Thorvaldur Skuli Palsson

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• PhD in Clinical Science and Biomedicine
• Professor (Associate) at Aalborg University Hospital

Background Musculoskeletal pain represents an increase in medical expenses due to disability and decreased quality of life among workers. Various biopsychosocial factors contribute to the development of persistent and disabling musculoskeletal pain. The Prevent for Work questionnaire (P4Wq) intended to analyze these factors. In this study, the orig...

Introduction Musculoskeletal pain is a significant public health concern in Europe. With the advent of the digital age, online health information-seeking behaviour has become increasingly important, influencing health outcomes and the ability of individuals to make well-informed decisions regarding their own well-being or of those they are responsi...

Introduction This study aimed to investigate the effect of sex on regional and widespread pain sensitivity following acute bouts of stretching and to investigate the acute effect of stretching on regional and widespread pain sensitivity following stretching. Methods 73 healthy adults (36 females; mean age 25.6 ± 6.7 years) with an age range from 1...

Introduction Rotator Cuff Related Shoulder Pain (RCRSP) represents a significant individual and societal burden. While conservative treatments are recommended, it is uncertain whether there are any factors that can affect the prognosis. This study investigated variations in modifiable factors between responders and non-responders to conservative tr...

Objectives This study aimed to determine the validity and reliability of a new device called MOTI for measuring balance by comparing its performance that with of the gold-standard force platform. Methods The study involved collecting data from both devices in dual- and single-leg standing positions with eyes open and closed and using statistical m...

Background: Delayed-onset muscle soreness (DOMS) is common after unaccustomed exercises and can restrict performance if intense physical activities are performed while the muscle is still sore. This study aimed to evaluate the recovery process following exercise-induced DOMS over a seven-day period by evaluating sensory, functional, and electromyo...

Background: Patients with spinal pain often exhibit movement limitations and altered motor control, which can be challenging to measure accurately in clinical practice. Inertial measurement sensors present a promising new opportunity to develop valid, low-cost, and easy-to-use methods for assessing and monitoring spinal motion in a clinical settin...

Background: Chronic musculoskeletal pain is a major health problem and a common cause of disability in the workplace. Beliefs related to musculoskeletal pain may influence its onset and perpetuation. Consequently, tools designed to identify potentially harmful beliefs are needed. However, the Pain Beliefs Questionnaire (PBQ) is not available for i...

Objective: The aim of this cross-sectional group comparison study was to investigate whether sleep disturbance facilitates pain sensitivity caused by an acute muscle injury. Methods: Thirty-six healthy individuals were included and randomly assigned to one of three groups in a non-balanced manner: a control group (n = 11) and two groups who perf...

Purpose: Altered head range of motion (RoM) and head repositioning accuracy (HRA) are commonly reported in neck pain. However, the quality of motion (QoM) is currently not easy to assess clinically. This study investigated the agreement of head rotation recordings using a 3D camera system compared to a commercially available inertial measurement un...

Background: Personality traits are associated with pain-related beliefs and coping strategies, and different chronic conditions are linked through specific personality profiles. This highlights the importance of having valid and reliable measures of personality traits for use in clinical and research settings when assessing patients in chronic pai...

Background: Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs. Methods: Twenty healthy women participated in three experimental sessions: Baselin...

Introduction: Sitting posture may contribute to spinal pain. Effects of postures on pain, sensitivity and muscle activity during computer tasks were investigated. Methods: Twenty-five healthy participants, seated at a workstation without backrest, completed four, 15-min typing tasks: A)Upright with forearm-support; B)Upright without forearm-support...

Evidence and gap maps (EGM) can be used to identify gaps within specific research areas and help guide future research agendas and directions. Currently, there are no EGMs within the broad domain of chronic musculoskeletal (MSK) pain in adults. The aim of this study was to create a contemporary EGM of interventions and outcomes used for research in...

Objectives Patient and stakeholder engagements in research have increasingly gained attention in healthcare and healthcare-related research. A common and rigorous approach to establish research priorities based on input from people and stakeholders is the James Lind Alliance Priority Setting Partnership (JLA-PSP). The aim of this study was to estab...

Background: Widespread pain partially depends upon sensitization of central pain mechanisms. However, mechanisms controlling pain distribution are not completely known. The present study sought to assess skin temperature variations in the area of experimentally-induced pain and potential sex differences. Methods: Pressure-pain thresholds (PPTs)...

Objectives: The purpose of this study was to investigate the effect of a posture-cueing shirt on sitting posture during a functional task. Methods: Thirty healthy male participants were seated at a standardized workstation while completing 3 laptop writing tasks of 15-minute duration wearing either a posture-cueing shirt, a compression shirt, or...

