text (pdf)
    fulltext
  • 27.
    Larsson, Kristina
    et al.
    Sophiahemmet University.
    Onell, Clara
    Sophiahemmet University.
    Edlund, Klara
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Lifestyle behaviors in Swedish university students before and during the COVID-19 pandemic2021Conference paper (Other academic)
  • 28. Leach, Matthew J
    et al.
    Palmgren, Per J
    Thomson, Oliver P
    Fryer, Gary
    Eklund, Andreas
    Lilje, Stina
    Sophiahemmet University.
    Adams, Jon
    Skillgate, Eva
    Sophiahemmet University.
    Sundberg, Tobias
    Sophiahemmet University.
    Skills, attitudes and uptake of evidence-based practice: A cross-sectional study of chiropractors in the Swedish Chiropractic Association2021In: Chiropractic and Manual Therapies, E-ISSN 2045-709X, Vol. 29, no 1, article id 2Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Evidence-based practice (EBP) is integral to the delivery of high-quality health care. Chiropractic has been a licensed health profession in Sweden since 1989, but little is known of the uptake of EBP in this professional group. This study explored the self-reported skills, attitudes and uptake of EBP, and the enablers and barriers of EBP uptake, among licensed chiropractors in Sweden.

    METHODS: Licensed chiropractors (n = 172) of the Swedish Chiropractic Association (Legitimerade Kiropraktorers Riksorganisation) were invited to participate in an anonymous online questionnaire, using the Evidence-Based Practice Attitude and Utilisation Survey (EBASE) in February 2019.

    RESULTS: Fifty-six (33%) chiropractors completed the survey. Participants were predominantly male, aged 30-49 years, held a Master's degree, and had received their highest qualification and practiced chiropractic for over a decade. Chiropractors rated their EBP skill-level mostly in the moderate to moderate-high range. The majority of chiropractors reported positive attitudes towards EBP, with most agreeing or strongly agreeing that EBP is necessary in the practice of chiropractic, and that EBP assists in making decisions about patient care. Chiropractors reported an average level of engagement in EBP activities. All participants indicated professional literature and research findings were useful in their day-to-day chiropractic practice. The main perceived enabler of EBP uptake was internet access in the workplace, whereas the main barrier to EBP uptake was lack of clinical evidence in chiropractic.

    CONCLUSIONS: Participating chiropractors of the Swedish Chiropractic Association were generally favourable of EBP, though only reported modest levels of EBP-related skills and engagement in EBP activities. Our findings suggest future studies investigating interventions focussed on improving chiropractors' skills and uptake of EBP are warranted.

    Download full text (pdf)
    fulltext
  • 29. Leach, MJ
    et al.
    Austin, P
    Fryer, G
    Thomson, OP
    Adams, J
    Skillgate, Eva
    Sophiahemmet University.
    Sundberg, Tobias
    Sophiahemmet University.
    Attitudes, skills, and use of evidence-based practice: A cross-sectional survey of Swedish osteopaths2020In: International Journal of Osteopathic Medicine, ISSN 1746-0689, E-ISSN 1878-0164, Vol. 38, p. 41-49Article in journal (Refereed)
    Download full text (pdf)
    fulltext
  • 30.
    Lilje, Stina
    et al.
    Sophiahemmet University.
    Eklund, Andreas
    Wykman, Anders
    Sundberg, Tobias
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Naprapathy versus orthopaedic standard care for common musculoskeletal disorders: Aan 8-year follow-up of a pragmatic randomized controlled trial in Sweden2021In: Chiropractic and Manual Therapies, E-ISSN 2045-709X, Vol. 29, no 1, article id 43Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Musculoskeletal pain is among the most common reasons for seeking care, specialist competence for its treatment in primary care limited and waiting lists for orthopaedics often amongst the longest. Many referrals to orthopaedics do not concern disorders that benefit from surgery. Manual therapy is effective, yet not integrated in national health care systems, and there is a lack of research on other than neck and low back pain, and a lack of long-term follow-ups. The present study evaluates the long-term effects of a manual therapy (naprapathy) for common orthopaedic disorders.

    METHODS: An 8-year follow-up (96 months) of a pragmatic randomized controlled trial of naprapathy (experimental group) versus standard orthopaedic care (control group) for non-surgical patients of working age with the most common musculoskeletal disorders on the waiting lists (n = 78). Bodily pain, physical function (SF36), Quality of life (QoL; SF6D), and data on health care utilization were collected. The treatments lasted from January 2007 to November 2007.

    RESULTS: N = 75 participants in the original study sample completed the 8-year follow-up. The differences in bodily pain (21.7 (95% CI: 9.1-34.3)), physical function (17.6 (6.7-28.4)), and QoLs (0.823 (95% CI: 0.785-0.862) compared with 0.713 (95% CI: 0.668-0.758)) were statistically significantly in favor of the experimental group (p-values < 0.01). After sensitivity analysis the experimental group had altogether 260 health care visits compared with 1161 in the control group.

