Nina Køpke Vøllestad

• Christensen, Lene; Veierød, Marit Bragelien; Vøllestad, Nina Køpke; Jakobsen, Vidar Eivind; Stuge, Britt; Cabri, Jan Maria Hendrick & Robinson, Hilde Stendal (2019). Kinematic and spatiotemporal gait characteristics in pregnant women with pelvic girdle pain, asymptomatic pregnant and non-pregnant women. Clinical Biomechanics.  ISSN 0268-0033.  68, s 45- 52 . doi: 10.1016/j.clinbiomech.2019.05.030 Vis sammendrag

  Background Walking difficulties are common among pregnant women with pelvic girdle pain. This cross-sectional study investigated the influence of pelvic girdle pain, pregnancy and speed on spatiotemporal and trunk, pelvic and hip kinematics during gait in the 2nd trimester of pregnancy. Methods Three-dimensional gait analysis at self-selected speed was performed in 25 pregnant women with pelvic girdle pain, 24 asymptomatic pregnant and 24 non-pregnant women. Linear mixed models were used to investigate between-group differences in gait variables. Adjustment for gait speed was included in the analysis. Correlations between speed and fear of movement, disability and pain were examined using Spearman correlation coefficient (rs). Findings Pregnant women with pelvic girdle pain walked 18% slower (estimated marginal means (95% confidence intervals) 1.18 (1.22, 1.24) meter/s) compared to asymptomatic pregnant women (1.44 (1.38, 1.50) meter/s) (P < 0.001). Moreover, with longer double limb support (5%, P = 0.04), shorter contralateral step length (3%, P = 0.03) and more restricted pelvic and hip kinematics (0.001 ≤ P ≤ 0.01) adjusted for speed. Only stance, double limb support and thoracic rotation (0.001 ≤ P ≤ 0.04) differed between asymptomatic pregnant and non-pregnant women. Speed was negatively correlated with fear of movement (rs = −0.63, P = 0.01) and disability (rs = −0.46, P = 0.03) in the pelvic girdle pain group. Interpretation Gait is primarily influenced by pelvic girdle pain and less by pregnancy. Pregnant women with pelvic girdle pain walked slower and with a more rigid gait pattern compared to asymptomatic pregnant women, presumably related to altered load transfer. Our results may assist clinical evaluation of pelvic girdle pain, as well as direct future research.

• Christensen, Lene; Vøllestad, Nina Køpke; Veierød, Marit Bragelien; Stuge, Britt; Cabri, Jan Maria Hendrick & Robinson, Hilde Stendal (2019). The Timed Up & Go test in pregnant women with pelvic girdle pain compared to asymptomatic pregnant and non-pregnant women. Musculoskeletal Science and Practice.  ISSN 2468-8630.  43, s 110- 116 . doi: 10.1016/j.msksp.2019.03.006 Vis sammendrag

  Background: The Timed Up and Go (TUG) test, a standardized functional mobility test, has been proposed as aphysical performance-based measure in pregnant women with pelvic girdle pain (PGP).Objectives:This cross-sectional study aimed to investigate physical function by the use of TUG in pregnantwomen with PGP compared to asymptomatic pregnant and non-pregnant women, and to identify factors asso-ciated with increased TUG.Methods:In total, 25 pregnant women with PGP, 24 asymptomatic pregnant and 25 asymptomatic non-pregnantwomen participated. One-way analysis of variance was used to explore difference in TUG between the groupsand multiple linear regression analyses to explore associations between TUG and potential explanatory variables.Results:The time on TUG varied among pregnant women with PGP, and was significantly higher (mean (95% CI)6.9 (6.5, 7.3) seconds) than for asymptomatic pregnant (5.8 (5.5, 6.0), p < 0.001) and non-pregnant (5.5 (5.4,5.6), p < 0.001) women. In the total study sample, group, increased BMI and sick leave were significantlyassociated with increased TUG (p-values≤0.02). In pregnant women with PGP, pain intensity was the onlysignificant clinical factor associated with increased TUG (p= 0.002).Conclusion:Pregnant women with PGP used longer time and showed larger variation in TUG than asymptomaticpregnant and non-pregnant women, this underpins that TUG targets activities relevant to PGP. Our resultsprovide new knowledge about factors influencing TUG time. Importantly, multivariable analyses suggest thatpain intensity should be considered when interpreting TUG time in pregnant women with PGP.

• Stafne, Signe Nilssen; Vøllestad, Nina Køpke; Mørkved, Siv; Salvesen, Kjell Å & Stendal Robinson, Hilde (2019). Impact of job adjustment, pain location and exercise on sick leave due to lumbopelvic pain in pregnancy: a longitudinal study. Scandinavian Journal of Primary Health Care.  ISSN 0281-3432.  37(2) . doi: 10.1080/02813432.2019.1608058 Fulltekst i vitenarkiv.
• Thornes, Elisabeth; Robinson, Hilde Stendal; Moosmeyer, Stefan; Ekeland, Arne Erling & Vøllestad, Nina Køpke (2019). Low-impact exercise program for patients with symptomatic lumbar spinal stenosis awaiting surgery: a controlled pilot study. European Journal of Physiotherapy.  ISSN 2167-9169.  s 1- 9 . doi: 10.1080/21679169.2018.1554000
• Balasundaram, Arun Prasad; Robinson, Hilde Stendal & Vøllestad, Nina Køpke (2018). Do the key prognostic factors for non-specific neck pain have moderation effects? ? A study protocol. Medical Hypotheses.  ISSN 0306-9877.  114, s 65- 68 . doi: 10.1016/j.mehy.2018.03.004 Fulltekst i vitenarkiv.
• Evensen, Kari Anne Indredavik; Robinson, Hilde Stendal; Meisingset, Ingebrigt; Woodhouse, Astrid; Thielemann, Marit; Bjorbærkmo, Wenche Schrøder; Myhre, Gard; Hansen, Anne Elisabeth; Vasseljen, Ottar & Vøllestad, Nina Køpke (2018). Characteristics, course and outcome of patients receiving physiotherapy in primary health care in Norway: design of a longitudinal observational project. BMC Health Services Research.  ISSN 1472-6963.  18(936) . doi: 10.1186/s12913-018-3729-y Fulltekst i vitenarkiv.
• Mahmood, Aqsa; Moen, Aurora Lie; Stafne, Signe Nilssen; Robinson, Hilde Stendal; Vøllestad, Nina Køpke; Salvesen, Kjell Å; Mørkved, Siv & Gjerstad, Johannes (2018). The MMP9 rs17576 A>G polymorphism is associated with increased lumbopelvic pain-intensity in pregnant women. Scandinavian Journal of Pain.  ISSN 1877-8860.  18(1), s 93- 98 . doi: 10.1515/sjpain-2017-0168 Fulltekst i vitenarkiv. Vis sammendrag

  Background and aims: Matrix metalloproteinase 9 (MMP9) is an enzyme that may affect degradation of several extracellular matrix (ECM) components in the pelvic ligaments during pregnancy. Previous studies indicate that genetic variations in the gene encoding MMP9 may affect the enzymatic activity. One such genetic variant is a single nucleotide polymorphism (SNP), rs17576 A>G. In this study we investigated whether the MMP9 SNP rs17576 A>G may be associated with increased lumbopelvic pain in 838 pregnant woman. The study was registered with ClinicalTrials.gov (NCT 00476567) on May 21, 2007. Methods: Lumbopelvic pain-intensity was measured by visual analog scale (VAS) at two time points during pregnancy, T1 (18–22 weeks), T2 (32–36 weeks) and 3 months after delivery. Blood samples were collected at each point and SNP genotyping was carried out using predesigned TaqMan SNP genotyping assays. Results: The results showed a significant association between the number of G alleles and pain-intensity in the evening at T2. The pain among G/G carriers was higher than among A/G carriers, which in turn was higher than among the A/A carriers. The most pronounced association between the G allele and pain-intensity was observed in primiparae. Conclusions: We conclude that the MMP9 rs17576 A>G polymorphism is associated with increased lumbopelvic pain-intensity during pregnancy. The present data support the hypothesis that lumbopelvic pain during pregnancy may be related to a relaxin – MMP9 – tissue remodeling mechanism.

• Myrhaug, Hilde Tinderholt; Odgaard-Jensen, Jan; Østensjø, Sigrid; Vøllestad, Nina Køpke & Jahnsen, Reidun Birgitta (2018). Effects of a conductive education course in young children with cerebral palsy: A randomized controlled trial. Developmental Neurorehabilitation.  ISSN 1751-8423.  21(8), s 481- 489 . doi: 10.1080/17518423.2017.1360961 Fulltekst i vitenarkiv.
• Robinson, Pernille Stendal; Balasundaram, Arun Prasad; Vøllestad, Nina Køpke & Robinson, Hilde Stendal (2018). The association between pregnancy, pelvic girdle pain and health-related quality of life – a comparison of two instruments.. Journal of Patient-Reported Outcomes.  ISSN 2509-8020.  2 . doi: 10.1186/s41687-018-0069-y Fulltekst i vitenarkiv.
• Steen, Unni; Wekre, Lena Lande & Vøllestad, Nina Køpke (2018). Physical functioning and activities of daily living in adults with amyoplasia, the most common form of arthrogryposis. A cross-sectional study. Disability and Rehabilitation.  ISSN 0963-8288.  40(23), s 2767- 2779 . doi: 10.1080/09638288.2017.1357211 Vis sammendrag

  Background: Amyoplasia, the most common form of arthrogryposis is characterized by typical deformities of the joints and replacement of skeletal muscles by fibrous tissue and fat. There is sparse literature on adaptation to adult life with amyoplasia. Purpose: To describe physical function and activity strategies in adults with amyoplasia, as this knowledge is important for relevant function-enhancing measures. Materials and methods: Twenty-two adults (20–91 years) with amyoplasia participated. Demographic factors and clinical history were registered. Body proportions were measured. Joint mobility and muscle strength in the upper limbs were examined. The Functional Independent Measure was used to assess performance of activities of daily living. Compensatory strategies were described. Results: The majority had undergone comprehensive conservative and surgical treatment. Mean height was below typical. Range of motion was below lower limit of normal in most joints, passive range of motion was mainly larger than active. Muscle strength was reduced for most movements. Seven were independent in all activities. Need of assistance was highest regarding bathing and dressing. A variety of compensatory strategies were used. Conclusions: Adults with amyoplasia are heterogeneous regarding function. Independence in everyday life requires a combination of muscle strength to move against gravity, ability to passive joint motion, and use of compensatory strategies.