Actions to improve occupational health and safety arose from the need to protect employees working in European industries, such as nuclear power plants or large-scale chemical industries, from accidents. Today, the field has evolved in many directions, with the prevention and management of musculoskeletal disorders (MSDs) being one of its main line...

Las acciones dirigidas a la mejora de la seguridad y de la salud laboral surgieron de la necesidad de proteger frente a los accidentes a los empleados que trabajaban en industrias europeas; como en centrales nucleares o en industrias químicas de gran escala. Actualmente, este campo ha evolucionado en multitud de direcciones, siendo la prevención y...

Le azioni volte a migliorare la salute e la sicurezza sul lavoro sono nate dalla necessità di proteggere dagli incidenti i dipendenti che lavorano nelle industrie europee, come le centrali nucleari o le grandi industrie chimiche. Oggi, questo campo si è evoluto in molte direzioni, e la prevenzione e la gestione dei disturbi muscoloscheletrici (DMS)...

Background Patient and stakeholder engagements in research have increasingly gained attention in healthcare and healthcare-related research. A common and rigorous approach to establish research priorities based on input from people and stakeholders is the James Lind Alliance Priority Setting Partnership (JLA-PSP). The aim of this study was to estab...

Spinal pain in adults is a significant burden, from an individual and societal perspective. According to epidemiologic data, spinal pain is commonly found in children and adolescents, where evidence emerging over the past decade has demonstrated that spinal pain in adults can, in many cases, be traced back to childhood or adolescence. Nevertheless,...

Objective The aim of this study was to develop a multifactorial, self-report questionnaire: Prevent for Work Questionnaire (P4Wq). The questionnaire is intended for screening for risk factors in work-related musculoskeletal disorders (WMSDs). Design Data were collected from otherwise healthy workers employed in three service areas at a specialist...

Introduction Work-related musculoskeletal (MSK) pain is a highly prevalent condition and one of the main contributors to disability and loss of work capacity. Current approaches to the management and prevention of work-related MSK pain do not consistently integrate current evidence-based knowledge and seem to be outdated. The Prevent4Work (P4W) Pro...

Objectives: To investigate the pain-sensory profile of patients with whiplash-associated disorders (WAD) prior and post 2-weeks of standardized rehabilitation and after at 6-months follow-up. Methods: Twenty-two WAD-participants (Grade-II; 14 women) and 22 sex-and age-matched healthy controls were enrolled. Pressure pain thresholds (PPTs) were a...

Objectives Clinical decisions rely on a patient’s ability to recall and report their pain experience. Monitoring pain in real-time (momentary pain) may reduce recall errors and optimize the clinical decision-making process. Tracking momentary pain can provide insights into detailed changes in pain intensity and distribution (area and location) over...

Background Endogenous pain inhibitory mechanisms are known to reduce pain intensity, but whether they influence the size and distribution of pain referral is unclear. This study aimed to determine if referred pain is reduced by applying a remote, conditioning painful stimulus. Methods Twenty‐four healthy men participated in this randomized, crosso...

The sacroiliac joint (SIJ) is often considered to be involved when people present for care with low back pain where SIJ is located. However, determining why the pain has arisen can be challenging, especially in the absence of a specific cause such as pregnancy, disease, or trauma, when the SIJ might be identified as a source of symptoms with the he...

Objective This study aims to define appropriate domains and items for the development of a self-administered questionnaire to assess the risk of developing work-related musculoskeletal disorder (WMSD) and the risk of its progression to chronicity. Design Literature review and survey study. Setting and participants A literature review and a two-ro...

Abstract Objective: Altered balance in nociception in response to noxious stimuli is commonly reported in chronic low back pain (LBP). However, it is unclear whether an improvement in the clinical presentation is contingent on a reduction in pain sensitivity. This study investigated whether the quantitative sensory testing (QST) profile changes in...

Background Beliefs and attitudes about back pain are relevant factors in relation to developing back pain. A Danish version of the Back Pain Attitudes Questionnaire (Back-PAQ) could be a way of assuring a more systematic examination of attitudes about back pain within patients with back pain, laypeople and healthcare professionals in Denmark. Obje...

Objectives The effect of stretching on joint range of motion is well documented, and although sensory perception has significance for changes in the tolerance to stretch following stretching the underlining mechanisms responsible for these changes is insufficiently understood. The aim of this study was to examine the influence of endogenous pain in...

