- 358405229230
Jari Ylinen
Kuopio University, Department of physical medicine and rehabilitation, Department Member
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... more
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. Result...
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To study the effectiveness of a 12-month exercise therapy on kinesiophobia and physical activity in patients with spondylolisthesis after lumbar spine fusion. Randomized controlled trial. Patients (n = 98) with spondylolisthesis who had... more
To study the effectiveness of a 12-month exercise therapy on kinesiophobia and physical activity in patients with spondylolisthesis after lumbar spine fusion. Randomized controlled trial. Patients (n = 98) with spondylolisthesis who had undergone lumbar spine fusion. 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. Before the intervention, the median (first quartile; third quartile) of TSK w...
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Fighter pilots' muscular strength and endurance are subjected to very high demands. Pilots' fatigued muscles are at higher risk for injuries. The purpose of this study was to compare the effects of two different training methods... more
Fighter pilots' muscular strength and endurance are subjected to very high demands. Pilots' fatigued muscles are at higher risk for injuries. The purpose of this study was to compare the effects of two different training methods in reducing muscular loading during in-flight and cervical loading testing (CLT). There were 16 volunteer Finnish Air Force cadets who were divided into 2 groups: a strength training group (STG) and a trampoline training group (TTG). During the 6-wk training period, the STG performed dynamic flexion and extension and isometric rotation exercises, and the TTG performed trampoline bouncing exercises. During in-flight and CLT, muscle strain from the sternocleidomastoid, cervical erector spinae, trapezius, and thoracic erector spinae muscles was recorded with EMG. In-flight muscle strain in the STG after the training period decreased in the sternocleidomastoid 50%, cervical erector spinae 3%, trapezius 4%, and thoracic erector spinae 8%. In the TTG, the ...
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A cross-sectional study was conducted. To compare maximal flexion, extension, and rotation strength as well as force-time characteristics of trunk muscles in patients who undergo lumbar disc herniation with those in healthy control... more
A cross-sectional study was conducted. To compare maximal flexion, extension, and rotation strength as well as force-time characteristics of trunk muscles in patients who undergo lumbar disc herniation with those in healthy control subjects 2 months after surgery. Insufficient attention has been paid to muscle strength characteristics after lumbar disc herniation surgery. For this study, 30 postoperative patients with lumbar disc herniation and 30 healthy control subjects volunteered to participate. Isometric trunk flexion, extension in the standing position, and seated rotation strength were tested bilaterally in a neutral posture and at 30 degrees axial prerotation. The area under the curve was calculated to analyze explosive force capacity. Dynamic endurance strength was measured by calculating the repetition maximum. Pain during the strength measurements was assessed by a visual analog scale. The healthy control subjects showed 44% and 36% higher isometric trunk flexion (P < 0.001) and extension (P < 0.001) forces, respectively, than the patients. The respective values for the area under the curve were 41% and 37% higher for the trunk flexors (P < 0.001) and extensors (P < 0.001) in the healthy control subjects than in the patients. The differences in trunk rotation force between the groups were statistically significant when the lower body was rotated 30 degrees to the right (P = 0.023) or to the left (P = 0.043) and the upper body was rotated in the opposite direction. Furthermore, in the dynamic endurance strength test, the healthy control subjects performed 70% more repetitions both for trunk flexors and extensors than did the patients. Some of the patients reported mild pain during the strength measurements, but the level of pain did not correlate with the strength values. The recovery of maximal endurance and explosive type strength characteristics is incomplete in patients with lumbar disc herniation 2 months after surgery. Active strength training is recommended to restore muscle function in these patients.