    CONCLUSIONS: Naprapathy is a continuously effective treatment. Together with earlier research our study suggests that specialized manual therapy should be considered when triaging patients with common non-surgical musculoskeletal disorders in national health care systems.

    TRIAL REGISTRATION: Not applicable, as per information given by ClinicalTrials.gov.

    Download full text (pdf)
    fulltext
  • 31. Lilje, Stina
    et al.
    Sanmartin Berglund, Johan
    Anderberg, Peter
    Palmlöf, Lina
    Skillgate, Eva
    Sophiahemmet University.
    The importance of weak physical performance in older adults for the development of musculoskeletal pain that interferes with normal life: A prospective cohort study2019In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 19, no 4, p. 789-796, article id /j/sjpain.ahead-of-print/sjpain-2019-0041/sjpain-2019-0041.xmlArticle in journal (Refereed)
    Abstract [en]

    Background and aims: There are associations between pain, comorbidity and risk of falling, and falling increases the risk of mortality in older persons, but few studies have investigated the development of pain as a result of impaired physical function. The aim of this study was to examine possible associations between weak physical performance and the development of musculoskeletal pain that interferes with normal life in a sample of older adults. The sample derived from a national, longitudinal multicenter study; the Swedish National Study on Ageing and Care; SNAC-B.

    Methods: The participants (n = 490) were between 60 and 78 years at the baseline examinations. Three variables were chosen for the exposure physical function, from the baseline examinations; One Leg Stand, Grip strength and Sit-to-Stand. The outcome musculoskeletal pain that interferes with normal life was measured using EQ5D and SF-12 6 years later, and logistic regression was used to investigate possible associations between the exposures and the outcome.

    Results: Maximum grip strength (Grippit) was inversely associated with musculoskeletal pain that interferes with normal life (OR 2.31; 95% CI 1.15-4.61), and One-Leg Stand and Sit-to-Stand were not associated with the development of pain (OR 1.30; 95% CI 0.64-2.64) and (OR 0.91; 95% CI 0.45-1.86), respectively.

    Conclusions: Weak grip strength was inversely associated with the development of musculoskeletal pain that interferes with normal life in older adults.

    Implications: Impaired proprioceptive function, strength and mobility in elderly with pain have been found in earlier research. Since pain increases the risk of falling, it is important to investigate if it may develop as a function of an impaired physical function. The results of the present study could be of importance for future prevention programs aiming to protect elderly from falling.

  • 32.
    Onell, Clara
    et al.
    Sophiahemmet University.
    Holm, Lena W
    Bohman, Tony
    Magnusson, Cecilia
    Lekander, Mats
    Skillgate, Eva
    Sophiahemmet University.
    Work ability and psychological distress in a working population: Results from the Stockholm Public Health Cohort2023In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 51, no 4, p. 595-601, article id 14034948211033692Article in journal (Refereed)
    Abstract [en]

    AIMS: Psychological distress is a global public health concern with individual and societal implications causing work-related disability and loss of productivity. It is less known how much work ability contributes to the development of psychological distress. This study aimed to assess the association between self-perceived physical and mental work ability in relation to job demands, and the incidence of psychological distress in a Swedish working population.

    METHODS: Data were obtained from three subsamples of the Stockholm Public Health Cohort with baseline in 2010 and follow-up in 2014, based on a working population in Stockholm County aged 18-60 years, with no or mild psychological distress at baseline (n=29,882). Self-perceived physical and mental work ability in relation to job demands were assessed at baseline with a subscale from the Work Ability Index. Study participants scoring 4 or more on the General Health Questionnaire 12 at follow-up were classified as having developed psychological distress during the study period. Poisson log linear regression was used to calculate crude and adjusted rate ratios with 95% confidence intervals.

    RESULTS: At follow-up, 2543 participants (12%) had developed psychological distress. Reporting poor physical and/or poor mental work ability in relation to job demands at baseline was associated with an almost doubled rate ratio of psychological distress at follow-up, compared to reporting good work ability (rate ratio 1.8; 95% confidence interval 1.6-2.0).

    CONCLUSIONS: Poor work ability is associated with a higher incidence of future psychological distress compared to good work ability.

