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Eva E. Skillgate

Lecturer senior

About me

I am an Associate Professor and senior lecturer in epidemiology. My background is in manual therapy (naprapath) and 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 clinically active researchers from different professions (physiotherapy, medicine, naprapathy, psychology, chiropractic, osteopathy), as well as a long row of students writing their thesis based on our material. Affiliated are national and international experts in the field.

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, Sophiahemmet Foundation, 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), and cohort studies aiming to identify risk factors for injuries in young elite handball (Karolinska Handball Study, KHAST) tennis (SMASH) and football players ( Karolinska football Injury Cohort - KIC) in Sweden.  In the  project “Long-lasting and disabling back and/or neck pain and psychological distress – modifiable factors for risk and prognosis in the working population” we aim to investigate how life style factors interact with work related factors in the development of and recovery from long lasting disabling back and/or neck pain, with or without psychological distress. In the new large cohort study Sustainable University Life (SUN), we aim to deepen the knowledge about mental illness and musculoskeletal pain in university students.

Research description

Some of the projects within MUSIC

I. Randomized controlled trials (RCT):

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. We also evaluate interventions to prevent sports injuries.

1. The BJÖRN-trial (n=409) about the effect of manual therapy on unspecific back and neck pain, to identified prognostic factors for back and neck pain and to evaluate the cost effectiveness.

2. The MINT-trial (Manual Intervention Trial) (n=1 060) 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. 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.

4. The KHAST-trial (Karolinska Handball study) (n=750) aims to evaluate interventions aiming to prevent injuries in the shoulder and knee in students at Handball-profiled High schools in Sweden. The project is performed in collaboration with the Swedish Handball association. 

II. Cohort studies  

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.

2. The SUN study (Sustainable University Life): In this extensive prospective cohort study we aim to identify modifiable risk factors for mental disorders and musculoskeletal pain in university students, in collaboration with University of Ontario Institute of Technology.

3. The KHAST-study (Karolinska Handball study) aims to deepen the knowledge about injuries and the functional status in the shoulder in adolescent elite handball players. A cohort of 470 players, 15-17 years, recruited from handball profiled high schools in Sweden, is followed for two seasons regarding shoulder injuries. The project is performed in collaboration with the Swedish Handball association.  

4. The KIC study (Karolinska Football Injury Cohort): This project is an innovative collaboration between epidemiology, medicine, psychology, orthopedics, physiotherapy and naprapathy, composed of research groups at fiver universities, in order to identify risk factors for overuse and traumatic injuries. In an extensive cohort study, 600 young female elite footballers will be included. Players free from injuries/pain will be followed prospectively 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 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.

5. The SMASH study (Shoulder Management & Assessment Serving High performance): In this cohort study of 300 young elite tennis players in Sweden, we aim to deepen the knowledge about risk factors for injuries in the shoulder and spine. The players are screened clinically and followed one year with weekly reports about injuries, training and match play. The project is performed in collaboration with the Swedish tennis association.  

6. SPEEiD18 (Speed and Power Exploring External and internal Demands 2018) – A project aiming to quantify the load in elite tennis players by measuring oxygen uptake and mechanical workload, a unique project which integrates physiology and biomechanics. The project is performed in collaboration with the Swedish Sports Confederation, Swedish Tennis Association, Good to Great Tennis Academy, Monark, Qualisys and Sophiahemmet University.

Teaching portfolio

I teach regularly at courses on bachelor, master and doctoral levels.

Education

Senior Lecturer in Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 2018.

Associate Professor/Docent in Epidemiology, Karolinska Institutet, 2014.

Professor in care science at Sophiahemmet University, 2018.

Doctor in Medical Science (Epidemiology), Karolinska Institutet. 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, 2007. 

Public Health Karolinska Institutet, 2003.

Licensed naprapath, 1994.

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