Margareta Barnekow-Bergkvist

Determinants of Self-Reported Neck-Shoulder and Low Back Symptoms in a General Population

Study Design. A combined cross‐sectional and longitudinal design. Objectives. To investigate relation between, on one hand, self‐reported neck‐shoulder symptoms and, on the other hand, low back symptoms and self‐reported work‐related physical load, psychosocial factors, and individual characteristics and to study the influence of physical capacity in adolescence on neck‐shoulder and low back symptoms in adulthood. Summary of Background Data. Heavy physical work and exposure to vibration constitute risk factors for low back problems, and repetitive and static work are risk factors for neck‐shoulder symptoms in many jobs. The interplay between individual factors and work‐related psychosocial and physical exposure, however, is not well documented. This study addresses effects of adolescent capacity on this interplay in a general population. Methods. A random sample of 425 Swedish students was investigated when the students were 16 years and 34 years of age. Sixty‐five percent participated in both examinations; only those who worked ≥ 6 hours/week at the follow‐up period, 148 men and 90 women, were included in these analyses. Data about musculoskeletal symptoms, work, and sociodemographic and individual characteristics were collected at the age of 34 years; physical performance data were collected at the ages of 16 years and 34 years. Results. Among the men, self‐employment and worry were associated with neck‐shoulder symptoms; among the women, monotonous work and high decision latitude were associated with neck‐shoulder symptoms. Low back problems were related to monotonous work among men and women and to exposure to vibration among men. Performance in certain fitness tests at the ages of 16 years and 34 years was negatively associated with musculoskeletal symptoms. Conclusions. The inverse relationships between performance at the age of 16 years and adult musculoskeletal symptoms may imply benefits of early fitness training.

Secular trends in body dimensions and physical fitness among adolescents in Sweden from 1974 to 1995

Aim: To investigate changes over time in body dimensions, and muscular and aerobic fitness in a representative sample of 16‐year‐old‐girls and boys in secondary schools in Sweden from 1974 to 1995 (n = 855).Method: Height and weight were measured and five tests were performed: run–walk, two‐hand‐lift, Sargent jump, sit‐ups, and bench‐press.Results: In 1995, girls and boys had higher body mass index (BMI) than in 1974. Girls and boys performed less well in bench‐press, sit‐ups, and run–walk‐tests in 1995. Boys, but not girls, performed better in Sargent jump in 1995 than in 1974. Girls and boys performed better in two‐hand‐lift in 1995 than in 1974. However, after adjustment for body dimensions, there were no differences in performance in two‐hand‐lift or run–walk‐tests between 1974 and 1995.Conclusion: There was a decreased aerobic fitness and an increased maximal static strength among adolescents in Sweden between 1974 and 1995. These changes were partly due to increased BMI. However, decreased daily physical activity level cannot be excluded as a contributing factor to the decreased aerobic fitness. The reduced performance in muscular endurance in 1995 was not related to increased BMI. Instead, it is suggested that it is to be related to a specific decrease in hip flexion and arm muscle endurance.

Physical activity pattern in men and women at the ages of 16 and 34 and development of physical activity from adolescence to adulthood.

The aim of this study was to investigate gender‐related differences in physical activity patterns at the ages of 16 and 34 and to analyse those factors that might contribute to an explanation of physical activity habits in adulthood. A randomly selected group, consisting of 220 boys and 205 girls, was tested in 1974 and reinvestigated in 1992 by means of a questionnaire. Eighty‐eight percent participated in the reinvestigation. At the age of 16 more boys (69%) than girls (51%) participated in some sports activity in their leisure time. The results showed an overall decrease in participation in vigorous physical activity, although participation in light physical activity remained relatively constant. At the age of 34, there was no difference in overall physical activity between men and women, but the men exercised more vigorously (44% vs. 29%). Early experience of physical activity at the age of 16 decreased the risk of becoming inactive in adulthood. At the age of 34 cohabiting for the men, and having children and high socio‐economic class for the women, increased the risk of being physically inactive in adulthood, whereas positive beliefs about health effects of exercise decreased the risk for both men and women.