Research Interests: Surgery, Biomedical Engineering, Skeletal muscle biology, Spine, Humans, and 15 moreFemale, Male, Exploration, Bending, Clinical Sciences, Middle Aged, Adult, Time Factors, Muscle contraction, Rotation, Cross sectional Study, Cross Sectional Studies, Biomechanical Phenomena, Isometric Contraction, and lumbar vertebrae
In all studies in which the strength of the neck extensor muscles has been measured, the level of thoracic support has been adjusted differently so direct comparison of the results is not possible. To measure and compare the isometric... more
In all studies in which the strength of the neck extensor muscles has been measured, the level of thoracic support has been adjusted differently so direct comparison of the results is not possible. To measure and compare the isometric force and isometric torque of neck extensor muscles at different levels of thoracic support. Twenty healthy women volunteered for the study. The maximum isometric force of the neck extensor muscles was measured with the thoracic support located at five different levels. The highest level was set at the level of the spine of the scapula (level I) and the other levels were located 2.5 cm lower than the previous one, with the lowest level set 10 cm below the highest level. The maximum isometric torque for each level was calculated by multiplying the isometric force by the length of the lever arm measured from the upper tip of the thoracic support to the centre point of the cell load at the occiput. The maximum isometric force and maximum isometric torque of the neck extensor muscles were increased step by step from 130.5 N to 138.9 N, 141.9 N, 147.9 N and 155.4 N and from 33.7 Nm to 38.7 Nm, 42.5 Nm, 47.2 Nm and 52.7 Nm, respectively. Except for the isometric force of the cervical extensor muscles measured at levels II and III, the differences between the other levels were significant (p<0.05). There was a significant correlation between isometric force and isometric torque measurements of the neck extensor muscles at different levels (0.81<r<0.96). Maximum isometric force and maximum isometric torque measurements of the neck extensor muscles vary with the length of the lever arm. It is recommended that a specific level of thoracic support should be used in follow-up and intervention studies. Setting the level of thoracic support at a specific level will make it possible to compare the strength of the neck extensor muscles in different studies. Measurements at the level of the spine of the scapula were easier and less time consuming.
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The aim was to assess the level of lower body pain among people with previous femoral neck fracture, and whether the type of surgery was associated with pain and physical function a mean of 2 years after surgery. The study included 115... more
The aim was to assess the level of lower body pain among people with previous femoral neck fracture, and whether the type of surgery was associated with pain and physical function a mean of 2 years after surgery. The study included 115 community-dwelling older adults aged 60 years and older with previous femoral neck fracture, and 31 reference subjects without previous lower limb injuries. A total of 30 patients had internal fixation surgery, 70 had hemiarthroplasty and 15 had total hip replacement. All patients had surgery in the same hospital and received typical inpatient rehabilitation. From 1.6 months to 7.5 years after the fracture, the patients underwent examination including clinical evaluation, measurements of pain in the lower body (visual analog scale), physical function (maximal walking speed, Timed Up & Go, Berg Balance Scale) and self-reported walking difficulties. Hip fracture patients reported more pain (81 ± 88 mm) compared with the reference group (25 ± 39 mm, P = ...
Research Interests: Risk assessment, Finland, Humans, Female, Male, and 15 moreMusculoskeletal pain, Hip Fractures, Clinical Sciences, Aged, Middle Aged, Prognosis, Geriatric Assessment, Risk Assessment, Reference Values, Pain Measurement, Geriatrics and Gerontology, Case Control Studies, Mobility limitation, Injury Severity Score, and Recovery of Function
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Subacromial impingement syndrome is a common orthopedic condition. Patients operated due to shoulder impingement (n=104) were sent a questionnaire inquiring rehabilitation procedures before and after surgery, pain and shoulder function.... more
Subacromial impingement syndrome is a common orthopedic condition. Patients operated due to shoulder impingement (n=104) were sent a questionnaire inquiring rehabilitation procedures before and after surgery, pain and shoulder function. Response rate was 68%, mean age of the patients was 53 years. Before surgery, 50% of the patients had received physiotherapy. The symptoms disappeared after surgery in the majority of the patients. However, 13% of the patients had significant shoulder pain (VAS over 30 mm) one year postoperatively and 15% had considerable functional deficit. To avoid unnecessary operations for shoulder impingement proper conservative treatment must be provided before surgery.
