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Toivonen LA, Mäntymäki H, Benneker LM, Kautiainen H, Häkkinen A, Neva MH. Non-linear Effect of Preexisting Cranial Adjacent Disc Degeneration on Cumulative 12-year Revision Risk Following Lumbar Fusions. Spine (Phila Pa 1976) 2024:00007632-990000000-00579. [PMID: 38305426 DOI: 10.1097/brs.0000000000004949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/25/2024] [Indexed: 02/03/2024]
Abstract
STUDY DESIGN Retrospective analysis of prospectively collected data. OBJECTIVE To evaluate how preexisting adjacent segment degeneration status impacts revision risk for adjacent segment disease (ASD) after lumbar fusions. SUMMARY OF BACKGROUND DATA ASD incurs late reoperations after lumbar fusion surgeries. ASD pathogenesis is multifactorial. Preexisting adjacent segment degeneration measured by Pfirrmann is suggested as one of the predisposing factors. We sought to find deeper insights into this association by using a more granular degeneration measure, the Combined imaging score (CIS). METHODS A total of 197 consecutive lumbar fusions for degenerative pathologies were enrolled in a prospective follow-up (median 12 years). Preoperative cranial adjacent segment degeneration status was determined using Pfirrmann and CIS, which utilizes both radiographs and magnetic resonance imaging. Based on CIS, patients were trichotomized into tertiles (CIS <7, CIS 7-10, and CIS >10). The cumulative ASD revision risk was determined for each tertile. After adjusting for age, sex, body mass index, sacral fixation, and fusion length, hazard ratios (95% confidence intervals, CI) for ASD revisions were determined for each Pfirrmann and CIS score. RESULTS Patients in the intermediate CIS tertile had a cumulative ASD revision risk of 25.4% (17.0% to 37.0%), while both milder degeneration (CIS <7) [13.2% (6.5% to 25.8%)] and end-stage degeneration (CIS >10) [13.6% (7.0% to 25.5%)] appeared to be protective against surgical ASD. Pfirrmann failed to show a significant association with ASD revision risk. Adjusted analysis of CIS suggested increased ASD revisions after CIS 7, which turned contrariwise after CIS 10. CONCLUSIONS The effect of preexisting adjacent segment degeneration on ASD reoperation risk is not linear. The risk seems to increase with advancing degeneration but diminish with end-stage degeneration. Therefore, end-stage degenerative segments may be considered to be excluded from fusion constructs. LEVEL OF EVIDENCE Therapeutic Level III.
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Affiliation(s)
- Leevi A Toivonen
- Department of Orthopedics and Traumatology, Tampere University Hospital and Tampere University, Tampere, Finland
| | - Heikki Mäntymäki
- Department of Orthopedics and Traumatology, Tampere University Hospital and Tampere University, Tampere, Finland
| | | | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Marko H Neva
- Department of Orthopedics and Traumatology, Tampere University Hospital and Tampere University, Tampere, Finland
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Toivonen LA, Häkkinen A, Pekkanen L, Kyrölä K, Kautiainen H, Neva MH. Benefits of lumbar spine fusion surgery reach 10 years with various surgical indications. N Am Spine Soc J 2023; 16:100276. [PMID: 37840551 PMCID: PMC10570578 DOI: 10.1016/j.xnsj.2023.100276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/28/2023] [Accepted: 09/02/2023] [Indexed: 10/17/2023]
Abstract
Background Context Lumbar spine fusion (LSF) surgery is a viable form of treatment for several spinal disorders. Treatment effects are preferably to be endorsed in real-life settings. Methods This prospective study evaluated the 10-year outcomes of LSF. A population-based series of elective LSFs performed at 2 spine centers between January 2008 and June 2012 were enrolled. Surgeries for tumor, acute fracture, or infection, neuromuscular scoliosis, or postoperative conditions were excluded. The following patient-reported outcome measures (PROMs) were collected at baseline, and 1, 2, 5, and 10 years postsurgery: VAS for back and leg pain, ODI, SF-36. Longitudinal measures of PROMs were analyzed using mixed-effects models. Results A total of 683 patients met the inclusion criteria, and 630 (92%) of them completed baseline and at least 1 follow-up PROMs, and they constituted the study population. Mean age was 61 (SD 12) years, 69% women. According to surgical indication, patients were stratified into degenerative spondylolisthesis (DS, n=332, 53%), spinal stenosis (SS, n=102, 16%), isthmic spondylolisthesis (IS, n=97, 15%), degenerative disc disease (DDD, n=52, 8%), and deformity (DF, n=47, 7%).All diagnostic cohorts demonstrated significant improvement at 1 year, followed by a partial loss of benefits by 10 years. ODI baselines and changes at 1 and 10 years were: (DS) 45, -21, and -14; (SS) 51, -24, and -13; (IS) 41, -24, and -20; (DDD) 50, -20, and -20; and (DF) 50, -21, and -16, respectively. Comparable patterns were seen in pain scores. Significant HRQoL achievements were recorded in all cohorts, greatest in physical domains, but also substantial in mental aspects of HRQoL. Conclusions Benefits of LSF were partially lost but still meaningful at 10 years of surgery. Long-term benefits seemed milder with degenerative conditions, reflecting the progress of the ongoing spinal degeneration. Benefits were most overt in pain and physical function measures.
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Affiliation(s)
- Leevi A. Toivonen
- Department of Orthopedics and Traumatology, Tampere University Hospital, Elämänaukio 2, PB 272, Tampere, 33101, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Seminaarinkatu 15, Jyväskylä, 40014, Finland
| | - Liisa Pekkanen
- Department of Surgery, Central Finland Healthcare District, Hoitajantie 3, Jyväskylä, 40620, Finland
| | - Kati Kyrölä
- Department of Surgery, Central Finland Healthcare District, Hoitajantie 3, Jyväskylä, 40620, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Yliopistonranta 8, Kuopio, 70210, Finland
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
| | - Marko H. Neva
- Department of Orthopedics and Traumatology, Tampere University Hospital, Elämänaukio 2, PB 272, Tampere, 33101, Finland
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Rinne M, Garam S, Kukkonen-Harjula K, Tokola K, Häkkinen A, Ylinen J, Nikander R. Response to the letter to the editor by Treleaven et al., May 14, 2023. Clin Rehabil 2023; 37:1575-1576. [PMID: 37408318 DOI: 10.1177/02692155231185469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Affiliation(s)
- Marjo Rinne
- Health Promotion Research, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Sanna Garam
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | | | - Kari Tokola
- Health Promotion Research, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Ylinen
- Department of Physical Medicine and Rehabilitation, Jyväskylä Central Hospital, Jyväskylä, Finland
| | - Riku Nikander
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
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Rinne M, Garam S, Kukkonen-Harjula K, Tokola K, Häkkinen A, Ylinen J, Nikander R. Neck-Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial. Clin Rehabil 2023; 37:1322-1331. [PMID: 37097883 PMCID: PMC10426253 DOI: 10.1177/02692155231170687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 03/29/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVES We investigated whether a specific exercise program for the neck-shoulder region reduces headache intensity, frequency, and duration, and how it influences neck disability among women with chronic headache compared to a control group. DESIGN Two-center randomized controlled trial. SUBJECTS 116 working-age women. INTERVENTION The exercise group (n = 57) performed a home-based program with six progressive exercise modules, over 6 months. The control group (n = 59) underwent six placebo-dosed transcutaneous electrical nerve stimulation sessions. Both groups performed stretching exercises. MAIN MEASURES The primary outcome was pain intensity of headache, assessed using the Numeric Pain Rating Scale. Secondary outcomes were frequency and duration of weekly headaches, and neck disability assessed using the Neck Disability Index. Generalized linear mixed models were used. RESULTS Mean pain intensity at baseline was 4.7 (95% CI 4.4 to 5.0) in the exercise group and 4.8 (4.5 to 5.1) in the control group. After 6 months the decrease was slight with no between-group difference. Headache frequency decreased from 4.5 (3.9 to 5.1) to 2.4 (1.8 to 3.0) days/week in the exercise group, and from 4.4 (3.6 to 5.1) to 3.0 (2.4 to 3.6) in the control group (between-group p = 0.017). Headache duration decreased in both groups, with no between-group difference. Greater improvement in the Neck Disability Index was found in the exercise group (between-group change -1.6 [95% CI -3.1 to -0.2] points). CONCLUSION The progressive exercise program almost halved headache frequency. The exercise program could be recommended as one treatment option for women with chronic headache.
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Affiliation(s)
- Marjo Rinne
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Sanna Garam
- School of Rehabilitation and Examination, Metropolia University of Applied Sciences, Helsinki, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Kari Tokola
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Department of Physical Medicine and Rehabilitation, Central Hospital of Central Finland and Central Finland Wellbeing Services County, Jyväskylä, Finland
| | - Jari Ylinen
- Department of Physical Medicine and Rehabilitation, Central Hospital of Central Finland and Central Finland Wellbeing Services County, Jyväskylä, Finland
| | - Riku Nikander
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Department of Physical Medicine and Rehabilitation, Central Hospital of Central Finland and Central Finland Wellbeing Services County, Jyväskylä, Finland
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Toivonen LA, Mäntymäki H, Häkkinen A, Kautiainen H, Neva MH. Reply to Letter to the Editor Regarding the Article "Postoperative Sagittal Balance has Only a Limited Role in the Development of Adjacent Segment Disease after Lumbar Spine Fusion for Degenerative Lumbar Spine Disorders: A Subanalysis of the 10-year Follow-up Study". Spine (Phila Pa 1976) 2023:00007632-990000000-00317. [PMID: 37052451 DOI: 10.1097/brs.0000000000004678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 04/14/2023]
Affiliation(s)
- Leevi A Toivonen
- Department of Orthopaedics and Trauma, University of Tampere, Faculty of Medicine and Life Sciences and Tampere University Hospital, Tampere, Finland
| | - Heikki Mäntymäki
- Department of Orthopaedics and Trauma, University of Tampere, Faculty of Medicine and Life Sciences and Tampere University Hospital, Tampere, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Marko H Neva
- Department of Orthopaedics and Trauma, University of Tampere, Faculty of Medicine and Life Sciences and Tampere University Hospital, Tampere, Finland
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Jokinen K, Häkkinen A, Luokkala T, Karjalainen T. Clinical Outcomes After Aggressive Active Early Motion and Modified Kleinert Regimens: Comparison of 2 Consecutive Cohorts. Hand (N Y) 2023; 18:335-339. [PMID: 34088233 PMCID: PMC10035109 DOI: 10.1177/15589447211017222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Modern multistrand repairs can withstand forces present in active flexion exercises, and this may improve the outcomes of flexor tendon repairs. We developed a simple home-based exercise regimen with free wrist and intrinsic minus splint aimed at facilitating the gliding of the flexor tendons and compared the outcomes with the modified Kleinert regimen used previously in the same institution. METHODS We searched the hospital database to identify flexor tendon repair performed before and after the new regimen was implemented and invited all patients to participate. The primary outcome was total active range of motion, and secondary outcomes were Disabilities of Arm, Shoulder, and Hand; grip strength; globally perceived function; and the quality of life. RESULTS The active range of motion was comparable between the groups (mean difference = 14; 95% confidence interval [CI], -8 to 36; P = .22). Disabilities of Arm, Shoulder, and Hand; grip strength; global perceived function; and health-related quality of life were also comparable between the groups. There was 1 (5.3%) rupture in the modified Kleinert group and 4 (15.4%) in the early active motion group (relative risk = 0.3; 95% CI, 0.04-2.5; P = .3). CONCLUSIONS Increasing active gliding with a free wrist and intrinsic minus splint did not improve the clinical outcomes after flexor tendon injury at a mean of 38-month follow-up.
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Affiliation(s)
- Kaisa Jokinen
- Central Finland Central Hospital, Jyväskylä, Finland
| | | | - Toni Luokkala
- Central Finland Central Hospital, Jyväskylä, Finland
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Sukanen M, Pajari J, Äyrämö S, Paloneva J, Waller B, Häkkinen A, Multanen J. Cross-cultural adaptation and validation of the Kerlan-Jobe Orthopaedic Clinic shoulder and elbow score in Finnish-speaking overhead athletes. BMC Sports Sci Med Rehabil 2022; 14:190. [PMID: 36345012 PMCID: PMC9640805 DOI: 10.1186/s13102-022-00581-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
Background The Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score (KJOC) is developed to evaluate the shoulder and elbow function in overhead athletes. To date, the score has not been adapted into Finnish language. The aim of this study was to perform a cross-cultural adaptation of the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score (KJOC) into Finnish language and evaluate its validity, reliability, and responsiveness in overhead athletes. Methods Forward–backward translation method was followed in the cross-cultural adaptation process. Subsequently, 114 overhead athletes (52 males, 62 females, mean age 18.1 ± 2.8 years) completed the Finnish version of KJOC score, Disabilities of the Arm, Shoulder and Hand (DASH), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and RAND-36 to assess validity of the KJOC score. To evaluate reliability and responsiveness, the participants filled in the KJOC score 16 days and eight months after the first data collection. Validity, reliability, and responsiveness of the Finnish KJOC score were statistically tested. Results Minor modifications were made during the cross-cultural translation and adaptation process, which were related to culture specific terminology in sports and agreed by an expert committee. Construct validity of the KJOC score was moderate to high, based on the correlations with DASH (r = − 0.757); DASH sports module (r = − 0.667); ASES (r = 0.559); and RAND-36 (r = 0.397) questionnaires. Finnish KJOC score showed excellent internal consistency (α = 0.92) and good test–retest reliability (2-way mixed-effects model ICC = 0.77) with acceptable measurement error level (SEM 5.5; MDC 15.1). Ceiling effect was detected for asymptomatic athletes in each item (23.2–61.1%), and for symptomatic athletes in item 5 (47.4%). Responsiveness of the Finnish KJOC score could not be confirmed due to conflicting follow-up results. Conclusion The Finnish KJOC score was found to be a valid and reliable questionnaire measuring the self-reported upper arm status in Finnish-speaking overhead athletes. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-022-00581-4.
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Toivonen LA, Mäntymäki H, Häkkinen A, Kautiainen H, Neva MH. Postoperative Sagittal Balance Has Only a Limited Role in the Development of Adjacent Segment Disease After Lumbar Spine Fusion for Degenerative Lumbar Spine Disorders: A Subanalysis of the 10-year Follow-up Study. Spine (Phila Pa 1976) 2022; 47:1357-1361. [PMID: 35853095 PMCID: PMC9451944 DOI: 10.1097/brs.0000000000004400] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/01/2022] [Accepted: 03/14/2022] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective additional analysis of a prospective follow-up study. OBJECTIVES We aimed to find out whether poor postoperative sagittal alignment increases revisions for adjacent segment disease (ASD) after lumbar spine fusion (LSF) performed for degenerative lumbar spine disease. SUMMARY OF BACKGROUND DATA Revisions for ASD accumulate over time after LSF for degenerative lumbar spine disease. The etiology of ASD is considered multifactorial. Yet, the role of postoperative sagittal balance in this process remains controversial. MATERIALS AND METHODS A total of 215 consecutive patients who had undergone an elective LSF surgery for spinal stenosis with (80%) or without (20%) spondylolisthesis were analyzed. Spinal reoperations were collected from the hospital records. Preoperative and postoperative sagittal alignment were evaluated from standing radiographs. The risk of revisions for ASD was evaluated by Cox proportional hazards regression models. RESULTS We did not find the poor postoperative balance [pelvic incidence-lumbar lordosis (LL) >9°] to significantly increase the risk of revisions for ASD: crude hazard ratio (HR)=1.5 [95% confidence interval (CI): 0.8-2.7], adjusted (by age, sex, pelvic incidence, fusion length, and the level of the caudal end of fusion): HR=1.7 (95% CI: 0.9-3.3). We found higher LL outside the fusion segment (LL-segmental lordosis) to decrease the risk of revisions for ASD: HR=0.9 (95% CI: 0.9-1.0). CONCLUSION Poor sagittal balance has only a limited role as a risk factor for the revisions for ASD among patients with degenerative spinal disease. However, the risk for ASD might be the greatest among patients with reduced spinal mobility.