Historically, the role of professionals specialized in occupational health and safety (OHS) has emerged from the need to protect employers working in major risk industries such as nuclear plants and large-scale chemical industries in Europe. More recently, a few studies highlighted that the range of activities linked to safety management responsibi...

Storicamente, il ruolo dei professionisti specializzati in salute e sicurezza sul lavoro (SSL) è emerso dalla necessità di proteggere i datori di lavoro che lavorano nelle industrie a maggior rischio come le centrali nucleari e le industrie chimiche su larga scala in Europa. Più di recente, alcuni studi hanno evidenziato che la gamma di attività le...

Históricamente, el papel de los profesionales especializados en la seguridad y salud ocupacionales (OHS, por sus siglas en inglés) surgió de la necesidad de proteger a los empleados que trabajaban en industrias de alto riesgo, como en centrales nucleares o en industrias químicas de gran escala en Europa. Más recientemente, diversos estudios señalan...

Objective: Nociception caused by injuries may sensitize central mechanisms causing expanded pain areas. After recovery, the status of such pain distribution and sensitivity mechanisms is unknown. The present study investigated whether individuals who have fully recovered from a distal radius fracture demonstrate increased pain sensitivity and expa...

Objective: To investigate the pain referral area (number of pixels) and extent (vector length) as elicited from increasing intensities of pressure-induced pain at the shoulder. Design: Cross-sectional design. Setting: Clinical laboratory setting. Participants: Twenty-two healthy men and women participated in two experimental sessions. Metho...

Background: Digital pain mapping allows for remote and ecological momentary assessment in patients over multiple time points spanning days to months. Frequent ecological assessments may reveal tendencies and fluctuations more clearly and provide insights into the trajectory of a patient’s pain. Objective: The primary aim of this study is to remote...

Background: Previous studies have found a negative association between a conditioning pain modulating (CPM) response and pain catastrophizing among pain-free subjects. This study investigated the difference in CPM response between patients with chronic low back pain (CLBP) and healthy controls, and the association between pain catastrophizing and...

BACKGROUND Digital pain mapping allows for remote and ecological momentary assessment in patients over multiple time points spanning days to months. Frequent ecological assessments may reveal tendencies and fluctuations more clearly and provide insights into the trajectory of a patient’s pain. OBJECTIVE The primary aim of this study is to remotely...

Background: Accidental falls are common among community-dwellers, probably due to the level of physical activity and impaired postural stability. Today, fall risk prediction tools' discriminative validity are only moderate. In order to increase the accuracy, multiple variables such as highly validated objective field measurements of physical activ...

Introduction Clinicians need support to effectively implement a biopsychosocial approach to people with pelvic girdle pain disorders. Purpose A practical clinical framework aligned with a contemporary biopsychosocial approach is provided to help guide clinician's management of pelvic girdle pain. This approach is consistent with current pain scien...

Objective The purpose of this study was to assess the relationship between an embodied sensory experience and the ability to translate the perception of this experience visually using modifiable motion graphics. Methods A custom-designed software was developed to enable users to modify a motion graphic in real-time. The motion graphics were design...

Background Musculoskeletal (MSK) pain is the primary contributor to disability worldwide. There is a growing consensus that MSK pain is a recurrent multifactorial condition underpinned by health and lifestyle factors. Studies suggest that education on work-related pain and individualised advice could be essential and effective for managing persiste...

Background and aims Assessing personality in research can be of importance, especially due to the potential relationship between different personality traits and the manifestation of symptoms in different clinical conditions. Therefore, it is important to have valid and reliable tools that allow for the assessment of personality traits. In this stu...

Introduction: Multidisciplinary care is recommended for disabling persistent low back pain (pLBP) nonresponsive to primary care. Cognitive functional therapy (CFT) is a physiotherapy-led individualised intervention targeting psychological, physical, and lifestyle barriers to recovery, to self-manage pLBP. Objectives: This pilot study investigate...

Purpose To quantify how postural stability is modified during experimental pain while performing different cognitively demanding tasks. Methods Sixteen healthy young adults participated in the experiment. Pain was induced by intramuscular injection of hypertonic saline solution (1 mL, 6%) in both vastus medialis and vastus lateralis muscles (0.9%...

The sacroiliac joint (SIJ) is often considered to be involved when people present for care with low back pain where the sacroiliac joint (SIJ) is located. However, determining why the pain has arisen can be challenging, especially in the absence of a specific cause such as pregnancy, disease, or trauma, where the SIJ may be identified as a source o...

Abstract This study had the objective of measuring the validity of using a smartphone-based application to measure range of motion (ROM) and quality of movement (QOM) of neck motion by comparing it with 3D-motion capture analysis. Methods Thirty healthy volunteers participated in this cross-sectional study. A helmet fitted with markers for motion...