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Despite chronic neck pain being so common in the population, few randomized studies have evaluated exercise methods in treating the neck disorders. The aim of this review was to reassess the effectiveness of different exercise methods in... more
Despite chronic neck pain being so common in the population, few randomized studies have evaluated exercise methods in treating the neck disorders. The aim of this review was to reassess the effectiveness of different exercise methods in relieving pain and improving disability in patients with chronic nonspecific neck pain. Ten randomized controlled or comparative high-quality trials were included in a more detailed analysis using patient-oriented primary outcome measures (e.g., patient's rated pain and disability) as well as pressure pain threshold and functional outcomes (neck strength and range of motion). Findings revealed moderate evidence supporting the effectiveness of both long-term dynamic as well as isometric resistance exercises of the neck and shoulder musculature for chronic or frequent neck disorders. Findings revealed no evidence supporting the long-term effectiveness of postural and proprioceptive exercises or other very low intensity exercises. Clinicians are en...
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Tissue compliance measurements were used for documentation of soft tissue consistency and made possible the diagnosis of muscle spasm and the effects of treatment. We have developed a new digital electronic operated tissue compliance... more
Tissue compliance measurements were used for documentation of soft tissue consistency and made possible the diagnosis of muscle spasm and the effects of treatment. We have developed a new digital electronic operated tissue compliance meter to quantify the soft tissue hardness and resistance more objectively than the conventional hand-held mechanical tissue compliance meters. The ranges of measurements were able to perform to a maximum depth of 50 millimeters from the body surface with maximal load of 4000 grams. In lateral epicondylitis was demonstrated the effect of treatment by increase of total work (area).
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Este libro presenta una revisión rigurosa de los efectos saludables de los estiramientos terapéuticos y muestra de forma comparativa las diferentes técnicas de estiramientos. El autor expone las bases teóricas y los mecanismos... more
Este libro presenta una revisión rigurosa de los efectos saludables de los estiramientos terapéuticos y muestra de forma comparativa las diferentes técnicas de estiramientos. El autor expone las bases teóricas y los mecanismos fisiológicos y fundamenta de forma ...
To study the effect of isometric neck strength exercises on upper cervical stability in patients with rheumatoid arthritis (RA). Twenty patients with a mean (SD) age of 58 (9) years and duration of RA of 27 (10) years volunteered for the... more
To study the effect of isometric neck strength exercises on upper cervical stability in patients with rheumatoid arthritis (RA). Twenty patients with a mean (SD) age of 58 (9) years and duration of RA of 27 (10) years volunteered for the study. Lateral radiographs of the cervical spine were taken to measure the current atlantoaxial distance (AAD) in flexion and extension. Maximal isometric neck flexion and extension strength values were measured by a dynamometer. Thereafter, AADs were measured from radiographs taken at 80-90% resistance of maximal strength. According to the full flexion radiographs at baseline, the patients were classified into three groups: eight patients without anterior atlantoaxial subluxation (aAAS) [AAD = 2.1 (2-3) mm], seven with unstable aAAS [AAD = 6.6 (5-8) mm], and five with stable aAAS [AAD = 5.5 (5-7) mm]. During resisted flexion the AAD decreased by 5 (3-7) mm (p<0.001) in the unstable aAAS group, while in the other two groups the changes were minor. During resisted extension the AAD increased by 3 (2-6) mm (p<0.001) in the cases with unstable aAAS only. Isometric exercising towards flexion decreases the AAD in cases with unstable aAAS. Submaximal loading of the neck extensors by pushing the back of the head against the resistance even in the neutral position of the cervical spine leads to a decrease in the width of the cervical spine canal and is not recommended in unstable aAAS.