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Affiliation(s)
- Leevi A. Toivonen
- Department of Orthopaedics and Trauma, Faculty of Medicine and Life Sciences and Tampere University Hospital, University of Tampere, Tampere, Finland
| | - Heikki Mäntymäki
- Department of Orthopaedics and Trauma, Faculty of Medicine and Life Sciences and Tampere University Hospital, University of Tampere, Tampere, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Marko H. Neva
- Department of Orthopaedics and Trauma, Faculty of Medicine and Life Sciences and Tampere University Hospital, University of Tampere, Tampere, Finland
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Oikkonen J, Virtanen A, Li Y, Isoviita VM, Zhang K, Jamalzadeh S, Marchi G, Häkkinen A, Muranen T, Lahtinen A, Hietanen S, Huhtinen K, Hynninen J, Hautaniemi S. 582P Longitudinal, multi-sample characterization of HGSC from DECIDER: A Finnish observational study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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de Zwart AH, Dekker J, Roorda LD, van der Esch M, Lips P, van Schoor NM, Heijboer AC, Turkstra F, Gerritsen M, Häkkinen A, Bennell K, Steultjens MP, Lems WF, van der Leeden M. High-intensity versus low-intensity resistance training in patients with knee osteoarthritis: A randomized controlled trial. Clin Rehabil 2022; 36:952-967. [PMID: 35331018 DOI: 10.1177/02692155211073039] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To assess whether (i) high-intensity resistance training (RT) leads to increased muscle strength compared to low-intensity RT in patients with knee osteoarthritis (OA); and (ii) RT with vitamin D supplementation leads to increased muscle strength compared to placebo in a subgroup with vitamin D deficiency. DESIGN Randomized controlled trial. SETTING Outpatient rehabilitation centre. SUBJECTS Patients with knee OA. INTERVENTIONS 12 weeks of RT at high-intensity RT (70-80% of 1-repetition maximum (1-RM)) or low-intensity RT (40-50% of 1-RM) and 24 weeks of vitamin D (1200 International units vitamin D3 per day) or placebo supplementation. MAIN MEASURES Primary outcome measure was isokinetic muscle strength. Other outcome measure for muscle strength was the estimated 1-RM. Secondary outcome measures were knee pain and physical functioning. RESULTS 177 participants with a mean age of 67.6 ± 5.8 years were included, of whom 50 had vitamin D deficiency. Isokinetic muscle strength (in Newton metre per kilogram bodyweight) at start, end and 24 weeks after the RT was 0.98 ± 0.40, 1.11 ± 0.40, 1.09 ± 0.42 in the high-intensity group and 1.02 ± 0.41, 1.15 ± 0.42, 1.12 ± 0.40 in the low-intensity group, respectively. No differences were found between the groups, except for the estimated 1-RM in favour of the high-intensity group. In the subgroup with vitamin D deficiency, no difference on isokinetic muscle strength was found between the vitamin D and placebo group. CONCLUSIONS High-intensity RT did not result in greater improvements in isokinetic muscle strength, pain and physical functioning compared to low-intensity RT in knee OA, but was well tolerated. Therefore these results suggest that either intensity of resistance training could be utilised in exercise programmes for patients with knee osteoarthritis. No synergistic effect of vitamin D supplementation and RT was found, but this finding was based on underpowered data.
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Affiliation(s)
- Arjan H de Zwart
- Reade, Amsterdam Rehabilitation Research Centre, Amsterdam, The Netherlands
| | - Joost Dekker
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam, the Netherlands
- Amsterdam Public Health research institute, Amsterdam UMC, Amsterdam, the Netherlands
| | - Leo D Roorda
- Reade, Amsterdam Rehabilitation Research Centre, Amsterdam, The Netherlands
| | - Martin van der Esch
- Reade, Amsterdam Rehabilitation Research Centre, Amsterdam, The Netherlands
- Center of expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Paul Lips
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Internal Medicine, Endocrine Section, VU University Medical Center, Amsterdam, The Netherlands
| | - Natasja M van Schoor
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Annemiek C Heijboer
- Amsterdam UMC, Vrije Universiteit Amsterdam, Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam, the Netherlands
- Amsterdam UMC, University of Amsterdam, Laboratory of Endocrinology, Department of Clinical Chemistry, Amsterdam, the Netherlands
| | - Franktien Turkstra
- Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, Netherlands
| | - Martijn Gerritsen
- Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, Netherlands
| | - Arja Häkkinen
- Health Sciences in the Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Central Finland Health Care District, Jyväskylä, Finland
| | - Kim Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Willem F Lems
- Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rheumatology, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Marike van der Leeden
- Reade, Amsterdam Rehabilitation Research Centre, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam, the Netherlands
- Amsterdam Public Health research institute, Amsterdam UMC, Amsterdam, the Netherlands
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Toivonen L, Pekkanen L, Neva MH, Kautiainen H, Kyrölä K, Marttinen I, Häkkinen A. Disability, Health-Related Quality of Life and Mortality in Lumbar Spine Fusion Patients-A 5-Year Follow-Up and Comparison With a Population Sample. Global Spine J 2022; 12:1052-1057. [PMID: 33203243 PMCID: PMC9210235 DOI: 10.1177/2192568220972977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
STUDY DESIGN Prospective follow-up study. OBJECTIVES We aimed to assess the effect of lumbar spine fusion (LSF) on disability, health-related quality of life and mortality in a 5-year follow-up, and to compare these results with the general population. METHODS 523 consecutive LSF operations were included in a prospective follow-up. Disability was assessed by the Oswestry Disability Index (ODI), and HRQoL by the 36-item Short Form (SF-36) questionnaire using the physical and mental summary scores (PCS and MCS). The patients were compared with an age-, sex-, and residential area matched general population cohort. RESULTS The preoperative ODI in the patients was 46 (SD 16), and the change at 5 years was -26 (95% CI: -24 to -28), p < 0.001. In the population, ODI (baseline 13, SD 16) remained unchanged. The preoperative PCS in the patients was 27 (SD 7), in the population 45 (SD 11), and the increase in the patients at 5 years was 8 (95% CI: 7 to 9), p < 0.001. The patients did not reach the population in ODI or PCS. The baseline MCS in the patients was 47 (SD 13), and the change at 5 years 4 (95% CI: 3 to 7), p < 0.001. MCS of the females reached the population at 5-year follow-up. When analyzing short and long fusions separately, comparable changes were seen in both subgroups. There was no difference in mortality between the patients (3.4%) and the population (4.8%), hazard ratio (HR) 0.86. CONCLUSIONS Although the patients who had undergone LSF benefited from surgery still at 5 years, they never reached the physical level of the population.
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Affiliation(s)
- Leevi Toivonen
- Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland
- Leevi Toivonen, Department of Orthopedics and Traumatology, Tampere University Hospital, Elämänaukio 2, 33520 Tampere, Finland.
| | - Liisa Pekkanen
- Department of Orthopedics and Traumatology, Central Finland Health Care District, Jyväskylä, Finland
| | - Marko H. Neva
- Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland
| | - Hannu Kautiainen
- Unit of Family Practice, Central Finland Health Care District, Jyväskylä, Finland
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Kati Kyrölä
- Department of Orthopedics and Traumatology, Central Finland Health Care District, Jyväskylä, Finland
| | - Ilkka Marttinen
- Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland
| | - Arja Häkkinen
- Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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12
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Häkkinen K, Newton RU, Walker S, Häkkinen A, Krapi S, Rekola R, Koponen P, Kraemer WJ, Haff GG, Blazevich AJ, Nosaka K, Ahtiainen J. Effects of Upper Body Eccentric versus Concentric Strength Training and Detraining on Maximal Force, Muscle Activation, Hypertrophy and Serum Hormones in Women. J Sports Sci Med 2022; 21:200-213. [PMID: 35719226 PMCID: PMC9157521 DOI: 10.52082/jssm.2022.200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/25/2022] [Indexed: 05/15/2023]
Abstract
Effects of eccentric (ECC) versus concentric (CON) strength training of the upper body performed twice a week for 10 weeks followed by detraining for five weeks on maximal force, muscle activation, muscle mass and serum hormone concentrations were investigated in young women (n = 11 and n = 12). One-repetition bench press (1RM), maximal isometric force and surface electromyography (EMG) of triceps brachii (TB), anterior deltoid (AD) and pectoralis major (PM), cross-sectional area (CSA) of TB (Long (LoH) and Lateral Head (LaH)) and thickness of PM, as well as serum concentrations of free testosterone, cortisol, follicle-stimulating hormone, estradiol and sex hormone-binding globulin were measured. ECC and CON training led to increases of 17.2 ± 11.3% (p < 0.001) and 13.1 ± 5.7% (p < 0.001) in 1RM followed by decreases of -6.6 ± 3.6% (p < 0.01) and -8.0 ± 4.5% (p < 0.001) during detraining, respectively. Isometric force increased in ECC by 11.4 ± 9.6 % (p < 0.05) from week 5 to 10, while the change in CON by 3.9±6.8% was not significant and a between group difference was noted (p < 0.05). Maximal total integrated EMG of trained muscles increased only in the whole subject group (p < 0.05). CSA of TB (LoH) increased in ECC by 8.7 ± 8.0% (p < 0.001) and in CON by 3.4 ± 1.6% (p < 0.01) and differed between groups (p < 0.05), and CSA of TB (LaH) in ECC by 15.7 ± 8.0% (p < 0.001) and CON by 9.7 ± 6.6% (p < 0.001). PM thickness increased in ECC by 17.7 ± 10.9% (p < 0.001) and CON by 14.0 ± 5.9% (p < 0.001). Total muscle sum value (LoH + LaH + PM) increased in ECC by 12.4 ± 6.9% (p < 0.001) and in CON by 7.1 ± 2.9% (p < 0.001) differing between groups (p < 0.05) and decreased during detraining in ECC by -6.5 ± 4.3% (p < 0.001) and CON by -6.1 ± 2.8% (p < 0.001). The post detraining combined sum value of CSA and thickness was in ECC higher (p < 0.05) than at pre training. No changes were detected in serum hormone concentrations, but baseline free testosterone levels in the ECC and CON group combined correlated with changes in 1RM (r = 0.520, p < 0.016) during training. Large neuromuscular adaptations of the upper body occurred in women during ECC, and CON training in 10 weeks. Isometric force increased only in response to ECC, and total muscle sum value increased more during ECC than CON training. However, no changes occurred in serum hormones, but individual serum-free testosterone baseline concentrations correlated with changes in 1RM during strength training in the entire group. Both groups showed significant decreases in neuromuscular performance and muscle mass during detraining, while post detraining muscle sum value was only in ECC significantly higher than at pre training.
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Affiliation(s)
- Keijo Häkkinen
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Robert U Newton
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Australia
| | - Simon Walker
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Sonja Krapi
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Rebekka Rekola
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Päivi Koponen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH and Exercise Medicine Research Institute, Edith Cowan University, Australia
| | - G Gregory Haff
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Australia
| | - Anthony J Blazevich
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Australia
| | - Kazunori Nosaka
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Australia
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Australia
| | - Juha Ahtiainen
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
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13
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Kyrölä K, Hiltunen S, Uimonen MM, Ylinen J, Häkkinen A, Repo JP. Psychometric Properties of the Scoliosis Research Society Questionnaire (Version 22r) Domains Among Adults With Spinal Deformity: A Rasch Measurement Theory Analysis. Neurospine 2022; 19:422-433. [PMID: 35577333 PMCID: PMC9260537 DOI: 10.14245/ns.2143354.677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/10/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Adult spinal deformity (ASD) have lower health-related quality of life (HRQoL) compared to the general population. Applying Rasch measurement theory (RMT), this study tested the revised Scoliosis Research Society-22 (SRS-22r) HRQoL instrument among symptomatic adult patients with degenerative spinal disorders and varying degrees of ASD.
Methods SRS-22r data from 637 outpatient spine clinic patients with degenerative spine conditions were investigated for unidimensionality, item/scale fit, differential item functioning (DIF), scale coverage/targeting, and person separation index (PSI) using RMT.
Results Unidimensionality of the SRS-22r was not supported for either the total score or for 3 of its 5 domains. Item fit was acceptable for 11/22 items. The individual domains showed good coverage despite the degree of structural disorders. Ordered thresholds were achieved by merging response categories in some of the items. DIF towards age or sex was found in 11/22 items and in some domain items. The PSI exceeded 0.7 for the SRS-22r total score.
Conclusion The individual domain scores of the SRS-22r perform better than the total score providing good coverage and targeting among patients with ASD. Refinements of items and domains may improve the structural validity of the instrument to meet the criteria for measuring ASD patients, even when multidimensionality persists.
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Affiliation(s)
- Kati Kyrölä
- Department of Surgery, Central Finland Healthcare District, Jyväskylä, Finland
- Corresponding Author Kati Kyrölä Department of Orthopaedics, Central Finland Healthcare District, Hospital Nova, Hoitajantie 3, 40620 Jyväskylä, Finland
| | - Susanna Hiltunen
- Department of Surgery, Central Finland Healthcare District, Jyväskylä, Finland
- Department of Orthopaedics, Kuopio University Hospital, Kuopio, Finland
| | - Mikko M. Uimonen
- Department of Surgery, Central Finland Healthcare District, Jyväskylä, Finland
| | - Jari Ylinen
- Department of Physical Medicine and Rehabilitation, Central Finland Healthcare District, Jyväskylä, Finland
| | - Arja Häkkinen
- Department of Physical Medicine and Rehabilitation, Central Finland Healthcare District, Jyväskylä, Finland
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jussi P. Repo
- Department of Surgery, Central Finland Healthcare District, Jyväskylä, Finland
- Department of Orthopaedics and Traumatology, Unit of Musculoskeletal Disease, Tampere University Hospital, Tampere, Finland
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14
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Määttä J, Takatalo J, Leinonen T, Pienimäki T, Ylinen J, Häkkinen A. Lower thoracic spine extension mobility is associated with higher intensity of thoracic spine pain. J Man Manip Ther 2022; 30:300-308. [PMID: 35257630 PMCID: PMC9487940 DOI: 10.1080/10669817.2022.2047270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives To evaluate the association of thoracic spine (TS) posture and mobility with TS pain. Methods Participants with TS pain reported maximum, average, and night pain in TS area, and pain summary score was calculated. Upright and sitting TS postures were evaluated by inspection. TS posture and mobility (flexion and extension) were recorded using an inclinometer and a tape measure, respectively. Correlations between posture and mobility assessments were calculated using Spearman rank correlation, the association of TS posture and mobility with TS pain by logistic regression analysis. Results The participants’ (n = 73, 52 females, age range 22–56) TS pain duration was 12 weeks on average. The correlations for measurements of TS posture and flexion mobility were higher than correlations of other TS measurements being between 0.53 and 0.82. Decreased extension mobility of the upper (from 1st to 6th TS segments; Th1–Th6) TS was associated with higher worst pain (OR 1.04, 95% CI 1.00–1.07) and whole TS with pain sum score (OR 1.05, 95% CI 1.01–1.08). Less kyphotic whole TS was associated with lower pain sum score (OR 0.96, 95% CI 0.92–1.00). Greater flexion mobility of upper and lower (Th6–Th12) TS were associated with lower pain sum score (OR 0.96, 95% CI 0.91–1.00, and OR 0.96, 95% CI 0.91–1.00, respectively). Conclusions Reduced thoracic extension mobility was associated with higher pain scores and the greater flexion mobility with lower pain scores. Future research is warranted to evaluate if treatments geared toward TS extension mobility improvements would result in lower TS pain.
