Biomedical subjects

U Moritz

Publications and source records attributed to U Moritz.

At least 19 recordsLinked to original sources

PubMed2001

Individual factors affecting stabilometry and one-leg hop test in 75 healthy subjects, aged 15-44 years.

The aims of this study were: 1) to investigate whether single-limb stabilometry and a one-leg hop test are influenced by age, sex, height, weight or activity level in healthy subjects, 2) to examine possible differences between the right and the left leg, 3) to determine Limb Symmetry Index (LSI) values, and 4) to study the relation between the stabilometric variables, that is, average speed (AS) and amplitude of center of pressure (CP) movements. Seventy-five healthy subjects (39 women) were studied, with a mean age of 29.5 years (SD 8.2, range 15-44), mean height 175 cm (SD 8.6, range 155-194), mean weight 67.8 kg (SD 9.7, range 50-90) and median value 8 (quartiles 8-9, range 7-10) on a 1-10 activity-level scale. AS was higher among the men compared to the women and increased with increasing age. The females hopped shorter distances than the males. The hop distance decreased with increasing age among the women. Height, weight and activity level within the actual range had no significant influence on stabilometric or hop-test values. When comparing patients with healthy subjects, they should be matched according to sex and age, with an age difference of less than 10 years within pairs.

Adolescent↗

PubMed2001

Influence of supervised and nonsupervised training on postural control after an acute anterior cruciate ligament rupture: a three-year longitudinal prospective study.

STUDY DESIGN: Prospective randomized longitudinal clinical trial with matched controls. OBJECTIVES: To investigate the long-term effect of training on postural control and extremity function after an acute anterior cruciate ligament (ACL) injury. BACKGROUND: ACL injuries may cause severe problems with recurrent giving way of the knee and reduced functional capacity. The effect of an acute ACL injury and the effect of various training programs on postural control, as well as the relation between postural control and extremity function after such an injury, have not been studied longitudinally. METHODS: Sixty-three consecutive patients, 35 men and 28 women (median age 24 years, quartiles 19-33 years), with an acute nonoperated ACL injury, randomized to neuromuscular supervised or self-monitored training, were examined with stabilometry (amplitude and average speed of center of pressure movements) and a one-leg hop test for distance after 6 weeks (stabilometry only), and after 3, 12, and 36 months, and were compared to a control group. RESULTS: Regardless of treatment, center of pressure amplitude was persistently higher in both the injured and uninjured legs during the 3-year follow-up, but average speed was less affected or unaffected compared to the control group. The one-leg hop had normalized in the neuromuscular group at the 12-month follow-up, but was shorter in both legs throughout the 3-year period in the self-monitored group. The median value (quartiles) for injured/uninjured legs at 3 months was 150 cm (120-174 cm)/177 cm (140-199 cm), at 12 months was 174 cm (140-200 cm)/180 cm (150-202 cm), and at 36 months was 172 cm (146-200 cm)/178 cm (150-200 cm) in the self-monitored group, compared to the control group (median 186 cm, quartiles 177-216 cm). CONCLUSIONS: The higher center of pressure amplitude in both legs over the 3-year period indicate persistently impaired postural control in single-limb stance. However, functional performance, as measured with the one-leg hop test, was restored by neuromuscular training, but not by self-monitored training.

Adolescent↗

PubMed2000

Bilateral proprioceptive defects in patients with a unilateral anterior cruciate ligament reconstruction: a comparison between patients and healthy individuals.

Proprioception of the knee was measured in 20 patients with reconstructed anterior cruciate ligaments and in 19 age-matched controls. The mean time from surgery was 2 years. Three tests of proprioception were used: (a) threshold to detection of passive motion from 20 and 40 degrees toward flexion and extension, (b) active reproduction of a 30 degrees passive angle change, and (c) visual reproduction of a 30 degrees passive angle change. The aim was a complete, bilateral, proprioceptive evaluation of patients who had undergone reconstruction of the anterior cruciate ligament. As compared with those in the control group, the knees with reconstructed anterior cruciate ligaments had a higher threshold to detection of passive motion in the extension trials from 20 and 40 degrees (p = 0.0003 and 0.04, respectively) and in the flexion trials from 20 and 40 degrees (p = 0.004 and 0.0008, respectively). When the uninjured knees of the patients were compared with those in the control group, higher values for threshold to detection of passive motion were found in the flexion trials from 20 degrees (p = 0.002) and 40 degrees (p = 0.02). Thus, decreased proprioceptive ability was present in some measurements of these patients after reconstructive surgery, not only in injured knees but also in uninjured knees, as compared with the reference group. The functional relevance of these findings was not investigated in this study, but the results suggest that bilateral proprioceptive considerations should be made when evaluating prognostic factors, treatment, and risk of contralateral knee injury in patients with reconstructed anterior cruciate ligaments.