    Download full text (pdf)
    fulltext
  • 33.
    Onell, Clara
    et al.
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Melin, Anna
    Källberg, Henrik
    Waldén, Markus
    Edlund, Klara
    Sophiahemmet University.
    Hägglund, Martin
    Côté, Pierre
    Asker, Martin
    Sophiahemmet University.
    Dietary habits in adolescent male and female handball players: The Swedish Handball Cohort2023Conference paper (Other academic)
  • 34.
    Onell, Clara
    et al.
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Melin, Anna
    Källberg, Henrik
    Sophiahemmet University.
    Waldén, Markus
    Edlund, Klara
    Sophiahemmet University.
    Hägglund, Martin
    Côté, Pierre
    Asker, Martin
    Dietary habits in adolescent male and female handball players: The Swedish Handball Cohort2023In: BMJ open sport & exercise medicine, ISSN 2055-7647, Vol. 9, no 4, article id e001679Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: This cross-sectional study aimed to describe dietary habits in Swedish adolescent handball players and differences with respect to sex and school grade.

    METHODS: Participants in the Swedish Handball Cohort answered a web-survey assessing adherence to sports nutrition recommendations for meal frequency and meal timing, and the Nordic Nutrition Recommendations (NNR) for fruits/vegetables and fish/seafood, food exclusions and use of dietary supplements. Differences with respect to sex and school grade were estimated with generalised linear models, generating prevalence ratios (PR) with 95% CIs.

    RESULTS: A total of 1040 participants (16.6±0.9 years, 51% males) were included. Overall, 70% and 90%, respectively, met recommendations for meal frequency and meal timing, whereas adherence to recommended carbohydrate intake during training/game was met by 17%. Adherence to the NNR for fruits/vegetables and fish/seafood was met by 16% and 37%, respectively. Twenty-eight per cent reported using dietary supplements. Females reported lower frequency of meals, especially morning snacks (-0.6 days/week (95% CI -0.3 to -0.9)) and evening snacks (-0.8 days/week (95% CI -0.5 to -1.1)), higher prevalence of exclusions due to intolerances (PR 1.66 (95% CI 1.31 to 2.01)) and other reasons (PR 1.36 (95% CI 1.08 to 1.64)), higher adherence to the NNR for fruits/vegetables (PR 2.30 (95% CI 1.98 to 2.62)) and use of micronutrient supplements (PR 1.72 (95% CI 1.43 to 2.00)) compared with males. Only small differences were observed between school grades.

    CONCLUSIONS: Swedish adolescent handball players' dietary habits are fairly in accordance with sports nutrition recommendations but not the NNR. Females appear to display more restrictive habits than males.

    Download full text (pdf)
    fulltext
  • 35.
    Onell, Clara
    et al.
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Melin, Anna
    Källberg, Henrik
    Waldén, Markus
    Edlund, Klara
    Sophiahemmet University.
    Hägglund, Martin
    Côté, Pierre
    Asker, Martin
    Sophiahemmet University.
    Matvanor inom svensk ungdomshandboll2023Conference paper (Other academic)
  • 36. Pico-Espinosa, Oscar Javier
    et al.
    Aboagye, Emmanuel
    Côté, Pierre
    Peterson, Anna
    Holm, Lena W.
    Jensen, Irene
    Skillgate, Eva
    Sophiahemmet University.
    Deep tissue massage and strengthening and stretching exercises for subacute or persistent neck pain: A cost-effectiveness analysis of the Stockholm Neck trial (STONE)2020Conference paper (Other academic)
  • 37. Pico-Espinosa, Oscar Javier
    et al.
    Aboagye, Emmanuel
    Côté, Pierre
    Peterson, Anna
    Holm, Lena W
    Jensen, Irene
    Skillgate, Eva
    Sophiahemmet University.
    Deep tissue massage, strengthening and stretching exercises, and a combination of both compared with advice to stay active for subacute or persistent non-specific neck pain: A cost-effectiveness analysis of the Stockholm Neck trial (STONE)2020In: Musculoskeletal science & practice, ISSN 2468-7812, Vol. 46, article id 102109Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the cost-effectiveness of deep tissue massage ('massage'), strengthening and stretching exercises ('exercises') or a combination of both ('combined therapy') in comparison with advice to stay active ('advice') for subacute and persistent neck pain, from a societal perspective.

    METHODS: We conducted a cost-effectiveness analysis alongside a four-arm randomized controlled trial of 619 participants followed-up for one year. Health-related quality of life was measured using EQ-5D-3L and costs were calculated from baseline to one year. The interventions were ranked according to quality adjusted life years (QALYs) in a cost-consequence analysis. Thereafter, an incremental cost per QALY was calculated.

    RESULTS: In the cost-consequence analysis, in comparison with advice, exercises resulted in higher QALY gains, and massage and the combined therapy were more costly and less beneficial. Exercises may be a cost-effective treatment compared with advice to stay active if society is willing to pay 17 640 EUR per QALY. However, differences in QALY gains were minimal; on average, participants in the massage group, spent a year in a state of health valued at 0.88, exercises: 0.89, combined therapy: 0.88 and, advice: 0.88.