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Affiliation(s)
- Juhani Määttä
- Medical Research Center Oulu, University of Oulu, Oulu, Finland.,Loisto Terveys, Oulu, Finland
| | - Jani Takatalo
- Medical Research Center Oulu, University of Oulu, Oulu, Finland.,Loisto Terveys, Oulu, Finland.,Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tero Leinonen
- Loisto Terveys, Oulu, Finland.,Fysios Oulu, Oulu, Finland
| | - Tuomo Pienimäki
- Department of Physical and Rehabilitation Medicine, University of Oulu, Oulu, Finland
| | - Jari Ylinen
- Central Hospital of Central Finland, Jyväskylä, Finland
| | - Arja Häkkinen
- Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Central Hospital of Central Finland, Jyväskylä, Finland
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15
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Appelqvist-Schmidlechner K, Raitanen J, Vasankari T, Kyröläinen H, Häkkinen A, Honkanen T, Vaara JP. Relationship Between Accelerometer-Based Physical Activity, Sedentary Behavior, and Mental Health in Young Finnish Men. Front Public Health 2022; 10:820852. [PMID: 35252097 PMCID: PMC8894611 DOI: 10.3389/fpubh.2022.820852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/26/2022] [Indexed: 11/13/2022] Open
Abstract
Healthy lifestyle behaviors including physical activity (PA) have been recognized to contribute positively to mental health. Most of the evidence on relationship between PA and mental health relies on self-reported PA results. Device-based measures on PA or sedentary behavior (SB) are less frequently used in mental health research. The present study aimed at examining the relationship between mental health and PA/SB measured by accelerometers in young Finnish men. The sample consisted of 409 men (mean age 28 ± 7 years), who participated in the military refresher training in Finland. Self-rated mental health was measured with Mental Health Inventory (MHI-5) and short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) measuring mental health both from the perspective of mental health problems and mental well-being. PA was measured with accelerometer from the perspective of light, moderate, vigorous, and total activity, as well as SB. Linear regression models and compositional analysis were applied. Age, education, marital status, employment status, BMI, alcohol use and smoking were used as covariates. Evidence on relationship between total PA (standardized regression coefficient 0.340; 95% CI 0.022–0.657, p = 0.036) and SB (standardized regression coefficient −0.340; 95% CI −0.657 to −0.022, p = 0.036) with symptoms of mental health problems was found after adjusting for age, education, marital and employment status. The relationship was marginally significant (p = 0.056) after adjusting also for BMI, alcohol use and smoking. No evidence on relationship between PA or SB and mental well-being was found, neither in standard linear regression analysis nor in compositional approach. In our sample of young adult men, PA seemed to have a stronger relationship with symptoms of mental health problems rather than with mental well-being. The findings lead to a conclusion that all PA per se may not be independently associated with mental well-being in young adult males and raise the question whether the domain of PA and its context play a critical role in these relationships.
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Affiliation(s)
- Kaija Appelqvist-Schmidlechner
- Finnish Institute for Health and Welfare, Mental Health Unit, Helsinki, Finland
- Centre for Military Medicine, Helsinki, Finland
- *Correspondence: Kaija Appelqvist-Schmidlechner
| | - Jani Raitanen
- Urho Kaleva Kekkonen Institute for Health Promotion Research, Tampere, Finland
- Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland
| | - Tommi Vasankari
- Urho Kaleva Kekkonen Institute for Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Heikki Kyröläinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Department of Physical Medicine and Rehabilitation, Central Hospital of Central Finland, Jyväskylä, Finland
| | | | - Jani P. Vaara
- Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
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16
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Toivonen LA, Mäntymäki H, Häkkinen A, Kautiainen H, Neva MH. Isthmic Spondylolisthesis is Associated with Less Revisions for Adjacent Segment Disease After Lumbar Spine Fusion Than Degenerative Spinal Conditions: A 10-Year Follow-Up Study. Spine (Phila Pa 1976) 2022; 47:303-308. [PMID: 35068470 PMCID: PMC8772434 DOI: 10.1097/brs.0000000000004242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 07/29/2021] [Accepted: 08/17/2021] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective, follow-up study. OBJECTIVE We aim to compare the rate of revisions for ASD after LSF surgery between patients with IS and DLSD. SUMMARY OF BACKGROUND DATA ASD is a major reason for late reoperations after LSF surgery. Several risk factors are linked to the progression of ASD, but the understanding of the underlying mechanisms is imperfect. If IS infrequently becomes complicated with ASD, it would emphasize the role of the ongoing degenerative process in spine in the development of ASD. METHODS 365 consecutive patients that underwent elective LSF surgery were followed up for an average of 9.7 years. Surgical indications were classified into 1) IS (n = 64), 2) DLSD (spinal stenosis with or without spondylolisthesis) (n = 222), and 3) other reasons (deformities, postoperative conditions after decompression surgery, posttraumatic conditions) (n = 79). All spinal reoperations were collected from hospital records. Rates of revisions for ASD were determined using Kaplan-Meier methods. RESULTS Altogether, 65 (17.8%) patients were reoperated for ASD. The incidences of revisions for ASD in subgroups were 1) 4.8% (95% CI: 1.6%-22.1%); 2) 20.5% (95% CI: 15.6%-26.7%); 3) 20.6% (95% CI: 12.9%-31.9%). After adjusting the groups by age, sex, fusion length, and the level of the caudal end of fusion, when comparing with IS group, the other groups had significantly higher hazard ratios (HR) for the revision for ASD [2) HR (95% CI) 3.92 (1.10-13.96), P = 0.035], [3) HR (95% CI) of 4.27 (1.11-15.54), P = 0.036]. CONCLUSION Among patients with IS, the incidence of revisions for ASD was less than a 4th of that with DLSD. Efforts to prevent the acceleration of the degenerative process at the adjacent level of fusion are most important with DLSD.Level of Evidence: 3.
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Affiliation(s)
- Leevi A. Toivonen
- Department of Orthopaedics and Trauma, University of Tampere, Faculty of Medicine and Life Sciences and Tampere University Hospital, Tampere, Finland
| | - Heikki Mäntymäki
- Department of Orthopaedics and Trauma, University of Tampere, Faculty of Medicine and Life Sciences and Tampere University Hospital, Tampere, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Marko H. Neva
- Department of Orthopaedics and Trauma, University of Tampere, Faculty of Medicine and Life Sciences and Tampere University Hospital, Tampere, Finland
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17
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Rajavuori A, Repo JP, Häkkinen A, Palonen P, Multanen J, Aukee P. Maternal risk factors of urinary incontinence during pregnancy and postpartum: A prospective cohort study. Eur J Obstet Gynecol Reprod Biol X 2021; 13:100138. [PMID: 34825175 PMCID: PMC8605044 DOI: 10.1016/j.eurox.2021.100138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/30/2021] [Accepted: 11/04/2021] [Indexed: 11/18/2022] Open
Abstract
Urinary incontinence after delivery affects every fifth woman. Urinary incontinence before pregnancy is a risk factor of postpartum incontinence. Primiparous women are at a greater risk of urinary incontinence after birth.
Introduction Urinary incontinence (UI) during pregnancy is a common health problem. Vaginal delivery in particular affects the pelvic floor and increases the risk of pelvic floor dysfunctions. This prospective cohort study was conducted to investigate the incidence of UI during pregnancy and three months postpartum and determine the risk factors underlying UI. Methods In total, 547 volunteer women were recruited from the maternity clinic of a tertiary hospital. The participants filled out a questionnaire twice, one in the second trimester and the other three months after delivery. A multivariate logistic regression model with forward stepwise selection was used to analyze known risk factors for UI. Results The prevalence of UI during pregnancy was 39.5% and three months after childbirth 16.1%. Twenty-two percent of participants had pre-existing UI compared to 41.0% of the 88 women with UI three months postpartum. UI before pregnancy (OR 2.2), during pregnancy (OR 3.8) and primiparity (OR 2.3) were significantly associated with postpartum UI. Conclusions Women with UI before or during pregnancy and who are primiparous are at increased risk for postpartum UI. To prevent and reduce the risk factors contributing to UI, pregnant women should be routinely counseled.
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Affiliation(s)
- Anna Rajavuori
- Department of Obstetrics and Gynecology, Turku University Hospital, PL 52, 20521 Turku, Finland
- Correspondence to: TYKS Obstetrics and Gynecology, PL 52, 20521 Turku, Finland.
| | - Jussi P. Repo
- Department of Orthopedics and Traumatology, Tampere University Hospital, PL 2000, 33521 Tampere, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, PL 35, FI-40014 Jyväskylän yliopisto, Finland
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Hoitajantie 3, 40620 Jyväskylä, Finland
| | - Pirkko Palonen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Hoitajantie 3, 40620 Jyväskylä, Finland
| | - Juhani Multanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, PL 35, FI-40014 Jyväskylän yliopisto, Finland
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Hoitajantie 3, 40620 Jyväskylä, Finland
| | - Pauliina Aukee
- Department of Obstetrics and Gynecology and Pelvic Floor Research and Therapy Unit, Central Finland Health Care Center, Hoitajantie 3, 40620 Jyväskylä, Finland
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18
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Multanen J, Häkkinen A, Kautiainen H, Ylinen J. Associations of neck muscle strength and cervical spine mobility with future neck pain and disability: a prospective 16-year study. BMC Musculoskelet Disord 2021; 22:911. [PMID: 34715847 PMCID: PMC8556991 DOI: 10.1186/s12891-021-04807-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 10/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background Neck pain has been associated with weaker neck muscle strength and decreased cervical spine range of motion. However, whether neck muscle strength or cervical spine mobility predict later neck disability has not been demonstrated. In this 16-year prospective study, we investigated whether neck muscle strength and cervical spine mobility are associated with future neck pain and related disability in women pain-free at baseline. Methods Maximal isometric neck muscle strength and passive range of motion (PROM) of the cervical spine of 220 women (mean age 40, standard deviation (SD) 12 years) were measured at baseline between 2000 and 2002. We conducted a postal survey 16 years later to determine whether any subjects had experienced neck pain and related disability. Linear regression analysis adjusted for age and body mass index was used to determine to what extent baseline neck strength and PROM values were associated with future neck pain and related disability assessed using the Neck Disability Index (NDI). Results The regression analysis Beta coefficient remained below 0.1 for all the neck strength and PROM values, indicating no association between neck pain and related disability. Of the 149 (68%) responders, mean NDI was lowest (3.3, SD 3.8) in participants who had experienced no neck pain (n = 50), second lowest (7.7, SD 7.1) in those who had experienced occasional neck pain (n = 94), and highest (19.6, SD 22.0) in those who had experienced chronic neck pain (n = 5). Conclusions This 16-year prospective study found no evidence for an association between either neck muscle strength or mobility and the occurrence in later life of neck pain and disability. Therefore, screening healthy subjects for weaker neck muscle strength or poorer cervical spine mobility cannot be recommended for preventive purposes.
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Affiliation(s)
- Juhani Multanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland. .,Department of Physical Medicine and Rehabilitation, Central Finland Hospital, Jyväskylä, Finland.
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Finland Hospital, Jyväskylä, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Jari Ylinen
- Department of Physical Medicine and Rehabilitation, Central Finland Hospital, Jyväskylä, Finland
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19
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Karhula ME, Kanelisto K, Hämäläinen P, Ruutiainen J, Era P, Häkkinen A, Salminen AL. Self-reported Reasons for Changes in Performance of Everyday Activities During a 2-Year Multidisciplinary Multiple Sclerosis Rehabilitation. Int J MS Care 2021; 24:110-116. [DOI: 10.7224/1537-2073.2020-061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Abstract
Background: Few multidisciplinary rehabilitation studies with a heterogeneous design have focused on people with multiple sclerosis (MS). This study compared subjective-reported changes in performance and satisfaction with daily activities among moderately and severely disabled people with MS during a 2-year, multidisciplinary, group-based, outpatient rehabilitation program comprising education in self-management and compensatory techniques, exercise, and guided peer support.
Methods: Thirty-eight adults with moderate disability (Expanded Disability Status Scale [EDSS] score of 4.0–5.5, 74% women, mean age of 48 years) and 41 persons with severe disability (EDSS 6.0–8.5, 63% women, mean age of 48 years) were assessed at baseline and after 12 and 21 months of outpatient rehabilitation using the Canadian Occupational Performance Measure. Group × time interactions were analyzed using mixed analysis of variance. Participants’ explanations of reasons for changes in activity performance were collected via semistructured interviews and content analyzed.
Results: Statistically significant improvements in Canadian Occupational Performance Measure performance and satisfaction scores were reported in both groups from baseline to 21 months of rehabilitation. No significant between-group differences in improvement were observed. The self-reported reasons for improvement were mainly linked to environmental factors.
Conclusions: The outpatient rehabilitation program, including four themes—cognition, mood, energy conservation, and body control—improved the self-reported performance of patients with MS with moderate and severe disabilities. Environmental factors warrant consideration during rehabilitation.