Adult↗

PubMed2000

Rehabilitation following acute anterior cruciate ligament injuries--a 12-month follow-up of a randomized clinical trial.

The efficacy of two non-operative rehabilitation programs was studied in a consecutive randomized controlled clinical trial of 100 patients after 12 months subsequent to an acute anterior cruciate ligament (ACL) injury. Follow up of randomization to two training models was evaluated after 3 and 12 months: A self-monitored training program (SM) of traditional mobility and muscle strength training of the injured leg was compared to a supervised (SV) training model exercising postural function in closed kinetic-chains. Nearly 50% of the patients in the SM group required supervision after 6 weeks. An intention-to-treat analysis was performed and showed significantly better values in most of the results of the supervised group at 3 and 12 months. An alternative analysis of subgroups showed a significant difference between transferred male patients and original SV male patients at 3 months but not at 12 months, indicating the importance of initial guiding after an ACL injury. No such difference was observed in the female patients.

Adolescent↗

PubMed2000

Pressure pain thresholds and electromyographically defined muscular fatigue induced by a muscular endurance test in normal women.

OBJECTIVE: This study was undertaken to examine the relation between muscular tenderness measured as pressure pain thresholds (PPTs) and electromyographic (EMG) signs of fatigue before and after a local standardized static muscle contraction. DESIGN: Pressure pain thresholds were measured in the shoulder region before, immediately after, and 10 minutes after a standardized static endurance test while monitoring the EMG signs of local muscular fatigue and its recovery. The study did not address local biochemical issues. SETTING: The study was conducted at the Department of Rehabilitation, Lund University Hospital, Lund, Sweden. SUBJECTS: Twenty-five healthy female volunteers without musculoskeletal problems participated in this study. INTERVENTION: A static endurance test was performed, which consisted of a submaximal unilateral activation of the right trapezius and deltoid muscles for as long as possible. OUTCOME MEASURES: Bilateral PPTs over the trapezius and deltoid muscles were measured with an electronic pressure algometer. Established surface EMG parameters of local muscular fatigue were assessed. The Borg Rating of Perceived Exertion scale was used. RESULTS: The average endurance time was 330 seconds. Immediately after the test, significant bilateral increases in the normalized PPTs over both muscles were found, although the increase was more pronounced on the test side: over the right trapezius muscle by 13% (p <0.001), over the right deltoid muscle by 23% (p <0.001), and over the left trapezius and deltoid muscles by 6% (p = 0.04) and (p = 0.009), respectively. These increases persisted 10 minutes after the end of the test. The subjects developed significant signs of fatigue as defined by EMG criteria in both muscles on the right side during the test. The recovery from fatigue was approximately half complete 15 seconds after the end of the test and complete or almost complete 10 minutes thereafter. CONCLUSIONS: Pressure pain thresholds over shoulder muscles remained elevated up to 10 minutes after a unilateral static endurance test. This time course was completely different from that of EMG-defined muscle fatigue, which showed a fast recovery. These findings indicate that the mechanisms of recovery from fatigue and nociception are independent of each other. The bilateral PPT increases might be explained by central antinociceptive mechanisms activated by static muscle work.

Adult↗

PubMed2000

Musculoskeletal symptoms among dental personnel; - lack of association with mercury and selenium status, overweight and smoking.

