I am an Associate Professor in epidemiology. My background is in clinical work as a licensed manual therapist (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 the activities 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 two more associate professors work in the group (Lena Holm and Eva Rasmussen-Bass). In the group are also one researcher (Tobias Sundberg), three post-docs (Fredrik Johansson, UlrikaTranaeus and Titti Lilje), two PhD-students (Martin Asker and Oscar Pico), five research assistants (Anna Peterson, Victor Lyberg, Martin Samuelsson, Nathan Weiss and Edvin Ambrus) and four masters students and more than 20 magister students. Also foreign students 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), Eva Vingård (Uppsala University) and Per Renström (Karolinska Institutet).
We have high quality scientific data as observational cohort studies and several large clinical trials. Funders are the Swedish Research Council (VR), FORTE, AFA, Folksam, Swedish Research Council for Sport Science, the Swedish and Norwegian Naprapathic Associations, and the Scandinavian College of Naprapathic Manual Medicine. Among ongoing data collections 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. I am also the PI for the AFA financed three year project “Long-lasting and disabling back and/or neck pain and psychological distress – modifiable factors for risk and prognosis in the working population” that aims to investigate how life style factors interact in the development of and recovery from long lasting disabling back and/or neck pain, with or without psychological distress.
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
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.
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 effectiveness
2. The MINT-trial (Manual Intervention Trial) (n=1 057) 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.
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 Linköping University, Halmstad University, The Swedish School of Sport and Health Sciences (GIH) and the Scandinavian College of Naprapathic Manual Medicine. It is partly funded by Swedish and Norwegian Naprapathic Associations.
I teach regularly at courses on bachelor, master and doctoral levels.
Effect of Early Intensive Care on Recovery From Whiplash-Associated Disorders: Results of a Population-Based Cohort Study
Archives of physical medicine and rehabilitation 2016;97(5):739-46
Expectations of recovery: A prognostic factor in patients with neck pain undergoing manual therapy treatment
European journal of pain (London, England) 2016;20(9):1384-91
Spinal pain--good sleep matters: a secondary analysis of a randomized controlled trial
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2016;25(3):760-5
The impact of work related physical activity and leisure physical activity on the risk and prognosis of neck pain - a population based cohort study on workers
BMC musculoskeletal disorders 2016;17():219-
Three combinations of manual therapy techniques within naprapathy in the treatment of neck and/or back pain: a randomized controlled trial
BMC musculoskeletal disorders 2016;17():176-
A psychological injury prevention group intervention in Swedish floorball
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2015;23(11):3414-20
Are prevalent self-reported cardiovascular disorders associated with delayed recovery from whiplash-associated disorders: a population-based cohort study
The Clinical journal of pain 2015;31(3):247-53
Asymptomatic Elite Adolescent Tennis Players' Signs of Tendinosis in Their Dominant Shoulder Compared With Their Nondominant Shoulder
Journal of athletic training 2015;50(12):1299-305
Measuring Eccentric Strength of the Shoulder External Rotators Using a Handheld Dynamometer: Reliability and Validity
Journal of athletic training 2015;50(7):719-25
Negative psychosocial and heavy physical workloads associated with musculoskeletal pain interfering with normal life in older adults: cross-sectional analysis
Scandinavian journal of public health 2015;43(5):453-9
Sports injury prevention in Swedish elite floorball players: evaluation of two consecutive floorball seasons
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2015;23(3):899-905
Adverse events after manual therapy among patients seeking care for neck and/or back pain: a randomized controlled trial
BMC musculoskeletal disorders 2014;15():77-
Association Between Life Events and Rheumatoid Arthritis: Results From a Population-Based Case-Control Study
ARTHRITIS CARE & RESEARCH 2014;66(6):844-851
Costs and utilities of manual therapy and orthopedic standard care for low-prioritized orthopedic outpatients of working age: a cost consequence analysis
The Clinical journal of pain 2014;30(8):730-6
Pain relief in a young woman with adhesive capsulitis after manual manipulation of the acromioclavicular joint for remaining symptoms after mobilisation under anaesthesia
BMJ case reports 2014;2014():-
The sex-specific interrelationship between spinal pain and psychological distress across time in the general population. Results from the Stockholm Public Health Study
The spine journal : official journal of the North American Spine Society 2014;14(9):1928-35
Concordance of upper limb neurodynamic tests with medical examination and magnetic resonance imaging in patients with cervical radiculopathy: a diagnostic cohort study
Journal of manipulative and physiological therapeutics 2013;36(9):626-32
Do physical activity level and body mass index predict recovery from persistent neck pain in men and women of working age? A population-based cohort study
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2013;22(9):2077-83
The influence of self-reported leisure time physical activity and the body mass index on recovery from persistent back pain among men and women: a population-based cohort study
BMC public health 2013;13():385-
Does income matter for troublesome neck pain? A population-based study on risk and prognosis
Journal of epidemiology and community health 2012;66(11):1063-70
Prognosis of patients with whiplash-associated disorders consulting physiotherapy: development of a predictive model for recovery
BMC musculoskeletal disorders 2012;13():264-
The age- and sex-specific occurrence of bothersome neck pain in the general population--results from the Stockholm public health cohort
BMC musculoskeletal disorders 2012;13():185-
The occurrence and severity of musculoskeletal disorders in Swedish military personnel during peacekeeping operations in Afghanistan
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2012;21(4):739-44
Naprapathic Manual Therapy or Conventional Orthopedic Care for Outpatients on Orthopedic Waiting Lists? A Pragmatic Randomized Controlled Trial
CLINICAL JOURNAL OF PAIN 2010;26(7):602-10
The Course of Symptoms for Whiplash-Associated Disorders in Sweden: 6-Month Followup Study
JOURNAL OF RHEUMATOLOGY 2010;37(7):1527-33
The long-term effects of naprapathic manual therapy on back and neck pain - Results from a pragmatic randomized controlled trial
BMC MUSCULOSKELETAL DISORDERS 2010;:26-
IS SMOKING AND ALCOHOL CONSUMPTION ASSOCIATED WITH LONG-TERM SICK LEAVE DUE TO UNSPECIFIC BACK OR NECK PAIN AMONG EMPLOYEES IN THE PUBLIC SECTOR? RESULTS OF A THREE-YEAR FOLLOW-UP COHORT STUDY
JOURNAL OF REHABILITATION MEDICINE 2009;41(7):550-6
Expectations for recovery important in the prognosis of whiplash injuries
PLOS MEDICINE 2008;5(5):e105-
Life events and the risk of low back and neck/shoulder pain of the kind people are seeking care for: results from the MUSIC-Norrtalje case-control study
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH 2007;61(4):356-61
Naprapathic manual therapy or evidence-based care for back and neck pain - A randomized, controlled trial
CLINICAL JOURNAL OF PAIN 2007;23(5):431-9
The role of coping style in the onset of a new episode of low back and neck/shoulder pain
PSYCHOTHERAPY AND PSYCHOSOMATICS 2007;76(4):253-5
Widespread pain following whiplash-associated disorders: Incidence, course, and risk factors
JOURNAL OF RHEUMATOLOGY 2007;34(1):193-200