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Affiliation(s)
- Maarit E. Karhula
- From the GeroCenter Foundation for Aging Research and Development (MEK, KK, PE) and Faculty of Sport and Health Sciences (AH), University of Jyväskylä, Jyväskylä, Finland; South-Eastern Finland University of Applied Sciences, Mikkeli, Finland (MEK); Masku Neurological Rehabilitation Centre, Masku, Finland (PH); Finnish Neuro Society, Masku, Finland (PH, JR); University of Turku, Turku, Finland (P
| | - Katja Kanelisto
- From the GeroCenter Foundation for Aging Research and Development (MEK, KK, PE) and Faculty of Sport and Health Sciences (AH), University of Jyväskylä, Jyväskylä, Finland; South-Eastern Finland University of Applied Sciences, Mikkeli, Finland (MEK); Masku Neurological Rehabilitation Centre, Masku, Finland (PH); Finnish Neuro Society, Masku, Finland (PH, JR); University of Turku, Turku, Finland (P
| | - Päivi Hämäläinen
- From the GeroCenter Foundation for Aging Research and Development (MEK, KK, PE) and Faculty of Sport and Health Sciences (AH), University of Jyväskylä, Jyväskylä, Finland; South-Eastern Finland University of Applied Sciences, Mikkeli, Finland (MEK); Masku Neurological Rehabilitation Centre, Masku, Finland (PH); Finnish Neuro Society, Masku, Finland (PH, JR); University of Turku, Turku, Finland (P
| | - Juhani Ruutiainen
- From the GeroCenter Foundation for Aging Research and Development (MEK, KK, PE) and Faculty of Sport and Health Sciences (AH), University of Jyväskylä, Jyväskylä, Finland; South-Eastern Finland University of Applied Sciences, Mikkeli, Finland (MEK); Masku Neurological Rehabilitation Centre, Masku, Finland (PH); Finnish Neuro Society, Masku, Finland (PH, JR); University of Turku, Turku, Finland (P
| | - Pertti Era
- From the GeroCenter Foundation for Aging Research and Development (MEK, KK, PE) and Faculty of Sport and Health Sciences (AH), University of Jyväskylä, Jyväskylä, Finland; South-Eastern Finland University of Applied Sciences, Mikkeli, Finland (MEK); Masku Neurological Rehabilitation Centre, Masku, Finland (PH); Finnish Neuro Society, Masku, Finland (PH, JR); University of Turku, Turku, Finland (P
| | - Arja Häkkinen
- From the GeroCenter Foundation for Aging Research and Development (MEK, KK, PE) and Faculty of Sport and Health Sciences (AH), University of Jyväskylä, Jyväskylä, Finland; South-Eastern Finland University of Applied Sciences, Mikkeli, Finland (MEK); Masku Neurological Rehabilitation Centre, Masku, Finland (PH); Finnish Neuro Society, Masku, Finland (PH, JR); University of Turku, Turku, Finland (P
| | - Anna-Liisa Salminen
- From the GeroCenter Foundation for Aging Research and Development (MEK, KK, PE) and Faculty of Sport and Health Sciences (AH), University of Jyväskylä, Jyväskylä, Finland; South-Eastern Finland University of Applied Sciences, Mikkeli, Finland (MEK); Masku Neurological Rehabilitation Centre, Masku, Finland (PH); Finnish Neuro Society, Masku, Finland (PH, JR); University of Turku, Turku, Finland (P
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20
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Multanen J, Uimonen MM, Repo JP, Häkkinen A, Ylinen J. Use of conservative therapy before and after surgery for carpal tunnel syndrome. BMC Musculoskelet Disord 2021; 22:484. [PMID: 34039330 PMCID: PMC8157685 DOI: 10.1186/s12891-021-04378-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background Conservative therapies are typically offered to individuals who experience mild or intermittent symptoms of carpal tunnel syndrome (CTS) or postoperatively to subjects who have undergone carpal tunnel release. Although long-term studies report mostly positive results for carpal tunnel release, knowledge on the need for conservative treatments following surgery is scarce. The aim of this retrospective cohort study was to examine the use of conservative therapies before and after carpal tunnel releasing surgery. Methods Of 528 patients who underwent carpal tunnel release surgery in the study hospital during the study period, 259 provided sufficiently completed questionnaires (response rate 49 %). The patients completed a questionnaire battery including a sociodemographic, medical history and symptom questionnaire, the Boston Carpal Tunnel Syndrome Questionnaire, 6-item CTS symptoms scale and EuroQoL 5D. Frequencies of conservative therapies pre- and postoperatively were calculated. Association between Pain VAS and satisfaction with treatment were examined in patient groups according to the use of conservative therapies. Results Of all patients, 41 (16 %) reported receiving only preoperative, 18 (7 %) reported receiving only postoperative, 157 (60 %) reported receiving both pre- and postoperative conservative therapies and 43 (17 %) did not receive any therapies. Preoperative use of conservative therapies was more common in females than males (82 % vs. 64 %; p = 0.002), but postoperatively no significant gender difference was observed. The patients who received conservative therapies were younger than non-users in both the preoperative (median age 59 vs. 66; p < 0.001) and postoperative (59 vs. 66; p = 0.04) phases. The patients reported high satisfaction with their treatment and simultaneous improvement in Pain VAS scores. Those receiving conservative therapies only preoperatively reported the highest satisfaction. Conclusions While the use of conservative therapies decreased after surgery, a large proportion of the patients received these adjunct interventions. Patients reported high satisfaction with their treatment one year post surgery. Pain outcome seems to be closely related to satisfaction with treatment. Level of Evidence Level III.
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Affiliation(s)
- Juhani Multanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland. .,Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland.
| | - Mikko M Uimonen
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
| | - Jussi P Repo
- Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
| | - Jari Ylinen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
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21
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Uimonen M, Repo JP, Grönroos K, Häkkinen A, Walker S. Validity and reliability of the motivation for physical activity (RM4-FM) questionnaire. J Exerc Rehabil 2021; 17:103-111. [PMID: 34012936 PMCID: PMC8103190 DOI: 10.12965/jer.2142194.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/25/2021] [Indexed: 11/22/2022] Open
Abstract
There is a lack of validated instruments measuring motivation for physical activity (RM4-FM) in the Finnish language. The study examined the translated RM4-FM instrument's psychometric properties in a sample of healthy, older Finnish adults. RM4-FM was translated and linguistically validated adhering to published guidelines. 65-75-year olds (n=102), completed the RM4-FM, the physical activity acceptance questionnaire (PAAQ) and sociodemographic characteristics questionnaires electronically. The RM4-FM was readministered one month after the initial assessment. RM4-FM translated well into Finnish. Motivation dimension scores were skewed towards high internal and low external motivation. A floor effect was confirmed in the external regulation dimension and a ceiling effect was confirmed in the identified regulation dimension. Confirmatory factor analysis indicated inadequacy of the four-dimension model. Separate assessment of each of the four motivation dimensions with Exploratory factor analysis showed unidimensionality for all dimensions. Exploratory factor analysis provided a best-fit model of three factors (influence of other people, intention of well-being and emotional aspect of motivation). Readministration of the instruments showed good test-retest reliability in all motivation dimensions. Female gender, higher education, and higher PAAQ score were associated with higher internal motivation and lower external motivation scores. The Finnish version of the RM4-FM instrument provides valid and reliable scores in assessing motivation for physical activity in healthy, older Finnish adults. The score distributions suggested shortages in the scale when evaluating internal motivation. The three-factor model of the RM4-FM provided more favorable structural validity compared to the original version.
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Affiliation(s)
- Mikko Uimonen
- Department of Surgery, Central Finland Health Care District, Jyväskylä, Finland
| | - Jussi P Repo
- Department of Surgery, Central Finland Health Care District, Jyväskylä, Finland
| | - Kiira Grönroos
- Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Arja Häkkinen
- Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Physical Medicine, Central Finland Health Care District, Jyväskylä, Finland
| | - Simon Walker
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
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22
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Appelqvist-Schmidlechner K, Kyröläinen H, Häkkinen A, Vasankari T, Mäntysaari M, Honkanen T, Vaara JP. Childhood Sports Participation Is Associated With Health-Related Quality of Life in Young Men: A Retrospective Cross-Sectional Study. Front Sports Act Living 2021; 3:642993. [PMID: 33969295 PMCID: PMC8100196 DOI: 10.3389/fspor.2021.642993] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/05/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of the study was to examine whether sports participation (SP), engagement in competitive sports (CS), and the type of sport undertaken at the age of 12 are associated with the physical and mental components of health-related quality of life (HRQoL) in young adulthood. The data were collected using questionnaires prior to a compulsory military refresher training course in Finland. The sample consisted of 784 men (mean age 26 years). HRQoL was measured with RAND 36 and childhood SP with a series of questions. Data were analyzed with logistic regression. Higher frequency of SP, participation in district-level CS; performing team, endurance, or extreme sports; and playing yard games in childhood were after adjustments all associated with better HRQoL in early adulthood. The association was mainly found with the mental component, and to a lesser extent with the physical component, of HRQoL. Team (OR 1.43, CI 1.00-2.06) and extreme sports (OR 1.77, CI 1.19-2.63) were associated with better mental HRQoL, while playing yard games (OR 0.62, CI 0.44-0.89) reduced the likelihood for having low physical HRQoL. SP in childhood-in the forms of team or individual sports, but also as informal physical activity, such as playing yard games-is associated with HRQoL in young adulthood.
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Affiliation(s)
- Kaija Appelqvist-Schmidlechner
- Finnish Institute for Health and Welfare, Mental Health Unit, Helsinki, Finland.,Centre for Military Medicine, Helsinki, Finland
| | - Heikki Kyröläinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
| | - Arja Häkkinen
- Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Tommi Vasankari
- Urho Kaleva Kekkonen Institute for Health Promotion, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | | | - Jani P Vaara
- Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
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23
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Toivonen L, Häkkinen A, Pekkanen L, Salonen A, Kautiainen H, Neva MH. Influence of Depressive Symptoms on the Outcome of Lumbar Spine Fusion-A 5-year Follow-up Study. Spine (Phila Pa 1976) 2021; 46:408-412. [PMID: 33181777 DOI: 10.1097/brs.0000000000003803] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective follow-up study. OBJECTIVE The aim of this study was to assess whether depressive symptoms change the outcome of lumbar spine fusion (LSF) surgery at a 5-year follow-up. SUMMARY OF BACKGROUND DATA Previous reports of the influence of depressive symptoms on the results of spine surgery are controversial, but the patient characteristics and indications for surgery varied widely between the studies. The influence of depressive symptoms on the 5-year outcome of LSF has not been studied. METHODS The study was based on data from a local LSF database from two hospitals comprising 392 consecutive patients (mean age 61 years, 277 women) who underwent an instrumented LSF and fulfilled the 5-year follow-up. At the 5-year follow-up, the patients were compared with a control group from the general population (n = 477, age-, sex-, and residential area-matched) extracted from Official Statistics of Finland. The prevalence of depressive symptoms was evaluated using the Depression Scale (DEPS; 0-30) and disability was evaluated by the Oswestry Disability Index (ODI; 0-100%). A DEPS score ≥12 was considered to indicate depressive symptoms. RESULTS Before surgery, 35% of the patients had depressive symptoms. The proportion diminished to 13% at 3 months postoperatively and increased to 24% at 5 years. In the population, the prevalence was 11% at baseline and 10% at the 5-year follow-up. The preoperative ODI was 54 in the patients with depressive symptoms, and it was 41 in the patients with no depressive symptoms. The changes at 5-year follow-up were -20 and -18, correspondingly. The same congruence was preserved when analyzing short and long fusions separately. These changes were statistically and clinically significant. In the control population, the ODI remained around 24 in depressive people and 10 in nondepressive people. CONCLUSION Our data suggest that patients with and without depressive symptoms may benefit equally well from LSF. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Leevi Toivonen
- Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland
| | - Arja Häkkinen
- Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Liisa Pekkanen
- Department of Orthopedics and Traumatology, Central Finland Health Care District, Jyväskylä, Finland
| | - Anne Salonen
- Department of Pediatric Surgery, Tampere University Hospital, Tampere, Finland
| | - Hannu Kautiainen
- Unit of Family Practice, Central Finland Health Care District, Jyväskylä, Finland and Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Marko H Neva
- Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland
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24
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Ylinen J, Pennanen A, Weir A, Häkkinen A, Multanen J. Effect of biomechanical footwear on upper and lower leg muscle activity in comparison with knee brace and normal walking. J Electromyogr Kinesiol 2021; 57:102528. [PMID: 33647872 DOI: 10.1016/j.jelekin.2021.102528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 12/27/2020] [Accepted: 01/20/2021] [Indexed: 11/29/2022] Open
Abstract
AIM To evaluate the activity of knee stabilizing muscles while using custom-made biomechanical footwear (BF) and to compare it when walking barefoot and with a knee brace (Unloader®). METHODS Seventeen healthy working-aged (mean age: 29 years; standard deviation: 8 years) individuals participated. The knee brace was worn on the right knee and BF in both legs. Surface electromyography (sEMG) data was recorded bilaterally from vastus medialis (VM), semitendinosus (ST), tibialis anterior (TA) and lateral gastrocnemius (LG) muscles during walking, and repeated-measures ANOVA with a post-hoc t-test was used to determine differences between the different walking modalities (barefoot, brace and BF). RESULTS Averaged sEMG was significantly higher when walking with BF than barefoot or knee brace in the ST muscles, in the right LG, and left TA muscle. It was significantly lower when walking with the brace compared to barefoot in the right ST and LG muscles, and left TA muscle. Analysis of the ensemble-averaged sEMG profiles showed earlier activation of TA muscles when walking with BF compared to other walking modalities. CONCLUSION BF produced greater activation in evaluated lower leg muscles compared to barefoot walking. Thus BF may have an exercise effect in rehabilitation and further studies about its effectiveness are warranted.
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Affiliation(s)
- Jari Ylinen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland.
| | - Antti Pennanen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland.
| | - Adam Weir
- Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; Aspetar Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Hospital, Doha, Qatar; Sport Medicine and Exercise Clinic Haarlem (SBK), Haarlem, the Netherlands
| | - Arja Häkkinen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.
| | - Juhani Multanen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.
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25
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Pirnes KP, Kallio J, Kankaanpää A, Häkkinen A, Tammelin T. Associations of neck and shoulder pain with objectively measured physical activity and sedentary time among school-aged children. Scand J Pain 2020; 20:821-827. [PMID: 32892186 DOI: 10.1515/sjpain-2020-0038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 06/21/2020] [Indexed: 11/15/2022]
Abstract
Objectives The potential effects of physical activity and sedentary time on children's increasing neck and shoulder pain are unclear. The aim of this cross-sectional study was to evaluate the associations between objectively measured physical activity or sedentary time and neck and shoulder pain in children. Methods Children (n=905; 10-15 years old) filled in an electronic questionnaire during school hours on the frequency of their neck and shoulder pain. Daytime moderate to vigorous physical activity and sedentary time were measured objectively with an ActiGraph accelerometer. A multinomial logistic regression was applied to study the associations. The results were adjusted for age, gender, body mass index and bedtime. Results Neck and shoulder pain experienced at least once a week was reported by 26.1% of children. A higher proportion of boys (45.9%) than girls (24.2%) achieved at least 60 min of moderate to vigorous physical activity/day (p<0.001). Girls were more sedentary than boys (sedentary time 66.4 vs. 63.1%) (p<0.001). Higher moderate to vigorous physical activity time was associated with a lower probability of experiencing neck and shoulder pain among boys, but not among girls. No association was found between sedentary time and neck and shoulder pain. Conclusions A quarter of the girls and boys reported frequent neck and shoulder pain. Boys achieved more moderate to vigorous physical activity than girls and higher moderate to vigorous physical activity was associated with a lower probability of having neck and shoulder pain, but only in boys. Neck and shoulder pain is the most common musculoskeletal pain and its prevalence is increasing. Preventing childhood pain is important, as neck and shoulder pain causes restrictions in daily living and is persistent to adulthood. Our study showed, that boys with more moderate to vigorous physical activity, had less weekly neck and shoulder pain symptoms. The present results are an addition to the list of benefits of physical activity and are valuable to, for example, healthcare personnel and teachers, who guide and teach children and adolescents. Families can benefit from new knowledge when considering supportive parenting activities. Municipalities can use the new information to design services for children or families.
