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ABSTRACT: PURPOSE: Few studies have examined responsiveness of bioimpedance (BIA) to detect changes over time in body composition using a longitudinal design. Accuracy of BIA and skinfold thickness in estimating body composition among 39-64 year-old women was investigated using dual-energy X-ray absorptiometry (DXA) as a criterion method both cross-sectionally and during a training intervention. METHODS: 97 women had percentage of fat assessed using DXA, skinfolds and eight-polar BIA using multi-frequency current. Fat mass and lean mass were estimated by DXA and BIA. Measurements were performed before and after the 21-week training intervention. RESULTS: At baseline relative to DXA, BIA under predicted percentage of fat (-6.50 %) and fat mass (-3.42 kg) and overestimated lean mass (3.18 kg) considerably. Also skinfold measurement under predicted percentage of fat compared to DXA, but the difference was smaller (-1.69 % units). Skinfold measurement overestimated percentage of fat at low values and underestimated at high values (r (2) = 0.535). A significant bias was detected between DXA and BIA's estimate of change in percentage of fat, fat mass and lean mass. Compared to DXA, BIA and skinfolds underestimated the training-induced positive changes in body composition. CONCLUSIONS: BIA and skinfold methods compared to DXA are not interchangeable to quantify the percentage of fat, fat mass and lean mass at the cross-sectional design in middle-aged women. Moreover, exercise training-induced small changes in body composition cannot be detected with BIA or skinfold method, even though DXA was able to measure statistically significant within-group changes in body composition after training.
Arbeitsphysiologie 06/2013; · 2.15 Impact Factor
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Benjamin Waller,
Matti Munukka,
Juhani Multanen,
Timo Rantalainen,
Tapani Pöyhönen,
Miika T Nieminen,
Ilkka Kiviranta,
Hannu Kautiainen,
Harri Selänne,
Joost Dekker,
Sarianna Sipilä,
Urho M Kujala, Arja Häkkinen,
Ari Heinonen
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ABSTRACT: Symptoms associated with osteoarthritis of the knee result in decreased function, loss of working capacity and extensive social and medical costs. There is a need to investigate and develop effective interventions to minimise the impact of and even prevent the progression of osteoarthritis. Aquatic exercise has been shown to be effective at reducing the impact of osteoarthritis. The purpose of this article is to describe the rationale, design and intervention of a study investigating the effect of an aquatic resistance exercise intervention on cartilage in postmenopausal women with mild knee osteoarthritis.
A minimum of 80 volunteers who meet the inclusion criteria will be recruited from the local population through newspaper advertisements. Following initial assessment volunteers will be randomised into two groups. The intervention group will participate in a progressive aquatic resistance exercise program of 1-hour duration 3 times a week for four months. The control group will be asked to maintain normal care during this period. Primary outcome measure for this study is the biochemical composition of knee cartilage measured using quantitative magnetic resonance imaging; T2 relaxation time and delayed gadolinium-enhanced magnetic resonance imaging techniques. In addition, knee cartilage morphology as regional cartilage thickness will be studied. Secondary outcomes include measures of body composition and bone traits using dual energy x-ray absorptiometry and peripheral quantitative computed tomography, pain, function using questionnaires and physical performance tests and quality of life. Measurements will be performed at baseline, after the 4-month intervention period and at one year follow up.
This randomised controlled trial will investigate the effect a progressive aquatic resistance exercise program has on the biochemical composition of cartilage in post-menopausal women with mild knee osteoarthritis. This is the first study to investigate what impact aquatic exercise has on human articular cartilage. In addition it will investigate the effect aquatic exercise has on physical function, pain, bone and body composition and quality of life. The results of this study will help optimise the prescription of aquatic exercise to persons with mild knee osteoarthritis.
ISRCTN65346593.