• Thornes, Elisabeth; Robinson, Hilde Stendal & Vøllestad, Nina Køpke (2018). Degenerative lumbar spinal stenosis and physical functioning: an exploration of associations between self-reported measures and physical performance tests. Disability and Rehabilitation.  ISSN 0963-8288.  40(2), s 232- 237 . doi: 10.1080/09638288.2016.1250123
• Thornes, Elisabeth; Robinson, Hilde Stendal & Vøllestad, Nina Køpke (2018). Dynamic balance in patients with degenerative lumbar spinal stenosis; A cross-sectional study. BMC Musculoskeletal Disorders.  ISSN 1471-2474.  19(192) . doi: 10.1186/s12891-018-2111-x Fulltekst i vitenarkiv.
• Wuytack, Francesca; Gutke, Annelie; Stuge, Britt; Mørkved, Siv; Olsson, Christina B; Robinson, Hilde Stendal; Vøllestad, Nina Køpke; Öberg, Birgitta; Wikmar, Lena Nilsson; Mena, Juan Jose Saldena & Smith, Valerie (2018). Protocol for the development of a core outcome set for pelvic girdle pain, including methods for measuring the outcomes: the PGP-COS study. BMC Medical Research Methodology.  ISSN 1471-2288.  18:158 . doi: 10.1186/s12874-018-0624-5 Fulltekst i vitenarkiv.
• Heggem Julsvoll, Elisabeth; Vøllestad, Nina Køpke; Opseth, Gro & Robinson, Hilde Stendal (2017). Inter-tester reliability of selected clinical tests for long-lasting temporomandibular disorders. Journal of Manual & Manipulative Therapy.  ISSN 1066-9817.  25(4), s 182- 189 . doi: 10.1080/10669817.2017.1322346 Fulltekst i vitenarkiv.
• Heggem Julsvoll, Elisabeth; Vøllestad, Nina Køpke & Robinson, Hilde Stendal (2017). Kan smerte og funksjon bidra til å diagnostisere temporomandibulær dysfunksjon? :. Fysioterapeuten.  ISSN 0016-3384.  84(3), s 20- 25 Fulltekst i vitenarkiv.
• Heggem Jolsvoll, Elisabeth; Vøllestad, Nina Køpke & Robinson, Hilde Stendal (2016). Validation of clinical tests for patients with long-lasting painful temporomandibular disorders with anterior disc displacement without reduction. Manual Therapy.  ISSN 1356-689X.  21, s 109- 119 . doi: 10.1016/j.math.2015.06.005
• Sveaas, Silje Halvorsen; Berg, Inger Jorid; Provan, Sella Aarrestad; Semb, Anne Grete; Olsen, Inge Christoffer; Ueland, Thor; Aukrust, Pål; Vøllestad, Nina Køpke; Hagen, Kåre Birger; Kvien, Tore Kristian & Dagfinrud, Hanne (2015). Circulating levels of inflammatory cytokines and cytokine receptors in patients with ankylosing spondylitis: A cross-sectional comparative study. Scandinavian Journal of Rheumatology.  ISSN 0300-9742.  44(2), s 118- 124 . doi: 10.3109/03009742.2014.956142
• Engebretsen, Eivind; Vøllestad, Nina Køpke; Wahl, Astrid Klopstad; Robinson, Hilde Stendal & Heggen, Kristin (2015). Unpacking the Process of Interpretation in Evidence-Based Decision-Making. Journal of Evaluation In Clinical Practice.  ISSN 1356-1294.  21, s 529- 531
• Haukaas, Fredrik Salvesen; Vøllestad, Nina Køpke; Robinson, Hilde Stendal & Aas, Eline (2015). Helseøkonomisk evaluering i fysioterapi. Fysioterapeuten.  ISSN 0016-3384.  82(10), s 22- 27
• Sveaas, Silje Halvorsen; Berg, Inger Jorid; Provan, Sella Aarrestad; Semb, Anne Grete; Hagen, Kåre Birger; Vøllestad, Nina Køpke; Fongen, Camilla; Olsen, Inge Christoffer; Michelsen, Annika; Ueland, Thor; Aukrust, Pål; Kvien, Tore Kristian & Dagfinrud, Hanne (2014). Efficacy of High Intensity Exercise on Disease Activity and Cardiovascular Risk in Active Axial Spondyloarthritis: A Randomized Controlled Pilot Study. PLOS ONE.  ISSN 1932-6203.  9(9) . doi: 10.1371/journal.pone.0108688
• Birkeflet, Oddveig; Laake, Petter & Vøllestad, Nina Køpke (2014). Poor multi-rater reliability in TCM pattern diagnoses and variation in the use of symptoms to obtain a diagnosis. Acupuncture in Medicine.  ISSN 0964-5284.  32(4), s 325- 332 . doi: 10.1136/acupmed-2013-010473
• Gutke, Annelie; Olsson, Christina B; Vøllestad, Nina Køpke; Öberg, Birgitta; Nilsson-Wikmar, Lena & Robinson, Hilde Stendal (2014). Association between lumbopelvic pain, disability and sick leave during pregnancy; a comparison of three Scandinavian cohorts. Journal of Rehabilitation Medicine.  ISSN 1650-1977.  46(5), s 468- 474 . doi: 10.2340/16501977-1801
• Robinson, Hilde Stendal; Vøllestad, Nina Køpke & Veierød, Marit Bragelien (2014). Clinical course of pelvic girdle pain postpartum - Impact of clinical findings in late pregnancy. Manual Therapy.  ISSN 1356-689X.  19(3), s 190- 196 . doi: 10.1016/j.math.2014.01.004
• Eilertsen, Heidi; Vøllestad, Nina Køpke & Hagve, Tor-Arne (2013). The Usefulness of Blast Flags on the Sysmex XE-5000 Is Questionable. American Journal of Clinical Pathology.  ISSN 0002-9173.  139(5), s 633- 640 . doi: 10.1309/AJCPDUZVRN5VY9WZ
• Halvorsen, Silje; Vøllestad, Nina Køpke; Provan, Sella Aarrestad; Semb, Anne Grete; van der Heijde, Désirée; Hagen, Kåre Birger & Dagfinrud, Hanne (2013). Cardiorespiratory Fitness and Cardiovascular Risk in Patients With Ankylosing Spondylitis: A Cross-Sectional Comparative Study. Arthritis Care and Research.  ISSN 0893-7524.  65(6), s 969- 976 . doi: 10.1002/acr.21926
• Lillehagen, Ida; Vøllestad, Nina Køpke; Heggen, Kristin & Engebretsen, Eivind (2013). Protocol for a qualitative study of knowledge translation in a participatory research project. BMJ Open.  ISSN 2044-6055.  3(8) . doi: 10.1136/bmjopen-2013-003328
• Vikne, Harald; Bakke, Eva; Liestøl, Knut; Engen, Stian Rugsveen & Vøllestad, Nina Køpke (2013). Muscle activity and head kinematics in unconstrained movements in subjects with chronic neck pain; cervical motor dysfunction or low exertion motor output?. BMC Musculoskeletal Disorders.  ISSN 1471-2474.  14(1), s 314 . doi: 10.1186/1471-2474-14-314 Fulltekst i vitenarkiv.
• Vikne, Harald; Bakke, Eva; Liestøl, Knut; Sandbæk, Gunnar & Vøllestad, Nina Køpke (2013). The smoothness of unconstrained head movements is velocity-dependent. Human Movement Science.  ISSN 0167-9457.  32(4), s 540- 554 . doi: 10.1016/j.humov.2012.12.013
• Birkeflet, Oddveig; Laake, Petter & Vøllestad, Nina Køpke (2012). Traditional Chinese medicine patterns and recommended acupuncture points in infertile and fertile women. Acupuncture in Medicine.  ISSN 0964-5284.  30(1), s 12- 16 . doi: 10.1136/acupmed-2011-010089
• Halvorsen, Silje; Vøllestad, Nina Køpke; Fongen, Camilla; Provan, Sella Aarrestad; Semb, Anne Grete; Hagen, Kåre Birger & Dagfinrud, Hanne (2012). Physical Fitness in Patients With Ankylosing Spondylitis: Comparison With Population Controls. Physical Therapy.  ISSN 0031-9023.  92(2), s 298- 309 . doi: 10.2522/ptj.20110137
• Halvorsen, Silje; Vøllestad, Nina Køpke; Provan, Sella Aarrestad; Semb, Anne Grete; van der Heijde, Désirée; Hagen, Kåre Birger & Dagfinrud, Hanne (2012). High cardiorespiratory fitness is related to lower cardiovascular risk in patients with ankylosing spondylitis. Arthritis Care and Research.  ISSN 0893-7524. . doi: 10.1002/acr.21925
• Oesch, Peter; Meyer, Kathrin; Bachmann, Stefan; Hagen, Kåre Birger & Vøllestad, Nina Køpke (2012). Comparison of Two Methods for Interpreting Lifting Performance During Functional Capacity Evaluation. Physical Therapy.  ISSN 0031-9023.  92(9), s 1130- 1140 . doi: 10.2522/ptj.20110473
• Vikne, Harald; Gundersen, Kristian; Liestøl, Knut; Mæhlen, Jan & Vøllestad, Nina Køpke (2012). Intermuscular relationship of human muscle fiber type proportions: Slow leg muscles predict slow neck muscles. Muscle and Nerve.  ISSN 0148-639X.  45(4), s 527- 535 . doi: 10.1002/mus.22315
• Vøllestad, Nina Køpke; Torjesen, Peter A & Robinson, Hilde Stendal (2012). Association between the serum levels of relaxin and responses to the active straight leg raise test in pregnancy. Manual Therapy.  ISSN 1356-689X.  17(3), s 225- 230 . doi: 10.1016/j.math.2012.01.003
• Birkeflet, Oddveig; Laake, Petter & Vøllestad, Nina Køpke (2011). Low inter-rater reliability in traditional Chinese medicine for female infertility. Acupuncture in Medicine.  ISSN 0964-5284.  29(1), s 51- 57 . doi: 10.1136/aim.2010.003186
• Dagfinrud, Hanne; Halvorsen, Silje; Vøllestad, Nina Køpke; Niedermann, K; Kvien, Tore Kristian & Hagen, Kåre Birger (2011). Exercise Programs in Trials for Patients With Ankylosing Spondylitis: Do They Really Have the Potential for Effectiveness?. Arthritis Care and Research.  ISSN 0893-7524.  63(4), s 597- 603 . doi: 10.1002/acr.20415
• Robinson, Hilde Stendal; Mengshoel, Anne Marit; Bjelland, Elisabeth Krefting & Vøllestad, Nina Køpke (2010). Pelvic girdle pain, clinical tests and disability in late pregnancy. Manual Therapy.  ISSN 1356-689X.  15(3), s 280- 285 . doi: 10.1016/j.math.2010.01.006
• Robinson, Hilde Stendal; Mengshoel, Anne Marit; Veierød, Marit Bragelien & Vøllestad, Nina Køpke (2010). Pelvic girdle pain: Potential risk factors in pregnancy in relation to disability and pain intensity three months postpartum. Manual Therapy.  ISSN 1356-689X.  15(6), s 522- 528 . doi: 10.1016/j.math.2010.05.007
• Robinson, Hilde Stendal; Veierød, Marit Bragelien; Mengshoel, Anne Marit & Vøllestad, Nina Køpke (2010). Pelvic girdle pain - associations between risk factors in early pregnancy and disability or pain intensity in late pregnancy: a prospective cohort study. BMC Musculoskeletal Disorders.  ISSN 1471-2474.  11 . doi: 10.1186/1471-2474-11-91
• Holm, Inger; Tveter, Anne Therese; Fredriksen, Per Morten & Vøllestad, Nina Køpke (2009). A normative sample of gait and hopping on one leg parameters in children 7-12 years of age. Gait & Posture.  ISSN 0966-6362.  29(2), s 317- 321 . doi: 10.1016/j.gaitpost.2008.09.016 Vis sammendrag

