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Musculoskeletal & Sports Injury Epidemiology Center (MUSIC)

The aim with the activities in the research group MUSIC is to achieve interdisciplinary and inter-professional clinically relevant research within musculoskeletal disorders and sports medicine. We use epidemiological methods as cohort studies and randomized controlled trials and the research concerns prevention, risk and prognosis, diagnosis and interventions. The research is interdisciplinary and inter-professional and concerns rehabilitation and diagnostics as well as studies on risk factors and prognostic factors. The research group is multi professional; medicine, epidemiology, occupational medicine, naprapathy, chiropractic, physiotherapy, insurance medicine and public health.


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

We perform clinical trials with the overall aim of evaluating the effect of commonly used treatment strategies, including manual therapy, for 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.

  • The BJÖRN-trial (n=409). The aim of this trial was to compare naprapathic manual therapy with evidence-based advice to stay active for back or neck pain regarding pain, disability, perceived recovery, health, sick leave, etc. Naprapathy is characterized by manual manipulations with a focus on soft and connective tissues, aiming to decrease pain and disability in the musculoskeletal system. Four hundred and nine patients with pain and disability in the back or neck lasting for at least 2 weeks, were included in this randomized controlled trial. Outcomes were measured by questionnaires at baseline and after 3, 7, 12, 26 and 52 weeks.Lyssna Data from the trial is also used to identified prognostic factors for back and neck pain and to evaluate the cost effectivenessLäs fonetiskt
  • The MINT-Trial (The Manual Intervention Trial) (n=1057): Our earlier trials indicate that manual therapy like naprapathy is an effective treatment for patients with unspecific back/neck pain. This trial aims to compare the effect of three different combinations of Naprapathic manual therapy (NMT) on such pain, to examine prevalence, severity and duration of adverse reactions after NMT, and to identify subgroups of patients who have greater benefit from the treatments. The method is a randomized controlled trial with three arms. Included are care seeking patients 18-65 years with non-specific neck and/or back pain. Patients got up to 6 treatments within 6 weeks and were followed with questionnaires regarding adverse reactions, pain intensity, pain related disability and perceived recovery the outcomes four times within a year. Data from the trial is also used to identified prognostic factors for back and neck pain.
  • Stockholm Neck trial (The STONE-trial) (n = 620) is performed in collaboration with Associate Professor Pierre Côté, 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 detailed course of neck pain. Study participants are followed by questionnaires and weekly SMS. In January 2017 are all study participants followed for one year and the main analyses will start. 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 Karolinska Institutet.

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

  • 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 include 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 Professor Johan Hallqvist at Uppsala University.
  • The 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 Associate Professor Pierre Côté University of Ontario Institute of Technology, Professor David Cassidy at the University of Toronto and the University of Southern Denmark, and Professor Linda Carroll at Edmonton University.

III. Sports injury studies

  • The Swedish young elite tennis cohort: In this cohort the young Swedish elite tennis players are followed to understand more about shoulder injuries and adaptations. PhD-student Fredrik Johansson is responsible for the implementation of this study, that is performed in collaboration with Professor Ann Cools at Ghent University.
  • Karolinska Handball study (The KHAST study). This project aims to deepen the knowledge about injuries and the functional status in the shoulder in adolescent elite handball players. A cohort of 471 players, 15-17 years, recruited from handball profiled high schools in Sweden, is followed over time regarding shoulder injuries. The data collection is finished and data analyses is ongoing. The project is discussed and approved by the Swedish Handball association and performed in collaboration with in collaboration with Professor Ann Cools at Ghent University and Professor Grethe Myklebust at the Norwegian School of Sports Science. PhD-student Martin Asker is responsible for the implementation of the study, and it is funded by Folksam, CIF, Svenska Naprapatförbundet and Naprapathögskolan.
  • The Karolinska Football Injury Cohort (The 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.A pilot study is ongoing. The project is located at the Musculoskeletal & Sports Injury Epidemiology Center, and is performed in collaboration with Associate Professors Markus Waldén and Martin Hägglund at Linköping University, Professor Urban Johnson at Halmstad University and PhD Ulrika Tranæus at The Swedish School of Sport and Health Sciences (GIH). It is partly funded by Karolinska Institutet and Naprapathögskolan.

Group members in MUSIC

Group leader


Eva E. Skillgate

Telefon: 08-524 879 95
Enhet: Interventions- och implementeringsforskning inom arbetshälsa

Associate professors

  • Lena Holm
  • Eva Rasmussen-Barr


Tobias Sundberg (associated)


  • Fredrik Johansson
  • Titti Lilje
  • Ulrika Tranaeus
  • Lina Palmlöf (associated)
  • Tony Bohman (associated)


  • Martin Asker
  • Oscar Pico

Research assistants

  • Anna Peterson
  • Edvin Ambrus
  • Martin Samuelsson
  • Victor Lyberg
  • Nathan Weiss

Master students

  • Maija Marjamäki
  • Sonja Broo
  • Peter Viklund
  • Martin Carlseus

Senior researchers and collaborators

  • Margareta Nordin (New York University)
  • Pierre Côté (University of Ontario Institute of Technology)
  • Eva Vingård (Uppsala Universitet)
  • David Cassidy (Toronto University and University of Southern Denmark)
  • Linda Carroll (University of Alberta, Edmonton)
  • Ann Cools (Ghent University)
  • Johan Hallqvist (Uppsala University)
  • Cecilia Magnusson (Karolinska Institutet)
  • Martin Hägglund (Linköping University)
  • Markus Waldén (Linköping University)
  • Urban Johnson (Halmstad University)