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The main aim of this study was to explore the occurrence and changes of neck pain in pain-free preadolescents. The evaluation was performed at 1- and 4-year follow-ups. Of the pain-free preadolescents, 366 (71.9%) completed structured... more
The main aim of this study was to explore the occurrence and changes of neck pain in pain-free preadolescents. The evaluation was performed at 1- and 4-year follow-ups. Of the pain-free preadolescents, 366 (71.9%) completed structured pain questionnaires at 1 and 4 years. The occurrence of neck pain at least once a month was 21.3 and 43.4% and at least once a week was 6.3 and 19.4%. Sex difference was found only at the 4-year follow-up, when subjects were 13-16-year-old. Neck pain was then more common among girls than boys (P < 0.001). The intensity of pain increased with the frequency of pain (P < 0.001). Of those with neck pain, 28% had used painkillers. The proportion increased with the frequency of neck pain (P = 0.054). Neck pain occurred more often with some other musculoskeletal pain than as a single pain. The frequency of neck pain correlated with the frequency of headache (r = 0.39 [95% confidence interval (CI), 0.30-0.47]) and with the disability (r = 0.26 [95% CI, 0.16-0.35]). This study strengthens the results of the previous cross-sectional studies that occurrence of neck pain increases with age, and that neck pain becomes more common among girls than boys in adolescence. Among preadolescents who were originally pain-free, there was only a small proportion who reported frequent neck pain at both 1 and 4 years. It also showed that the frequency of neck pain reflects the intensity of pain fairly well.
Research Interests: Pain, Adolescent, Humans, Child, Female, and 15 moreMale, Neck Pain, Musculoskeletal pain, Prevalence, Analysis of Variance, Retrospective Studies, Chi Square Distribution, Cross sectional Study, Pain Measurement, Confidence Interval, Disabled Persons, Disability Evaluation, Sex Characteristics, Psychology and Cognitive Sciences, and Medical and Health Sciences
Lumbar spine fusion (LSF) has been reported to change the biomechanics of the spine and therefore the rehabilitation after LSF is important. In this study, the effect of selected neutral spine control exercises on activation of trunk... more
Lumbar spine fusion (LSF) has been reported to change the biomechanics of the spine and therefore the rehabilitation after LSF is important. In this study, the effect of selected neutral spine control exercises on activation of trunk muscles after LSF was evaluated. Muscle activity was measured by surface electromyography of the rectus abdominis, external oblique, longissimus, and multifidus muscles during 6 exercises in 22 LSF patients (mean age = 59 years; age range = 25-84 years; 50% women). Muscle activity concurrent with trunk flexion and extension during maximal voluntary isometric contraction (MVIC) was used as a reference value. Pain during the effort was assessed with a visual analog scale (VAS). The highest activity in the rectus abdominis muscles was measured during bilateral shoulder extension (51% of MVIC), and in the external oblique, it occurred during unilateral shoulder horizontal adduction (48% of MVIC) and unilateral hip extension (46% of MVIC) exercises. The highest activation of the multifidus and longissimus muscles (60-104%) was measured during bilateral shoulder flexion and modified Roman chair exercises. The mean (SD) self-reported back pain VAS scores during exercises varied from 3 (7) to 16 (26). Neutral spine control exercises activate trunk muscles and cause minimal pain and are therefore feasible exercises for home-based training to improve muscle endurance and postural control after LSF. In addition, the level of muscle activity during bilateral shoulder flexion and modified Roman chair exercises was over 60% of MVIC, justifying their use in training for strength of the trunk extensor muscles.
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Special training methods in wrestling have been assumed to improve the stability and tolerance of the neck. The aim of this study was to measure the neck strength levels reached in an extremely physically demanding sport. A neck strength... more
Special training methods in wrestling have been assumed to improve the stability and tolerance of the neck. The aim of this study was to measure the neck strength levels reached in an extremely physically demanding sport. A neck strength measurement system was used to measure various parameters of maximal isometric neck strength in Finnish senior wrestlers competing at the international level. The results were compared with those achieved by junior wrestlers and a control group. The means (SD) of the maximal isometric neck strength for cervical rotation were 0.4 (0.1) Nm.kg(-1) for the senior wrestlers, 0.3 (0.1) Nm.kg(-1) for the junior wrestlers, and 0.2 (0.1) Nm.kg(-1) for the nonsportsmen. The respective results for cervical flexion were 4.4 (1.4), 3.8 (0.7), and 2.3 (0.8) Nm.kg(-1); for extension, 6.0 (1.1), 5.9 (0.7), and 4.0 (0.9) Nm.kg(-1). Neck strength in flexion seems to improve more than in extension as the result of wrestling. The greatest difference was found in rotation, which in the senior wrestlers was almost 3 times that in the nonsportsmen. There was great individual variation within all groups, and the results revealed weaknesses in all directions. Maximal neck strength measurements provide information useful in planning training programs to correct possible muscle deficiency and imbalance.