    CONCLUSIONS: Exercises are cost-effective compared to advice given that the societal willingness to pay is above 17 640 EUR per year in full health gained. Massage and a combined therapy are not cost-effective. While exercise appeared to have the best cost/benefit profile, even this treatment had only a modest benefit and treatment innovation is needed. Advice to stay active remains as a good therapeutic alternative from an economical perspective.

    Download full text (pdf)
    fulltext
  • 38. Prego-Domínguez, Jesús
    et al.
    Skillgate, Eva
    Sophiahemmet University.
    Orsini, Nicola
    Takkouche, Bahi
    Social factors and chronic pain: The modifying effect of sex in the Stockholm Public Health Cohort Study2022In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, Vol. 61, no 5, p. 1802-1809, article id keab528Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To assess the relation between social factors (socioeconomic status, household load and job strain) and chronic pain occurrence, and the role of gender in this relation.

    METHODS: We used data corresponding to 8 years of follow-up of the Stockholm Public Health Cohort Study (2006 to 2014) to compute Adjusted Incidence Rate Ratios (IRR) and additive interaction measures of chronic pain episodes, social factors, and sex in 16,687 subjects.

    RESULTS: For men, increased rates were observed for skilled workers (IRR=1.27, 95% Confidence Interval (CI): 0.99, 1.61) and lower non-manual employees (IRR=1.37, 95%CI: 1.05, 1.78), compared to unskilled workers; subjects with high household load (IRR=1.39; 95%CI: 1.03, 1.88), compared to those with null score; and active jobs (IRR=1.27, 95%CI: 1.06, 1.51), compared to low strain jobs. For women, we observed decreased rates for lower (IRR=0.82, 95%CI: 0.68, 0.99), intermediate (IRR=0.74, 95%CI: 0.63, 0.88) and higher non-manual employees (IRR=0.65, 95%CI: 0.54, 0.79), compared to unskilled workers. Compared to subjects with a null score, women with low household load showed a lower rate (IRR=0.85; 95%CI: 0.72, 1.00). Compared to low strain jobs, passive jobs (IRR=1.21; 95%CI: 1.02, 1.44) and high strain jobs (IRR=1.46; 95%CI: 1.02, 2.09) showed higher rates.

    CONCLUSION: In general, our analysis yielded different results, if not opposite, when data were stratified by sex. Sex may then represent an effect modifier of the relation between social factors and chronic pain.

    RHEUMATOLOGY KEY MESSAGES: Low socioeconomic status and high job strain household load are related to chronic pain occurrence.Sex is an effect modifier of the relation between socioeconomic status and chronic pain; that is, this relation is different between men and women.

    Download full text (pdf)
    fulltext
  • 39. Prego-Domínguez, Jesús
    et al.
    Skillgate, Eva
    Sophiahemmet University.
    Orsini, Nicola
    Takkouche, Bahi
    Social factors and pain worsening: A retrospective cohort study2021In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 127, no 2, p. 289-295, article id S0007-0912(21)00272-5Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Pain, specifically chronic pain, is a major public health issue worldwide with considerable health-related consequences and large economic impact. The relation between socioeconomic status and pain occurrence is well established. However, little is known on the relation between socioeconomic factors and worsening of pain, including progression from non-chronic pain to chronic pain.

    METHODS: To assess the relation between socioeconomic status and pain worsening, we used the Stockholm Public Health Cohort Study from 2006 to 2014 and analysed data of 9721 participants who completed follow-up. The adjusted incidence rate ratios (IRRs) of moderate and severe pain worsening episodes were computed, using a pain amplification model, which encompasses spreading, somatisation, and psychological distress components. Multiple imputation analysis was performed subsequently to adjust for cohort attrition.

    RESULTS: Compared with non-skilled workers, self-employed subjects (IRR=1.18; 95% confidence interval [CI], 1.01-1.39) and non-manual employees were at higher risk of moderate worsening (lower non-manual employees: IRR=1.21; 95% CI, 1.03-1.41; intermediate non-manual employees: IRR=1.26; 95% CI, 1.10-1.44; higher non-manual employees: IRR=1.25; 95% CI, 1.08-1.45). This risk increase was limited to worsening starting at stage 0 (non-chronic pain). No association was found between socioeconomic status and severe pain worsening.

    CONCLUSION: Our results support a moderate association between intermediate and high socioeconomic status, and moderate pain worsening. This association could be explained by the heterogeneous composition of the socioeconomic variable used in this cohort, and by changes in exposure and other time-varying covariables' status during follow-up.

  • 40. Rasmussen-Barr, E
    et al.
    Magnusson, C
    Nordin, M
    Skillgate, Eva
    Sophiahemmet University.
    Are respiratory disorders risk factors for troublesome low-back pain? A study of a general population cohort in Sweden2019In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 28, no 11, p. 2502-2509Article in journal (Refereed)
    Abstract [en]

    PURPOSE: A multi-morbidity perspective of troublesome low back pain (LBP) has been highlighted for example in relation to respiratory disorders. Our purpose was to investigate whether respiratory disorders are risk factors for reporting troublesome LBP in people with no or occasional LBP at baseline.