BMC Musculoskeletal Disorders 01/2013; 14:82. · 1.58 Impact Factor
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ABSTRACT: The purpose of this study was to investigate acute neuromuscular and endocrine responses and recovery to a single session of combined endurance and strength loading using two loading orders. Forty-two men were demographically matched to perform a single session of combined endurance+strength (E+S) or strength+endurance (S+E) loading. The strength loading was conducted on a leg press and included sets of power, maximal strength and hypertrophic loads with an overall duration of 30 minutes. The endurance loading was conducted on a bike ergometer and performed by continuous cycling over 30min at 65% of subject's individual maximal Watts. Both loading conditions led to significant acute reductions in maximal force production (E+S, -27%, p<0.001; S+E, -22%, p<0.001), rapid force produced in 500ms (E+S, -26%, p<0.001; S+E, -18%, p<0.001) and counter movement jump jumping height (E+S, -15%, p<0.001; S+E, -12%, p<0.001) while no significant differences between the two loadings were observed. Maximal and explosive force production recovered after 48h following both loading conditions. Whereas no significant acute responses were found in concentrations of serum testosterone (T) and thyroid releasing hormone (TSH) in the two loading conditions, concentrations of T were significantly reduced in E+S during recovery at 24h (-13%, p<0.05) and 48h (-11%, p=0.068) but not in S+E and TSH following both loading conditions (24h, E+S, -32%, p<0.001; S+E, -25%, p<0.01; 48h, E+S, -25%, p<0.001, S+E,-18%, p<0.01). The present loading conditions showed that neuromuscular performance recovered already within 2 days, while endocrine function, observed particularly by decreased concentrations in serum testosterone following the E+S loading order, remained altered still after 48h of recovery. These results emphasize the different needs for recovery following two loading orders.
The Journal of Strength and Conditioning Research 12/2012; · 1.83 Impact Factor
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ABSTRACT: Purpose: To assess the disability and relationship between functional status and health related quality of life (HRQoL) in patients in the early recovery phase following spinal fusion. Methods: This is a prospective cohort study. Since 2008 data of spinal fusion patients have been collected prospectively in two Finnish hospitals. In August 2009, complete data of 173 patients were available. The measurement tool of disability was the Oswestry Disability Index (ODI) and it was also examined in the framework of International Classification of Functioning, Disability and Health (ICF) using body functions and structures, activities and participation components. Results: Preoperatively the mean total ODI was 45 (SD17) and mean (95% confidence interval) change to 3 months postoperatively was -19 (-22 to -17). When the ODI was linked to the ICF, there was a 55% improvement in the body structure and functions component and a 44% improvement in both the activities and the participation components. However, 25% of the patients still had the total ODI score over 40 three months postoperatively. Preoperatively, the mean (95% CI) Physical Component Summary Score (PCS) of the Short Form 36-questionnaire (SF-36) was 27 (26 to 28) and the mean Mental Component Summary Score (MCS) of SF-36 was 47 (45 to 49). Postoperatively the improvement was 9 (95% CI: 8 to 11) in PCS and 6 (95% CI: 4 to 7) in MCS (p < 0.001). Conclusions: Spinal fusion is successful in the early recovery period in terms of reduction of pain and disability. The significant changes in the ODI were seen in all three components of the ICF model. In addition, improvement in functioning was significantly related to positive change in HRQoL. Still there is a subgroup of patients having marked disability needing more intensive rehabilitation and follow-ups. [Box: see text].
Disability and Rehabilitation 11/2012; · 1.50 Impact Factor
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ABSTRACT: To examine the effects of local cooling on mechanical properties of the quadriceps muscle in healthy subjects.
Thirty-nine healthy subjects (27 women, 12 men, mean age 39, range 20-62) volunteered.
A cold gel pack was applied to the quadriceps muscle for 20 min. Properties were quantified by analyzing the frequency (tension), decrement (elasticity) and stiffness of damped oscillations and the compliance of the muscle before, immediately after and after 15-min after cooling.
The largest responses immediately after cooling were seen in the oscillation decrement parameter, 7.9 (3.7-12.1) %, and in the compliance parameter, -7.5 (-9.8 to -5.3) %. Responses in the oscillation frequency, 6.5 (2.3-10.6) %, and stiffness parameters, 4.0 (0.8-7.1) %, were also statistically significant. The compliance still showed a -6.1 (-7.7 to -4.5) % decrease after the 15 min recovery phase, while no remaining alteration was found in the oscillation parameters.