Background and aims The concept of bad posture being a dominant driver of pain is commonly held belief in the society. This may explain the significant attention supportive clothing such as posture-correcting shirts has recently gained in Scandinavia and the USA. The aim of this scoping review was to present an overview and synthesis of the availab...

Background and aims. The effect of stretching on joint range of motion is well documented and is primarily related to changes in the tolerance to stretch, but the mechanisms underlying this change are still largely unknown. The aim of this study was to investigate the influence of a remote, painful stimulus on stretch tolerance. Methods. Thirty-fou...

Background and aims Achilles tendinopathy is common among runners, but the etiology remains unclear. High mechanical pain sensitivity may be a predictor of increased risk of developing Achilles tendinopathy in this group. The purpose of this study was to investigate whether local pain sensitivity could predict the development of Achilles tendinopat...

Background and aims For some women, lumbopelvic pain (LPP) developed during pregnancy becomes a continuing post-partum problem. Increased understanding of potential prognostic factors is required. This study investigated whether active straight leg raise (ASLR), sleep dysfunction and pressure pain sensitivity during pregnancy are correlated with LP...

Aim of Investigations: Introduction: Neck and shoulder pain is one of the most prevalent musculoskeletal complaints in the working population. Interestingly, neck pain has been linked to inappropriate sitting posture in office workers. By investigating the effect of different sitting positions in healthy participants, it is possible to gain insig...

Facilitated pain mechanisms have been demonstrated in musculoskeletal pain, but it is unclear whether a recent painful injury leaves the pain system sensitized. Pain characteristics were assessed in individuals who recently recovered from ankle pain (recovered pain group; n = 25) and sex-matched control subjects (n = 25) in response to tonic pressu...

Musculoskeletal trauma and pain can sensitize central pain mechanisms but whether these normalize upon recovery is unknown. This study compared the extent of pain referral in individuals recovered from a musculoskeletal trauma and healthy controls. Twenty pain-free participants recovered from a shoulder fracture and 20 age/gender matched controls p...

Background and aims: Exercise-induced hypoalgesia (EIH) is a well-established phenomenon in pain-free individuals that describes a decrease in pain sensitivity after an acute bout of exercise. The EIH response has been demonstrated to be sub-optimal in the presence of persisting pain. Menstrual pain is a common recurrent painful problem with many...

Purpose: To summarise recommendations about 20 non-surgical interventions for recent onset (<12 weeks) non-specific low back pain (LBP) and lumbar radiculopathy (LR) based on two guidelines from the Danish Health Authority. Methods: Two multidisciplinary working groups formulated recommendations based on the GRADE approach. Results: Sixteen re...

Collect Once - Use Many Times can possibly increase the research potential of clinical data from electronic healthcare records (EHR). The objective of this study was to achieve an increased understanding of the research potential of low back pain patients' municipal EHR by assessing the data quality. This explanatory sequentially mixed-methods case...

Introduction: Measurement of static joint range of motion is used extensively in orthopaedic and rehabilitative communities to benchmark treatment efficacy. Static measures are, however, insufficient in providing detailed information about patient impairments. Dynamic range of motion measures could provide more detailed information about patient i...

Aims The purpose of this study was to investigate potential gender differences in pain referral patterns induced by a tonic painful mechanical stimulus. Methods Forty-five healthy adults (22 women) participated in this study. Pressure pain thresholds (PPTs) were assessed at the infraspinatus, the brachioradialis and the gastrocnemius muscles on th...

Background: Assessing human performance in a clinical setting can be challenging as this requires the clinician to detect subtle variations in movement and range of motion with the naked eye. Research findings consistently demonstrate differences between clinical groups and healthy volunteers during standardized clinical tests but this is often don...

Objective.: To examine the effect of motor activity on the magnitude and duration of altered corticomotor output following experimental muscle pain. Design. : Experimental, pre-post test. Setting. : University laboratory. Subjects. : Twenty healthy individuals. Methods.: Participants were randomly allocated to a Rest or Movement group. The...

Over the past several years, our group has conceived a completely new technological approach toward BCIs aimed at reversing the maladaptive plasticity induced by musculoskeletal pain. The EEG activity patterns of participants with chronic pain (tennis elbow) were differentiated from those of healthy, age and sex matched controls during real-time mo...

Objectives: To report normative responses to the HAGOS questionnaire for Australian football players and to determine whether any of the HAGOS questionnaire sub scales can differentiate players with and without groin pain. Design: Case-control. Setting: Clinical setting. Participants: Professional (n = 66) and semi-professional (n = 9) Austr...

