Projekt GrOBEat - Græsfodret økologisk kalvekød - kvaliteten af kød fra 8 måneders kalve

Bachelor projekt i Agrobiologi under projektet GrOBeat

Muscle activity and head kinematics in unconstrained movements in subjects with chronic neck pain; cervical motor dysfunction or low exertion motor output?

Background: Chronic neck pain after whiplash associated disorders (WAD) may lead to reduced displacement and peak velocity of neck movements. Dynamic neck movements in people with chronic WAD are also reported to display altered movement patterns such as increased irregularity, which is suggested to signify impaired motor control. As movement irregularity is strongly related to the velocity and displacement of movement, we wanted to examine whether the increased irregularity in chronic WAD could be accounted for by these factors. Methods: Head movements were completed in four directions in the sagittal plane at three speeds; slow (S), preferred (P) and maximum (M) in 15 men and women with chronic WAD and 15 healthy, sex and age-matched control participants. Head kinematics and measures of movement smoothness and symmetry were calculated from position data. Surface electromyography (EMG) was recorded bilaterally from the sternocleidomastoid and splenius muscles and the root mean square (rms) EMG amplitude for the accelerative and decelerative phases of movement were analyzed. Results: The groups differed significantly with regard to movement velocity, acceleration, displacement, smoothness and rmsEMG amplitude in agonist and antagonist muscles for a series of comparisons across the test conditions (range 17 – 121%, all p-values < 0.05). The group differences in peak movement velocity and acceleration persisted after controlling for movement displacement. Controlling for differences between the groups in displacement and velocity abolished the difference in measures of movement smoothness and rmsEMG amplitude. Conclusions: Simple, unconstrained head movements in participants with chronic WAD are accomplished with reduced velocity and displacement, but with normal muscle activation levels and movement patterns for a given velocity and displacement. We suggest that while reductions in movement velocity and displacement are robust changes and may be of clinical importance in chronic WAD, movement smoothness of unconstrained head movements is not

Associations between treatment goals, patient characteristics, and outcome measures for patients with musculoskeletal disorders in physiotherapy practice

Background Goal setting is linked to person-centred care and is a core component in physiotherapy, but the associations between goal classes, patient characteristics and outcome measures for musculoskeletal disorders has not been investigated. The study’s purpose was to examine 1) how goals used in clinical practice for patients with musculoskeletal disorders (MSD) are distributed in classes based on ICF, 2) if goal classes were associated with patient characteristics and 3) whether goal classes were associated with treatment outcome. Methods Data analysis from a longitudinal observational study (N = 2591). Goals were classified in symptom, function/structure, activity/participation and non-classifiable. Associations between patient characteristics and goal classes were examined using x2 and one-way ANOVA. Association between goal classes and outcomes were examined using multiple logistic and linear regression models. Outcomes are reported at 3 months or end of treatment if prior to 3 months. Results There was a high variability in goals used for patients with MSD. 17% had symptom goals, 32.3% function/structure, 43.4% activity/participation and 7.4% non-classifiable goals. We found significant associations between goal classes and age, gender, severity, region of pain/diagnosis and emotional distress (all p < .001). Activity/participation goals were associated with better outcomes on GPE (OR 1.80, 95% CI 1.23–2.66). Non-classifiable goal was associated with poorer outcomes on pain intensity (B .87, 95% CI .32–1.43). Conclusion There is an association between goal classes and patient characteristics. Including activity/participation in the main goal was associated with better outcomes for GPE and having a non-classifiable goal was associated with poorer outcomes for pain intensity. Trial registration The project is approved by the Regional committee for Medical and Health Research Ethics in Norway (REC no. 2013/2030). https://clinicaltrials.gov/ct2/show/NCT03626389

Can pain and function contribute in diagnosing temporomandibular disorders?

Purpose: To examine whether persons with temporomandibular disorders (TMD) with or without anterior disc displacement without reduction (ADDWOR) report pain and function differently. Design: A quantitatively cross-sectional study. Materials: Thirty-five persons, aged 18–70 years (89% women) with 58 symptomatic joints or pain in surrounding area and reduced mouth-opening were recruited among patients from health-professionals in the region of Oslo, Norway. Methods: The participants reported pain on a visual analog scale (VAS) and function by the Patient-Specific Functional Scale (PSFS). Results: There was not a significant difference between the two groups with respect to duration of pain (p=0.624), pain on the examination day (p=0.602) or worst experienced pain (p=0.664). Persons with ADDWOR have major problems with chewing hard food and yawning (84%) compared with those without ADDWOR (78%). There was a significant difference in function (PSFS) between the two groups (p=0.005). Conclusion: The study shows that persons with TMD with ADDWOR reports function differently on PSFS than persons with TMD without ADDWOR, but the kind and degree of functional problems does not reveal whether ADDWOR is present or not. There was not a significant difference between the two groups with respect to pain reporting