The quadriceps muscle became tenser, stiffer, and less elastic as a result of cooling, and the mechanical properties were not fully recovered after 15 min. Careful warming-up is suggested after cooling to enable normalization of mechanical properties of the muscle and to avoid injuries.
Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine 11/2012; 13(4):265-9. · 0.67 Impact Factor
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ABSTRACT: Lumbar spine fusion (LSF) effectively decreases pain and disability in specific spinal disorders; however, the disability rate following surgery remains high. This, combined with the fact that in Western countries the number of LSF surgeries is increasing rapidly it is important to develop rehabilitation interventions that improve outcomes.
In the present RCT-study we aim to assess the effectiveness of a combined back-specific and aerobic exercise intervention for patients after LSF surgery. One hundred patients will be randomly allocated to a 12-month exercise intervention arm or a usual care arm. The exercise intervention will start three months after surgery and consist of six individual guidance sessions with a physiotherapist and a home-based exercise program. The primary outcome measures are low back pain, lower extremity pain, disability and quality of life. Secondary outcomes are back function and kinesiophobia. Exercise adherence will also be evaluated. The outcome measurements will be assessed at baseline (3 months postoperatively), at the end of the exercise intervention period (15 months postoperatively), and after a 1-year follow-up.
The present RCT will evaluate the effectiveness of a long-term rehabilitation program after LSF. To our knowledge this will be the first study to evaluate a combination of strength training, control of the neutral lumbar spine position and aerobic training principles in rehabilitation after LSF.
ClinicalTrials.gov Identifier NCT00834015.
BMC Musculoskeletal Disorders 07/2012; 13:123. · 1.58 Impact Factor
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ABSTRACT: BACKGROUND: There is a lack of knowledge on the influence of different levels of physical activity (PA) on unintentional injuries among those with depressive symptoms (DS). The aim of this study was to evaluate the relationship between PA categories and unintentional injuries among participants with and without DS based on a cross-sectional population-based FIN-D2D survey conducted in 2007. METHODS: Out of 4500, 2682 participants (60 %) aged 45-74 years attended in this study. The unintentional injuries over the past year were captured in a questionnaire. DS were determined with the Beck Depression Inventory (equal or higher than 10 points) and PA with the International Physical Activity Questionnaire. The statistical significance between DS and unintentional injury categories was evaluated by using t-test, chi-square test, or permutation test, analysis of covariance, or regression models. The factors related to unintentional injuries were estimated by univariate and multivariate logistic regression models. RESULTS: The proportion of subjects with unintentional injuries was higher among those with DS (17%) compared to those without DS (10%) (age- and gender-adjusted p=0.023). The median (range) number of activity-loss days after injury was 22 (0-365) in participants with DS and 7 (0-120) in participants without DS (p=0.009). The percentage of subjects with unintentional injuries was not significantly different between PA categories in participants with DS and without DS A stepwise multivariate logistic regression analysis showed that DS, functional ability, and musculoskeletal diseases were related to unintentional injuries. CONCLUSIONS: PA level was not related to unintentional injuries, whereas those with DS had a higher prevalence of unintentional injuries and prolonged activity-loss after injury. These results underline the importance of injury prevention, especially among those who have DS and additional risk factors.