Our objective was to describe the occurrence of musculoskeletal symptoms and how they affect the daily life of three different occupational groups of dental personnel. A cross sectional-study was performed among 268 dental staff members and 111 referents. Female dental hygienists and female dentists showed, compared with their referents, higher prevalence of symptoms during the past 12 months from neck, shoulders and hands/wrists. Both dental groups also had higher frequencies of combined symptoms from these body regions, as well as longer duration of symptoms in neck and shoulders during the past 12-month period. Male dentists had higher frequencies of neck and shoulder symptoms compared with their referents. Female dental assistants did not deviate from their referents. The symptoms from each single body region, or the occurrence of symptoms from multiple regions in a subject, did not show any statistically significant association with mercury (whole blood and urinary levels) or selenium (plasma level) status, neither with smoking habits nor overweight (Body Mass Index). The high frequency of musculoskeletal disorders probably reflects the specific work load in dentistry, with high demands on vision and precision and fine manipulative hand movements and work with unsupported, elevated arms. The symptoms might impair work capacity and the future possibility to stay in the profession. Further studies are needed to verify this.

Adult↗

PubMed1999

Proprioceptive defects after an anterior cruciate ligament rupture -- the relation to associated anatomical lesions and subjective knee function.

A disturbed proprioception has been described in patients with an anterior cruciate ligament (ACL) deficient knee. The relation to demographic data and to different commonly associated anatomical lesions, as well as to subjective knee function, was prospectively studied in 16 consecutive patients after an acute knee ligament injury. All patients had a complete rupture of the ACL, but variable associated anatomical lesions. The threshold to detect a passive motion, as a measure of their proprioceptive ability, was registered repeatedly during the first year after injury. Four of the patients had consistently severe and persistent deficits at 1, 2 and 8 months. These four individuals had more chondral lesions and a lower subjective rating of their knee function than the remaining patients. In the whole group there were significant correlations between the recorded thresholds and associated chondral lesions, meniscal lesions and the subjective rating of knee function. We found no significant relation between age, gender, activity level, grade of mechanical laxity increase or a medial collateral ligament rupture, and the proprioceptive recordings. Thus, morphological lesions other than a rupture of the ACL seem to contribute to the proprioceptive deficits after a knee ligament injury, and the patients' ability to detect a passive motion showed a relation to subjective knee function from the time of injury onwards.

Adolescent↗

PubMed1999

Musculoskeletal disorders among female dental personnel--clinical examination and a 5-year follow-up study of symptoms.

OBJECTIVES: To explore the natural course of musculoskeletal disorders during a 5-year period among dental personnel, to survey findings and diagnoses according to a standardized protocol, and to compare and evaluate different methods for the detection of musculoskeletal disorders in a population. METHODS: In a 5-year follow-up study, dental personnel (n = 90) and referents (n = 30) were studied. The Nordic questionnaire (years 0 and 5), the present pain rating according to the Borg category ratio scale, and physical examination (year 5) were used. RESULTS: In year 0 the prevalence of symptoms in the shoulders, the wrists/hands, and, unexpectedly, the hips was higher in the dental personnel as compared with the referents. Furthermore, those (16%) who had left the dental profession during the observation period showed a higher prevalence of and, often, combined symptoms from several body regions in year 0 than did those who stayed. Dental personnel who remained in the profession tended to have an increased risk of developing more symptoms in the shoulders and the elbows/wrists/hands in year 5 as compared with year 0 and at year 5 were in more pain and had received more diagnoses for the neck/shoulder region relative to the referents. Furthermore, there was a considerable variation in symptoms during the follow-up period. The sensitivity of the pain rating and of the Nordic questionnaire in detecting musculoskeletal disorders was high for the neck and shoulders but was not as high for the elbow, wrists/hands, or hips. The association was better for diagnoses than for findings. The opposite patterns were observed for specificity. CONCLUSIONS: Dental personnel had an increased risk of developing musculoskeletal disorders as verified by symptoms and diagnoses and more painful or persistent conditions. This led to a selection out of work. The questionnaire and the present pain rating gave a relatively good picture of the prevalence of musculoskeletal disorders arising from the neck, shoulders, and hips and would be useful as screening tools. Their sensitivity in detecting disorders was higher for diagnoses than for findings. However, these methods were not as sensitive for disorders involving the elbows/wrists/hands. Physical examinations gave more detailed information.

Adult↗

PubMed1999

Wrist positions and movements as possible risk factors during machine milking.

