Prevalence and distribution of musculoskeletal pain in patients with dizziness—A systematic review

Background and purpose Musculoskeletal disorders are among the leading causes of disability globally, but their role in patients with dizziness and imbalance is not well understood or explored. Such knowledge may be important as musculoskeletal pain and dizziness can mutually influence each other, leading to a complex condition requiring more comprehensive approaches to promote successful recovery. We conducted a systematic review to examine the extent and characteristic of reported musculoskeletal pain in patients with dizziness. Methods A comprehensive literature search in Medline, Embase, Cochrane, Scopus, Amed, Google Scholar, SveMed+, and Web of Science was conducted in March 2021. Inclusion criteria were studies examining patients with a vestibular diagnosis, patients with cervicogenic dizziness and patients included based on having dizziness as a symptom; and reported musculoskeletal pain. Data regarding age, sex, sample size, diagnosis and musculoskeletal pain was extracted. The Crowe Critical Appraisal Tool was used for assessing methodical quality of the included studies. Results Out of 1507 screened studies, 16 studies met the inclusion criteria. The total sample consisted of 1144 individuals with dizziness. The frequency of patients reporting pain ranged between 43% and 100% in the included studies. Pain intensity were scored between 5 and 7 on a 0–10 scale. Pain in the neck and shoulder girdle was most often reported, but musculoskeletal pain in other parts of the body was also evident. Discussion In the included studies, musculoskeletal pain was highly prevalent in patients with dizziness, with pain intensity that may have a moderate to severe interference with daily functioning. Pain in the neck and shoulder is well documented, but there are few studies addressing musculoskeletal pain in additional parts of the body. More research is needed to understand the relations between dizziness and musculoskeletal pain.publishedVersio

Musculoskeletal pain patterns and association between dizziness symptoms and pain in patients with long term dizziness – a cross-sectional study

Background The impact of long-term dizziness is considerable both on the personal level and in society and may lead to self-imposed restrictions in daily activities and social relations due to fear of triggering the symptoms. Musculoskeletal complaints seem to be common in persons with dizziness, but studies addressing these complaints as a widespread occurrence, are scarce. This study aimed to examine the occurrence of widespread pain in patients with long-term dizziness and investigate the associations between pain and dizziness symptoms. Further, to explore whether diagnostic belonging is related to the occurrence of pain. Methods This cross-sectional study was conducted in an otorhinolaryngology clinic and included 150 patients with persistent dizziness. The patients were categorized into three groups: episodic vestibular syndromes, chronic vestibular syndromes, and non-vestibular group. The patients completed questionnaires on dizziness symptoms, catastrophic thinking, and musculoskeletal pain when entering the study. Descriptive statistics were used to describe the population, and associations between pain and dizziness were investigated by linear regression. Results Pain was reported by 94.5% of the patients. A significantly higher prevalence of pain was reported in all the ten pain sites examined compared to the general population. Number of pain sites and pain intensity were associated with the dizziness severity. Number of pain sites was also associated with dizziness-related handicap, but not with catastrophic thinking. There was no association between pain intensity and dizziness-related handicap or catastrophic thinking. Pain was equally distributed in the diagnostic groups. Conclusion Patients with long-term dizziness have a considerably higher prevalence of pain and number of pain sites than the general population. Pain co-exists with dizziness and is associated with dizziness severity. These findings may indicate that pain should be systematically assessed and treated in patients with persisting dizziness.publishedVersio

Combined cognitive and vocational interventions after mild to moderate traumatic brain injury: study protocol for a randomized controlled trial

Background A considerable proportion of patients with mild to moderate traumatic brain injury (TBI) experience long-lasting somatic, cognitive, and emotional symptoms that may hamper their capacity to return to work (RTW). Although several studies have described medical, psychological, and work-related factors that predict RTW after TBI, well-controlled intervention studies regarding RTW are scarce. Furthermore, there has traditionally been weak collaboration among health-related rehabilitation services, the labor and welfare sector, and workplaces. Methods/design This study protocol describes an innovative randomized controlled trial in which we will explore the effect of combining manualized cognitive rehabilitation (Compensatory Cognitive Training [CCT]) and supported employment (SE) on RTW and related outcomes for patients with mild to moderate TBI in real-life competitive work settings. The study will be carried out in the southeastern region of Norway and thereby be performed within the Norwegian welfare system. Patients aged 18–60 years with mild to moderate TBI who are employed in a minimum 50% position at the time of injury and sick-listed 50% or more for postconcussive symptoms 2 months postinjury will be included in the study. A comprehensive assessment of neurocognitive function, self-reported symptoms, emotional distress, coping style, and quality of life will be performed at baseline, immediately after CCT (3 months after inclusion), following the end of SE (6 months after inclusion), and 12 months following study inclusion. The primary outcome measures are the proportion of participants who have returned to work at 12-month follow-up and length of time until RTW, in addition to work stability as well as work productivity over the first year following the intervention. Secondary outcomes include changes in self-reported symptoms, emotional and cognitive function, and quality of life. Additionally, a qualitative RTW process evaluation focused on organizational challenges at the workplace will be performed. Discussion The proposed study will combine cognitive and vocational rehabilitation and explore the efficacy of increased cross-sectoral collaboration between specialized health care services and the labor and welfare system. If the intervention proves effective, the project will describe the cost-effectiveness and utility of the program and thereby provide important information for policy makers. In addition, knowledge about the RTW process for persons with TBI and their workplaces will be provided. Trial registration ClinicalTrials.gov, NCT03092713. Registered on 10 March 2017