  BACKGROUND: Accomplishment of a series of successive hops is an advanced motor skill and requires adequate timing and coordination. Hopping on one leg performance might therefore be a more sensitive test with higher discriminatory power than ordinary gait in evaluating motor competence both in healthy and diseased children. OBJECTIVE: The purpose of the study was to develop a normative sample on walking at a normalized speed of 1.5m/s and hopping on one leg parameters in children 7-12 years of age, and to evaluate the influence of age and gender on the different parameters. METHOD: 360 girls and boys between 7 and 12 years participated in the study. All data were collected using the GAITRite((R)) system. The children were instructed to walk at four different speeds and to hop on either leg with as long serial jumps as possible across the whole walkway. RESULTS: There was an increase in absolute step length of 15% from 7 to 12 years of age. However, for normalized step length there was no increase. The total increase in absolute and normalized hop length from 7 to 12 years was 64% and 36%, respectively. Multiple regression analysis displayed a significant increase for absolute and normalized hopping length with age. CONCLUSION: While step length only showed a small increase from 7 to 12 years of age, hop length showed significant increase both in absolute and normalized values. The variability, however, was large, indicating that a normative sample of hop length measurements includes a wide range of values for each age group.

• Vøllestad, Nina Køpke & Stuge, B (2009). Prognostic factors for recovery from postpartum pelvic girdle pain. European spine journal.  ISSN 0940-6719.  18(5), s 718- 726 . doi: 10.1007/s00586-009-0911-2
• Giske, Liv; Vøllestad, Nina Køpke; Mengshoel, Anne Marit; Jensen, Jørgen; Knardahl, Stein & Røe, Cecilie (2008). Attenuated adrenergic responses to exercise in women with fibromyalgia - A controlled study. European Journal of Pain.  ISSN 1090-3801.  12(3), s 351- 360 . doi: 10.1016/j.ejpain.2007.07.007 Vis sammendrag

  The pathogenesis of widespread pain and fibromyalgia (FM) is unknown. Altered responses from the hypothalamus-pituitary-adrenal axis, sympathetic nervous system and muscular system have been suggested as being of importance. The present study was undertaken to determine: (i) whether the sympathoadrenal response to repetitive isometric contractions until exhaustion is altered in patients with FM, and (ii) whether sympathoadrenal responses are associated with muscle fatigue and pain during exercise. Nineteen women with FM, and 19 healthy women matched for age, smoking and self-reported physical activity, participated. Maximal voluntary contraction (MVC), repetitive isometric contractions (6s contraction and 4s resting phases) were performed with both quadriceps muscles at 30% of MVC until exhaustion. Muscle activity was recorded from the quadriceps muscles by surface electromyography (EMG). Plasma adrenalin (Adr), noradrenalin (NAdr) and cortisol were measured and perceived exertion and pain reported during exercise. Attenuated Adr responses (p<0.001) with normal plasma NAdr and cortisol (p>0.19) responses were found during exercise in the FM group compared with the control group. Significantly higher EMG amplitude (%EMG(max)) during the contraction phases (p=0.001) was found in the FM than in the control group. Perceived exertion and pain responses to exercise were higher in the FM group than in the controls (p<0.001), without relationship to the sympathoadrenal responses. In conclusion; the exercise was perceived as being more painful and strenuous in the FM group. Muscle performance was altered with increased muscle activity during the exercise. Women with FM showed an attenuated Adr response to repetitive isometric exercise.

• Holm, Inger; Fredriksen, PM; Fosdahl, M & Vøllestad, Nina Køpke (2008). A normative sample of isotonic and isokinetic muscle strength measurements in children 7 to 12 years of age. Acta Paediatrica.  ISSN 0803-5253.  97(5), s 602- 607 . doi: 10.1111/j.1651-2227.2008.00709.x Vis sammendrag

  AIM: To provide normative age- and gender-associated values on muscular strength, power and endurance and to establish a reference database on healthy school children aged 7 to 12 years. In addition, associations between some simple functional tests and the more sophisticated isokinetic strength measures were investigated. METHODS: Three hundred seventy-six children, 191 girls and 185 boys, performed different muscle-strength tests like knee flexion/extension, handgrip, back extension and vertical jump. RESULTS: There was a significant and linear increase in strength with no gender differences from 7 up to 11 years of age. There was a large variability within each age group, indicating that a normative sample of muscle-strength measurements includes a wide range of values for each age group. The relationship between hand- grip strength and observed quadriceps strength was high (r = 0.84) and the correlation between vertical jump and relative quadriceps strength was moderate (r = 0.50). CONCLUSION: All the different strength measures showed almost the same pattern, indicating increased absolute strength values with increasing age and no significant gender differences except for flexion at the age of 11 and 12 years . The association between grip strength, vertical jump and quadriceps strength measured isokinetically was moderate to strong. The back muscle endurance test (The Biering-Sørensen test) showed a great roof effect and should not be included in a test battery for school children.

• Holm, Inger & Vøllestad, Nina Køpke (2008). Significant effect of gender on hamstring-to-quadriceps strength ratio and static balance in prepubescent children from 7 to 12 years of age. American Journal of Sports Medicine.  ISSN 0363-5465.  36, s 2007- 2013 . doi: 10.1177/0363546508317963 Vis sammendrag

  BACKGROUND: A number of studies have reported lower muscular strength of the hamstring and the quadriceps and better postural control in female compared with male athletes. Whether those differences are innate and also exist in children and adolescents or are caused by training and participation in different sports is unknown. HYPOTHESIS: Gender differences in hamstring and quadriceps muscular strength and static balance exist even before maturity. STUDY DESIGN: Cross-sectional study; Level of evidence, 4. METHODS: A total of 368 children between 7 and 12 years of age participated in the study. They performed isokinetic concentric hamstring and quadriceps muscle strength measurements at 60 and 240 deg/s and a static balance test using the KAT 2000. Data analysis consisted of independent-samples t tests and multiple regression analysis. RESULTS: Gender had a significant effect on both the hamstring/quadriceps (HQ) ratios and static balance in children between 7 and 12 years of age. Except for the 7-year-old participants, boys showed significantly higher HQ ratios than the girls in every age group, indicating that the hamstring muscles in girls were relatively weak when compared with the quadriceps muscles. There was also a gender effect on the balance index with better balance in girls than boys. CONCLUSION: There is a significant gender difference in HQ ratios and static balance in children between 8 and 12 years of age. Because many children start their handball careers before the age of 10 years, the present findings indicate that prevention programs including hamstring strength training should be prescribed at an earlier age than recommended in previously published studies.