High prevalence of hand and wrist symptoms has been found in females working with machine milking. Therefore the aim of this study was to quantify the positions and movements of the wrist during machine milking, and to compare tethering and loose-housing systems with respect to this. Biaxial electrogoniometers and data loggers were used for recording flexion and deviation angles of both the right and left wrists in 11 healthy milkers. For each individual 25 min of representative work was recorded in each system. High values of dorsiflexion and radial deviation were found, which might induce an increased risk of carpal tunnel syndrome. Moreover, the velocity and repetitiveness were close to those values described in repetitive work with a high risk of elbow and hand disorders in the fish-processing industry and giro-form data entry work. According to our findings, the load on the upper extremities has increased with respect to dorsiflexed hand position and repetitiveness when milking in the modern loose-housing milking system. This is probably due to the change of the working position and/or the higher productivity (number of cows that milked per time unit) in the loose-housing system as compared to the old-fashioned tethering system. These negative effects on wrist positions and movements should be considered when building new milking systems.

Adult↗

PubMed1999

Proprioception in people with anterior cruciate ligament-deficient knees: comparison of symptomatic and asymptomatic patients.

STUDY DESIGN: Nonrandomized prospective study. OBJECTIVE: To evaluate proprioception in 2 groups of patients with anterior cruciate ligament (ACL) deficiency who had different severity of symptoms. BACKGROUND: Defective proprioception has previously been found in patients with ACL-deficient knees. It has been suggested that sensory receptors of the ACL and other knee joint ligaments contribute to proprioception and knee joint function and stability. METHODS AND MEASURES: A total of 17 patients with ACL deficiency (mean [SD] age, 28.8 +/- 5.6 years; range, 22-39 years) with few, if any, symptoms were compared with 20 patients with ACL deficiency (mean [SD] age, 26.6 +/- 6.1 years; range, 18-39 years) having instability and episodes of giving way. The groups were compared with each other and with an age-matched reference group of 19 nonimpaired subjects. Their mean (SD) age was 25.6 +/- 3.7 years (range, 20-37 years). Three tests of proprioception were used: threshold to detection of passive motion from 2 starting positions (20 degrees and 40 degrees of knee flexion) toward flexion and extension, active reproduction of a 30 degrees passive angle change, and visual reproduction of a 30 degrees passive angle change. The Wilcoxon rank sum test was used for between-group comparisons. RESULTS: Symptomatic patients had higher threshold to detection of passive motion in their injured side in the flexion trial from 20 degrees (median of 1.5 degrees vs median of 0.5 degree) and in the extension trial from 40 degrees (median of 1.0 degree vs median of 0.5 degree) than the asymptomatic patients. No differences were found in the other threshold tests, active or visual reproduction tests. CONCLUSIONS: Patients with severe symptoms related to ACL deficiency were found to have inferior proprioceptive ability in some measurements compared with patients with a good knee function. The findings indicate that proprioceptive deficits might influence the outcome of an ACL injury treated nonoperatively.

Adult↗

PubMed1998

Upper extremity nerve involvement in Swedish female machine milkers.

Entrapment of the median nerve in the proximal forearm, the so-called pronator syndrome, is considered a rather rare condition but it is four times more common in women than in men. In this study, 23 of 30 female machine milkers with symptoms in the forearm and hand were clinically diagnosed as having the pronator syndrome. The diagnosis of median nerve involvement was based on the clinical history and on physical examination by a hand surgeon. All 23 milkers complained of aching in the volar part of the forearm and had a sensation of numbness, tingling, and decreased muscle strength in their hands, mostly in the hands which usually were statically loaded with heavy equipment. Objectively, all had an experience of tenderness over the pronator teres muscle. Furthermore, they showed reduced muscle strength, especially in the following muscles: pronator teres (PT), flexor carpi radialis (FCR), flexor pollicis longus (FPL), and flexor digitorum profundus II (FDP II). To validate the manual muscle testing, Mannerfeldt's intrinsicmeter was used to quantify the clinically observed weakness. Eight of the 23 milkers with pronator syndrome were surgically released from neuropathy and were almost symptom-free at follow-up after six months. One patient had a slight sensation of numbness and had to be given surgical carpal tunnel release later on. The external exposure of the arm during the application of the milking cluster probably causes muscle and fascial tensions that induce compression of the nerve. Further studies are needed to establish the level of the internal exposure.

Adult↗

PubMed1998

Interdisciplinary rehabilitation of hospital employees with musculoskeletal disorders.