    METHODS: This prospective cohort study was based on the Stockholm Public Health Cohort 2006/2010. We included adults reporting no or occasional LBP the last 6 months at baseline (n = 17,177). Exposures were self-reported asthma and/or Chronic Obstructive Pulmonary Disease (COPD). Outcome was troublesome LBP defined as reporting LBP a couple of days per week or more often that restricted work capacity or hindered daily activities to some or to a high degree, the last 6 months. Binomial regression models were used to calculate risk ratios (RR) with 95% confidence intervals (95% CI).

    RESULTS: Adjusted results indicate that those suffering from asthma had a risk of troublesome LBP at follow-up (RR 1.29, 95% CI 0.92-1.81) as do those suffering from COPD (RR 2.0, 95% CI 1.13-3.56). If suffering from asthma and concurrent COPD the RR was 3.55 (95% CI 1.58-7.98).

    CONCLUSION: Our findings indicate that suffering from asthma and/or COPD increases the risk of developing troublesome LBP, which highlights the importance to consider the overall health of people at risk of troublesome LBP and to take the multi-morbidity perspective into consideration. Future longitudinal studies are needed to confirm our findings. These slides can be retrieved under Electronic Supplementary Material.

  • 41. Rasmussen-Barr, E
    et al.
    Nordin, M
    Skillgate, Eva
    Sophiahemmet University.
    Are respiratory disorders risk factors for troublesome neck/shoulder pain?: A study of a general population cohort in Sweden2022In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The etiology of neck/shoulder pain is complex. Our purpose was to investigate if respiratory disorders are risk factors for troublesome neck/shoulder pain in people with no or occasional neck/shoulder pain.

    METHODS: This prospective cohort study was based on the Stockholm Public Health Cohorts (SPHC) 2006/2010 and the SPHC 2010/2014. We included adults who at baseline reported no or occasional neck/shoulder pain in the last six months, from the two subsamples (SPHC 06/10 n = 15 155: and SPHC 2010/14 n = 25 273). Exposures were self-reported asthma at baseline in SPHC 06/10 and Chronic Obstructive Pulmonary Disease (COPD) at baseline in SPHC 10/14. The outcome was having experienced at least one period of troublesome neck/shoulder pain which restricted work capacity or hindered daily activities to some or to a high degree during the past six months, asked for four years later. Binomial regression analyses were used to calculate risk ratios (RR) with 95% confidence intervals (95% CI).

    RESULTS: Adjusted results indicate that those reporting to suffer from asthma at baseline had a higher risk of troublesome neck/shoulder pain at follow-up four years later (RR 1.48, 95% CI 1.10-2.01) as did those reporting to suffer from COPD (RR 2.12 95%CI 1.54-2.93).

    CONCLUSION: Our findings indicate that those with no or occasional neck/shoulder pain and reporting to suffer from asthma or COPD increase the risk for troublesome neck/shoulder pain over time. This highlights the importance of taking a multi-morbidity perspective into consideration in health care. Future longitudinal studies are needed to confirm our findings.

    Download full text (pdf)
    fulltext
  • 42.
    Skillgate, Eva
    et al.
    Sophiahemmet University.
    Isacson Hjortzberg, My
    Strömwall, Petra
    Hallqvist, Johan
    Onell, Clara
    Sophiahemmet University.
    Holm, Lena W
    Bohman, Tony
    Non-preferred work and the incidence of spinal pain and psychological distress: A prospective cohort study2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 19, article id 10051Article in journal (Refereed)
    Abstract [en]

    Mental illness and psychological distress are global concerns. This study aimed to investigate the association between having non-preferred work and the incidence of spinal pain, psychological distress, and spinal pain with concurrent psychological distress, and if associations are modified by sleep disturbance. A prospective study of 4285 participants 23-62 years old was conducted, from years 2007 to 2010. Participants reported their work situation as preferred/non-preferred regarding profession/workplace with a high/low possibility to change. Psychological distress was measured with the General Health Questionnaire 12 and spinal pain with questions about neck/back pain. Binominal regression analyses calculated relative risk (RR) with 95% confidence interval (CI). Non-preferred work with a low possibility to change was associated with a higher incidence of spinal pain (RR 1.8; 95% CI 1.2-2.6) and psychological distress (RR 1.8; 95% CI 1.4-2.4) compared to preferred work. The RR was 1.4 (95% CI 0.9-2.1) for spinal pain and 1.3 (95% CI 1.0-1.7) for psychological distress among those with a high possibility to change. Non-preferred work yielded a higher incidence of spinal pain with concurrent psychological distress (RR 1.9; 95% CI 1.0-3.7). Sleep disturbance did not modify associations. A replication based on newer data is needed to confirm the results. In conclusion, non-preferred work is associated with a higher incidence of spinal pain and psychological distress, especially if the possibility to change job is low.