BMC Public Health 07/2012; 12(1):516. · 2.00 Impact Factor
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ABSTRACT: Purpose: To analyze trunk muscle function pre- and postoperatively in patients undergoing lumbar spine fusion. Associations between changes in trunk muscle strength and disability were also studied. Method: A total of 114 patients undergoing lumbar spine fusion participated in the study. The flexion and extension strength of the trunk was measured preoperatively and 3 months after surgery using a strain-gauge dynamometer. Disability and pain during the past week was evaluated with the Oswestry disability index (ODI) and visual analog scale (VAS), respectively. Results: Preoperative trunk extension and flexion strength levels were 319 N and 436 N in males, respectively, and 160 N and 214 N in females, respectively. In females 3 months postoperatively, the trunk extension strength increased by 39 N (p < 0.001) and flexion by 38N (p < 0.001), whereas it remained unchanged in males. The preoperative extension/flexion strength ratio was 0.79 in females and 0.76 in males. Three months postoperatively, the strength ratio decreased to 0.66 in males (p = 0.02). The mean ODI improved by 47% and back pain decreased by 65% (both p < 0.001). The changes in the ODI correlated with changes in trunk extension (r = -0.38) and flexion (r = -0.43) strength. Conclusions: Patients undergoing lumbar spine fusion had low trunk muscle strength and strength imbalance. Back fusion surgery leads to considerable relief of pain and disability, but patients still have low trunk extension and flexion strength levels 3 months postoperatively. Therefore, there is need for a proper progressive strength training protocols to normalize back function. [Box: see text].
Disability and Rehabilitation 06/2012; · 1.50 Impact Factor
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ABSTRACT: Purpose:To determine the relationship between functional disability and health-related quality of life (HRQoL) in rotator cuff tear (RCT) patients. Method:In 67 RCT patients (mean age, 54 years; 57% males), functional disability was self-reported with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), HRQoL with the Short-Form 36 Health Survey (SF-36), and pain by visual analogue scale. ASES results were divided into tertiles (12-38, 39-51, and 52-82). Results:Mean ASES score was 48 (range, 12-82). Patients with the highest functional disability and highest pain level had the lowest HRQoL. For the highest, middle, and lowest ASES categories, respectively, mean SF-36 Physical Component Summary (PCS) scores were 35 SD 5, 36 SD 8, and 41 SD 6 (p< 0.001) (r = 0.47 for ASES vs. PCS; p< 0.001), and Mental Component Summary (MCS) scores were 50 SD 13, 56 SD 10, and 58 SD 8 (p = 0.011) (r = 0.37 for ASES vs. MCS; p= 0.003). Conclusions: Patients with higher functional disability had lower HRQoL. RCT extensively affects patients' lives; therefore, capturing both generic and shoulder-specific measures of RCT problems is recommended. [Box: see text].
Disability and Rehabilitation 04/2012; 34(24):2071-5. · 1.50 Impact Factor
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ABSTRACT: Purpose: To evaluate whether long-term neck and upper body exercises conducted in economical community-based outpatient clinic and home-based settings could improve health-related quality of life (HRQoL)for individuals affected by chronic neck pain. The effect of baseline HRQoL and neck pain values on training adherence was also studied. Methods: Subjects (n = 101, 91 women/10 men, mean age 41.0 ± 9.5 years) with chronic non-specific neck pain were randomized to a combined strength-training and stretching-exercise group (CSSG, n = 49) or to a stretching exercise group (SG, n = 52). HRQoL was assessed at baseline and after 12 months using the RAND-36 questionnaire. Comparisons between groups were performed using bootstrap-type analysis of covariance. The impact of HRQoL and neck pain values on training adherence, determined using participants' exercise logs, was studied using generalized estimating equations. Results: CSSG showed significant improvements in five and SG in four of eight of the HRQoL dimensions. There were no significant differences between the groups. Adherence to long-term training was only slightly affected by baseline-assessed HRQoL and neck pain values. Conclusions: The two training protocols were feasible and equally effective in improving HRQoL. Baseline HRQoL and pain values had only a minor effect on training adherence. [Box: see text].