At Lund University Hospital a cooperation project started in 1989 between the Rehabilitation Clinic and the Occupational Health Service Unit for the rehabilitation of 34 hospital employees with musculoskeletal problems and a median sick-listing time of 6 months, treated as day-patients by an interdisciplinary team. Evaluation instruments used were the Nottingham Health Profile (NHP), Pain Drawing, Visual Analogue Scale for pain, and the Disability Rating Index (DRI). The most prominent immediate effect was a significant increase of perceived energy and significant improvement of the total score of health-related quality of life (NHP). After 12 months, 25 out of 34 (74%) subjects had returned to work. The reference group used consisted of 57 subjects referred earlier from the Occupational Health Service Unit to the Personnel Department, for vocational rehabilitation. The groups were followed by 2-4 years using questionnaires concerning working conditions and current health status. There was a significant difference (p = 0.038) in return to work: intervention group 77%, reference group 58%.

Adult↗

PubMed1998

Early rehabilitation of acute anterior cruciate ligament injury--a randomized clinical trial.

UNLABELLED: The efficacy of a 6-week rehabilitation program was evaluated in 100 consecutive patients, age 15-42 years, with acute anterior cruciate ligament (ACL) injury. Arthroscopy revealed associated lesions in 82% of the patients. Except for resections on menisci with large and unstable lesions, no surgery was performed. The patients were randomly assigned to supervised training or self-monitored training after instruction. RESULTS: At the 6-week follow-up there was no difference between the groups with regard to pain at rest, pain during walking, or experience of giving-way episodes, Tegner activity level of Lysholm knee score. Only 2 of the 100 patients were observed without joint mobility restriction. The only significant difference between the groups was the improvement of muscle function in men in the supervised training group. CONCLUSION: Six weeks' rehabilitation is too short a time period from original injury to obtain normal mobility and restored knee function.

Adolescent↗

PubMed1998

Stabilometry and one-leg hop test have high test-retest reliability.

The purpose of this study was to investigate the reliability of repeated measurements and a possible learning or tiring process in single-limb stabilometry and one-leg hop test. An additional purpose was to study the correlation between different stabilometric variables. Seventy-five healthy subjects were examined twice with a median interval of 7 d, and with three consecutive measurements on each occasion. Single-limb stabilometry and one-leg hop test were found to have high reliability (ICC r = 0.68-0.83 and 0.96, respectively). The correlation between consecutive measurements was acceptable to high in stabilometry (r = 0.42-0.90, P = 0.002-P < 0.001) and high in the one-leg hop test (r = 0.91-0.97, P < 0.001). A learning process over time was observed. The correlation between the stabilometric variables was high (r = 0.73-0.95, P < 0.001).

Adolescent↗

PubMed1998

Neck support pillows: a comparative study.

BACKGROUND: Special neck support pillows claiming to improve rest and reduce neck pain are currently being advertised. OBJECTIVE: To test whether neck pillows have any positive effect on neck pain and quality of sleep compared with usual pillows and, if so, to find the optimal characteristics of such a pillow. METHODS: Thirty-seven hospital employees and 18 neck patients were asked to test six neck pillows with different shapes and consistency randomly over the course of 3 wk, to grade them according to comfort and to describe the characteristics of an ideal pillow. RESULTS: Thirty-six of 55 persons found the pillows positively affected sleep and 27 of 42 found that they positively affected neck pain. The ideal pillow should be soft and not too high, should provide neck support and should be allergy-tested and washable. The pillow that included two firmer supporting cores for neck lordosis received the best rating. CONCLUSION: A neck pillow with good shape and consistency and with firm support for cervical lordosis can be recommended as a part of treatment for neck pain.

Adult↗

PubMed1997

Proprioception after an acute knee ligament injury: a longitudinal study on 16 consecutive patients.