Objectives: To investigate the effects of experimental adductor pain on the pain referral pattern, mechanical sensitivity and muscle activity during common clinical tests. Design: Repeated-measures design. Methods: In two separate sessions, 15 healthy males received a hypertonic (painful) and isotonic (control) saline injection to either the a...

Facilitated pain mechanisms and impaired pain inhibition are often found in chronic pain patients. This study compared clinical pain profiles, pain sensitivity, as well as pro-nociceptive and anti-nociceptive mechanisms in patients with localized low back pain (n=18), localized neck pain (n=17), low back and radiating leg pain (n=18), or neck and r...

With conflicting evidence regarding the effectiveness of manual therapy calls have arisen within some quarters of the physiotherapy profession challenging the continued use of manual skills for assessment and treatment. A reconceptualisation of the importance of manual examination findings is put forward, based upon a contemporary understanding of...

Aim of Investigation A common feature in musculoskeletal pain is the recurrence of pain after the initial painful episode even after complete tissue healing. This may suggest that the nociceptive system undergoes changes following the tissue insult which do not return to normal. This study aimed to investigate whether individuals who have recovere...

Several chronic pain conditions are accompanied with enlarged referred pain areas. This study investigated a novel method for assessing referred pain. In 20 healthy subjects pressure pain thresholds (PPTs) were recorded and pressure stimuli (120%PPT) were applied bilaterally for 5-s and 60-s at the infraspinatus muscle to induce local and referred...

This is the first study to evaluate the mechanical sensitivity, clinical classifications and prevalence of groin pain in Australian football players.

Question: Do Australian (Rules) Football players have hyperalgesia when experiencing groin pain? Design: Case-control design Participants: Professional (n=66) and semi-professional (n=9) Australian football players were recruited with and without current or previous groin injuries were recruited during the pre-season through two AFL clubs. Outcome...

Background: Lumbopelvic pain (LPP) following pregnancy is common but the underlying pain mechanisms are poorly understood. A previous history of LPP increases the risk for developing pain during pregnancy indicating that the pain system may become sensitized and more susceptible to nociceptive stimuli. The aim of this study was to compare the mecha...

The criterion of long-standing groin pain diagnoses in athletes usually relies on palpation and clinical tests. An experimental pain model was developed to examine the clinical tests under standardized conditions. Pain was induced by hypertonic saline injected into the proximal adductor longus (AL) tendon or rectus femoris (RF) tendon in 15 healthy...

Lumbopelvic pain (LPP) is common in pregnancy but the sensitisation factors underlying the condition are largely unknown. This study characterised the somatosensory profile of pregnant and non-pregnant women and the relationship between pain, hypersensitivity and commonly used manual clinical tests. Thirty-nine pregnant and 22 non-pregnant women we...

Background / aim: Experimental pain models of induced short duration pain allow the pain provocation tests to be evaluated in healthy individuals. This study was aimed at establishing the best clinical test(s) to identify adductor longus tendon experimental pain. Methods: Experimental pain was induced in 15 healthy, physically-active, male particip...

Background / aim: Little attention has been given to symptomology in longstanding groin pain. This study aims to establish the pain distribution in experimentally-induced groin pain. Methods: Experimental pain was induced by hypertonic saline injection (1 mL, 5.8%) into the proximal adductor longus tendon (AL) or rectus femoris muscle (RF) of 15 h...

Objectives: The active straight leg raise (ASLR) test is widely used clinically to assess severity of lumbopelvic pain due to decreased stability of the sacroiliac joint (SIJ). This study aimed to bypass the influence of decreased SIJ stability on the ASLR test by investigating the effect of experimental pelvic pain and hyperalgesia on the outcome...

Introduction Longstanding groin injuries are a challenging area of sports medicine. Before we move forward in management we must first better understand the structures that form this region. This includes the gross anatomy and its function as well as the cells that underpin this function. The adductor longus has a fibrocartilage enthesis proximally...

The extra-articular sacroiliac joint (SIJ) structure is a potential source for low back and pelvic pain. This study hypothesised that experimental pain induced in a superficial pelvic ligament causes (1) hyperalgesia to pressure, (2) distinct pain referral, and (3) an increased frequency of positive pain provocation tests of the SIJ complex. Thirty...

Sustained postural loading of the cervical spine during work or recreational tasks may contribute to the development of neck pain. The aim of this study was to compare neck muscle endurance and fatigue characteristics during sub-maximal isometric endurance tests in patients with postural neck pain, with asymptomatic subjects. Thirteen female patien...