Relationships between work-related factors and disorders in the neck-shoulder and low-back region among female and male ambulance personnel

Relationships between work‐related factors and disorders in the neck‐shoulder and low‐back region among female and male ambulance personnel: Ulrika Aasa, et al. Centre for Musculoskeletal Research, University of Gävle, Sweden—This cross‐sectional study on a random sample of 1,500 ambulance personnel investigated the relationships between self‐reported work‐related physical and psychosocial factors, worry about work conditions, and musculoskeletal disorders among female and male ambulance personnel. Three different outcomes, complaints, activity limitation, and sick leave, for the neck‐shoulder and low‐back region, respectively, were chosen. Among the female personnel, physical demands was significantly associated with activity limitation in the neck‐shoulder (OR 4.13) and low‐back region (OR 2.17), and psychological demands with neck‐shoulder (OR 2.37) and low‐back (OR 2.28) complaints. Among the male personnel, physical demands was significantly associated with low‐back complaints (OR 1.41) and activity limitation (OR 1.62). Psychological demands and lack of social support were significantly associated with neck‐shoulder complaints (OR 1.86 and OR 1.58, respectively) and activity limitation (OR 3.46 and OR 1.71) as well as activity limitation due to low‐back complaints (OR 2.22 and OR 1.63). Worry about work conditions was independently associated with activity limitation due to low‐back complaints among the female (OR 5.28), and to both neck‐shoulder and low‐back complaints (OR 1.79 and OR 2.04, respectively) and activity limitation (OR 2.32 and OR 1.95) among the male personnel. In conclusion, the association patterns between physical and psychological demands and MSDs suggest opportunities for intervention.

Prediction of physical fitness and physical activity level in adulthood by physical performance and physical activity in adolescence--an 18-year follow-up study.

Barnekow‐Bergkvist M, Hedberg G, Janlert U, Jansson E. Prediction of physical fitness and physical activity level in adulthood by physical performance and physical activity in adolescence ‐ An 18‐year follow‐up study.

Adolescent determinants of cardiovascular risk factors in adult men and women

Aims: To investigate how physical activity, physical performance and sociodemographic characteristics at the age of 16 are related to adult health habits (physical activity, dietary intake, smoking) and biological risk factors for cardiovascular diseases (being overweight, low aerobic fitness, unfavorable levels of serum lipids, high blood pressure). Methods: A randomly selected group of 220 male and 205 female students at 16 years of age was tested in 1974, and reinvestigated 18 years later. Results: The predictive health profiles for adult lifestyle and biological risk factors were different in men and women. Leisure sports activity along with high performance in the nine-minute run among the boys and in the two-hand lift test among the girls were significant predictors of adult physical activity. A positive attitude to aerobic exercise and high performance in the nine-minute run test among the boys and high marks in physical education among the girls decreased the risk of smoking. Leisure sports activities together with body mass index at young ages were the most powerful predictors of adult biological risk factors, but attitudes to sports and educational level were also significant determinants. Conclusion: These results contribute to the knowledge of which factors at young ages may promote adult healthy habits in particular physical activities.

Secular trends in sports: participation and attitudes among adolescents in Sweden from 1974 to 1995

Aim: To study the secular trend (time changes) in participation in leisure‐time sports activities and in attitudes towards sports activities and physical education in a representative sample of Swedish adolescents between 1974 and 1995. Methods: A questionnaire was distributed to 16‐y‐old girls and boys (n= 395 in 1974, n= 542 in 1995) to assess participation in leisure‐time sports activity, attitudes towards sports activities and attitudes towards physical education at school. Height and weight were measured and body mass index (BMI) was calculated. Results: Compared with 1974, more subjects in 1995 answered that they were engaged in leisure‐time sports activities, and that they were members of sports clubs. BMI increased from 1974 to 1995. By 1995, adolescents participated in and had become more interested in individual sports activities, including keep‐fit activities (e.g. strength training and aerobics) compared with 1974. A gender difference in the feeling of anxiety towards physical education, with more girls experiencing it, appeared in 1995, but not in 1974.

Prediction of development of fatigue during a simulated ambulance work task from physical performance tests

The aims of this study were (1) to identify which physical performance tests could best explain the development of fatigue during a simulated ambulance work task, (2) to investigate the effect of height and weight and (3) to investigate in what respects these findings differ between female and male ambulance personnel. Forty-eight male and 17 female ambulance personnel completed a test battery assessing cardio-respiratory capacity, muscular strength and endurance, and co-ordination. The subjects also completed a simulated ambulance work task — carrying a loaded stretcher. The work task was evaluated by development of fatigue. Univariate and multiple regression analyses were used to investigate to what extent the tests in the test battery were able to explain the variance of developed fatigue. The explained variance was higher for female than for male ambulance personnel (time > 70% of HRpeak: R2 = 0.75 vs 0.10, accumulated lactate: R2 = 0.62 vs 0.42, perceived exertion: R2 = 0.75 vs 0.10). Significant predictors in the models were VO2max, isometric back endurance, one-leg rising, isokinetic knee flexion and shoulder extension strength. Height, but not weight, could further explain the variance. The high physical strain during carrying the loaded stretcher implies the importance of investigating whether improved performance, matching the occupational demands, could decrease the development of fatigue during strenuous tasks.

Relationships between physical activity and physical capacity in adolescent females and bone mass in adulthood

This study investigates whether physical activity and physical performance in adolescence are positively related to adult bone mineral density (BMD). In 1974, physical activity, endurance, and muscular strength were measured in 204 randomly selected female students, age 16.1 ± 0.3 year (range 15–17 years). Twenty years later, 36 of the women volunteered to undergo a measurement of their BMD. Women who were members in a sports club in adolescence had significantly higher adult BMD (mean differences of 5% to 17% depending on site) compared with subjects who were not engaged in a sports club. Furthermore, women with persistent weight‐bearing activity in adulthood had significantly higher BMD compared with women who had stopped being active or had never been active. The differences ranged between 5% and 19% with the highest difference found in trochanter BMD. Stepwise regression analyses showed that membership in a sports club at baseline was a significant independent predictor of BMD in the total body, lumbar spine, legs, trochanter, and femoral neck, explaining 17–26% of the variation in BMD. Change in body weight was a strong independent predictor of BMD of the total body and arms, explaining 8% of the variation in both sites. In addition, running performance at baseline was an independent predictor of total body BMD, whereas the two‐hand lift performance significantly predicted BMD of the total body, legs and trochanter. The hanging leg‐lift and handgrip were both significant predictors of arm BMD. In conclusion, membership in a sports club and site‐specific physical performance in adolescence together with the change in body weight were significantly associated with adult BMD in premenopausal women.

Low physical activity among adolescents in practical education.

The aim of this study was to investigate physical activity levels and factors related to physical activity among 16‐year‐old girls and boys in secondary school practical and theoretical programs. An additional aim was to identify factors contributing to differences in physical activity patterns between the educational programs. Sixteen‐year‐old students in the first year of secondary school in Sweden (n=585) were systematically selected and 93% agreed to complete a questionnaire. Compared with students in theoretical programs, those in practical programs spent less time and energy per day in physical activity. Girls in practical programs were the least physically active, and boys in theoretical programs the most physically active students. Statistical analysis showed that, among students in practical programs, the influence of educational program on physical activity level was explained by lower socio‐economic level, less parental support, lower perceived health level, and negative attitudes toward outdoor physical activities. These data suggest that promotion of physical activity should focus on students, especially girls, in practical programs. Because the difference in physical activity levels between educational programs was partly an effect of less positive parental influence, school‐based programs may be especially influential in increasing physical activity levels among secondary school students.