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Previously, in a randomized study, we showed that women with chronic neck pain were able to perform intensive training for neck and shoulder muscles and that the increase in strength was accompanied by a reduction in pain and disability.... more
Previously, in a randomized study, we showed that women with chronic neck pain were able to perform intensive training for neck and shoulder muscles and that the increase in strength was accompanied by a reduction in pain and disability. The changes were significantly greater in the training groups compared with controls. The aim of the present study was to evaluate whether the controls would achieve similar results. Thus, 59 women in the control group initiated high-intensity strength training. Maximal isometric neck strength increased by 44% in both flexion and rotation and 27% in extension at the 2-year follow-up. Statistically and also clinically significant decreases in neck pain and disability indices occurred. Stretching and aerobic exercising during the first follow-up year produced only minor changes in both subjective and functional measures. Adding progressive strength training for the second year led to a significant improvement in neck strength and also to a considerable decrease in the pain and disability scores. Thus, to achieve effective rehabilitation in cases of chronic neck pain, a combination of strength training and stretching exercises are recommended.
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This study examined the force production characteristics, activation/coactivation and endurance capacity of the neck extension and flexion muscles in healthy men (n=29) and women (n=28) divided into three age groups (18-26 years, 30-37... more
This study examined the force production characteristics, activation/coactivation and endurance capacity of the neck extension and flexion muscles in healthy men (n=29) and women (n=28) divided into three age groups (18-26 years, 30-37 years and 45-55 years). Force and electromyography (EMG) measurements were performed during the maximal voluntary isometric extension and flexion actions. This was followed by an endurance test (ET; 60% force level of maximal voluntary contraction sustained until exhaustion), after which the force and EMG recordings were repeated. Men were both stronger and had higher values (P<0.001) for explosive force (rate of force development, RFD) than women in both actions. Younger subjects of both genders exhibited larger (P<0.05 in women) RFD values than older subjects in extension. The coactivation of the antagonist muscles during the maximal extension or flexion did not differ significantly between men and women, but the coactivation of the antagonists was larger (P<0.05) in the older age groups than in the youngest group. Women maintained the 60% force level longer than men in both actions (extension, P<0.001; flexion, not significant). The fatiguing loading led to significant decreases in maximal isometric force (P<0.001) and RFD (P<0.01-0.001), but these relative decreases did not differ between the groups. In conclusion, large gender differences in the voluntary extension and flexion force production characteristics of the neck muscles did exist, as reported earlier for other muscles of the body. No age-related differences were observed in maximal force of the extension and flexion actions within the age ranges of the subject groups studied here, but the older subjects exhibited greater coactivation and produced lower force values in the early portions of the force/time curve of the extension than the youngest group. The data indicate that explosive force production may be sensitive to aging earlier than maximal strength in the case of the neck extensor muscles.
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To assess the prognostic value of some preoperative and early post-operative indicators in the prediction of disability 14 months after lumbar disc surgery. Of 173 patients, who had participated in baseline measurements, 145 (84%)... more
To assess the prognostic value of some preoperative and early post-operative indicators in the prediction of disability 14 months after lumbar disc surgery. Of 173 patients, who had participated in baseline measurements, 145 (84%) attended the 14-month follow-up. Before surgery the duration and intensity of pain was assessed. Follow-up questionnaires were completed during check-ups and included items on pain (VAS), Oswestry and Million disability indices, depression (BDS) and work status. Two months after surgery average back pain was 67% lower and leg pain 70% lower than pre-operatively. The median Oswestry and Million disability indices were 14 and 15 at 2-months and remained low also at 14-months check-up. Further, the post-operative Oswestry and Million disability indices and BDS were highly associated with 14-month back and leg pain. Although the outcome of the patients was mostly good, 5% and 8% of them, respectively, reported severe pain at 2- and 14-month check-ups. As recovery following lumbar disc surgery occurred to a great extent during the first 2 months, the early post-operative outcome appears to be quite a reliable indicator of the postoperative outcome in 1-year follow-up. The strong association between pain and the disability indices allows us to conclude that both the Million and Oswestry indices are clinically useful instruments in the evaluation of outcome in these cases.