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Affiliation(s)
- Katariina Pauliina Pirnes
- Faculty of Sport and Health Sciences, Jyväskylän yliopisto, PL 35, 40014 Jyväskylän yliopisto, Finland
| | - Jouni Kallio
- Faculty of Sport and Health Sciences, Jyväskylän yliopisto, PL 35, 40014 Jyväskylän yliopisto, Finland
| | - Anna Kankaanpää
- Faculty of Sport and Health Sciences, Jyväskylän yliopisto, PL 35, 40014 Jyväskylän yliopisto, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, Jyväskylän yliopisto, PL 35, 40014 Jyväskylän yliopisto, Finland
| | - Tuija Tammelin
- Faculty of Sport and Health Sciences, Jyväskylän yliopisto, PL 35, 40014 Jyväskylän yliopisto, Finland
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26
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Multanen J, Ylinen J, Karjalainen T, Ikonen J, Häkkinen A, Repo JP. Structural validity of the Boston Carpal Tunnel Questionnaire and its short version, the 6-Item CTS symptoms scale: a Rasch analysis one year after surgery. BMC Musculoskelet Disord 2020; 21:609. [PMID: 32919457 PMCID: PMC7488577 DOI: 10.1186/s12891-020-03626-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/02/2020] [Indexed: 11/24/2022] Open
Abstract
Background The Boston Carpal Tunnel Questionnaire (BCTQ) and its shorter version, the Six-Item Carpal Tunnel Symptoms Scale (CTS-6), are widely used for assessing function and/or symptoms in patients with carpal tunnel syndrome. This study examined the structural validity of the BCTQ and CTS-6 among patients who had undergone surgery for treatment of carpal tunnel syndrome. Methods The data for this cross-sectional analysis were obtained from 217 adult patients who had undergone carpal tunnel release surgery 1 year earlier. All patients completed the CTS-6, Symptom Severity Scale (SSS) and Functional Status Scale (FSS) of the BCTQ at 12 months after surgery. The Rasch Measurement Theory (RMT) was applied to investigate the unidimensionality, residual correlation, differential item functioning, scale coverage/targeting, and person separation of the CTS-6, SSS and FSS of the BCTQ. Results The FSS showed unidimensionality and good scale and item fit. All items showed ordered response category thresholds. Eight of the FSS items displayed differential item functioning favoring age or gender. The multidimensional structure of the CTS-6 was absorbed by creating a testlet for frequency of symptoms or testlets for pain and numbness. The testlets supported unidimensionality in the BCTQ SSS. One item in the CTS-6 and two items in the BCTQ SSS showed differential item functioning favoring age or gender. Four items in the BCTQ SSS and two items in the CTS-6 exhibited disordered response category thresholds. Merging of the relevant response categories led to ordered response category thresholds. The person separation indices were 0.73, 0.86 and 0.77 for the CTS-6, BCTQ SSS and FSS, respectively. Conclusions Based on the RMT analysis, the CTS-6 has superior psychometric properties compared to the BCTQ SSS in surgically treated patients. The CTS-6 might be more accurate when separated into item sets measuring pain or numbness. The FSS of the BCTQ has acceptable construct validity, although gender differences at some ages were observed in responses.
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Affiliation(s)
- Juhani Multanen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland. .,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - Jari Ylinen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
| | - Teemu Karjalainen
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
| | - Joona Ikonen
- Department of Hand Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Arja Häkkinen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jussi P Repo
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
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Rissanen JA, Häkkinen A, Laukkanen J, Kraemer WJ, Häkkinen K. Acute Neuromuscular and Hormonal Responses to Different Exercise Loadings Followed by a Sauna. J Strength Cond Res 2020; 34:313-322. [PMID: 31490429 DOI: 10.1519/jsc.0000000000003371] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Rissanen, JA, Häkkinen, A, Laukkanen, J, Kraemer, WJ, and Häkkinen, K. Acute neuromuscular and hormonal responses to different exercise loadings followed by a sauna. J Strength Cond Res 34(2): 313-322, 2020-The purpose of this study was to investigate acute responses of endurance (E + SA), strength (S + SA), and combined endurance and strength exercise (C + SA) followed by a traditional sauna bath (70° C, 18% relative humidity) on neuromuscular performance and serum hormone concentrations. Twenty-seven recreationally physically active men who were experienced with taking a sauna participated in the study. All the subjects performed a sauna bath only (SA) first as a control measurement followed by S + SA and E + SA (paired matched randomization) and C + SA. Subjects were measured PRE (before exercise), MID (immediately after exercise and before sauna), POST (after sauna), POST30min (30 minutes after sauna), and POST24h (24 hours after PRE). Maximal isometric leg press (ILPFmax) and bench press (IBPFmax) forces, maximal rate of force development (RFD) and countermovement vertical jump (CMVJ), serum testosterone (TES), cortisol (COR), and 22-kD growth hormone (GH22kD) concentrations were measured. All exercise loadings followed by a sauna decreased ILPFmax (-9 to -15%) and RFD (-20 to -26%) in POST. ILPFmax, RFD, and CMVJ remained at significantly (p ≤ 0.05) lowered levels after S + SA in POST24h. IBPFmax decreased in POST in S + SA and C + SA and remained lowered in POST24h. SA decreased ILPFmax and IBPFmax in POST and POST30min and remained lowered in ILPFmax (-4.1%) at POST24h. GH22kD, TES, and COR elevated significantly in all loadings measured in the afternoon in MID. SA only led to an elevation (15%) in TES in POST. The strength exercise followed by a sauna was the most fatiguing protocol for the neuromuscular performance. Traditional sauna bathing itself seems to be strenuous loading, and it may not be recommended 24 hours before the next training session. A sauna bath after the loadings did not further change the hormonal responses recorded after the exercise loadings.
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Affiliation(s)
| | - Arja Häkkinen
- Health Sciences in the Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Central Finland Health Care District, Jyväskylä, Finland; and
| | - Jari Laukkanen
- Health Sciences in the Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Central Finland Health Care District, Jyväskylä, Finland; and
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, Ohio
| | - Keijo Häkkinen
- Neuromuscular Research Center, Biology of Physical Activity
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Takatalo J, Ylinen J, Pienimäki T, Häkkinen A. Intra- and inter-rater reliability of thoracic spine mobility and posture assessments in subjects with thoracic spine pain. BMC Musculoskelet Disord 2020; 21:529. [PMID: 32778081 PMCID: PMC7418198 DOI: 10.1186/s12891-020-03551-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 07/31/2020] [Indexed: 11/17/2022] Open
Abstract
Background The thoracic spine (TS) has been neglected in the study of the spine despite its essential role in the stability and posture of the entire spinal complex. Therefore, there is an inevitable need to investigate the reproducibility of different thoracic spinal posture measures used in subjects with TS pain. Methods Thirty-two subjects (16 females and 16 males, mean age 39 years) were evaluated by two physiotherapists on the same day to gauge inter-rater reliability and on two consecutive days to gauge intra-rater reliability. TS posture was assessed by observation, and thoracic spine mobility was measured by manual assessment of segmental flexion and extension mobility in a seated position. Additionally, posterior-to-anterior accessory mobility in a prone position was assessed manually. Moreover, cervicothoracic flexion in a seated position, thoracic posture, and thoracic flexion and extension mobility in a standing position were assessed with a tape measure, and flexion and extension mobility in a seated position and TS posture in seated and standing positions were measured with an inclinometer. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), mean difference (MD), Bland-Altman (B&A) plot features and coefficient of repeatability (CR) were calculated. Results The mean and standard deviation (SD) of the duration of TS pain was 22 (SD 45) months, with the intensity of pain being rated at 27 (SD 21) mm on a visual analogue scale (VAS). Intra-rater reliability was very strong (ICC ≥ 0.80) for the evaluation of seated and standing upper TS posture, standing whole TS posture and seated lower TS posture with an inclinometer. Moreover, TS posture evaluation with a measuring tape, posture inspection in a seated position, and manual assessment of segmental extension were found to have very strong intra-rater reliability. Inter-rater reliability was very strong for inclinometer measurements of standing and seated upper TS posture as well as standing whole TS posture. Conclusion Intra-rater reliability was higher than inter-rater reliability in most of the evaluated measurements. Overall, posture measurements with an inclinometer were more reliable than mobility measurements with the same instrument. The manual assessments can be used reliably when same evaluator performs the examination. Trial registration Clinical Trials, NCT01884818. Registered 24 June 2013, https://clinicaltrials.gov/ct2/show/NCT01884818?cond=thoracic+spine&cntry=FI&rank=1
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Affiliation(s)
- Jani Takatalo
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyväskylä, Finland. .,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
| | - Jari Ylinen
- Central Finland Central Hospital, Jyväskylä, Finland
| | - Tuomo Pienimäki
- The Social Insurance Institution of Finland, Helsinki, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyväskylä, Finland.,Central Finland Central Hospital, Jyväskylä, Finland
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29
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Abstract
AbstractThis study investigated acute hemodynamic, plasma volume and immunological
responses to four loading protocols: sauna only, and sauna after endurance,
strength or combined endurance and strength exercise. Twenty-seven healthy,
slightly prehypertensive men (age 32.7±6.9 years) were measured at PRE,
MID (after exercise), POST, POST30min and POST24h. The measurements consisted
systolic and diastolic blood pressure, heart rate, body temperature and
concentrations of high-sensitive C-reactive protein, white blood cells and
plasma volume measurements. Endurance+sauna showed significant decreases
in systolic blood pressure at POST (–8.9 mmHg), POST30min (–11.0
mmHg) and POST24h (–4.6 mmHg). At POST30min, significant decreases were
also observed in sauna (–4.3 mmHg) and combined+sauna
(–7.5 mmHg). Diastolic blood pressure decreased significantly from -5.4
to –3.9 mmHg at POST in all loadings. Plasma volume decreased
significantly at MID in all exercise loadings and at POST in
endurance+sauna and strength+sauna. Plasma volume increased
significantly (p < 0.01) in endurance+sauna and
combined+sauna at POST24h. White blood cells increased following all
exercise+sauna loadings at MID, POST and POST30min, whereas high
sensitive C-reactive protein showed no changes at any measurement point. The
combination of endurance exercise and sauna showed the greatest positive effects
on blood pressure. Both loadings including endurance exercise increased plasma
volume on the next day.
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Affiliation(s)
- Joonas Antero Rissanen
- Neuromuscular Research Center, Biology of Physical Activity, Faculty of
Sport and Health Sciences, University of Jyväskylä,
Jyväskylä, Finland
| | - Keijo Häkkinen
- Neuromuscular Research Center, Biology of Physical Activity, Faculty of
Sport and Health Sciences, University of Jyväskylä,
Jyväskylä, Finland
| | - Jari Antero Laukkanen
- Department of Physical Medicine and Rehabilitation, Central Finland
Central Hospital, Jyväskylä, Finland
- Health Sciences, Faculty of Sport and Health Sciences, University of
Jyväskylä, Jyväskylä, Finland
| | - Arja Häkkinen
- Department of Physical Medicine and Rehabilitation, Central Finland
Central Hospital, Jyväskylä, Finland
- Health Sciences, Faculty of Sport and Health Sciences, University of
Jyväskylä, Jyväskylä, Finland
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30
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Ilves O, Neva MH, Häkkinen K, Dekker J, Järvenpää S, Kyrölä K, Häkkinen A. Effectiveness of a 12-month home-based exercise program on trunk muscle strength and spine function after lumbar spine fusion surgery: a randomized controlled trial. Disabil Rehabil 2020; 44:549-557. [PMID: 32525413 DOI: 10.1080/09638288.2020.1772383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: The effectiveness of a 12-month home-exercise program on trunk muscle strength after lumbar spine fusion surgery was evaluated. Materials and methods: Three months postoperatively, 98 patients were randomized either to the exercise group (EG), with a progressive 12-month home-based exercise program, or to usual care group (UCG), with one guidance session for light home-exercises. Maximal trunk muscle strength was measured by a strain-gauge dynamometer and trunk extensor endurance was measured by Biering-Sørensen's test at baseline and after the intervention. Results: The mean change in extension strength during the intervention was 75 N in EG and 58 N in UCG. Flexion strength improved 50 N in UCG and 45 N in EG. Trunk extension/flexion strength ratio changed from 0.90 to 1.02 in EG and from 0.98 to 1.00 in UCG. In EG, Biering-Sørensen's test improved by 17 s, and in UCG, it improved by 24 s. No statistically significant between-group differences were found in any variables. Median exercise frequency in EG decreased from 2.5×/week during the first two intervention months to 1.7×/week during the last two intervention months. Conclusions: Twelve-month progressive exercise program was equally effective as usual care in improving trunk muscle strength. Home exercise adherence decreased, which may have influenced the strength changes.Implications for rehabilitationThe 12-month home-based exercise program was equally as effective as usual care after lumbar spine fusion (LSF) in improving trunk muscle strength, however, the back-specific exercises led to better trunk muscle strength balance in exercise group only.The adherence to the home based exercise program is a challenge; therefore, different techniques could be implemented to provide purposeful support for each individual in their long-term exercising.It is important to recognize those who need more individualized rehabilitation in recovery of the spine function, while others may manage with subtle intervention after LSF.
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Affiliation(s)
- Outi Ilves
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Marko H Neva
- Department of Orthopaedics and Trauma, Tampere University Hospital, Tampere, Finland
| | - Keijo Häkkinen
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Joost Dekker
- Department of Rehabilitation Medicine and Department of Psychiatry, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Salme Järvenpää
- Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä, Finland
| | - Kati Kyrölä
- Department of Orthopaedics and Trauma, Central Finland Health Care District, Jyväskylä, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä, Finland
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31
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Appelqvist-Schmidlechner K, Vaara JP, Vasankari T, Häkkinen A, Mäntysaari M, Kyröläinen H. Muscular and cardiorespiratory fitness are associated with health-related quality of life among young adult men. BMC Public Health 2020; 20:842. [PMID: 32493259 PMCID: PMC7268218 DOI: 10.1186/s12889-020-08969-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/21/2020] [Indexed: 11/17/2022] Open
Abstract
Background Despite numerous studies providing evidence for positive effects of physical activity and physical fitness, evidence for association between physical fitness and health-related quality of life (HRQoL) in young adults is limited. The aim of the present cross-sectional study was to investigate the association of cardiorespiratory and muscular fitness with HRQoL from the perspective of its physical and mental components among young adult Finnish males. Methods The sample consisted of 754 men, with the mean age of 26 years (SD 6.7 years), who participated in the military refresher training. HRQoL was measured using the Finnish RAND 36-item health survey. Cardiorespiratory fitness was determined by a bicycle ergometer test, and muscular fitness by various tests measuring maximal strength and muscular endurance. Logistic regression modelling was used to compare low, moderate and high physical and mental component of HRQoL scores to the respective levels of muscular and cardiorespiratory fitness. Results The findings of the adjusted (age, educational level, marital status, employment status, smoking, use of alcohol and BMI) analysis showed that cardiorespiratory and muscular fitness are positively associated with both physical and mental components of HRQoL. In terms of the physical component of HRQoL, even a moderate fitness level was positively associated with better HRQoL. In terms of the mental component of HRQoL, the impact was seen only in the group with the highest fitness level. Conclusions The findings suggest a positive contribution of physical fitness to mental health and highlight the importance of both muscular and cardiorespiratory fitness in the promotion of HRQoL. Even lighter forms of physical activity that result in moderate physical fitness could contribute to the physical component of HRQoL. In terms of the mental component of HRQoL, higher levels of physical fitness may be needed to gain higher levels of HRQoL among young males.