• Jubrias, SA; Vøllestad, Nina Køpke; Gronka, RK & Kushmerick, MJ (2008). Contraction coupling efficiency of human first dorsal interosseous muscle. Journal of Physiology.  ISSN 0022-3751.  586(7), s 1993- 2002 . doi: 10.1113/jphysiol.2007.146829 Vis sammendrag

  During working contractions, chemical energy in the form of ATP is converted to external work. The efficiency of this conversion, called 'contraction coupling efficiency', is calculated by the ratio of work output to energy input from ATP splitting. Experiments on isolated muscles and permeabilized fibres show the efficiency of this conversion has a wide range, 0.2-0.7. We measured the work output in contractions of a single human hand muscle in vivo and of the ATP cost of that work to calculate the contraction coupling efficiency of the muscle. Five subjects performed six bouts of rapid voluntary contractions every 1.5 s for 42 s (28 contractions, each with time to peak force < 150 ms). The bouts encompassed a 7-fold range of workloads. The ATP cost during work was quantified by measuring the extent of chemical changes within the muscle from (31)P magnetic resonance spectra. Contraction coupling efficiency was determined as the slope of paired measurements of work output and ATP cost at the five graded work loads. The results show that 0.68 of the chemical energy available from ATP splitting was converted to external work output. A plausible mechanism to account for this high value is a substantially lower efficiency for mitochondrial ATP synthesis. The method described here can be used to analyse changes in the overall efficiency determined from oxygen consumption during exercise that can occur in disease or with age, and to test the hypothesis that such changes are due to reduced contraction coupling efficiency.

• Holm, Inger; Fredriksen, PM; Fosdahl, MA; Olstad, M & Vøllestad, Nina Køpke (2007). Impaired motor competence in school-aged children with complex congenital heart disease. Archives of Pediatrics & Adolescent Medicine.  ISSN 1072-4710.  161, s 945- 950
• Giske, L; Roe, C; Knardahl, S & Vøllestad, Nina Køpke (2007). Pain and sympathoadrenal responses to dynamic exercise in women with the Fibromyalgia syndrome. Journal of Musculoskeletal Pain.  ISSN 1058-2452.  15, s 25- 38 . doi: 10.1300/J094v15n04_04
• Giske, Liv; Røe, Cecilie; Knardahl, Stein & Vøllestad, Nina Køpke (2007). Pain and Sympathoadrenal Responses to Dynamic Exercise in Women with the Fibromyalgia Syndrome. Journal of Musculoskeletal Pain.  ISSN 1058-2452.  15(4), s 25- 38 . doi: 10.1300%2fJ094v15n04_04 Vis sammendrag

  Objectives: To determine whether sympathoadrenal responses during exhaustive bicycling is attenuated in fibromyalgia syndrome [FMS] patients compared to demographically matched healthy normal control [HNC] subjects, and whether pain during exercise is related to sympathoadrenal responses. Another objective was to determine whether exercise exacerbates pain and fatigue in the subsequent days. Methods: Thirty women [15 FMS, 15 HNC] women matched for age, exercise frequency, and smoking habits bicycled with a stepwise increment in workload until exhaustion. Heart rate, oxygen uptake, and plasma catecholamine concentrations were determined before, during, and after exercise. Pain and perceived exertion were recorded during exercise. Average pain, sleep disturbance, and fatigue were recorded for the seven days preceding the exercise and for Day 1 and Day 7 after the exercise. Results: Plasma catecholamine concentrations, heart-rate, and oxygen uptake increased similarly during exercise in FMS patients and controls. By contrast, the oxygen uptake at exhaustion was significantly lower in the FMS group. However, when the FMS and HNC subjects were re-matched according to peak oxygen uptake, there were still no significant differences in biological responses were found. Pain increased substantially during exercise in the FMS group. Despite that, no increase in pain or fatigue was observed in the days following exercise. Conclusion: The FMS patients were less physically fit than the HNCs. The catecholamine and heart rate responses during dynamic exercise were normal in the FMS patients. However, the increase in exercise-induced pain reported in the FMS group could not be explained by an attenuated catecholamine response. Exhaustive dynamic exercise did not induce increased pain or fatigue in patients with FMS.

• Grotle, Margreth; Brox, Jens Ivar; Glomsrød, Bredo; Lønn, Jan Harald & Vøllestad, Nina Køpke (2007). Prognostic factors in first-time care seekers due to acute low back pain. European Journal of Pain.  ISSN 1090-3801.  11(3), s 290- 298 . doi: 10.1016/j.ejpain.2006.03.004 Vis sammendrag

  There is limited knowledge on prognostic factors for developing chronic low back pain (LBP) at an early stage of LBP. The objectives of this study were to investigate the clinical course of pain and disability, and prognostic factors for non-recovery after 1-year, in patients seeking help for the first time due to acute LBP. An inception cohort study included 123 patients with acute LBP lasting less than 3 weeks and consulting primary care for the first time. Main outcome measures were pain intensity, Roland-Morris disability questionnaire (RMQ), and sickness absence. Eleven patients (9%) did not return for the 12-month follow-up. There were large and significant reductions in pain intensity (P<0.001) and RMQ scores (P<0.001) during follow-up. Patients with neurological signs showed significantly less improvement in pain (P=0.001) and RMQ (P=0.004) compared with those without neurological signs. The proportions with sickness absence due to LBP at 6, 9, and 12 months were 7%, 8%, and 9%, respectively. At 12 months, 17% of patients had not fully recovered. Multivariate logistic regression analyses showed that high scores on a psychosocial screening (acute low back pain screening questionnaire) and emotional distress (Hopkin's symptom check list) were significantly associated with non-recovery at 12 months, with odds ratios of 4.4 (95% confidence interval 1.1-17.4) and 3.3 (1.1-10.2), respectively.

• Stuge, Britt & Vøllestad, Nina Køpke (2007). Important aspects for efficacy of treatment with specific stabilizing exercises for postpartum pelvic girdle pain, In Andry Vlemming; Vert Mooney & Rob Stoeckart (ed.),  Movement, Stability & Lumbopelvic Pain. Integration of research and therapy.  Elsevier.  ISBN 978-0-443-10178-6.  Chap. 36.  s 547 - 561
• Vikne, Harald; Raastad, Truls; Wisnes, Alex; Refsnes, Per Egil; Gjøvaag, Terje & Vøllestad, Nina Køpke (2007). Hvor nødvendig er trening med høy belastning?. Fysioterapeuten.  ISSN 0016-3384.  6(25), s 25- 27
• Grotle, Margreth; Brox, Jens Ivar & Vøllestad, Nina Køpke (2006). Reliability, validity and responsiveness of the fear-avoidance beliefs questionnaire: methodological aspects of the Norwegian version. Journal of Rehabilitation Medicine.  ISSN 1650-1977.  38(6), s 346- 353 Vis sammendrag

  OBJECTIVE: To evaluate reliability, validity and responsiveness of the Fear-Avoidance Beliefs Questionnaire (FABQ) for use in Norwegian patients with low back pain. DESIGN: A prospective cohort study with 2 groups. PATIENTS: The questionnaire was tested in 123 patients with acute low back pain and 50 patients with chronic low back pain. METHODS: A translation and cross-cultural adaptation was performed. Test-retest reliability was assessed in 28 patients with chronic low back pain. Responsiveness was assessed in acute low back pain. RESULTS: Two factors for the FABQ were confirmed; fear-avoidance beliefs about work (FABQ-Work) and physical activity (FABQ-PA), accounting for 60% and 54% of the total variance in acute and chronic low back pain, respectively. For FABQ-Work and FABQ-PA internal consistency was 0.90 and 0.79, intra-class correlation coefficients 0.82 and 0.66, minimal detectable changes 12 and 9 points, and coefficients of variation were 16% and 23%. The FABQ correlated weakly to moderately with pain, disability, distress, and clinical variables. Standardized response means were low for FABQ-Work (0.32) and moderate (0.56) for FABQ-PA. Both FABQ subscales showed initially floor and/or ceiling effects. CONCLUSION: The Norwegian FABQ version had acceptable factor structure, internal consistency, test-retest reliability and construct validity. The responsiveness of the FABQ-Work was low, and for the FABQ-PA moderate, in the acute sample.