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The aim was to evaluate the effect of the posterior surgical approach on hip muscle strength and range of movement (ROM). Maximal isometric external and internal rotator strength of the hip muscles and bilateral leg extension strength... more
The aim was to evaluate the effect of the posterior surgical approach on hip muscle strength and range of movement (ROM). Maximal isometric external and internal rotator strength of the hip muscles and bilateral leg extension strength were measured by dynamometers. Active (AROM) and passive (PROM) range of motion of the hip were measured by goniometers in 30 patients before and 3, 6 and 12 months after hip resurfacing. Postoperatively the patients were advised to return to their usual physical activities. Prior to the surgery internal rotation strength was on the same level on both sides, whereas external rotation strength of the operated hip was 26% (p < 0.001) lower compared with the unoperated side. External rotation strength remained at the lowered level, but internal rotation strength of the operated hip increased over the level of the contralateral side (both p < 0.001) at 12-month follow-up leading to the imbalance in external/internal rotation strength ratio (p < 0.001). Preoperatively, all active and passive ROMs of the operated side were statistically lower than on the unoperated side (p < 0.001). ROMs of the operated hip improved significantly with the exceptions that active external rotation decreased after the operation (p < 0.001). The patients reported remarkable decrease in pain postoperatively. However, the surgical procedure, particularly the division of the external hip rotator muscles led to specific external rotation strength and ROM deficits. Because typical spontaneous physical activity could not restore hip function, there is a need for specific postoperative rehabilitative programs.
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Research Interests: Mechanical Engineering, Physiotherapy, Biomedical Engineering, Adolescent, Humans, and 15 moreClinical Biomechanics, Female, Male, Neck Pain, Cervical Vertebrae, Repeated Measures, Adult, Muscle Testing, Reproducibility of Results, Neck Muscles, Sensitivity and Specificity, Tensile Strength, Reference Values, Equipment Design, and Isometric Contraction
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Research Interests: Exercise therapy, Medicine, Muscle strength, Humans, Physical Rehabilitation, and 15 moreFemale, Exercise, Abdominal Muscles, Electromyography, Posture, Clinical Sciences, Middle Aged, Adult, Physical Exercise, Postural Balance, ISOMETRIC, Cross sectional Study, Cross Sectional Studies, Cohort Studies, and Isometric Contraction
Research Interests: Exercise therapy, Medicine, Muscle strength, Humans, Physical Rehabilitation, and 15 moreFemale, Exercise, Abdominal Muscles, Electromyography, Posture, Clinical Sciences, Middle Aged, Adult, Physical Exercise, Postural Balance, ISOMETRIC, Cross sectional Study, Cross Sectional Studies, Cohort Studies, and Isometric Contraction
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To compare the effects of manual therapy and stretching exercise on neck pain and disability. An examiner-blinded randomized cross-over trial. A total of 125 women with non-specific neck pain. PATIENTS were randomized into 2 groups. Group... more
To compare the effects of manual therapy and stretching exercise on neck pain and disability. An examiner-blinded randomized cross-over trial. A total of 125 women with non-specific neck pain. PATIENTS were randomized into 2 groups. Group 1 received manual therapy twice weekly and Group 2 performed stretching exercises 5 times a week. After 4 weeks the treatments were changed. The follow-up times were after 4 and 12 weeks. Neck pain (visual analogue scale) and disability indices were measured. Mean value (standard deviation) for neck pain was 50 mm (22) and 49 mm (19) at baseline in Group 1 and Group 2, respectively, and decreased during the first 4 weeks by 26 mm (95% Confidence Interval 20-33) and 19 mm (12-27), respectively. There was no significant difference between groups. Neck and shoulder pain and disability index decreased significantly more in Group 1 after manual therapy (p=0.01) as well as neck stiffness (p=0.01). Both stretching exercise and manual therapy considerably decreased neck pain and disability in women with non-specific neck pain. The difference in effectiveness between the 2 treatments was minor. Low-cost stretching exercises can be recommended in the first instance as an appropriate therapy intervention to relieve pain, at least in the short-term.