Disability and Rehabilitation 03/2012; 34(23):1971-7. · 1.50 Impact Factor
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ABSTRACT: It is possible to measure muscle tone reliably, quickly and objectively using tonometers although they are not yet widely used. In clinical practice it may be helpful if clinicians could assess the degree of contraction in different parts of a muscle without having to perform time-consuming EMG measurements. The purpose of this study was to evaluate the responsiveness of different muscle tone characteristics to progressively increased contraction force of quadriceps muscle. Twenty healthy subjects (mean age 39.9 years, 50% females) volunteered. Using two different tonometers various muscle viscoelastic properties were measured. The frequency (Hz), logarithmic decrement, and stiffness ((N/m) of damped mechanical oscillation of the muscle tissue and tissue compliance (mJ) were registered from rectus femoris muscle at rest and 20, 40, 60, 80 % of maximal voluntary contraction determined using dynamometry. All values changed linearly with increasing force level. Compliance, oscillation stiffness and frequency parameters showed large effect sizes (ES≥0.8). The standardized response mean for compliance was 5.3 (4.8 to 5.7) mJ, for oscillation stiffness 1.8 (1.3 to 2.2) N/m, frequency 1.1 (0.6 to 1.5) Hz, and decrement -0.6 (-1.0 to -0.2). The results indicate that the compliance and oscillation stiffness parameters showed the highest responsiveness and can thus best detect changes in muscle contraction state. The additional value of using tonometers to measure these properties in clinical practice should be investigated further.
The Journal of Strength and Conditioning Research 03/2012; · 1.83 Impact Factor
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ABSTRACT: Due to large volume of knee osteoarthritis referrals and increasing waiting times, the contents of referrals and patient's pathways were analyzed in the Jyväskylä Central Hospital.
The referral contents of 171 knee osteoarthritis patients referred to the orthopedic outpatient clinic were screened, and the post-referral treatment decisions were pulled from the medical records.
Most of the referrals had information about the diagnosis (90%), pain (88%) and symptom duration (80%). The least frequently mentioned were BMI (3%) and the implementation of conservative treatment (7%). During the specialist visit following the referral, 62% of the patients ended up in operative and 38% in conservative treatment. There was no connection between the referral contents and the line of treatment chosen.
Conservative treatment of knee osteoarthritis should be optimized prior to referral to specialist care.
Duodecim; lääketieteellinen aikakauskirja 01/2012; 128(15):1593-9.
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ABSTRACT: Dual-energy X-ray absorptiometry (DXA) is a technique enabling the measurement of bone mineral density (BMD) around prostheses after hip resurfacing arthroplasty (HRA). In this study, we evaluated the consistency of different DXA acquisition modes with 33 patients who had undergone HRA. Patients were scanned with DXA immediately after surgery and at 3-, 6-, and 12-mo time points. All the patients were scanned with dual femur and orthopedic hip acquisition modes and analyzed using 10-region ROI model. With both acquisition modes, a statistically significant decrease (p<0.05, Wilcoxon's test) in BMD at 3mo was revealed in 3 ROIs, located to upper and lateral upper femur. Both acquisition modes detected similarly (p<0.01) preservation of the femoral bone stock within 12mo in all but 1 ROI. The applied acquisition protocols involved the use of different footplates for hip fixation. Because the differences between acquisition modes ranged between +1.6% and -7.1% and the reproducibility of BMD values can vary by as much as 28% due to hip rotation, it is proposed that both dual femur and orthopedic hip acquisition modes can be used to monitor the changes in BMD after HRA. However, the same hip rotation is recommended for all DXA measurements.
Journal of Clinical Densitometry 11/2011; 15(1):72-7. · 1.29 Impact Factor
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ABSTRACT: Follow-up study.
To study whether neck muscle strength or cervical spine mobility values could serve as predictors for future neck pain among originally pain-free working-age subjects during a long period.
Neck pain has been associated with weaker neck muscle strength and lower cervical spine mobility in several studies. However, causality between physical capacity and neck pain has not been shown.
Isometric neck muscle strength and passive range of motion of the cervical spine of 220 healthy female volunteers, aged 20 to 59 years, were measured. A postal survey was conducted 6 years later to determine whether any volunteers had experienced neck pain. The receiver operator characteristics curve was used to study how well the neck strength and mobility values in different movement planes at baseline served as predictors of future neck pain.
Of the 192 (87%) responders, 37 (19%) reported neck pain for 7 days during the past year. In predicting neck pain, areas under the receiver operator characteristics curves (95% confidence intervals) in different movement planes were 0.52 to 0.56 (0.41-0.66) for isometric neck strength and 0.54 to 0.56 (0.44-0.76) for passive mobility of the cervical spine.