A defect in proprioception has been found in selected patient groups that have an anterior cruciate ligament deficient knee at different times after the original injury. The time of development and the extent of such defects were studied longitudinally on 16 consecutive patients. During the first year after a primary knee injury, which included a complete rupture of the anterior cruciate ligament, we repeatedly performed three tests of proprioception: (a) one to determine the threshold for detecting a passive motion from starting positions of 20 and 40 degrees, (b) an active reproduction of a passive angular change, and (c) a visual estimation of a passive angular change. The injured limb was compared with the uninjured limb and with the limbs of an age-matched reference group of healthy subjects. The population did not have a normal distribution, and some patients had consistently extreme recordings in the threshold tests at the various times of testing. Significant differences were found between the groups at the starting position of 20 degrees, when the injured knee was compared with the uninjured knee, after 1 month (p = 0.05), and after 2 months (p = 0.03). There was a trend toward a higher threshold for detecting a passive motion when the injured side was compared with the knees of the reference group at 1 month (p = 0.06) but not later on. A similar pattern was found for the injured knee at the starting position of 40 degrees, but it was not significant. An impaired ability to detect a passive motion was registered for the nearly extended knee 1 and 2 months after a primary injury. In the active reproduction and visual estimation tests, no significant defects were found at any time during the first year in these consecutively studied patients.

Adolescent↗

PubMed1997

Cervical radiculopathy: pain, muscle weakness and sensory loss in patients with cervical radiculopathy treated with surgery, physiotherapy or cervical collar. A prospective, controlled study.

This prospective, randomised study compares the efficacy of surgery, physiotherapy and cervical collar with respect to pain, motor weakness and sensory loss in 81 patients with long-lasting cervical radiculopathy corresponding to a nerve root that was significantly compressed by spondylotic encroachment, with or without an additional bulging disk, as verified by MRI or CT-myelography. Pain intensity was registered on a visual analogue scale (VAS), muscle strength was measured by a hand-held dynamometer, Vigorometer and pinchometer. Sensory loss and paraesthesia were recorded. The measurements were performed before treatment (control 1), 4 months after the start of treatment (control 2) and after a further 12 months (control 3). A healthy control group was used for comparison and to test the reliability of the muscle-strength measurements. The study found that before start of treatment the groups were uniform with respect to pain, motor weakness and sensory loss. At control 2 the surgery group reported less pain, less sensory loss and had better muscle strength, measured as the ratio of the affected side to the non-affected side, compared to the two conservative treatment groups. After a further year (control 3), there were no differences in pain intensity, sensory loss or paraesthesia between the groups. An improvement in muscle strengths, measured as the ratio of the affected to the non-affected side, was seen in the surgery group compared to the physiotherapy group in wrist extension, elbow extension, shoulder abduction and internal rotation, but there were no differences in the ratios between the collar group and the other treatment groups. With respect to absolute muscle strength of the affected sides, there were no differences at control 1. At control 2, the surgery group performed some-what better than the two other groups but at control 3 there were no differences between the groups. We conclude that pain intensity, muscle weakness and sensory loss can be expected to improve within a few months after surgery, while slow improvement with conservative treatments and recurrent symptoms in the surgery group make the 1-year results about equal.

Adult↗

PubMed1997

Quantifying work load in neck, shoulders and wrists in female dentists.

OBJECTIVE: To assess the work load in neck and upper limbs of dentists. METHODS: Twelve right-handed female dentists (six with and six without a history of definite neck/shoulder disorders, pair-wise matched for age) were studied when performing authentic dental work. Electromyography (EMG) was used to quantify the muscular load of the shoulders bilaterally and of the right forearm. Positions and movements of the head and wrists were measured, using inclinometers and electrogoniometers. RESULTS: During work, the median load for the right upper trapezium muscle was 8.4% of the maximal voluntary EMG activity (MVE); during 90% of the time the load was > or = 3.3% MVE ("static" load). The figures were somewhat lower on the left side (7.0% and 2.5% MVE, respectively). Subjects with disorders had over all lower load levels for the trapezius muscles, although not statistically significant at < 0.05, than those without disorders. During a standardized reference contraction for the trapezius, the load was 17% MVE, and the quotient between MVE and torque [normalized to maximal voluntary torque (MVC)] was 0.5. These figures may be used for transformations. The muscular load on the right forearm was similar to the loads on the trapezius. The head was, on average, forward tilted > or = to 39 degrees, and during 10% of the time > or = 49 degrees. The left hand was held in more static positions, with palmar flexion and ulnar deviation, also reflected by lower angular velocities and repetitiveness, as compared with the right one, which was dorsiflexed. CONCLUSIONS: Dentists are exposed to high load on the trapezius muscles bilaterally, and steep, prolonged forward bending of the head. Further, for the wrists the postures were constrained, but the dynamic demands were low.

Adult↗