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Referral to a specialist has a significant influence on management of the patient and costs associated with the treatments. However, development and research of the process by which patients are referred has been almost neglected.... more
Referral to a specialist has a significant influence on management of the patient and costs associated with the treatments. However, development and research of the process by which patients are referred has been almost neglected. Expectations considering the purpose, contents, and timing of the referral of the consulting physician and the consultant do not always meet. A structured, electronic consultation letter was developed to respond this need. Functionality and interactivity are the key elements of the referral, including (1) an electronic referral letter to a specialist, (2) interactive education in clinical examination and management of shoulder disorders, and (3) an instrument of clinical examination and documentation of shoulder disorders.
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The anatomy of the human cervical region has a special complexity. Ultrasonography is a scanning technique, which has been successfully used to identify and measure the cervical muscle dimensions. The purpose of this study was to detect... more
The anatomy of the human cervical region has a special complexity. Ultrasonography is a scanning technique, which has been successfully used to identify and measure the cervical muscle dimensions. The purpose of this study was to detect with the use of real-time ultrasonography the dimensional changes of the human semispinalis capitis muscle (SECM) during isometric cervical extension. Six junior ice hockey players took part in the study. We simultaneously measured the values of estimates, such as breadth or anteroposterior dimension (APD) and width or lateral dimension (LD), of the SECM cross-sectional area during isometric cervical extension at different maximum voluntary contraction (MVC) percent levels (0%, 20%, 40%, 60%, 80%, and 100%). The result of multiplication of the linear dimensions (APD x LD), considered as the size of the SECM, increased (p < 0.05) with increasing the level of the cervical extension force. The correlation between muscle size and extension force of 10...
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Lumbar spine fusion (LSF) has been reported to change the biomechanics of the spine and therefore the rehabilitation after LSF is important. In this study, the effect of selected neutral spine control exercises on activation of trunk... more
Lumbar spine fusion (LSF) has been reported to change the biomechanics of the spine and therefore the rehabilitation after LSF is important. In this study, the effect of selected neutral spine control exercises on activation of trunk muscles after LSF was evaluated. Muscle activity was measured by surface electromyography of the rectus abdominis, external oblique, longissimus, and multifidus muscles during 6 exercises in 22 LSF patients (mean age = 59 years; age range = 25-84 years; 50% women). Muscle activity concurrent with trunk flexion and extension during maximal voluntary isometric contraction (MVIC) was used as a reference value. Pain during the effort was assessed with a visual analog scale (VAS). The highest activity in the rectus abdominis muscles was measured during bilateral shoulder extension (51% of MVIC), and in the external oblique, it occurred during unilateral shoulder horizontal adduction (48% of MVIC) and unilateral hip extension (46% of MVIC) exercises. The highest activation of the multifidus and longissimus muscles (60-104%) was measured during bilateral shoulder flexion and modified Roman chair exercises. The mean (SD) self-reported back pain VAS scores during exercises varied from 3 (7) to 16 (26). Neutral spine control exercises activate trunk muscles and cause minimal pain and are therefore feasible exercises for home-based training to improve muscle endurance and postural control after LSF. In addition, the level of muscle activity during bilateral shoulder flexion and modified Roman chair exercises was over 60% of MVIC, justifying their use in training for strength of the trunk extensor muscles.