• Grotle, Margreth; Vøllestad, Nina Køpke & Brox, Jens Ivar (2006). Clinical course and impact of fear-avoidance beliefs in low back pain: Prospective cohort study of acute and chronic low back pain: II. Spine.  ISSN 0362-2436.  31(9), s 1038- 1046 Vis sammendrag

  STUDY DESIGN: Prospective inception cohort study. OBJECTIVES: To compare the clinical course of fear-avoidance beliefs in acute and chronic low back pain (LBP) and investigate the contribution of fear-avoidance beliefs to predict pain and disability after 1 year. SUMMARY OF BACKGROUND DATA: Fear-avoidance beliefs are involved in disability development. There is little knowledge on the development of fear-avoidance beliefs among different LBP subgroups. METHODS: Patients with acute (n = 123) and chronic (n = 50) LBP completed a comprehensive assessment, including the Fear-Avoidance Beliefs Questionnaire (FABQ), and were followed at 3, 6, 9, and 12 months. RESULTS: At baseline, patients with chronic LBP had significantly higher FABQ-scores for work (FABQ-Work) than patients with acute LBP (P < 0.001), and this difference remained unchanged over 1 year (P > 0.21). At baseline, there was no statistical significant difference in FABQ-scores for physical activity (FABQ-PA) between the two groups (P = 0.57). FABQ-PA scores decreased significantly over the first 4 weeks among patients with acute LBP during follow-up and remained unchanged thereafter, whereas in the chronic sample the FABQ-PA scores were unchanged throughout the first year (time effect, P < 0.001; and interaction effect, P < 0.001). In the acute sample, FABQ-Work predicted pain (P < 0.05) and disability at 12 months (P = 0.01). In the chronic sample, FABQ-PA predicted disability at 12 months (P = 0.03). The associations between the FABQ and pain/disability disappeared with distress included in the models. CONCLUSION: Patients with chronic LBP had more fear-avoidance beliefs for work than patients with acute LBP. There were small changes in fear-avoidance beliefs during the year of follow-up, except for a rapid decrease during the first month in the FABQ-PA in the acute sample. Fear-avoidance beliefs predicted pain and disability at 12 months after adjusting for socio-demographic and pain variables. Distress was a stronger predictor than fear-avoidance beliefs.

• Grotle, Margreth; Vøllestad, Nina Køpke & Brox, JI (2006). Screening for yellow flags in first-time acute low back pain: Reliability and validity of a Norwegian version of the Acute Low Back Pain Screening Questionnaire. The Clinical Journal of Pain.  ISSN 0749-8047.  22, s 458- 467
• Røe, Cecilie; Steingrímsdóttir, Ólöf Anna; Knardahl, Stein; Bakke, Eva & Vøllestad, Nina Køpke (2006). Long-term repeatability of force, endurance time and muscle activity during isometric contractions. Journal of Electromyography & Kinesiology.  ISSN 1050-6411.
• Røe, Cecilie; Steingrimsdottir, Olof Anna; Knardahl, Stein; Bakke, Eva & Vøllestad, Nina Køpke (2006). Long-term repeatability of force, endurance time and muscle activity during isometric contractions. Journal of Electromyography & Kinesiology.  ISSN 1050-6411.  16(1), s 103- 113 . doi: 10.1016/j.jelekin.2005.03.004 Vis sammendrag

  We determined the repeatability and correlations between force, endurance and muscle activity during isometric contractions over three years. Twenty-six subjects, with and without complaints of the shoulder and neck, performed standardized maximal and submaximal shoulder-abduction contractions and wrist extension-contractions at yearly intervals from 1997 to 1999. Peak forces developed during maximal contraction and the endurance times of submaximal contractions during shoulder abduction and wrist extension were measured. Electromyography (EMG) of muscle activity was recorded bilaterally from the upper trapezius, middle deltoid, and forearm extensor muscles. Root mean square EMG amplitudes were calculated. We found statistically significant associations between peak forces developed during wrist extension and shoulder abduction, and between endurance times of submaximal wrist extension and shoulder abduction. No statistically significant changes in peak force and EMG(peak) were found over the measurement years. The responses were not statistically significantly influenced by gender, or neck and shoulder pain. However, we observed considerable intra-individual variation in the inter-year measurements particularly for the responses to submaximal contraction. Such large variations represent a challenge when attempting to use the responses to interpret the effects of therapies.

• Stuge, Britt; Holm, Inger & Vøllestad, Nina Køpke (2006). To treat or not to treat postpartum pelvic girdle pain with stabilizing exercises?. Manual Therapy.  ISSN 1356-689X.  11(4), s 337- 343 Vis sammendrag

  Women with pelvic girdle pain (PGP) often consult physical therapists for help and are treated with different therapies without firm evidence for the effectiveness. Two randomized controlled trials have investigated the effect of stabilizing exercises for PGP. The most recent study demonstrated significant positive results in favour of exercises (Stuge et al. The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy. A randomized controlled trial. Spine 2004a;29(10):351-9), the other did not (Mens et al. Diagonal trunk muscle exercises in peripartum pelvic pain: a randomized clinical trial. Phys. Ther. 2000;80(12):1164-73). Consequently, the two studies provide contradictory advice for treatment of PGP. The question is thus, whether stabilizing exercises should be recommended as treatment for PGP. Both the studies are of high methodological quality and are comparable with regard to subjects studied. However, there are several differences in the interventions and these are explored and discussed for better understanding of the conflicting results. Exercises that focused on only global muscles showed no effect. However, these exercises were not individualized and they were instructed by videotape. In the more recent study, exercises that initially focused on local muscles, and then gradually added global muscles showed a significant, positive effect. Exercises in that study were supervised, corrected, individualized concerning choice of exercises, order and dosage, and pain was avoided. This comparison indicates that effective treatment of postpartum PGP may be achieved when exercises for the entire spinal musculature are included, individually guided and adapted to each individual.

• Stuge, Britt; Mørkved, Siv; Dahl, Haldis haug & Vøllestad, Nina (2006). Abdominal and pelvic floor muscle function in women with and without long lasting pelvic girdle pain. Manual Therapy.  ISSN 1356-689X.  11(4), s 287- 296
• Østensjø, Sigrid; Bjorbækmo, Wenche Schrøder; Carlberg, EB & Vøllestad, Nina Køpke (2006). Assessment of young children with disabilities: an ICF based analysis of concepts and content og the Pediatric Evaluation of Disability Inventory (PEDI). Disability and Rehabilitation.  ISSN 0963-8288.  28(8), s 489- 504
• Dagfinrud, Hanne Solveig; Vøllestad, Nina Køpke; Loge, Jon Håvard; Kvien, Tore Kristian & Mengshoel, Anne Marit (2005). Fatigue in patients with ankylosing spondylitis: a comparison with the general population and associations with clinical and self-reported measures. Arthritis and Rheumatism.  ISSN 0004-3591.  53(1), s 5- 11 Vis sammendrag

  OBJECTIVE: To investigate 1) levels of fatigue in patients with ankylosing spondylitis (AS) compared with the general population; 2) the relationships between fatigue and demographic, self-reported, and clinical measures; and 3) the performance of both a generic and a disease-specific measure of fatigue. METHODS: Patients with AS (n = 152) were compared with people from the general population (n = 2,323). Fatigue was assessed by the Short Form 36 (SF-36) vitality scale and the fatigue item of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Other measures of self-reported health included BASDAI for disease activity, Bath Ankylosing Spondylitis Functional Index for functional abilities, and the SF-36 for mental health. Clinical measures comprised Bath Ankylosing Spondylitis Metrology Index for joint mobility and erythrocyte sedimentation rate and C-reactive protein as inflammatory markers. The explanatory power of demographic, self-reported, and clinical measures was examined in a block regression model. RESULTS: The mean +/- SD SF-36 vitality score was 43 +/- 24 in the patients and 60 +/- 21 in the general population (P < 0.001). The SF-36 vitality and the BASDAI fatigue scores were consistently associated with measures of mental health and disease activity. Clinical measures did not show explanatory power. A cutoff at 70 mm on the BASDAI fatigue item implied specificity of 0.77 and sensitivity of 0.82. CONCLUSION: Self-reported measures of disease activity and mental health contributed significantly to explain fatigue, whereas clinical measures of inflammation and joint mobility did not. The BASDAI fatigue item reached acceptable sensitivity and specificity with a cutoff at 70 mm when using the low vitality scores of SF-36 as an external indicator.

• Grotle, Margreth; Brox, Jens Ivar; Veierød, Marit Bragelien; Glomsrød, Bredo; Lønn, JH & Vøllestad, Nina Køpke (2005). Clinical course and prognostic factors in acute low back pain: patients consulting primary care for the first time. Spine.  ISSN 0362-2436.  30(8), s 976- 982 Vis sammendrag

  STUDY DESIGN: Inception cohort study. OBJECTIVES: To examine the clinical course of acute low back pain and to evaluate prognostic factors for nonrecovery. SUMMARY OF BACKGROUND DATA: Few studies have explored clinical course and prognostic factors in patients who consult primary care for their first time because of an episode of low back pain of <3 weeks duration. METHODS: A total of 123 patients with acute low back pain <3 weeks consulting primary care for the first time were included, and 120 completed 3 months follow-up. Baseline assessments included sociodemographic characteristics, back pain history and current status, psychological questionnaires and clinical examination. Main outcome measures were pain intensity, disability by Roland Morris Disability Questionnaire, and recovery of disability. Potential prognostic factors for recovery or not were analyzed by multivariate logistic regression. RESULTS: At 4 weeks and 3 months 76% of the patients had recovered. Mean pain intensity and mean disability scores dropped 58% and 68%, respectively, of initial levels during the 3 months. The proportion with sickness absence was 8% at 4 weeks and 6% at 3 months. Several sociodemographic, clinical, and psychological factors were of prognostic value. Compared with their respective reference categories, age above 45 years (odds ratio 4.4, 95% confidence interval 1.4-14.0), smoking (3.0, 1.1-8.5), two or more neurological signs (4.6, 1.4-14.9), a score of >or=90 on the psychosocial screening (3.1, 1.0-9.4), and high levels of distress (4.1, 1.3-12.8) were the best prognostic factors of nonrecovery at 3 months. CONCLUSION: During a period of 3 months, 24% of the patients had not recovered. Psychological factors and neurological signs were strongly associated with nonrecovery at 3 months. In addition to the traditional examination of neurological symptoms and signs, psychological factors should be considered already at the initial visit of an episode of low back pain.