    Download full text (pdf)
    fulltext
  • 43. Smedbråten, Kaja
    et al.
    Grotle, Margreth
    Jahre, Henriette
    Richardsen, Kåre Rønn
    Småstuen, Milada Cvancarova
    Skillgate, Eva
    Sophiahemmet University.
    Øiestad, Britt Elin
    Lifestyle behaviour in adolescence and musculoskeletal pain 11 years later: The Trøndelag Health Study2022In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 26, no 9, p. 1910-1922Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is limited knowledge on the association between lifestyle behaviour in adolescence and musculoskeletal pain in young adulthood. This study aimed to investigate whether an accumulation of adverse lifestyle behaviours in adolescents with and without musculoskeletal pain at baseline, was associated with persistent musculoskeletal pain (pain duration ≥3 consecutive months the last year) 11 years later.

    METHODS: Longitudinal data from the Trøndelag Health Study in Norway including 1824 adolescents (13-19 years old) was analysed. The outcome was persistent musculoskeletal pain (≥3 months). The number of adverse lifestyle behaviours (low physical activity level, sleep problems, insufficient fruit/vegetables consumption, smoking, frequent alcohol intoxication [drunkenness] and/or illicit drug use) were summed up to comprise an ordinal variable and analysed with 0 or 1 adverse behaviours as the reference. Multiple logistic regression analyses, stratified by individuals with and without baseline musculoskeletal pain, were conducted. The results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs).

    RESULTS: In adolescents with musculoskeletal pain at baseline, reporting ≥ four adverse lifestyle behaviours increased the odds of persistent musculoskeletal pain (OR 2.23, 95% CI 1.36, 3.66) 11 years later. Two and three adverse behaviours were not associated with future persistent musculoskeletal pain. In adolescents without musculoskeletal pain at baseline, an accumulation of adverse lifestyle behaviours was not associated with future persistent musculoskeletal pain.

    CONCLUSION: An accumulation of adverse lifestyle behaviours in adolescents with musculoskeletal pain at baseline was associated with persistent musculoskeletal pain 11 years later, but not in adolescents without musculoskeletal pain at baseline.

    SIGNIFICANCE: An accumulation of four or more adverse lifestyle behaviours in adolescents with musculoskeletal pain was associated with persistent musculoskeletal pain in young adulthood. In future health care of adolescents with musculoskeletal pain, lifestyle behaviours should be assessed, with emphasis on accumulation of multiple adverse lifestyle behaviours. Focusing on an accumulation of multiple adverse lifestyle behaviours, rather than each individual behaviour, might provide a potential area for future research and interventions targeting musculoskeletal pain in youth.

    Download full text (pdf)
    fulltext
  • 44.
    Sundberg, Tobias
    et al.
    Sophiahemmet University.
    Leach, Matthew J
    Lilje, Stina
    Thomson, Oliver P
    Fryer, Gary
    Palmgren, Per J
    Adams, Jon
    Skillgate, Eva
    Sophiahemmet University.
    Attitudes, skills and implementation of evidence-based practice: A national cross-sectional survey of licensed naprapaths in Sweden2023In: Chiropractic and Manual Therapies, E-ISSN 2045-709X, Vol. 31, article id 3Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Evidence-based practice (EBP) is fundamental to the delivery of high-quality, safe and effective health care. Naprapaths, manual therapy providers that specialize in the treatment of musculoskeletal pain and dysfunction, became a Swedish licensed health profession in 1994. This study investigated the attitudes, skills and implementation of EBP among licensed naprapaths in Sweden.

    METHODS: Licensed naprapaths (n = 950) of Svenska Naprapatförbundet (the Swedish Naprapathy Association) were invited by email to take part in this cross-sectional anonymous online study using the Evidence-Based Practice Attitude and Utilisation Survey in February 2019.

    RESULTS: Fourteen percent (137/950) of invited naprapaths completed the survey. There was an approximately equal gender divide among responders; most were in the mid-career age range, practiced in city areas, and had a university or college certificate/diploma as their highest qualification. The majority of naprapaths agreed or strongly agreed that EBP was necessary in the practice of naprapathy, assisted them in making care decisions, and improved the quality of patient care. Naprapaths' self-reported skills in EBP were mostly in the moderate to moderate-high range. The majority of participating naprapaths reported infrequent implementation of EBP. Perceived minor or moderate barriers to EBP uptake included a lack of colleague support for EBP and a lack of relevant resources. Access to the internet and free online databases were reported as very useful enablers to improving EBP uptake.

    CONCLUSIONS: The licensed naprapaths participating in this survey reported positive attitudes toward EBP, moderate levels of EBP skills, and infrequent implementation of EBP.