The Atlantic salmon genome provides insights into rediploidization

The whole-genome duplication 80 million years ago of the common ancestor of salmonids (salmonid-specific fourth vertebrate whole-genome duplication, Ss4R) provides unique opportunities to learn about the evolutionary fate of a duplicated vertebrate genome in 70 extant lineages. Here we present a high-quality genome assembly for Atlantic salmon (Salmo salar), and show that large genomic reorganizations, coinciding with bursts of transposon-mediated repeat expansions, were crucial for the post-Ss4R rediploidization process. Comparisons of duplicate gene expression patterns across a wide range of tissues with orthologous genes from a pre-Ss4R outgroup unexpectedly demonstrate far more instances of neofunctionalization than subfunctionalization. Surprisingly, we find that genes that were retained as duplicates after the teleost-specific whole-genome duplication 320 million years ago were not more likely to be retained after the Ss4R, and that the duplicate retention was not influenced to a great extent by the nature of the predicted protein interactions of the gene products. Finally, we demonstrate that the Atlantic salmon assembly can serve as a reference sequence for the study of other salmonids for a range of purposes.publishedVersio

Oversettelse av Wheelchair Skills Test - Questionnaire versjon 4.3 og undersøkelse av test-retest reliabilitet av den norske versjonen Test for rullestolferdigheter - spørreskjema

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Frå sofaen til sykkelsetet : evaluering av tilskotsordninga til lavterskel fysisk aktivitet

Rapporten er altså tufta på evaluering av Tilskotsordninga til lavterskel fysisk aktivitet, som var initiert som ein del av oppfølginga av Handlingsplanen for fysisk aktivitet, Saman for fysisk aktivitet Tilskotsordninga er eit verkemiddel for tiltak som skal fange opp dei som fell utanfor dei ordinære aktivitets- og idrettstilboda, og midlane vert fordelte til regionale og lokale lag og organisasjonar, som driv aktivitetsfremjande arbeid retta mot den inaktive delen av befolkninga, og særleg barn og unge. Til grunn for evalueringa ligg fylkesvise oversikter over fordeling av midlane i 2007, det vil seie kven som har søkt og kven som har fått midlar til ulike tiltak/aktivitetar. Den mest omfattande delen av datagrunnlaget er intervju med ulike informantgrupper, som representantar i fylka (fylkeskommunen eller fylkesmannen) som er ansvarlege for fordeling av midlane frå tilskotsordninga, representantar for eit utval hovudorganisasjonar (sentralleddet i 11 organisasjonar) og eit utval regionale (3) og lokale organisasjonar/lag (16), som har fått midlar til tiltak/aktivitetar. Rapporten har fokus på fordelingsprofil og ulike aktørarar sine vurderingar av ordningar. Evalueringa viser at tilskotsordninga er eit viktig bidrag med tanke på å nå mål i handlingsplanen for fysisk aktivitet. Gjennom tilskotsordninga er det mykje fokus på aktivitetar i nærmiljøet, på at aktivitetane skal ha eit sosialt element og på at alle og særleg barn/unge skal ha tilbod om aktivitetar i fritida. At folk skal kunne delta etter evne, kjem mellom anna til uttrykk ved at det er snakk om lavterskel aktivitet. Men folk som er inaktive har ofte eit særleg behov for at aktivitetane, både fysisk og sosialt, er lagt til rette slik at det er mogleg for dei å delta. Med tanke på at handlingsplanen også siktar mot å utjamne sosiale skilnader i fysisk aktivitet, vil det truleg vere behov for endå fleire tiltak retta mot spesifikke målgrupper. Utifrå evalueringa ser det ut til at delmålet Aktiv etter evne, bør få meir fokus

Partnarskap for folkehelse og Helse i plan. Undervegsrapport

Partnarskap for folkehelse og Helse i plan er to verkemiddel eller arbeidsmetodar, som vert brukte i satsinga på å fremje folkehelse. Målet med satsinga på folkehelse, slik ein les det i folkehelsemeldinga: Resept for et sunnere Norge (St.meld nr 16 (2002-2003), er eit sunnare Norge gjennom ein politikk, som for det første skal medverke til å betre den generelle helsetilstanden i befolkninga, og som for det andre skal medverke til ei utjamning av helsesituasjonen mellom ulike sosiale lag. På oppdrag for Helsedirektoratet evaluerer Møreforsking og NIBR dei to verkemidla Partnarskap for folkehelse og Helse i plan. Undervegsrapportar frå evalueringa er publiserte i desse dagar. Evalueringa viser at dei formelle sidene ved arbeidet, slik som organisering og politisk forankring, i stor grad er på plass. I mange fylke og kommunar er dei også komne langt når det gjeld konkrete tiltak og aktivitetar overfor ulike målgrupper. Neste steg i arbeidet vert å operasjonalisere folkehelsearbeidet, også gjennom forankring i økonomiplanar og handlingsplanar lokalt, og skape meir operative arenaer for tverrfagleg arbeid. Dei to verkemidla ser ut til å vere føremålstenlege med tanke på å fremje samarbeid på tvers av nivå og sektorar. Evalueringa skal vere ferdig ved årsskiftet 2009/2010