• Grotle, Margreth; Brox, Jens Ivar & Vøllestad, Nina Køpke (2005). Functional status and disability questionnaires: what do they assess? A systematic review of back-specific outcome questionnaires. Spine.  ISSN 0362-2436.  30(1), s 130- 140 Vis sammendrag

  Study design. A systematic literature review of outcome questionnaires specificly designed and used for assessing functional status or disabiliy in patients with low back pain. Objectives. To provide a comprehensive overview of all functioning/disability questionnaires used the last years, and classify the content of the questionnaires in order to identify the concept(s) and construct(s) reflected in the questionnaires. Summary of background data. A number of clinical tools designed for evaluating the functional status of patients with low back pain have been developed. There has been little focus on the differences in content of the questionnaires and the concepts and constructs reflected in these. Methods. Papers including questionnaires for assessing disability, function, activity limitations, or participation restrictions in adult patients (> 18 years) with low back pain were searched in the Medline and Cinahl databases for the period January 1996-2002. ¿Back pain¿ and ¿low back pain¿ were combined with relevant terms. Hand-searches were carried out in journals and textbooks. Two independent and blinded researchers read and selected abstracts and questionnaires. The content of the included questionnaires was catehegorized into impairments, activities of daily living and social function as well as subgroups of these. Results. A total of 35 back-specific questionnaires were identified. A considerable variation with respect to content was found. All outcome questionnaires assessed activities of daily living and a majority also assessed social functions and bodily aspects such as pain and symptoms, sleep disturbances, psychological dysfunctions, and/or physical impairments. Seven questionnaires assessed solely activities of daily living. Several questionnaires also included other constructs. Conclusions. The outcome questionnaires differed with regard to content, concept(s) and construct(s), thus reflecting different interpretations of disability.

• Steingrimsdottir, OA; Vøllestad, Nina Køpke & Knardahl, Stein (2005). A prospective study of the relationship between musculoskeletal or psychological complaints and muscular responses to standardized cognitive and motor tasks in a working population. European Journal of Pain.  ISSN 1090-3801.  9, s 311- 324
• Steingrímsdóttir, Ólöf Anna; Vøllestad, Nina Køpke & Knardahl, Stein (2005). A prospective study of the relationship between musculoskeletal or psychological complaints and muscular respnses to standardized cognitive and motor tasks in a working population. European Journal of Pain.  ISSN 1090-3801.
• Vøllestad, Nina Køpke & Mengshoel, Anne Marit (2005). Relationships between neuromuscular functioning, disability and pain in fibromyalgia. Disability and Rehabilitation.  ISSN 0963-8288.  27(12), s 667- 673
• Østensjø, Sigrid; Carlberg, EB; Carlberg, EB; Vollestad, NK & Vøllestad, Nina Køpke (2005). The use and impact of assistive devices and other environmental modifications on everyday activities and care in young children with cerebral palsy. Disability and Rehabilitation.  ISSN 0963-8288.  27, s 849- 861
• Grotle, Margreth; Vøllestad, Nina Køpke; Veierød, Marit Bragelien & Brox, Jens Ivar (2004). Fear-avoidance beliefs and distress in relation to disability in acute and chronic low back pain. Pain.  ISSN 0304-3959.  112(3), s 343- 352 Vis sammendrag

  Patients with chronic low back pain (LBP) frequently demonstrate high scores for fear-avoidance beliefs and distress. We need better knowledge about fear-avoidance beliefs and distress in early stages of LBP. The objectives of this study were to compare the level of fear-avoidance beliefs and distress in patients with acute LBP to patients with chronic LBP, and to assess the relationship of fear-avoidance beliefs and distress to disability in acute and chronic LBP. Two different back pain groups including 123 patients with acute and 233 patients with chronic LBP were studied. Main outcome measures were Oswestry Disability Index and work loss. The scores for fear-avoidance beliefs and distress in patients with acute LBP were significantly lower than among patients with chronic LBP. The results of the multivariate regression analyses, adjusting for sociodemographic, pain and clinical variables, demonstrated that whereas fear-avoidance beliefs for physical activity and distress were significantly associated with the Oswestry Disability Index, fear-avoidance beliefs for work and distress were significantly associated with work loss. The associations showed the same pattern in acute and chronic LBP. In addition, several of the pain and clinical variables were significantly associated with the Oswestry Disability Index and fingertip-floor distance was associated with work loss. In conclusion, fear-avoidance beliefs and distress influence pain-related disability both in early acute and long-term chronic LBP. The results replicate previous reports on the association between pain experience, fear-avoidance beliefs, distress, and disability in chronic LBP, and extend the findings to patients at an early stage of acute LBP.

• Grotle, Margreth; Brox, JI & Vøllestad, Nina Køpke (2004). Concurrent comparison of responsiveness in pain and functional status measurements used for patients with low back pain. Spine.  ISSN 0362-2436.  29, s E492- E501 Vis sammendrag

  STUDY DESIGN: Prospective study of two samples of patients with acute and chronic low back pain, respectively. OBJECTIVES: To compare the responsiveness of four functional status questionnaires, Roland Morris Disability Questionnaire (RMDQ), Oswestry Disability Index (ODI), Disability Rating Index (DRI), and Physical Functioning scale of the SF-36 (PFSF-36), and two pain scales, a Numerical Pain Rating Scale (NRS) and Visual Analogue Scale (VAS). SUMMARY OF BACKGROUND DATA: Concurrent comparisons of different outcome measurements in back patients have been requested. METHODS: Norwegian versions of the scales and questionnaires were completed by 54 patients with acute (<3 weeks) and 50 patients with chronic low back pain (>3 months). Clinical change was estimated on a global change index. An alternative external criterion was the expected clinical course in the two cohorts. Mean changes, standardized response mean (SRM), and area under the receiver operating characteristic (ROC) curves with cutoff point for highest sensitivity and specificity were calculated. RESULTS: At the follow-up, 63% of the acute and 41% of the chronic sample reported improvement on the global change index. Large SRMs (1.3-2.0) and areas under the ROC curves (0.84-0.93) were found for the measurements in the acute sample. In the chronic sample, the SRMs (0.4-1.1) and areas under the ROC curves (0.65-0.83) were lower, in particular for the PFSF-36 and the VAS. There was no statistically significant difference between the responsiveness in the measurements, except for higher responsiveness in the NRS compared with the VAS when using expected clinical course as the external criterion for change. CONCLUSION: The results suggest that all the outcome measures were appropriate for measuring changes in functional status and pain in patients with acute low back pain, whereas among chronic patients the RMDQ, ODI, DRI, and NRS were most appropriate.

• Steingrimsdottir, OA; Knardahl, Stein & Vøllestad, Nina Køpke (2004). Prospective study of the relationship between musculosketel and psychological complaints and electromyographic activity muscular contractions in a working population. Scandinavian Journal of Work, Environment and Health.  ISSN 0355-3140.  30(5), s 410- 420
• Steingrimsdottir, Olof Anna; Vøllestad, Nina Køpke; Røe, Cecilie & Knardahl, Stein (2004). Variation in reporting of pain and other subjective health complaints in a working population and limitations of single sample measurements. Pain.  ISSN 0304-3959.  110, s 130- 139
• Stuge, Britt; Lærum, Even; Kirkesola, Gitle & Vøllestad, Nina Køpke (2004). The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy - A randomized controlled trial. Spine.  ISSN 0362-2436.  29, s 351- 359 Vis sammendrag

  STUDY DESIGN. : A randomized controlled trial with stratified block design. OBJECTIVES. : To evaluate a treatment program focusing on whether specific stabilizing exercises for patients with pelvic girdle pain after pregnancy reduce pain, improve functional status, and improve quality of life. SUMMARY OF BACKGROUND DATA. : The evidence of effectiveness of treatment for pelvic girdle pain is weak. Recent research has focused on the importance of activation of muscles for motor control and stability of the lumbopelvic region. To the authors' knowledge, the efficacy of applying these principles for pelvic girdle pain has not previously been evaluated in a randomized controlled trial. METHODS. : Eighty-one women with pelvic girdle pain were assigned randomly to two treatment groups for 20 weeks. One group received physical therapy with a focus on specific stabilizing exercises. The other group received individualized physical therapy without specific stabilizing exercises. Assessments were administered by a blinded assessor, at baseline, after intervention and 1 year post partum. Main outcome measures were pain, functional status and quality of life. RESULTS. : There were no dropouts. After intervention and at 1 year post partum, the specific stabilizing exercise group showed statistically and clinically significant lower pain intensity, lower disability, and higher quality of life compared with the control group. Group difference in median values for evening pain after treatment was 30 mm on the Visual Analog Scale. Disability was reduced by more than 50% for the exercise group; changes were negligible in the control group. Significant differences were also observed for physical tests, in favor of the specific exercise group. CONCLUSION. : An individualized treatment approach with specific stabilizing exercises appears to be more effective than physical therapy without specific stabilizing exercises for women with pelvic girdle pain after pregnancy.