    Download full text (pdf)
    fulltext
  • 45.
    Sundberg, Tobias
    et al.
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Gustavsson, Petter
    Rudman, Ann
    Early career demanding psychosocial work environment and severe back pain and neck/shoulder pain in experienced nurses: A cohort study2023In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, article id 14034948231151992Article in journal (Refereed)
    Abstract [en]

    AIMS: Back pain and neck/shoulder pain are common among nurses. The aim of this study was to investigate the association between nurses' exposure to a demanding psychosocial work environment during the first three years after graduation and the occurrence of severe back pain and neck/shoulder pain in the longer term, 11-15 years later.

    METHODS: The Longitudinal Analysis of Nursing Education (LANE) study (nursing graduates from 26 Swedish universities in the years 2002, 2004 and 2006) was used to create two risk cohorts of nurses not reporting severe back pain (n=1764) or neck/shoulder pain (n=1707). Nurses exposed to a demanding psychosocial work environment for one, two or three of the first three years in their career were compared to nurses not having a demanding psychosocial work environment for any of these three years regarding the incidence of severe back pain or neck/shoulder pain at follow-up, 11-15 years later. Relative risks (RR) with 95% confidence intervals (CI) were calculated using binomial regression.

    RESULTS: The RR (95% CI) of having severe back pain for nurses who had a demanding psychosocial work environment for one of the three years was 1.36 (0.82-2.28) and 2.08 (1.21-3.57) for two of the three years and 2.82 (1.43-5.55) for all three years. Corresponding RRs (95% CIs) for severe neck/shoulder pain were 1.35 (0.87-2.10), 1.49 (0.88-2.51) and 1.41 (0.62-3.20), respectively.

    CONCLUSIONS: Nurses who were repeatedly exposed to a demanding psychosocial work environment early in their career reported severe back pain to a higher extent in the longer term.

    Download full text (pdf)
    fulltext
  • 46. Tabell, Vesa
    et al.
    Tarkka, Ina M
    Holm, Lena W
    Skillgate, Eva
    Sophiahemmet University.
    Do adverse events after manual therapy for back and/or neck pain have an impact on the chance to recover?: A cohort study2019In: Chiropractic and Manual Therapies, E-ISSN 2045-709X, Vol. 27, article id 27Article in journal (Refereed)
    Abstract [en]

    Background: Manual therapy is a commonly used treatment for patients with back and neck pain. Studies have shown that manual therapy-related adverse events are mainly short in duration and mild or moderate by their intensity, affecting up to 50% of the patients. If the presence of adverse events has an impact on the chance to recover from back/neck pain is poorly understood. The aim of this study was to investigate if mild or moderate adverse events after manual therapy has an impact on the chance to recover from back/neck pain in men and women.

    Methods: A prospective cohort study of 771 patients with at least three treatment sessions in a randomized controlled trial performed in January 2010 - December 2013. Adverse events within 24 h after each treatment were measured with questionnaires and categorized as: no, mild or moderate, based on bothersomeness. Outcome measure was the perceived recovery at seven weeks and at three months follow-up. Odds Ratios (OR) and 95% confidence intervals (CI) were calculated by Logistic regression to investigate the associations between the exposure and outcome, and to test and adjust for potential confounding.

    Results: There were no statistically significant associations observed between the experience of mild or moderate adverse events and being recovered at the seven weeks follow-up. The only statistically significant association observed at the three months follow-up was for mild adverse events in men with an OR of 2.44, 95% CI: 1.24-4.80 in comparison to men with no adverse events.

    Conclusion: This study indicates that mild adverse events after manual therapy may be related to a better chance to recover in men.

    Trial registration: The study is based on data from a trial registered in Current Controlled Trials (ISRCTN92249294).

    Download full text (pdf)
    fulltext
  • 47. Tranaeus, Ulrika
    et al.
    Ivarsson, Andreas
    Johnson, Urban
    Weiss, Nathan
    Sophiahemmet University.
    Samuelsson, Martin
    Skillgate, Eva
    Sophiahemmet University.
    The role of the results of functional tests and psychological factors on prediction of injuries in adolescent female football players2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 1, article id 143Article in journal (Refereed)
    Abstract [en]

    Football is a popular sport among adolescent females. Given the rate of injuries in female footballers, identifying factors that can predict injuries are important. These injuries are often caused by complex reasons. The aim of this study was to investigate if the combination of demographic (age, number of training and match play hours/week), psychosocial (perceived stress, adaptive coping strategies) and physiological factors (functional performance) can predict a traumatic injury in adolescent female footballers. A cohort consisting of 419 female football players aged 13-16 years was established. Baseline questionnaires covered potential risk factors for sport injuries, and measurements included football-related functional performance tests. Data were collected prospectively with a weekly online questionnaire for 52 weeks covering, e.g., injuries, training, and match play hours/week. A total of 62% of the players reported at least one traumatic injury during the 52 weeks. The coping strategy "positive reframing" had the strongest association with the risk of traumatic injuries. The combination of more frequent use of the coping strategy, positive reframing, and high levels of physical performance capacity may prevent a traumatic injury in adolescent female footballers. Coaches are encouraged to adopt both physiological and psychological factors when preventing injuries in young female footballers.