The results suggest that neither isometric neck muscle strength nor passive mobility of cervical spine has predictive value for later occurrences of neck pain in pain-free working-age women. Thus, screening healthy subjects for weaker neck muscle strength or decreased mobility of the cervical spine may not be recommended for preventive purposes.
Spine 10/2011; 37(12):1036-40. · 2.08 Impact Factor
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ABSTRACT: The purpose of the present study was to assess the relationships between maximal strength and muscular endurance test scores additionally to previously widely studied measures of body composition and maximal aerobic capacity. 846 young men (25.5 ± 5.0 yrs) participated in the study. Maximal strength was measured using isometric bench press, leg extension and grip strength. Muscular endurance tests consisted of push-ups, sit-ups and repeated squats. An indirect graded cycle ergometer test was used to estimate maximal aerobic capacity (V(O2)max). Body composition was determined with bioelectrical impedance. Moreover, waist circumference (WC) and height were measured and body mass index (BMI) calculated. Maximal bench press was positively correlated with push-ups (r = 0.61, p < 0.001), grip strength (r = 0.34, p < 0.001) and sit-ups (r = 0.37, p < 0.001) while maximal leg extension force revealed only a weak positive correlation with repeated squats (r = 0.23, p < 0.001). However, moderate correlation between repeated squats and V(O2)max was found (r = 0.55, p < 0.001) In addition, BM and body fat correlated negatively with muscular endurance (r = -0.25 - -0.47, p < 0.001), while FFM and maximal isometric strength correlated positively (r = 0.36-0.44, p < 0.001). In conclusion, muscular endurance test scores were related to maximal aerobic capacity and body fat content, while fat free mass was associated with maximal strength test scores and thus is a major determinant for maximal strength. A contributive role of maximal strength to muscular endurance tests could be identified for the upper, but not the lower extremities. These findings suggest that push-up test is not only indicative of body fat content and maximal aerobic capacity but also maximal strength of upper body, whereas repeated squat test is mainly indicative of body fat content and maximal aerobic capacity, but not maximal strength of lower extremities.
The Journal of Strength and Conditioning Research 10/2011; 26(8):2078-86. · 1.83 Impact Factor
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ABSTRACT: To determine the prevalence of chronic back pain and its changes over 5 years in patients with RA compared with community controls and to evaluate the influence of chronic back pain in functional capacity, general pain and global health.
The prevalence of chronic back pain in 1076 patients with RA and in 1491 community controls was evaluated using a mailed questionnaire, which also queried the functional capacity on the HAQ, and general pain and global health on visual analogue scales.
Chronic back pain was more frequent in the general population than in patients with RA: 19% of patients with RA and 25% of controls reported chronic back pain (P < 0.001). After 5 years, 57% of these patients initally reporting pain and 58% of controls still reported chronic back pain. In community controls with and without chronic back pain, the median HAQ, general pain and global health were 0.13 vs 0.00, 28 vs 6 and 28 vs 11, respectively (P < 0.001). The figures were 0.88 vs 0.63 (P = 0.05), 42 vs 26 and 42 vs 30 (P < 0.001), respectively, in patients with RA. All analyses were adjusted for age and sex.
Chronic back pain does not occur more frequently in patients with RA than in the general population. Almost 60% of patients and controls who reported chronic back pain still reported it 5 years later. In patients with RA and in the control population, subjects with chronic back pain had worse functional capacity, general pain and global health.
Rheumatology (Oxford, England) 05/2011; 50(9):1635-9. · 4.24 Impact Factor
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ABSTRACT: A combination of endurance and strength training is generally used to seek further health benefits or enhanced physical performance in older adults compared with either of the training modes alone. The mean change within a training group, however, may conceal a wide range of individual differences in the responses. The purpose, therefore, was to examine the individual trainability of aerobic capacity and maximal strength, when endurance and strength training are performed separately or concurrently.
For this study, 175 previously untrained volunteers, 89 men and 86 women between the ages of 40 and 67 yr, completed a 21-wk period of either strength training (S) twice a week, endurance training (E) twice a week, combined training (ES) four times per week, or served as controls. Training adaptations were quantified as peak oxygen uptake (VO2peak) in a bicycle ergometer test to exhaustion and maximal isometric bilateral leg extension force (MVC) in a dynamometer.