• Stuge, Britt; Lærum, Even; Veierød, Marit Bragelien & Vøllestad, Nina Køpke (2004). The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy - A two-year follow-up of a randomized clinical trial. Spine.  ISSN 0362-2436.  29, s E197- E203 Vis sammendrag

  STUDY DESIGN: A randomized clinical trial. OBJECTIVES: To examine the effects of a treatment program focusing on specific stabilizing exercises after a 2-year follow-up period. SUMMARY OF BACKGROUND DATA: An individualized treatment approach with specific stabilizing exercises is shown to be effective for women with pelvic girdle pain 1 year after delivery. No previous study has examined the long-term effects of treatment for women with postpartum pelvic girdle pain. METHODS: Eighty-one women with pelvic girdle pain postpartum were assigned randomly to 2 treatment groups for 20 weeks. Patient self-reported questionnaires measuring pain, disability, and health-related quality of life were collected after 20 weeks of treatment and 1 and 2 years postpartum. RESULTS: All 81 women returned the questionnaires for the 2-year follow-up. Sixteen were excluded from the analysis, mainly due to new pregnancies. The significant differences between the groups in functional status, pain, and physical health (SF-36) were maintained 2 years after delivery. Minimal disability was found in 85% of the specific stabilizing exercise group as compared to 47% in the control group. The control group showed significant improvement in functional status with median change score of 6.0 (Q1-Q3 of -12-0). Minimal evening pain was reported by 68% in the specific stabilizing exercise group versus 23% in the control group. However, the group differences disappeared for all measures when controlling for score level 1 year after delivery by regression analysis. CONCLUSION: The significant differences between the groups persisted with continued low levels of pain and disability in the specific stabilizing exercise group 2 years after delivery. Significant reduction in disability was found within the control group. Those with the highest level of disability and greatest potential for improvements recovered most, regardless of intervention group.

• Østensjø, Sigrid; Carlberg, EB; Vollestad, NK & Vøllestad, Nina Køpke (2004). Motor impairments in young children with cerebral palsy: relationship to gross motor function and everyday activities. Developmental Medicine & Child Neurology.  ISSN 0012-1622.  46, s 580- 589

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• Meisingset, Ingebrigt; Robinson, Hilde Stendal; Evensen, Kari Anne Indredavik; Woodhouse, Astrid; Vasseljen, Ottar; Granviken, Fredrik; Bones, Anita; Vada, Bjørg; Brauten, Lise; Myhre, Gard; Hansen, Anne-Elisabeth; Blaker, Irma Brandeggen; Karlsen, Ragnhild; Thielemann, Marit & Vøllestad, Nina Køpke (2018). Hvem får oppfølging av avtalefysioterapeuter i primærhelsetjenesten.
• Grongstad, Anita; Spruit, Martijn A.; Oldervoll, Line Merethe; Vøllestad, Nina Køpke & Edvardsen, Anne (2017). Muscle strength trainig; does number of repetitions affect fatigue in sarcoidosis?.
• Grongstad, Anita; Spruit, Martijn A.; Vøllestad, Nina Køpke; Oldervoll, Line Merethe & Edvardsen, Anne (2017). Does endurance exercise intensity affect fatigue in sarcoidosis patients?.
• Larsen, Øivind; Tellnes, Gunnar; Bruusgaard, Dag & Vøllestad, Nina Køpke (2017). Per Sundby. Tidsskrift for Den norske legeforening.  ISSN 0029-2001.  137(3), s 226 Vis sammendrag

  Minneord over professor i sosialmedisin ved Universitetet i Oslo Per Sundby (1928-2016).

• Meisingset, Ingebrigt; Robinson, Hilde Stendal; Evensen, Kari Anne Indredavik; Woodhouse, Astrid; Thielemann, Marit; Bones, Anita; Sandsør, Marthe; Guttormsen, Vidar; Bakka, Marianne; Hansen, Anne-Elisabeth; Blaker, Irma Brandeggen; Karlsen, Ragnhild; Robinson, Roar; Vasseljen, Ottar & Vøllestad, Nina Køpke (2017). Pasienter hos privatpraktiserende fysioterapeuter i primærhelsetjenesten;hvem er de?. Fysioterapeuten.  ISSN 0016-3384.  (2)
• Woodhouse, Astrid; Robinson, Hilde Stendal; Evensen, Kari Anne Indredavik; Meisingset, Ingebrigt; Thielemann, Marit; Bjorbærkmo, Wenche Schrøder; Hansen, Anne Elisabeth; Vøllestad, Nina Køpke & Vasseljen, Ottar (2017). Fysioterapeuter i primærhelsetjenesten - Hva gjør vi egentlig. Fysioterapeuten.  ISSN 0016-3384.  (10), s 24- 26
• Engebretsen, Eivind; Vøllestad, Nina Køpke; Wahl, Astrid Klopstad; Robinson, Hilde Stendal & Heggen, Kristin (2015). Opening the black box of clinical decision making: Interpretation is a central feature in evidence-based medicine. LSE Impact Blog. . doi: http://blogs.lse.ac.uk/impactofsocialsciences/2015/05/08/interpretation-in-evidence-based-medicine/
• Tellnes, Gunnar; Irgens, Lorentz M.; Kristensen, Petter; Larsen, Øivind; Vøllestad, Nina Køpke; Lie, Rolv T.; Bjertness, Espen; Wergeland, Ebba & Lund, Johan (2015). MINNEORD: Tor Bjerkedal. Tidsskrift for Den norske legeforening.  ISSN 0029-2001.  135(17) . doi: 10.4045/tidsskr.15.0755 Vis sammendrag

  Professor i forebyggende medisin, dr.med. Tor Bjerkedal døde 11. 6. 2015, 88 år gammel. Etableringen av Medisinsk fødselsregister kom til å bli hans livsverk, og dette arbeidet var han engasjert i inn til det siste. Tor Bjerkedal deltok i motstandsarbeid under den annen verdenskrig, og han satt på Grini deler av krigsårene. Etter krigen fikk han plass på legestudiet i København, der han også traff den danske tannlegestudenten Gudrun Kjerulff som ble hans kone. Sammen fikk de tre barn, seks barnebarn og tre oldebarn. I 1952 fullførte Bjerkedal legeutdanningen ved Universitetet i Oslo. Han arbeidet deretter et års tid som distriktslege i Vik i Sogn før han i 1954 ble vitenskapelig assistent ved Hygienisk Institutt i Oslo. Bjerkedal hadde flere forskningsopphold i USA og tok mastergrad i folkehelse ved Harvard i 1958. Sin doktorgrad om tuberkulose forsvarte han ved Universitetet i Oslo i 1965, og året etter ble han styrer for Institutt for hygiene og sosialmedisin ved Universitetet i Bergen. Gjennom sin tilknytning til Statistisk sentralbyrå ble Bjerkedal engasjert i arbeidet med den medisinske fødselsmeldingen. Han overbeviste raskt alle involverte parter om at dette datagrunnlaget i forskning og helsetjeneste burde knyttes til et aktivt medisinsk forskningsmiljø. I 1970 etablerte Bjerkedal Medisinsk fødselsregister, verdens første i sitt slag. Han var en drivende kraft i nordisk og internasjonalt samarbeid innenfor dette fagfeltet. Videre gjennomførte han forsøk med nye rutiner for systematisk og standardisert registering av helseopplysninger om småbarn, med mål om å effektivisere helsestasjonsarbeidet. Han etablerte også et system, SYSVAK, for registrering av alle vaksinasjoner utført på småbarn og skolebarn. Bjerkedal tok tidlig i bruk informasjonsteknologi, noe han ble en pådriver for å innføre i helsevesenet. Her møtte han en rekke tilbakeslag og frustrasjoner. Selv i sine senere år kunne han registrere at hans visjoner ennå langt fra var realiserte. I 1976 ble Bjerkedal styrer for Institutt for forebyggende medisin, Universitetet i Oslo. Han var arbeidsom og utholdende, og ble en nestor i forebyggende medisin og epidemiologi. Samtidig var han en visjonær og hjelpsom kollega. Noen kunne kanskje oppleve hans krav til kvalitet og nøyaktighet som en utfordring. Men kanskje ikke alle så de samme mulighetene som Bjerkedal selv så, eller riktig forsto hans kraftfulle personlighet og de mange visjonene som var en naturlig del av hans liv. Kanskje hadde tiden på Grini og oppholdene i USA også satt sitt preg på hans visjonære, kvalitetsbevisste, kritiske og handlekraftige måte å arbeide på? Han var veileder for en rekke stipendiater og forskere, noe som bidro til å gi ham en bred akademisk kompetanse innen samfunnsmedisin. Hans store lidenskap var registerepidemiologi for å finne årsaker til sykdom. Dette ga mulighet for helsefremmende og forebyggende tiltak. Han forsket også på arbeidsmedisin, infeksjonsmedisin, kreftsykdommer, trygdemedisin og initierte global helseforskning i Palestina. I sin lange pensjonisttid publiserte Bjerkedal over 50 artikler. Da han var 76 år, etablerte han en fødselskohort basert på de ti første årgangene i Medisinsk fødselsregister og koblet denne til et flertall nasjonale registre. Dette har resultert i et stort antall originalartikler, også i Science. Samarbeidet med Haakon Natvig på Hygienisk institutt i 1960-årene omfattet en oppfølging av det såkalte «oljeforsøket». Bjerkedal fulgte opp denne kohorten helt til de yngste gjenlevende var over 90 år gamle. Siste publikasjon med ham som førsteforfatter sto i Tidsskriftet i 2012. En visjonær og hjelpsom kollega har gått bort. Varm takk til vår venn Bjerkedal for hans innsats til folkehelsens beste. Våre tanker går til Gudrun og øvrige familie. På vegne av kolleger tilknyttet Universitetet i Oslo og Universitet i Bergen