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Affiliation(s)
| | - Jani P Vaara
- The Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
| | | | - Arja Häkkinen
- Department of Physical Medicine and Rehabilitation, Health Sciences / Central Hospital of Central Finland, University of Jyväskylä, Jyväskylä, Finland
| | | | - Heikki Kyröläinen
- The Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland.,Department of biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland
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32
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Multanen J, Kiuru P, Piitulainen K, Ylinen J, Paloneva J, Häkkinen A. Enhanced rehabilitation guidance after arthroscopic capsulolabral repair of the shoulder: a randomized controlled trial. Clin Rehabil 2020; 34:890-900. [PMID: 32380852 PMCID: PMC7350199 DOI: 10.1177/0269215520919472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To compare the effects of a 12-month home-based exercise program to usual care in patients after arthroscopic capsulolabral repair of the shoulder. Design: Randomized controlled trial. Setting: Outpatient physical and rehabilitation medicine clinic. Subjects: Forty-five patients (mean age: 35 years; standard deviation (SD): 10 years) who underwent arthroscopic capsulolabral repair due to labral lesion were randomized into an exercise group (EG) or a control group (CG). Intervention: The EG received a 12-month home-based additional exercise program with four physiotherapy follow-up visits, while the CG received standard postoperative exercise instructions. Main measures: Self-reported shoulder disability was assessed with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and quality of life with the Short-Form (SF)-36 Health Survey. The function of the operated shoulder was evaluated with strength and range of motion measurements. Results: No between-group differences were observed in any of the outcomes at the follow-up. Mean ASES score improved by 16 (95% confidence interval (CI): 10–23) points from the baseline 78 (SD: 17) in the EG and 13 (95% CI: 7–19) points from the baseline 79 (SD: 17) in the CG. Both groups achieved a significant improvement in the dimensions of Physical Functioning, Role-Physical, and Bodily Pain of the SF-36 and in every aspect of strength and range of motion measures. In EG, exercise adherence was moderate (52%) during the first six months and poor (22%) during the last six months. Conclusion: Home-based additional exercises with four outpatient follow-up visits did not improve outcome after arthroscopic capsular repair of the shoulder.
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Affiliation(s)
- Juhani Multanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Finland Hospital District, Jyväskylä, Finland
| | - Pauli Kiuru
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kirsi Piitulainen
- Department of Physical Medicine and Rehabilitation, Central Finland Hospital District, Jyväskylä, Finland
| | - Jari Ylinen
- Department of Physical Medicine and Rehabilitation, Central Finland Hospital District, Jyväskylä, Finland
| | - Juha Paloneva
- Department of Surgery, Central Finland Hospital District, Jyväskylä, Finland.,School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Finland Hospital District, Jyväskylä, Finland
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33
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Pirnes KP, Kallio J, Siekkinen K, Hakonen H, Häkkinen A, Tammelin T. Test-retest repeatability of questionnaire for pain symptoms for school children aged 10-15 years. Scand J Pain 2020; 19:575-582. [PMID: 30917106 DOI: 10.1515/sjpain-2018-0338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 02/15/2019] [Indexed: 11/15/2022]
Abstract
Background and aims There is a growing body of evidence, that pain is common at school age. Less is known about the repeatability of pain questionnaires for children. This study aimed to assess the test-retest repeatability of the Finnish version of the electronic pain questionnaire for school-aged children. Methods Primary (n = 79) and lower secondary (n = 127) schoolchildren aged 10-15 years from two schools from the Jyväskylä region of Finland, filled in an electronic questionnaire twice in an interval of 2 weeks. It captured the frequency of pain symptoms with a five-point Likert-scale questionnaire covering nine areas of the body for the last 3 months. The intraclass correlation coefficient (ICC) values 0.40-0.59 reflected fair and 0.60-0.74 good repeatability. Results The highest prevalences of pain were in the head (29%) and neck and shoulder (NS) (23%) areas. ICC values showed good repeatability for questions about pain frequency in the head, NS and lower extremities. In primary school, these values were good in the lower extremities and fair in NS, lower back and the head. In lower secondary school, the ICC values were good in NS and the head, fair in the stomach and lower extremities. Conclusions This electronic questionnaire was an acceptably repeatable indicator to measure the frequency of pain in the most prevalent pain areas: the head and NS. Implications It is important to be aware of the impact of health-related outcomes on children's ability to be successful in their lives. With the help of a simple electronic questionnaire, it is possible to cost-effectively capture, for example, the prevalence and frequency of pain during the school hours. The identification of children's pain symptoms accurately provides more possibilities to prevent and to minimize the chronic pain among schoolchildren.
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Affiliation(s)
- Katariina P Pirnes
- Faculty of Sport and Health Science, University of Jyväskylä, Seminaarinkatu 15, Jyväskylän Yliopisto 40014, Finland
| | - Jouni Kallio
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Kirsti Siekkinen
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Harto Hakonen
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Science, University of Jyväskylä, Seminaarinkatu 15, Jyväskylän Yliopisto 40014, Finland
| | - Tuija Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
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34
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Ikonen J, Hulkkonen S, Ryhänen J, Häkkinen A, Karppinen J, Repo JP. The structural validity of the Finnish version of the Disabilities of the Arm, Shoulder and Hand: A Rasch model analysis. Hand Therapy 2020. [DOI: 10.1177/1758998320907116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Introduction The construct validity of the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) has previously been questioned. The purpose of this study was to evaluate the measurement properties of the Finnish version of the DASH for assessing disability in patients with hand complaints using Rasch Measurement Theory. Methods A cohort of 193 patients with typical hand and wrist complaints were recruited at a surgery outpatient clinic. The DASH scores were analysed using the Rasch model for differential item functioning, unidimensionality, fit statistics, item residual correlation, coverage/targeting and reliability. Results In the original DASH questionnaire, the item response thresholds were disordered for 2 of 30 of the items. The item fit was poor for 9 of 30 of the items. Unidimensionality was not supported. There was substantial residual correlation between 87 pairs of items. Item reduction (chi square 95, degrees of freedom 50, p < 0.001) and constructing two testlets led to unidimensionality (chi square 0.64, degrees of freedom 4, p = 0.96). Person separation index was 0.95. The testlets had good fit with no differential item functioning towards age or gender. Conclusion Unidimensionality of the original Finnish version of the DASH was not supported, meaning the questionnaire seems to gauge traits other than disability alone. Hence, the clinician must be careful when trying to measure change in patients’ scores. Item reduction or the creation of testlets did not lead to good alternatives for the original Finnish DASH. Differential item functioning showed that the original Finnish scale exhibits minor response bias by age in one item. The original Finnish DASH covers different levels of ability well among typical hand surgery patients.
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Affiliation(s)
- J Ikonen
- Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland
- Department of Hand Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - S Hulkkonen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - J Ryhänen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - A Häkkinen
- Faculty of Sports and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - J Karppinen
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Finnish Institute of Occupational Health, Oulu, Finland
| | - JP Repo
- Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland
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35
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Munukka M, Waller B, Häkkinen A, Nieminen MT, Lammentausta E, Kujala UM, Paloneva J, Kautiainen H, Kiviranta I, Heinonen A. Effects of progressive aquatic resistance training on symptoms and quality of life in women with knee osteoarthritis: A secondary analysis. Scand J Med Sci Sports 2020; 30:1064-1072. [PMID: 31999876 DOI: 10.1111/sms.13630] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 01/27/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To conduct a secondary analysis to study the effects, those 4 months of aquatic resistance training have on self-assessed symptoms and quality of life in post-menopausal women with mild knee osteoarthritis (OA), after the intervention and after a 12-month follow-up period. METHODS A total of 87 post-menopausal volunteer women, aged 60-68 years, with mild knee OA were recruited in a randomized, controlled, 4-month aquatic training trial (RCT) and randomly assigned to an intervention (n = 43) and a control (n = 44) group. The intervention group participated in 48 supervised aquatic resistance training sessions over 4 months while the control group maintained their usual level of physical activity. Additionally, 77 participants completed the 12-month post-intervention follow-up period. Self-assessed symptoms were estimated using the OA-specific Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Health-related Quality of life (HRQoL) using the generic Short-form Health Survey (SF-36). RESULTS After 4 months of aquatic resistance training, there was a significant decrease in the stiffness dimension of WOMAC -8.5 mm (95% CI = -14.9 to -2.0, P = .006) in the training group compared to the controls. After the cessation of the training, this benefit was no longer observed during the 12-month follow-up. No between-group differences were observed in any of the SF-36 dimensions. CONCLUSIONS The results of this study show that participation in an intensive aquatic resistance training program did not have any short- or long-term impact on pain and physical function or quality of life in women with mild knee OA. However, a small short-term decrease in knee stiffness was observed.
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Affiliation(s)
- Matti Munukka
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Benjamin Waller
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Physical Activity, Physical Education, Sport and Health Research Centre (PAPESH), Sports Science Department, School of Science and Engineering, Reykjavik University, Reykjavik, Iceland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
| | - Miika T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | | | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Juha Paloneva
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Ilkka Kiviranta
- Department of Orthopaedics and Traumatology, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
| | - Ari Heinonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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36
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Aartolahti E, Lönnroos E, Hartikainen S, Häkkinen A. Long-term strength and balance training in prevention of decline in muscle strength and mobility in older adults. Aging Clin Exp Res 2020; 32:59-66. [PMID: 30830597 PMCID: PMC6974487 DOI: 10.1007/s40520-019-01155-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 02/17/2019] [Indexed: 11/24/2022]
Abstract
Background Reductions in muscle strength and poor balance may lead to mobility limitations in older age. Aims We assessed the effects of long-term once-weekly strength and balance training (SBT) on muscle strength and physical functioning in a community-based sample of older adults. Methods 182 individuals [130 women and 52 men, mean age 80 (SD ± 3.9) years] underwent supervised SBT as part of the Geriatric Multidisciplinary Strategy for the Good Care of the Elderly study. Training was offered once a week for 2.3 years. Isometric knee extension and flexion strength, chair rise, maximal walking speed, timed up and go (TUG) and Berg Balance Scale (BBS) were measured at baseline, after 2-year training and at post intervention follow-up. A linear mixed model was used to examine the change in physical functioning over time. Results During the intervention, both women (2.5 s, p < 0.001) and men (1.4 s, p = 0.013) improved their chair rise capacity. Women’s knee extension and flexion strength improved by 14.1 N (p = 0.003) and 16.3 N (p < 0.001), respectively. Their maximal walking speed also improved by 0.08 m/s (p < 0.001). In men, no changes in muscle strength or walking speed occurred during training or follow-up. No changes in BBS and TUG were observed at the end of the intervention, but decrease in BBS was observed at post-intervention follow-up in men. Conclusions In community-dwelling older adults with variety in health and functioning supervised strength and balance training once a week may help to prevent age-related decline in mobility and muscle strength.
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Affiliation(s)
- Eeva Aartolahti
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland.
| | - Eija Lönnroos
- Institute of Public Health and Clinical Nutrition, Department of Geriatrics, University of Eastern Finland, Kuopio, Finland
| | - Sirpa Hartikainen
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
- Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
- Department of Physical and Rehabilitation Medicine, Central Finland Health Care District, Jyvaskyla, Finland
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37
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Simula AS, Jenkins HJ, Holopainen R, Oura P, Korniloff K, Häkkinen A, Takala EP, Hancock MJ, Karppinen J. Transcultural adaption and preliminary evaluation of "understanding low back pain" patient education booklet. BMC Health Serv Res 2019; 19:1010. [PMID: 31888605 PMCID: PMC6936060 DOI: 10.1186/s12913-019-4854-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 12/20/2019] [Indexed: 12/21/2022] Open
Abstract
Background Low back pain (LBP) is the number one cause of disability globally. LBP is a symptom associated with biological, psychological and social factors, and serious causes for pain are very rare. Unhelpful beliefs about LBP and inappropriate imaging are common. Practitioners report pressure from patients to provide inappropriate imaging. A recently developed patient education and management booklet, ‘Understanding low back pain’, was designed to target previously identified barriers for reducing inappropriate imaging. The booklet includes evidence-based information on LBP and supports communication between patients and practitioners. Our aim was to 1) describe the translation process into Finnish and 2) study patients’ and practitioners’ attitudes to the booklet and to evaluate if it improved patients’ understanding of LBP and practitioners’ ability to follow imaging guidelines. Methods We translated the booklet from English to Finnish. Preliminary evaluation of the booklet was obtained from LBP patients (n = 136) and practitioners (n = 32) using web-based questionnaires. Open-ended questions were analysed using thematic analysis. Results Approximately half of the patients reported that reading the booklet helped them to understand LBP, while a third thought it encouraged them to perform physical activity and decreased LBP-related fear. Eighty percent of practitioners reported that the booklet helped them to follow imaging guidelines. In addition, practitioners reported that they found the booklet helpful and that it decreased the need for imaging. Conclusions The booklet seemed to be helpful in LBP management and in decreasing the need for LBP imaging according to patients and practitioners. Further research on the clinical effectiveness of the booklet in controlled study settings is needed. Trial registration ISRCTN, ISRCTN14389368, Registered 4 April 2019 - Retrospectively registered; ISRCTN11875357, Registered 22 April 2019 - Retrospectively registered.
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Affiliation(s)
- Anna Sofia Simula
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. .,Faculty of Medicine, Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland. .,Department of General Medicine Mikkeli Central Hospital (Essote), Mikkeli, Finland.
| | - Hazel J Jenkins
- Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Balaclava Road, North Ryde, NSW, 2109, Australia.,Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, Australia
| | - Riikka Holopainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, FI-40014, Jyväskylä, Finland
| | - Petteri Oura
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Faculty of Medicine, Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Katariina Korniloff
- School of Health and Social Studies, JAMK University of Applied Sciences, PO BOX 207, FI-40101, Jyväskylä, Finland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, FI-40014, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Jyväskylä Central Hospital, Keskussairaalantie 19, 40620, Jyväskylä, Finland
| | - Esa-Pekka Takala
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00032, Helsinki and Oulu, Työterveyslaitos, Finland
| | - Mark J Hancock
- Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Balaclava Road, North Ryde, NSW, 2109, Australia
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Faculty of Medicine, Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Finnish Institute of Occupational Health, P.O. Box 40, FI-00032, Helsinki and Oulu, Työterveyslaitos, Finland
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38
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Multanen J, Ylinen J, Karjalainen T, Kautiainen H, Repo JP, Häkkinen A. Reliability and Validity of The Finnish Version of The Boston Carpal Tunnel Questionnaire among Surgically Treated Carpal Tunnel Syndrome Patients. Scand J Surg 2019; 109:343-350. [PMID: 31132964 DOI: 10.1177/1457496919851607] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS The Boston Carpal Tunnel Questionnaire is the most commonly used outcome measure in the assessment of carpal tunnel syndrome. The purpose of this study was to translate the original Boston Carpal Tunnel Questionnaire into Finnish and validate its psychometric properties. MATERIALS AND METHODS We translated and culturally adapted the Boston Carpal Tunnel Questionnaire into Finnish. Subsequently, 193 patients completed the Finnish version of the Boston Carpal Tunnel Questionnaire, 6-Item CTS Symptoms Scale, and EuroQol 5 Dimensions 12 months after carpal tunnel release. The Boston Carpal Tunnel Questionnaire was re-administered after a 2-week interval. We calculated construct validity, internal consistency, test-retest reliability, and coefficient of repeatability. We also examined floor and ceiling effects. RESULTS The cross-cultural adaptation required only minor modifications to the questions. Both subscales of the Boston Carpal Tunnel Questionnaire (Symptom Severity Scale and Functional Status Scale) correlated significantly with the CTS-6 and EuroQol 5 Dimensions, indicating good construct validity. The Cronbach's alpha was 0.93 for both the Symptom Severity Scale and Functional Status Scale, indicating high internal consistency. Test-retest reliability was excellent, with an intraclass correlation coefficient greater than 0.8 for both scales. The coefficient of repeatability was 0.80 for the Symptom Severity Scale and 0.68 for the Functional Status Scale. We observed a floor effect in the Functional Status Scale in 28% of participants. CONCLUSION Our study shows that the present Finnish version of the Boston Carpal Tunnel Questionnaire is reliable and valid for the evaluation of symptom severity and functional status among surgically treated carpal tunnel syndrome patients. However, owing to the floor effect, the Functional Status Score may have limited ability to detect differences in patients with good post-operative outcomes.