A large range in training responses, similar to endurance or strength training alone, was also observed with combined endurance and strength training in both ΔVO2peak (from -8% to 42%) and ΔMVC (from -12% to 87%). There were no significant correlations between the training responses in VO2peak and MVC in the E, S, or especially in the ES group, suggesting that the same subjects did not systematically increase both aerobic capacity and maximal strength.
The goal of combined endurance and strength training--increasing both aerobic capacity and maximal strength simultaneously--was only achieved by some of the older subjects. New means are needed to personalize endurance, strength, and especially combined endurance and strength training programs for optimal individual adaptations.
Medicine and science in sports and exercise 03/2011; 43(3):484-90. · 3.71 Impact Factor
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ABSTRACT: Prospective clinical validation study.
The aims of this study were to translate into Finnish and culturally adapt and study the psycho-metric properties of the Oswestry Disability Index (ODI) version 2.0.
The ODI is one of the most commonly reported back-specific disability questionnaires. It is widely used both in clinical work and in medical studies. To date, no validated Finnish version of the ODI version 2.0 has been reported.
The ODI version 2.0 was translated into the Finnish language. A total of 115 patients with back pain, referred by the primary care physician to the outpatient clinic of the department of physical medicine and rehabilitation, were recruited for this study. The patients answered a questionnaire package that included the Finnish ODI 2.0, Back Pain Questionnaire for Visual Analogue Assessment (Million-VAS), Visual Analogue Scales of back and leg pain (VASback, VASleg), the Depressions Scale, and a question on their subjectively perceived health. The package was administered twice; 2 weeks before and at the arrival to the clinic.
Reproducibility of the ODI was 0.90 (95% confidence interval [CI] = 0.85-0.94) and the internal consistency was 0.86 (95% CI = 0.81-0.90). Factor analysis showed that the ODI was loaded on 2 factors, which explained 51% of the total variance. In testing convergent validity ODI correlated with Million-VAS, r = 0.75 (95% CI = 0.64-0.84); VASback, r = 0.48 (95% CI = 0.32-0.62); and VAS leg, r = 0.41 (95% CI = 0.23-0.57).
The Finnish ODI version 2.0 proved to be a valid and reliable instrument that showed psychometric properties comparable with the original English version. Therefore, it can be used in assessing the disability among Finnish-speaking patients with back pain for both clinical and scientific purposes.
Spine 02/2011; 36(4):332-8. · 2.08 Impact Factor
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ABSTRACT: Hip resurfacing arthroplasty (HRA) is considered a bone-preserving procedure and may eliminate proximal femoral stress shielding and osteolysis. However, in addition to implant-related stress-shielding factors, various patient-related factors may also have an effect on bone mineral density (BMD) of the proximal femur in patients with HRA. Thus, we studied the effects of stem-neck angle, demographic variables, and physical functioning on the BMD of the proximal femur in a one-year follow-up.
Thirty three patients (9 females and 24 males) with a mean (SD) age of 55 (9) years were included in the study. BMD was measured two days and 3, 6, and 12 months postoperatively and 10 regions of interest (ROI) were used. Stem-neck angle was analyzed from anteroposterior radiographs.
Three months postoperatively, BMD decreased in six out of 10 regions of interest (ROI) on the side operated on and in one ROI on the control side (p<0.05) compared to the second postoperative day. At 12 months, BMD had increased in 7 ROIs on the operated side and one ROI on the control side (all p<0.001). Correlation was found between the stem-neck angle and BMD in ROIs 2, 3, 7, and 9 (r=0.36-0.61). In multiple regression analysis, stem-neck angle, age, sex, body mass index, and walking distance did not explain the BMD changes.
After an early drop, the BMD of the upper femur was restored and even exceeded the preoperative level at one year follow-up. From a clinical standpoint, the changes in BMD in these HRA patients could not be explained by stem-neck angle or patient related factors.
BMC Musculoskeletal Disorders 01/2011; 12:100. · 1.58 Impact Factor