• Vasseljen, Ottar & Vøllestad, Nina Køpke (2015). Forskning og praksis - sammen om fagutvikling.
• Eilertsen, Heidi; Hagve, Tor-Arne & Vøllestad, Nina Køpke (2013). Interinstrumental variability of the blast flag on Sysmex XE-5000.
• Eilertsen, Heidi; Vøllestad, Nina Køpke & Hagve, Tor-Arne (2013). The reliability of the blast flagging on the Sysmex XE-5000 is questionable.
• Vøllestad, Nina Køpke (2013). FYSIOPRIM - for å styrke primærhelsetjenesten gjennom forskning. Fysioterapeuten.  ISSN 0016-3384.  2, s 27- 27 Vis sammendrag

  FYSIOPRIM er lagt opp for å favne hele dette spekteret gjennom arbeid innenfor tre hovedområder som beskrives nedenfor. Metoder og verktøy Ett hovedmål er å utvikle og etablere metoder for standardisert registrering av data som er relevante for klinisk praksis. Dette gjør vi gjennom å utvikle og teste ut kjernesett av metoder som gir relevante opplysninger om pasientene, hvilken behandling de får og hvordan de responderer på behandlingen. I ett delprosjekt har vi et særlig fokus på måleinstrumenter for fysisk form, der metodiske egenskaper for aktuelle spørreskjemaer og fysiske tester undersøkes. Muligheten for klinisk nytte og anvendelse er førende for utviklingen og etableringen av metodene, samtidig som en systematisk registering av kliniske data også vil kunne gi bedre grunnlag for forskning i primærhelsetjenesten. Kliniske studier og forløpsstudier I FYSIOPRIM gjennomføres flere kliniske studier som har til hensikt å skape kunnskap om kliniske forløp, samhandlingsprosesser og behandlingseffekter (inkludert kost:nytte). Tre studier er lagt opp som randomiserte kontrollerte kliniske (RCT) studier, hvorav to undersøker effekten av intervensjon for personer som har artrose i knær og/eller hender. Videre skal det undersøkes om behandlingen av artrosepasienter følger anbefalinger i gjeldende internasjonale retningslinjer. I en annen RCT undersøkes bevegelsesmønster og motorisk kontroll hos pasienter med nakkesmerter, om ordinær fysioterapibehandling påvirker motorisk avvik og om avviksmønster kan knyttes til symptomendringer. For å få mer innsikt i samhandlingsprosessene mellom pasient og terapeut og i de individuelle forløpene, har vi også en studie av nakkepasienter der kvalitativ og kvantitativ tilnærming kombineres. Til sammen vil disse kliniske studiene kunne gi et fundament for videreutvikling av klinisk praksis og muligheter for mer tilpasset behandling. Det er lagt opp til to forløpsstudier, der den ene tar utgangspunkt i en befolkningsstudie (HUNT3) og følger en gruppe personer med nyoppståtte rygg- og nakkeplager gjennom ett års tett oppfølging. Den andre forløpsstudien vil ta utgangspunkt i pasienter som søker behandling hos privatpraktiserende fysioterapeuter og vi vil følge dem gjennom og etter en behandlingsperiode. Her benyttes registreringsmetodene vi har utviklet (se ovenfor). Antallet pasienter i denne gruppen vil bli så stort at vi kan studere forskjellige pasientgrupper (f. eks. nakke- eller ryggplager), og derved sammenligne med andre studier i FYSIOPRIM (og utenfor). Gjennom forløpsstudiene vil vi også identifisere prediktorer for langvarige plager. Modeller for samarbeid Et helt sentralt mål for FYSIOPRIM er å prøve ut ulike samarbeidsmodeller mellom fysioterapeuter i primærhelsetjenesten og forskere. Slik vil vi skape grunnlag for bedre samarbeid og derved sikre varig økt forskningsinnsats i primærhelsetjenesten, og bedre tjenester i fremtiden. Dette gjøres på flere måter. For det første har vi gjennom hele prosjektperioden et formalisert samarbeid med fysioterapeuter fra primærhelsetjenesten. Disse deltar regelmessig i diskusjoner i alle faser av prosjektet og har derved en gjennomgående påvirkning på forskningen. Samarbeidet har også ført til at forskerne har deltatt i samtaler med administrasjonen i kommunene om hvordan vi best kan samarbeide om forskning og bruk av forskningsresultater. Vi har nylig utlyst hospitantstillinger for å prøve ut samarbeidsformer mellom klinikere og forskere enda bredere. Det er vår ambisjon at det nære samarbeidet mellom forskere og klinikere vil synliggjøre gevinster i form av positive effekter for klinisk praksis, og at det bidrar til at viktige spørsmål fra primærhelsetjenesten blir tatt opp av forskerne.

• Eilertsen, Heidi; Vøllestad, Nina Køpke & Hagve, Tor-Arne (2012). The usefulness of blast reports on the Sysmex XE-5000 instrument.
• Vøllestad, Nina Køpke; Fretland, Jan Olav; Fuglseth, Anna Mette; Habib, Laurence Marie Anna; Malterud, Nina; Ringdal, Ole; Skretting, Kathrine & Vinje, John-Wilhelm (2012). Én ph.d.‐grad for fremtidens behov?Kunnskap, ferdigheter, generell kompetanseInnstilling fra en arbeidsgruppe oppnevnt av UHRs styre i samarbeid med Forskningsutvalget.
• Vøllestad, Nina Køpke (2011). Primary care research – new opportunities. Public Service Review: Science & Technology.  ISSN 1757-2770.  13, s 110- 111
• Vøllestad, Nina Køpke; Halvorsen, Silje & Dagfinrud, Hanne (2009). Exercise and physical activity - responses in healthy and persons having musculoskeletal disorders.
• Heggen, Kristin & Vøllestad, Nina Køpke (2007). Lite gjennomtenkt om karakterskala. Morgenbladet.  ISSN 0805-3847.
• Robinson, Hilde Stendal; Mengshoel, Anne Marit & Vøllestad, Nina Køpke (2007). Pelvic girdle pain in pregnancy - comparison of prevalence based on self reports and clinical examinations.
• Robinson, Hilde Stendal; Bjorbærkmo, Wenche Schrøder; Rugseth, Gro; Mengshoel, Anne Marit; Vøllestad, Nina Køpke; Heggen, Kristin; Hem, Marit Helene; Schriver, Nina B.; Juul-Kristensen, Birgit & Engelsrud, Gunn (2006). Dokumentar - en problematisk sjanger. Fysioterapeuten.  ISSN 0016-3384.  73(1), s 33- 34
• Engelsrud, Gunn; Rugseth, Gro; Bjorbærkmo, Wenche Schrøder; Robinson, Hilde Stendal; Vøllestad, Nina Køpke; Heggen, Kristin; Hem, Marit Helene; Mengshoel, Anne Marit & Schriver, Nina B. (2005). Dokumentar, en problemfri sjanger?. Fysioterapeuten.  ISSN 0016-3384.  11(72), s 30- 30
• Grotle, Margreth; Brox, Jens Ivar & Vøllestad, Nina Køpke (2005). Reliability and responsiveness of the fear-avoidance beliefs questionnaire; validation of the Norwegian version among patients with acute and chronic low back pain. Annals of the Rheumatic Diseases.  ISSN 0003-4967.  64, s 520- 520
• Grotle, Margreth; Brox, Jens Ivar & Vøllestad, Nina Køpke (2005). To the editor - In response. Spine.  ISSN 0362-2436.  30, s 1342- 1342
• Grotle, Margreth; Brox, JJI; Glomsrod, B; Lonn, J & Vøllestad, Nina Køpke (2005). Psyhological factors predict chronicity in patients seeking help for their first time due to acute low back pain. Annals of the Rheumatic Diseases.  ISSN 0003-4967.  64
• Grotle, Margreth; Brox, Jens Ivar; Glomsrød, Bredo; Lønn, JH; Veierød, Marit Bragelien & Vøllestad, Nina Køpke (2004). Clinical course and prognostic factors in acute low back pain: patients consulting primary care for the first time.
• Grotle, Margreth; Brox, Jens Ivar; Glomsrød, Bredo; Lønn, JH; Veierød, Marit Bragelien & Vøllestad, Nina Køpke (2004). Clinical course and prognostic factors in acute low back pain: patients consulting primary care for the first time.
• Grotle, Margreth; Vøllestad, Nina Køpke; Veierød, Marit Bragelien & Brox, Jens Ivar (2004). Fear-avoidance beliefs in relation to disability at different stages of low back pain: comparison of short-term and long-term chronic pain.
• Grotle, Margreth; Vøllestad, Nina Køpke; Veierød, Marit Bragelien & Brox, Jens Ivar (2004). Fear-avoidance beliefs in relation to disability at different stages of low back pain: comparison of short-term and long-term chronic pain.

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