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Affiliation(s)
- J Multanen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
| | - J Ylinen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
| | - T Karjalainen
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
| | - H Kautiainen
- Department of General Practice, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - J P Repo
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
| | - A Häkkinen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Küüsmaa-Schildt M, Liukkonen J, Vuong MK, Nyman K, Häkkinen K, Häkkinen A. Effects of morning vs. evening combined strength and endurance training on physical performance, sleep and well-being. Chronobiol Int 2019; 36:811-825. [PMID: 30950283 DOI: 10.1080/07420528.2019.1592184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of the present study was to examine how combined strength and endurance training in the morning and evening influences the adaptations in strength and endurance performance, perception of time management, psychological well-being and sleep. The combined training period lasted for 24 weeks and the participants were divided into the morning training (MG, n = 18), evening training (EG, n = 24) and control groups (CG, n = 10). Isometric leg press force (iLP), maximal oxygen consumption (VO2max), sleep behavior, fatigue, time management, motivation, self-esteem and health-related quality of life (HRQoL) were assessed. Morning to evening difference in iLP was observed in both MG and EG at Pre and Post, with higher force values in the evening, but not for VO2max. iLP force increased significantly in EG in the morning (p < 0.001) and evening (p = 0.010). VO2max increased in MG and EG both in the morning (both p < 0.001) and in the evening (MG: p < 0.001; EG: p = 0.003). Participants of the present study slept 7-8 h per night and the self-reported sleep duration, get-up time and the average time to go to bed were similar between the groups and did not change from Pre to Post. From HRQoL dimensions, the score for bodily pain decreased in MG (p = 0.029) and significant between-group differences were observed for Pre-Post changes in MG and EG (p = 0.001) as well as between MG and CG (p < 0.001). In vitality, a significant between-group difference was observed for Pre to Post changes in MG and EG (p = 0.014). Perception of time management decreased in EG (p = 0.042) but stayed unchanged for MG and CG. For the intrinsic motivation to participate, significant between-group differences were observed for MG and EG (p = 0.033) and between MG and CG (p = 0.032) for Pre to Post changes. Self-esteem improved in MG (p = 0.029) and EG (p = 0.024). The present combined strength and endurance training program performed in the morning and in the evening led to similar improvements in strength and endurance performance. Training in the morning or in the evening did not disrupt the already good sleep behavior and it was able to further increase the self-esteem. Although training in the morning hours may leave more time for free time activities or social life (i.e. family and friends) compared to the evening training, it might be more challenging to stay motivated to participate in prolonged training programs in the morning hours.
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Affiliation(s)
- M Küüsmaa-Schildt
- a Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland
| | - J Liukkonen
- b Behavioral Sciences, Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland d
| | - M K Vuong
- a Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland
| | - K Nyman
- c Department of Cardiology , Central Hospital of Central Finland , Jyväskylä , Finland
| | - K Häkkinen
- a Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland
| | - A Häkkinen
- c Department of Cardiology , Central Hospital of Central Finland , Jyväskylä , Finland.,d Health Sciences, Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväs , Finland
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Hulkkonen S, Repo JP, Häkkinen A, Karppinen J, Ryhänen J. Cross-Cultural Adaptation and Validation of the Finnish Version of the Michigan Hand Outcomes Questionnaire. Scand J Surg 2018; 109:159-165. [PMID: 30545274 DOI: 10.1177/1457496918818981] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Michigan Hand Outcomes Questionnaire is a widely used patient-reported outcome measure in hand surgery. The aim of this study was to translate and validate the Michigan Hand Outcomes Questionnaire into Finnish for Finnish patients with hand problems following international standards and guidelines. MATERIAL AND METHODS The original English Michigan Hand Outcomes Questionnaire was translated into Finnish. Altogether, 115 patients completed the Finnish Michigan Hand Outcomes Questionnaire, and reference outcomes: Disabilities of the Arm and Shoulder, EQ-5D 3L and pain intensity on a visual analog scale. Grip and key pinch forces were measured. After 1-2 weeks, 63 patients completed the Finnish Michigan Hand Outcomes Questionnaire the second time. The Michigan Hand Outcomes Questionnaire was analyzed for internal consistency, repeatability, correlations with the reference outcomes, and factor analysis. RESULTS Cronbach's alpha ranged from 0.90 to 0.97 in all the Michigan Hand Outcomes Questionnaire subscales, showing high internal consistency. The intraclass correlation coefficient showed good to excellent test-retest reliability ranging from 0.66 to 0.91 in all the Michigan Hand Outcomes Questionnaire subscales. In factor analysis, the structure with six subscales was not confirmed. All the subscales correlated with Disabilities of the Arm and Shoulder score, and five subscales correlated with EQ-5D index. CONCLUSION The Finnish version of the Michigan Hand Outcomes Questionnaire showed similar properties compared to the original English version and thus can be used as patient-reported outcome measure for Finnish patients with hand problems.
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Affiliation(s)
- S Hulkkonen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - J P Repo
- Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland
| | - A Häkkinen
- Faculty of Sports and Health Sciences, University of Jyväskylä, Finland
| | - J Karppinen
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.,Finnish Institute of Occupational Health, Oulu, Finland
| | - J Ryhänen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Repo JP, Tukiainen EJ, Roine RP, Kautiainen H, Lindahl J, Ilves O, Järvenpää S, Häkkinen A. Reliability and validity of the Finnish version of the Visual Analogue Scale Foot and Ankle (VAS-FA). Foot Ankle Surg 2018; 24:474-480. [PMID: 29409192 DOI: 10.1016/j.fas.2017.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 04/06/2017] [Accepted: 05/26/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND There have previously been no validated foot and ankle-specific patient-reported outcome measures in Finnish. METHODS The Visual Analogue Scale Foot and Ankle (VAS-FA) was translated and adapted into Finnish. Thereafter, 165 patients who had undergone foot and ankle surgery completed a questionnaire set on two separate occasions. Analyses included testing of floor-ceiling effect, internal consistency, reproducibility, and validity. RESULTS Minor linguistic differences emerged during the translation. Some structural adjustments were made. The mean (SD) total VAS-FA score was 74 (23). In the three subscales, maximum scores were noted in 2-5% of the responses, and internal consistency ranged from 0.81 to 0.94. Reproducibility was excellent (ICC, 0.97). The total VAS-FA score correlated significantly with the Lower Extremity Functional Scale (r=0.84) and the 15D Mobility dimension (r=0.79). The VAS-FA loaded on two factors (pain/movement and problems/limitations). CONCLUSIONS The Finnish version of the VAS-FA has high reliability and strong validity.
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Affiliation(s)
- Jussi P Repo
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, HUS, Finland.
| | - Erkki J Tukiainen
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, HUS, Finland
| | - Risto P Roine
- Group Administration, University of Helsinki and Helsinki University Hospital, HUS, Finland; Department of Health and Social Management, Research Centre for Comparative Effectiveness and Patient Safety, University of Eastern Finland, Kuopio, Finland
| | - Hannu Kautiainen
- Department of General Practice, University of Helsinki and Helsinki University Hospital, HUS, Finland
| | - Jan Lindahl
- Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, HUS, Finland
| | - Outi Ilves
- Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Salme Järvenpää
- Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Arja Häkkinen
- Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Department of Physical Medicine, Central Finland Health Care District, Jyväskylä, Finland
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Kyrölä K, Kautiainen H, Pekkanen L, Mäkelä P, Kiviranta I, Häkkinen A. Long-term clinical and radiographic outcomes and patient satisfaction after adult spinal deformity correction. Scand J Surg 2018; 108:343-351. [DOI: 10.1177/1457496918812201] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background and Aims: Adult spinal deformity surgery has increased with the aging population and modern surgical approaches, although it has high complication and reoperation rates. The permanence of radiographic correction, mechanical complications, predictive factors for poor patient-reported outcomes, and patient satisfaction were analyzed. Material and Methods: A total of 79 adult patients were retrospectively analyzed at baseline and 1–9 years after adult spinal deformity correction between 2007 and 2016. Patient-reported outcomes (Oswestry Disability Index, visual analog scale, and Scoliosis Research Society–30 scores), changes in radiographic alignment, indications for reoperation, predictors of poor outcomes according to the Oswestry Disability Index and Scoliosis Research Society–30 scores, and patient satisfaction with management were studied. Results: Oswestry Disability Index and visual analog scale scores (p = 0.001), radiographic correction of thoracic kyphosis, lumbar lordosis, and pelvic retroversion (p ⩽ 0.001) and sagittal vertical axis (p = 0.043) were significantly better at 4–5 years of follow-up than at baseline. The risk for the first reoperation owing to mechanical failure of instrumentation or bone was highest within the first year, at 13.9% (95% confidence interval = 8.0%–23.7%), and 29.8% (95% confidence interval = 19.4%–43.9%) at the 5-year follow-up. Oswestry Disability Index and Scoliosis Research Society–30 total scores had a good correlation (r = −0.78; 95% CI = −0.86 to –0.68; p < 0.001). Satisfaction with management was correlated with patient-reported outcomes. Male sex and depression (p = 0.021 and 0.018, respectively) predicted poor outcomes according to the Oswestry Disability Index and/or Scoliosis Research Society–30 score. Conclusion: The achieved significant radiographic correction was maintained 5 years postoperatively. Despite reoperations, patient satisfaction and clinical outcomes were good. Depression and male sex predicted poor clinical outcomes.
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Affiliation(s)
- K. Kyrölä
- Department of Orthopaedics and Traumatology, Central Hospital of Central Finland, Jyväskylä, Finland
| | - H. Kautiainen
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - L. Pekkanen
- Department of Orthopaedics and Traumatology, Central Hospital of Central Finland, Jyväskylä, Finland
| | - P. Mäkelä
- Department of Orthopaedics and Traumatology, Oulu University Hospital, Oulu, Finland
| | - I. Kiviranta
- Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - A. Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Department of Physical Rehabilitation, Central Hospital of Central Finland, Jyväskylä, Finland
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Ilves OE, Neva MH, Häkkinen K, Dekker J, Kraemer WJ, Tarnanen S, Kyrölä K, Ylinen J, Piitulainen K, Järvenpää S, Kaistila T, Häkkinen A. Trunk Muscle Strength After Lumbar Spine Fusion: A 12-Month Follow-up. Neurospine 2018; 16:332-338. [PMID: 30653909 PMCID: PMC6603846 DOI: 10.14245/ns.1836136.068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/06/2018] [Indexed: 11/21/2022] Open
Abstract
Objective The aim of this study was to investigate changes in trunk muscle strength 12 months after lumbar spine fusion (LSF) compared to preoperative strength.
Methods A total of 194 patients (mean±standard deviation [SD] age, 61±21 years) who underwent LSF participated in this prospective longitudinal study. Physical measurements of the participants were made before surgery and 12 months postoperatively. Isometric trunk extension and flexion strength was measured using a strain-gauge dynamometer in the standing position. Strength changes were calculated. Regression analysis was performed to explore which factors predicted strength levels at 12 months postoperatively.
Results The preoperative mean±SD extension strength was 205±144 N, which increased to 258±142 N (p<0.001) at the 12-month follow-up. Flexion strength increased from 295±172 N to 364±164 N (p<0.001). The preoperative extension/flexion strength ratio was 0.75±0.38 and remained similar (0.73±0.26) at 12 months postoperatively (p=0.39).
Conclusion Although trunk muscle strength increased by 26% for extension and 23% for flexion at the 12-month postoperative follow-up, both values remained objectively low. In addition, flexion strength remained higher than extension strength, which indicates an imbalance between those muscle groups. Age, severe back pain, and low trunk muscle strength before surgery predicted low trunk muscle strength at 1 year after spinal fusion.