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The purpose of the present study was to investigate neuromuscular performance characteristics in open-wheel and rally drivers using the cross-sectional study design. The subjects (N = 28) consisted of experienced international-level... more
The purpose of the present study was to investigate neuromuscular performance characteristics in open-wheel and rally drivers using the cross-sectional study design. The subjects (N = 28) consisted of experienced international-level open-wheel drivers (n = 9), experienced international-level rally drivers (n = 9) and a physically active nondriving male control group (n = 10). In 3 separate test sessions, speed, muscle strength, and endurance tests were performed. The rally drivers had higher (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) grip, shoulder flexion, and ankle plantar flexion strength, as compared to the control group. The open-wheel drivers showed higher strengths (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) than the controls in neck forces, grip, shoulder flexion, and leg extension. The rally drivers were stronger (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) than the open-wheel drivers in grip, plantar flexion, and trunk extension forces, whereas the open-wheel drivers were stronger (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) than the rally drivers in neck lateral flexions and extension forces. Thus, competitive long-term open-wheel and rally drivers differ specifically in neuromuscular performance. For practice, these findings suggest that rally drivers should concentrate on training hand, ankle, and trunk muscles, whereas open-wheel drivers should train neck muscles, especially, and all other muscle groups rather equally.
Research Interests:
To compare the efficacy of three 12-month training programmes on headache and upper extremity pain in patients with chronic neck pain. A total of 180 female office workers, with chronic, non-specific neck pain were randomly assigned to 3... more
To compare the efficacy of three 12-month training programmes on headache and upper extremity pain in patients with chronic neck pain. A total of 180 female office workers, with chronic, non-specific neck pain were randomly assigned to 3 groups. The strength group performed isometric, dynamic and stretching exercises. The endurance group performed dynamic muscle and stretching exercises. The control group performed stretching exercises. Pain was assessed with a visual analogue scale. Each group was divided into 3 subgroups according to headache intensity. At the 12-month follow-up headache had decreased by 69% in the strength group, 58% in the endurance group and 37% in the control group compared with baseline. Neck pain diminished most in the strength group with the most severe headache (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). In the dose analysis, one metabolic equivalent per hour of training per week accounted for a 0.6-mm decrease in headache on the visual analogue scale. Upper extremity pain decreased by 58% in the strength group, 70% in the endurance group and 21% in the control group. All of the training methods decreased headache. However, stretching, which is often recommended for patients, was less effective alone than when combined with muscle endurance and strength training. Care must be taken in recommending the type of training to be undertaken by patients with severe cervicogenic headache.
Research Interests:
Research Interests: Biomedical Engineering, Treatment Outcome, Employment, Activities of Daily Living, Finland, and 23 moreWorking Time, Humans, Functional Capacity, Back Pain, Chronic Disease, Female, Male, Follow-up studies, Risk factors, Early Retirement, Clinical Sciences, Postoperative pain, Middle Aged, Questionnaires, Adult, Time Factors, Workers Compensation, Risk Factors, Physical Function, Cumulant, Work Capacity Evaluation, lumbar vertebrae, and Disability Evaluation
To compare the effectiveness of a 12-month home-based combined strength training and stretching programme against stretching alone in the treatment of chronic neck pain. A randomized follow-up study. One hundred and one patients with... more
To compare the effectiveness of a 12-month home-based combined strength training and stretching programme against stretching alone in the treatment of chronic neck pain. A randomized follow-up study. One hundred and one patients with chronic non-specific neck pain were randomized in two groups. The strength training and stretching group was supported by 10 group training sessions and the stretching group was instructed to perform stretching exercises only as instructed in one group session. Neck pain, disability, neck muscle strength and mobility of cervical spine were measured before and after the intervention. No significant differences in improvement in neck pain and disability were found between the two training groups. Mean (SD) pain decreased from 64 (17) mm by 37 (95% confidence interval (CI) 44 to 30) mm in the strength training and stretching group, and from 60 (17) mm by 32 (39 to 25) mm in the stretching group. The improvements in disability were significant in both groups (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001), while the changes in neck strength and mobility were minor. Training adherence decreased over time from the targeted three sessions a week, ending up at 1.1 (0.7) times a week for strength training and stretching group and 1.4 (0.8) times a week for stretching group. No statistically significant differences in neck pain and disability were observed between the two home-based training regimens. Combined strength training and stretching or stretching only were probably as effective in achieving a long-term improvement although the training adherence was rather low most of the time.