Shoulder patients in primary and specialist health care. A cross-sectional study

Objectives Shoulder pain is a prevalent problem and has a considerable impact on the use of primary and specialist health care in Norway. It is important to improve short-term recovery and reduce long-term consequences regarding pain and disability, the high costs of treatment and the amount of sick-leave. Treatment for non-specific shoulder pain is mainly non-operative. The aims of this study were to investigate if there are differences in main characteristics, pain and disability (SPADI-score) and psycho-social factors between patients in primary and specialist health care. Methods This cross-sectional study included patients consulting physiotherapy in primary health care and patients at an outpatient clinic in specialist health care. Well-known and tested questionnaires for these populations were used and variables were divided into clinical, sociodemographic, psycho-social, and shoulder pain and disability. Descriptive statistics were applied. Two-sample t-test and linear regression were used for continuous data whereas chi-square tests and logistic regression were applied to test differences in categorical data between the two study populations. Results Two hundred and 36 patients were recruited from primary health care (FYSIOPRIM, Physiotherapy In Primary Care) and 167 from specialist health care. Patients in primary health care reported less regular use of pain medication (30.7 vs. 61.3%) and fewer patients had symptom duration >12 months (41.9 vs. 51.0%). Furthermore, they reported lower pain intensity, less shoulder pain and disability (SPADI-score), lower scores on psycho-social factors, but higher on expectations of recovery. Conclusions Patients with shoulder pain treated in primary health care and in specialist health care are different according to factors such as duration of symptoms, pain and disability, and some of the psycho-social variables. However, the differences are small and the variations within the two study samples is large. Patients treated in primary health care seemed to be less affected and to have higher expectations concerning their recovery. However, based on our results we may question why many patients are referred to specialist health care rather than continuing treatment in primary health care

Kan smerte og funksjon bidra til å diagnostisere temporomandibulær dysfunksjon?

Temporomandibulær dysfunksjon (TMD) er en samlebetegnelse for tilstander som kan gi symptomer fra kjeveledd og tyggemuskulatur (1, 2). De vanligste symptomene er smerter, endret bevegelsesmønster, funksjonsforstyrrelser (for eksempel problemer med å gape, tygge, gjespe, snakke og smile), leddlyder samt låsning og luksasjon av leddet (3). I tillegg opplever mange å ha øresus, nakkesmerter og hodepine. Bruk av kjeven innebærer aktiviteter der begge leddene brukes samtidig, som når vi spiser, drikker, gjesper, synger, kaster opp og ikke minst når vi må gape høyt hos tannlegen. I vår relasjonelle omgang med andre mennesker, for eksempel når vi snakker eller kysser noen, bruker vi også kjeven. Alle nevnte aktiviteter kan bli påvirket ved TMD. Videre vil smerte eller redusert bevegelsesutslag i et av kjeveleddene påvirke funksjonen i det andre leddet. Kjeveleddet er spesielt rent anatomisk, bygget opp med en leddskive (diskus) som deler leddet i to leddhuler (øvre og nedre del). Ved bevegelser av kjeven skjer det bevegelse i begge disse, dvs. mellom leddskiven og kondylen og mellom leddskiven og tinningbenet. I bakkant går leddskiven over i et retrodiskalt vev. Dette vevet er rikt innervert og har god blodgjennomstrømning samtidig som det er tøyelig nok til å tillate at leddskiven beveger seg både ved åpning og lukking av munnen (4-6). Helsedirektoratets nasjonale faglige retningslinje og ”Diagnostic Criteria for TMD” (DC/TMD) viser til at flere av diagnosene som hører inn under TMD innebærer en forskyvning av leddskiven (2, 7). Den mest vanlige er at leddskiven forskyves fremover slik at denne ligger foran kjevebenshodet (kondylen) ved lukket munn. Dette kalles en fremre forskyvning eller anterior diskus displassering (ADD) og medfører forandringer i intraartikulære strukturer. Leddskiven kan enten gli tilbake (normaliseres) på kondylen når det gapes (anterior disc displacement with reduction - ADDwR) eller forbli liggende i forskjøvet posisjon dvs. uten normalisering (anterior disc displacement without reduction - ADDWOR)