    Download full text (pdf)
    fulltext
  • 48. Tranaeus, Ulrika
    et al.
    Weiss, Nathan
    Sophiahemmet University.
    Lyberg, Victor
    Hagglund, Martin
    Waldén, Markus
    Johnson, Urban
    Asker, Martin
    Skillgate, Eva
    Sophiahemmet University.
    Study protocol for a prospective cohort study identifying risk factors for sport injury in adolescent female football players: The Karolinska football Injury Cohort (KIC)2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 1, article id e055063Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Football is a popular sport among young females worldwide, but studies concerning injuries in female players are scarce compared with male players. The aim of this study is to identify risk factors for injury in adolescent female football players.

    METHODS AND ANALYSIS: The Karolinska football Injury Cohort (KIC) is an ongoing longitudinal study that will include approximately 400 female football academy players 12-19 years old in Sweden. A detailed questionnaire regarding demographics, health status, lifestyle, stress, socioeconomic factors, psychosocial factors and various football-related factors are completed at baseline and after 1 year. Clinical tests measuring strength, mobility, neuromuscular control of the lower extremity, trunk and neck are carried out at baseline. Players are followed prospectively with weekly emails regarding exposure to football and other physical activity, health issues (such as stress, recovery, etc), pain, performance and injuries via the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O). Players who report a substantial injury in the OSTRC-O, that is, not being able to participate in football activities, or have reduced their training volume performance to a moderate or major degree, are contacted for full injury documentation. In addition to player data, academy coaches also complete a baseline questionnaire regarding coach experience and education.

    ETHICS AND DISSEMINATION: The study was approved by the Regional Ethical Review Authority at Karolinska Institutet, Stockholm, Sweden (2016/1251-31/4). All participating players and their legal guardians give their written informed consent. The study will be reported in accordance with the Strengthening the Reporting of Observational studies in Epidemiology. The results will be published in peer-reviewed academic journals and disseminated to the Swedish football movement through stakeholders and media.

    Download full text (pdf)
    fulltext
  • 49.
    Weiss, Nathan
    et al.
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University.
    Axén, Iben
    Psychological distress and musculoskeletal pain in manual therapists during the second wave of the COVID-19 pandemic in Sweden: A cross-sectional study2023In: Chiropractic and Manual Therapies, E-ISSN 2045-709X, Vol. 31, article id 34Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The COVID-19 pandemic had an unprecedented impact on healthcare, and the health of healthcare workers has been subject of much research. However, studies of health-related factors in manual therapists during the COVID-19 pandemic are scarce. Research in this field can provide valuable insights for future crises policy and guidelines, including in regions where the public health response to COVID-19 contrasts with that of most other international jurisdictions. The aim was to describe the prevalence of psychological distress and musculoskeletal pain, and to investigate factors potentially associated with high psychological distress and activity-limiting musculoskeletal pain in clinically active chiropractors and naprapaths during the second wave of the COVID-19 pandemic in Sweden.

    METHODS: A cross-sectional survey was distributed to a representative sample of Swedish manual therapists, between November 2020 and January 2021. High psychological distress and activity-limiting musculoskeletal pain were investigated regarding associations with residing in a municipality with a high spread of infection, a previous/ongoing SARS-CoV-2 infection, clinical interferences and economic consequences associated with the pandemic. Generalized Linear Models with log link and binomial distribution were used, computing prevalence ratios (PR) with 95% confidence intervals (95% CI).

    RESULTS: A total of 762 participants were included, representing 46% of the source population. The prevalence of depressive, anxiety, and stress symptoms was 17%, 7%, and 12%, respectively. Neck (50%), low back (46%), upper back (40%), and shoulders (39%) were the most prevalent musculoskeletal pain areas. Economic consequences due to the pandemic were associated with high psychological distress (PR = 2.30, 95% CI: 1.48-3.53).

    CONCLUSIONS: During the second wave of the COVID-19 pandemic in Sweden, manual therapists primarily suffered from musculoskeletal pain related to the back and shoulders, while depressive symptoms were the most common symptom of psychological distress. Owners of businesses that suffered economic consequences had a higher prevalence of high psychological distress, which may call for targeted support of this group in future similar contexts. Future longitudinal studies during the pandemic are warranted to assess these associations further.

    Download full text (pdf)
    fulltext
1 - 49 of 49
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf