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About me

I am an Associate Professor in epidemiology. My background is in clinical work as a licensed naprapath with musculoskeletal pain and sports injuries and in Public Health. I defended my thesis in epidemiology at Karolinska Institutet in 2007. In 2008 - 2009 I had post doc positions at Toronto University and Uppsala University, and in 2009 I started the research group called MUSIC (Musculoskeletal & Sports Injury Epidemiology Center) at the Institute of Environmental Medicine, Karolinska Institutet, for which I am the research group leader.  The aim with MUSIC is to achieve interdisciplinary and inter-professional clinically relevant research within musculoskeletal disorders and sports medicine. The research concerns prevention, risk and prognosis, diagnosis and interventions. The MUSIC group involves among others caregivers from different professions (physiotherapy, medicine, naprapathy, chiropractic, osteopathy) who work close to clinical settings. I am the research group leader and run the center with Associate professor Lena Holm. Others in the group are one associate professor (Eva Rasmussen-Bass), three PhD-students (Fredrik Johansson, Martin Asker, Oscar Pico), two post-docs (UlrikaTranaeus and Titti Lilje), two research assistants (Anna Peterson and Caroline Alstergren) and sixteen magister/master students.  Also foreign students as well as clinicians from Canada and Switzerland are associated to our group. Affiliated are experts in the field; professors Margareta Nordin (New York University), Pierre Coté (University of Ontario Institute of Technology) and Eva Vingård (Uppsala University).

We have high quality scientific data as observational cohort studies and several large clinical trials. Also I have funding from the Swedish Research Council (VR), FORTE, AFA, Folksam, Swedish Research Council for Sport Science and KI for data collections in ongoing projects. Among them are an RCT about massage and physical training for long lasting neck pain (Stockholm Neck Trial – STONE, n= 620), and cohort studies aiming to identify risk factors for injuries in young elite handball (Karolinska Handball Study, KHAST) tennis (The Swedish young elite tennis cohort) and football players ( Karolinska football Injury Cohort - KIC) in Sweden.  

 

International and national collaborators:

Professor Margareta Nordin,  New York University, USA

Professor Eva Vingård, Uppsala Universitet

Associate Professor Pierre Coté, University of Ontario Institute of Technology

Professor Cecilia Magnusson, Centrum för Epidemiologi och samhällsmedicin vid Stockholms Läns Landsting, and Institutionen för Folkhälsovetenskap vid Karolinska Institutet.

Professor David Cassidy, Toronto University and University of Southern Denmark

Professor Johan Hallqvist, Uppsala Universitet

Professor Linda Carroll, University of Alberta, Edmonton

Professor Johan Berglund, Blekinge Tekniska Högskola

Professor Ulf Persson, the Swedish Institute for Health Economics

Professor Anne Cools, Ghent University

Professor Grethe Myklebust (physio therapy, sports medicine) at Oslo Sports Trauma Research Center

Assistant Professor Markus Waldén, Linköpings Universitet

Associate Professor Martin Hägglund, Linköpings Universitet

Professor Urban Johnson, Högskolan I Halmstad

Professor Jan Hartvigsen, University of Southern Denmark

MD, PhD Maria Wertli, Horten Center for Patient Oriented Research and Knowledge Transfer University of Zurich

Professor Robert Schleip, Ulm University

Education

Associate Professor/Docent in Epidemiology, Karolinska Institutet, 2014

Doctor in Medical Science (Epidemiology), Karolinska Institutet, 2007. Doctoral thesis:” Back and neck pain. Epidemiological studies on some risk factors and treatments, including Naprapathic manual therapy”. Research education at the Institute of Environmental medicine and Health Care Sciences Postgraduate School, Karolinska Institutet. 

Public Health Karolinska Institutet, 2003

Licensed naprapath since 1994. Naprapathögskolan 1984 – 1988

 

Research description

Some of the projects within MUSIC

I. Randomized controlled trials (RCT) of interventions for back and neck pain:

We perform clinical trials with the overall aim to evaluate the effect of commonly used treatment strategies including manual therapy as Naprapathy, on musculoskeletal disorders. Specific aims are to deepen the knowledge of the effect of treatments on back/neck pain regarding pain, disability, perceived recovery, cost utility and adverse reactions.

1. The BJÖRN-trial (n=409) about the effect of naprapathic manual therapy on unspecific back and neck pain. Data from the trial is also used to identified prognostic factors for back and neck pain and to evaluate the cost effectivenessLyssna

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2. The MINT-trial (Manual Intervention Trial) (n=1 070) about the treatment effects of combinations of manual therapy (naprapathy) as well as the occurrence and severity of adverse events directly after manual therapy. Data from the trial is also used to identified prognostic factors for back and neck pain.

3. Three smaller RCTs (n= 100, 46 and 33 respectively) in collaboration with Ulm University, aiming to evaluate the effect of specific receptor stimulation with manual therapy on the calf muscle, the lower back, and the shoulder.

4. The STONE-trial (Stockholm Neck trial) (n = 620) in collaboration with University of Ontario Institute of Technology, to explore the effect of massage therapy and physical training on sub-acute and long lasting neck pain, and to study the course of neck pain. Data will also be used to identify prognostic factors for future secondary prevention strategies and to perform a health economic evaluation. This trial is ongoing and is funded by VR, FORTE and KI.  

II. Cohort studies of factors of importance for the prognosis of back/neck pain.

1. The Stockholm Public Health Cohort (SPHC): I am the PI for the research regarding musculoskeletal pain in the SPHC, a prospective cohort set within the framework of the Stockholm County Council Public Health Surveys. The cohorts includes in total more than  100 000 persons, which provide statistical power for interaction analyses on risk and prognostic factors for pain/recovery for back pain, neck pain and comorbidity with psychological distress. SPHC is resident in the Department of Public Health and the PI is Professor Cecilia Magnusson. The research is performed in collaboration with them and with Uppsala University.

2. Whiplash pain cohorts: We have access to several cohorts of patients from Sweden and Canada with neck pain after Whiplash. The research about prognostic factors for neck pain after is performed in collaboration with University of Ontario Institute of Technology, Toronto University, University of Southern Denmark and Edmonton University.

 

3. The HAKuL-study: A cohort study with follow-up of over 8 000 employees in the public sector. The aim is to assess the importance of health, life style and work environmental factors for sick absence over a 10-12 years period.

 

III. Sports injury studies

1. The Swedish young elite tennis cohort: This is a PhD-student project (Fredrik Johansson) about shoulder injuries and adaptations in young Swedish elite tennis players in collaboration with Ghent University.

 

2. The KHAST-study (Karolinska Handball study) is a PhD-student project (Martin Asker) aiming to deepen the knowledge about injuries and the functional status in the shoulder in adolescent elite handball players. A cohort of 400 players, 15-17 years, recruited from handball profiled high schools in Sweden, is followed for two seasons regarding shoulder injuries. The project is discussed and approved by the Swedish Handball association. The study is funded by Folksam insurance.

 

3. The Karolinska Football Injury Cohort (KIC study): This project is an innovative collaboration between epidemiology, medicine, psychology, orthopedics, physiotherapy and naprapathy, composed of research groups at four universities, in order to identify risk factors for overuse and traumatic injuries. In an extensive cohort study, 600 young female footballers from Academies and elite football gymnasiums (NIU) in the Stockholm, Göteborg and Malmö will be included. Players free from injuries/pain in the hip, back and/or head/neck will be followed prospectively one year regarding incident cases of injuries to the to the hip, back and head/neck.  Players answer an extensive questionnaire, are screened clinically at baseline and after 6 months, and followed prospectively with weekly web-based questionnaires regarding match and training exposure and new injuries during one year. Risk factors and factors of importance for no injury will be identified by comparing exposed and unexposed with an extensive confounding control.

The project has a unique holistic and multidisciplinary perspective that potentially can answer a long row of research questions, separately for common but unexplored risk factors and pain sights. This will contribute considerably to the research area. The project is located at the Musculoskeletal & Sports Injury Epidemiology Center, and is performed in collaboration with Associate Professors Markus Waldén (Orthopedics and Sports Medicine) and Martin Hägglund (Physiotherapy and sports medicine) at Linköping University, Professor Urban Johnson (Sports psychology) at Halmstad University and PhD Ulrika Tranaeus (Naprapathy, Sports psychology) at The Swedish School of Sport and Health Sciences (GIH). It is partly funded by KI, Naprapathögskolan and the Swedish Naprapathic Association.

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