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Affiliation(s)
- Outi Elina Ilves
- Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Marko Henrik Neva
- Department of Orthopedics and Trauma, Tampere University Hospital, Tampere, Finland
| | - Keijo Häkkinen
- Biology of Physical Activity, Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Joost Dekker
- Departments of Rehabilitation Medicine and Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Sami Tarnanen
- Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kati Kyrölä
- Department of Orthopedics and Traumatology, Central Finland Health Care District, Jyväskylä, Finland
| | - Jari Ylinen
- Department of Orthopedics and Trauma, Tampere University Hospital, Tampere, Finland.,Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä, Finland
| | - Kirsi Piitulainen
- Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä, Finland
| | - Salme Järvenpää
- Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä, Finland
| | - Tiina Kaistila
- Department of Orthopedics and Trauma, Tampere University Hospital, Tampere, Finland
| | - Arja Häkkinen
- Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä, Finland
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Multanen J, Honkanen M, Häkkinen A, Kiviranta I. Construct validity and reliability of the Finnish version of the Knee Injury and Osteoarthritis Outcome Score. BMC Musculoskelet Disord 2018; 19:155. [PMID: 29788950 PMCID: PMC5964707 DOI: 10.1186/s12891-018-2078-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 05/07/2018] [Indexed: 12/17/2022] Open
Abstract
Background The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a commonly used knee assessment and outcome tool in both clinical work and research. However, it has not been formally translated and validated in Finnish. The purpose of this study was to translate and culturally adapt the KOOS questionnaire into Finnish and to determine its validity and reliability among Finnish middle-aged patients with knee injuries. Methods KOOS was translated and culturally adapted from English into Finnish. Subsequently, 59 patients with knee injuries completed the Finnish version of KOOS, Western Ontario and McMaster Osteoarthritis Index (WOMAC), Short-Form 36 Health Survey (SF-36) and Numeric Pain Rating Scale (Pain-NRS). The same KOOS questionnaire was re-administered 2 weeks later. Psychometric assessment of the Finnish KOOS was performed by testing its construct validity and reliability by using internal consistency, test-retest reliability and measurement error. The floor and ceiling effects were also examined. Results The cross-cultural adaptation revealed only minor cultural differences and was well received by the patients. For construct validity, high to moderate Spearman’s Correlation Coefficients were found between the KOOS subscales and the WOMAC, SF-36, and Pain-NRS subscales. The Cronbach’s alpha was from 0.79 to 0.96 for all subscales indicating acceptable internal consistency. The test-retest reliability was good to excellent, with Intraclass Correlation Coefficients ranging from 0.73 to 0.86 for all KOOS subscales. The minimal detectable change ranged from 17 to 34 on an individual level and from 2 to 4 on a group level. No floor or ceiling effects were observed. Conclusion This study yielded an appropriately translated and culturally adapted Finnish version of KOOS which demonstrated good validity and reliability. Our data indicate that the Finnish version of KOOS is suitable for assessment of the knee status of Finnish patients with different knee complaints. Further studies are needed to evaluate the predictive ability of KOOS in the Finnish population. Electronic supplementary material The online version of this article (10.1186/s12891-018-2078-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Juhani Multanen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Keskussairaalantie 19, FI-40620, Jyväskylä, Finland.
| | - Mikko Honkanen
- Department of Surgery, Mikkeli Central Hospital, Mikkeli, Finland
| | - Arja Häkkinen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Keskussairaalantie 19, FI-40620, Jyväskylä, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Ilkka Kiviranta
- Department of Orthopaedics and Traumatology, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
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Multanen J, Häkkinen A, Heikkinen P, Kautiainen H, Mustalampi S, Ylinen J. Pulsed electromagnetic field therapy in the treatment of pain and other symptoms in fibromyalgia: A randomized controlled study. Bioelectromagnetics 2018; 39:405-413. [PMID: 29709070 DOI: 10.1002/bem.22127] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 03/12/2018] [Indexed: 11/09/2022]
Abstract
Low-energy pulsed electromagnetic field (PEMF) therapy has been suggested as a promising therapy to increase microcirculation, which is of great concern in patients with fibromyalgia. This study evaluated the effectiveness of PEMF therapy on the treatment of fibromyalgia. A group of 108 women with fibromyalgia were allocated to a 12-week treatment period with an active Bio-Electro-Magnetic-Energy-Regulation (BEMER) device and a similar treatment period with an inactive device. Each patient received active and sham treatments in a random order. Pain and stiffness were assessed on a visual analog scale (VAS, scale 0-100 mm), and functional status was assessed by the Fibromyalgia Impact Questionnaire (FIQ). Mean VAS pain scores before the active and sham treatment periods were 66 (SD 22) and 63 (SD 22), respectively. After treatment periods, mean VAS pain scores had decreased significantly in active treatment, -12, 95% CI [-18, -6], and in sham treatment, -11, 95% CI [-17, -5]. Similarly, the decrease in stiffness and FIQ index after both treatments was statistically significant. However, per-protocol analysis showed no differences between active and sham treatments at any of the outcomes. This study demonstrated that low-energy PEMF therapy was not efficient in reducing pain and stiffness or in improving functioning in women with fibromyalgia. Bioelectromagnetics. 39:405-413, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Juhani Multanen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
| | - Arja Häkkinen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pauli Heikkinen
- Department of Physics, University of Jyväskylä, Jyväskylä, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Sirpa Mustalampi
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
| | - Jari Ylinen
- Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
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Kyrölä K, Repo J, Mecklin JP, Ylinen J, Kautiainen H, Häkkinen A. Spinopelvic Changes Based on the Simplified SRS-Schwab Adult Spinal Deformity Classification: Relationships With Disability and Health-Related Quality of Life in Adult Patients With Prolonged Degenerative Spinal Disorders. Spine (Phila Pa 1976) 2018; 43:497-502. [PMID: 28767623 DOI: 10.1097/brs.0000000000002370] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional, observational study. OBJECTIVE To study the occurrence of sagittal malalignment, the adaptability of a simplified sagittal modifiers grading of the Scoliosis Research Society (SRS)-Schwab adult spinal deformity (ASD) classification, and the deformity-specific SRS questionnaire version 30 (SRS-30) in an unselected adult cohort with symptomatic degenerative spinal disorders. SUMMARY OF BACKGROUND DATA The sagittal modifiers of the SRS-Schwab ASD classification correlate with health-related quality of life (HRQoL) measures in patients with ASD. The deformities and disabilities caused by sagittal malalignment in patients with common degenerative spinal disorders of multiple etiologies are rarely studied. A simplified and categorizing version of the SRS-Schwab ASD classification in relation to the Oswestry Disability Index (ODI) and the SRS-30 outcomes has not yet been developed. METHODS We recruited 874 consecutive patients with degenerative spinal disorders between March 2013 and February 2014. Full spine radiographs were taken and the patients divided into sagittal deformity severity groups: mild or none, moderate, and marked deformity. Participants completed the ODI, SRS-30, and a general health questionnaire. RESULTS We included 637 patients in the analysis. The severity of sagittal deformity was mild or none in 407 (63.9%) patients, moderate in 159 (25.0%), and marked in 71 (11.1%). Linearity across the modifier grades and deformity classes was found for ODI total score (P = 0.033), and the function/activity (P = 0.004) and self-image/appearance (P = 0.030) domains of the SRS-30. Age, body mass index, duration of symptoms, and the use of painkillers increased while physical activity, working, and educational status decreased significantly with deformity severity. CONCLUSION Sagittal spinopelvic malalignment is significantly related to deterioration of the ODI and the SRS-30 in symptomatic adults with degenerative spinal disorders. The SRS-Schwab classification sagittal modifiers categorized into three groups is a practical tool to detect various clinically significant grades of deformity in a cohort with no recognized ASD. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Kati Kyrölä
- Department of Orthopaedics and Traumatology, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Jussi Repo
- Department of Orthopaedics and Traumatology, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Jukka-Pekka Mecklin
- Department of Education and Science, Central Finland Health Care District, Jyväskylä, Finland.,Department of Surgery, University of Eastern Finland, Jyväskylä, Finland
| | - Jari Ylinen
- Department of Physical Rehabilitation, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Hannu Kautiainen
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Arja Häkkinen
- Department of Physical Rehabilitation, Central Hospital of Central Finland, Jyväskylä, Finland.,Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Appelqvist-Schmidlechner K, Vaara J, Häkkinen A, Vasankari T, Mäkinen J, Mäntysaari M, Kyröläinen H. Relationships Between Youth Sports Participation and Mental Health in Young Adulthood Among Finnish Males. Am J Health Promot 2017; 32:1502-1509. [DOI: 10.1177/0890117117746336] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Purpose: To examine whether retrospectively assessed sports participation (SP) and competitive sports (CS) at the age of 12 years is associated with mental health and health behavior in young adulthood among males. Design: A cross-sectional study using self-administered questionnaires. Setting: Conducted prior to compulsory military refresher training course in Finland allowing geographically representative sample of Finnish young men. Participants: Six hundred eighty males aged between 20 and 35 years. Measures: Mental well-being was measured with the short version of Warwick-Edinburgh Mental Well-Being Scale and mental distress with 5 items of The Short Form Helalth Survey (SF-36) scale. Analysis: Binary logistic regression models. Results: Sports participation at the age of 12 was associated with better mental health in young adulthood, with both mental well-being (odds ratio [OR] = 1.86, 95% confidence interval 1.11-3.11) and mental distress (OR = 0.61, 0.41-0.90). Age, years of education, and current physical activity were controlled. Higher level of intensity of SP and the level of CS in childhood were associated with lower level of mental distress in adulthood. No association was found between the level of CS in childhood and mental well-being in adulthood. Further, youth SP seemed to be a risk factor for increased alcohol consumption and use of snuff in adulthood. Conclusions: Despite negative outcomes related to health behavior, the findings provide support for the association between youth SP and positive mental health outcomes in adulthood among males.
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Affiliation(s)
| | - Jani Vaara
- Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
| | - Arja Häkkinen
- Department of Physical Medicine and Rehabilitation, Central Hospital of Central Finland, Jyväskylä, Finland
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Juha Mäkinen
- Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
| | | | - Heikki Kyröläinen
- Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
- Department of Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland
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Munukka M, Waller B, Häkkinen A, Nieminen MT, Lammentausta E, Kujala UM, Paloneva J, Kautiainen H, Kiviranta I, Heinonen A. Physical Activity Is Related with Cartilage Quality in Women with Knee Osteoarthritis. Med Sci Sports Exerc 2017; 49:1323-1330. [PMID: 28240703 DOI: 10.1249/mss.0000000000001238] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE To study the relationship between 12-month leisure-time physical activity (LTPA) level and changes in estimated biochemical composition of tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis (OA). METHODS Originally, 87 volunteer postmenopausal women, age 60 to 68 yr, with mild knee OA (Kellgren Lawrence I/II and knee pain) participated in a randomized controlled, 4-month aquatic training trial (RCT), after which 76 completed the 12-month postintervention follow-up period. Self-reported LTPA was collected along the 12-month period using a diary from which MET task hours per month were calculated. Participants were divided into MET task hour tertiles: 1, lowest (n = 25); 2 = middle (n = 25) and 3 = highest (n = 26). The biochemical composition of the cartilage was estimated using transverse relaxation time (T2) mapping sensitive to the properties of the collagen network and delayed gadolinium-enhanced magnetic resonance imaging of the cartilage (dGEMRIC index) sensitive to the cartilage glycosaminoglycan content. Secondary outcomes were cardiorespiratory fitness, isometric knee extension and flexion force, and the knee injury and OA outcome questionnaire. RESULTS During the 12-month follow-up period, there was a significant linear relationship between higher LTPA level and increased dGEMRIC index changes in the posterior region of interest (ROI) of the lateral (P = 0.003 for linearity) and medial (P = 0.006) femoral cartilage. Furthermore, these changes were seen in the posterior lateral femoral cartilage superficial (P = 0.004) and deep (P = 0.007) ROI and in the posterior medial superficial ROI (P < 0.001). There was no linear relationship between LTPA level and other measured variables. CONCLUSIONS These results suggest that higher LTPA level is related to regional increases in estimated glycosaminoglycan content of tibiofemoral cartilage in postmenopausal women with mild knee OA as measured with dGEMRIC index during a 12-month period.
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Affiliation(s)
- Matti Munukka
- 1Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND; 2Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, FINLAND; 3Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FINLAND; 4Department of Diagnostic Radiology, Oulu University Hospital, Oulu, FINLAND; 5Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, FINLAND; 6Department of Surgery, Central Finland Central Hospital, Jyväskylä, FINLAND; 7Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, FINLAND; 8Unit of Primary Health Care, Kuopio University Hospital, Kuopio, FINLAND; and 9Department of Orthopaedics and Traumatology, University of Helsinki, and Helsinki University Hospital, Helsinki, FINLAND
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49
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Ilves O, Häkkinen A, Dekker J, Wahlman M, Tarnanen S, Pekkanen L, Ylinen J, Kautiainen H, Neva M. Effectiveness of postoperative home-exercise compared with usual care on kinesiophobia and physical activity in spondylolisthesis: A randomized controlled trial. J Rehabil Med 2017; 49:751-757. [PMID: 28862315 DOI: 10.2340/16501977-2268] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To study the effectiveness of a 12-month exercise therapy on kinesiophobia and physical activity in patients with spondylolisthesis after lumbar spine fusion. DESIGN Randomized controlled trial. SUBJECTS Patients (n = 98) with spondylolisthesis who had undergone lumbar spine fusion. METHODS All patients (mean age 59 years) had received lumbar spine fusion surgery and identical postoperative instructions. Three months postoperatively, they were randomized into an exercise group (n = 48) or usual care group (n = 50). The exercise group received 12-month progressive home-based training with regular booster sessions, and the usual care group a single session of physiotherapy instruction. Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK) and physical activity by the International Physical Activity Questionnaire (IPAQ) preoperatively, 3 months after lumbar spine fusion, and at the end of the 12-month intervention. RESULTS Before the intervention, the median (first quartile; third quartile) of TSK was 32.5 (29.0; 37.0) in the exercise group and 30.0 (25.8; 36.0) in the usual care group, changing to 30.0 (25; 36) in the exercise group and to 30.5 (24; 36.3) in the usual care group (between-group p = 0.17). IPAQ metabolic equivalent minutes per week increased from 1,863 (1,040; 3,042) to 3,190 (1,634; 6,485) in the exercise group and from 2,569 (1,501; 4,075) to 3,590 (1,634; 6,484) in the usual care group (between-group p = 0.92). CONCLUSION Progressive 12-month home-exercise starting 3 months postoperatively was not superior to usual care in decreasing kinesiophobia or increasing physical activity in spondylolisthesis.
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Affiliation(s)
- Outi Ilves
- Department of Health Sciences, University of Jyvaskyla, 40014 Jyvaskyla, Finland.
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50
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Waller B, Munukka M, Rantalainen T, Lammentausta E, Nieminen MT, Kiviranta I, Kautiainen H, Häkkinen A, Kujala UM, Heinonen A. Effects of high intensity resistance aquatic training on body composition and walking speed in women with mild knee osteoarthritis: a 4-month RCT with 12-month follow-up. Osteoarthritis Cartilage 2017; 25:1238-1246. [PMID: 28263901 DOI: 10.1016/j.joca.2017.02.800] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 01/31/2017] [Accepted: 02/21/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the effects of 4-months intensive aquatic resistance training on body composition and walking speed in post-menopausal women with mild knee osteoarthritis (OA), immediately after intervention and after 12-months follow-up. Additionally, influence of leisure time physical activity (LTPA) will be investigated. DESIGN This randomised clinical trial assigned eighty-seven volunteer postmenopausal women into two study arms. The intervention group (n = 43) participated in 48 supervised intensive aquatic resistance training sessions over 4-months while the control group (n = 44) maintained normal physical activity. Eighty four participants continued into the 12-months' follow-up period. Body composition was measured with dual-energy X-ray absorptiometry (DXA). Walking speed over 2 km and the knee injury and osteoarthritis outcome score (KOOS) were measured. LTPA was recorded with self-reported diaries. RESULTS After the 4-month intervention there was a significant decrease (P = 0.002) in fat mass (mean change: -1.17 kg; 95% CI: -2.00 to -0.43) and increase (P = 0.002) in walking speed (0.052 m/s; 95% CI: 0.018 to 0.086) in favour of the intervention group. Body composition returned to baseline after 12-months. In contrast, increased walking speed was maintained (0.046 m/s; 95% CI 0.006 to 0.086, P = 0.032). No change was seen in lean mass or KOOS. Daily LTPA over the 16-months had a significant effect (P = 0.007) on fat mass loss (f2 = 0.05) but no effect on walking speed. CONCLUSIONS Our findings show that high intensity aquatic resistance training decreases fat mass and improves walking speed in post-menopausal women with mild knee OA. Only improvements in walking speed were maintained at 12-months follow-up. Higher levels of LTPA were associated with fat mass loss. TRIAL REGISTRATION NUMBER ISRCTN65346593.
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Affiliation(s)
- B Waller
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - M Munukka
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - T Rantalainen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia.
| | - E Lammentausta
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
| | - M T Nieminen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Finland.
| | - I Kiviranta
- Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - H Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.
| | - A Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - U M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - A Heinonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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