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Q&A with May Arna Risberg

May Arna Risberg PT, PhD, is Associate Professor, Physical Therapist, at NAR (The Norwegian Research Center for Active Rehabilition) which was founded in 2003 and is a formal collaboration between The Orthopedic Center, Oslo University Hospital, Ullevaal, (UUS), The Norwegian Sport Medicine Clinic (Hjelp24 NIMI) and the Norwegian School of Sport Sciences, Department of Sport Medicine. She is also Adjunct Clinical Professor at the University of Delaware.

Your work appears to focus on ‘Active Rehabilitation’: what is Active Rehabilitation?

Active rehabilitation is physical activity and exercise therapy as interventions for improving patients’ function and health. It aims to normalize dysfunctions through specific exercise therapy to achieve an individual’s goal to get back to activities of daily living and sports activities.

What are your roles at NAR?

As Chair of the Norwegian Research Center, I have three key roles. I supervise the Masters and PHD students – we currently have nine PHD students, five of whom will graduate in (Spring) 2010 and three Masters Students.  I am also responsible for the planning of the Center’s wide-ranging research programmes and projects and developing our global collaborative partnerships.

What are NAR’s main research areas?
  
NAR’s aim is to coordinate the clinical environment and research resources within the area of Active Rehabilitation as an intervention for patients with acute injuries/disorders and overuse injuries of the musculoskeletal system. Our main research areas at present are to investigate the effect of Sport Physical Therapy, active rehabilitation and exercise therapy programmes on patients with lower extremity injuries and disorders. These include the knee (ligament injuries, meniscus lesions, osteoarthritis and cartilage lesions) and the hip (osteoarthritis).

What other medical conditions do NAR’s rehabilitation programmes focus on?

In addition to the above mentioned, we have also developed a research program for low back pain and osteoporosis.

Do you use a particular methodology in your research programmes?

Our main methodology is clinical research, RCTs and development of clinical research tools. Additionally, we include more basic science studies where our methodology is dGEMRIC and gait and motion analysis.

What significant papers have you had published this year?

At NAR we have many research programs in progress, and it’s very encouraging to see our work published. This year we’ve had three research papers¹²³ on the effect of neuromuscular training and the significance of preoperative quadriceps muscle strength on the long term outcome after ACL reconstruction; furthermore, our systematic review of Knee OA after ACL injury was also published⁴. It was also rewarding to see our randomized controlled two year trial on the effect of physical activity after breast cancer surgery published in Acta Oncologica⁵ and the effect of interval training in patients with chronic heart failure in Am J Cardiol⁶.

Which project will be published next?

Our next big project will be submitted to the BMJ in October which will be the results of our randomized controlled trial examining the effect of exercise therapy and patient education in patients with hip OA.

Tell us about your next significant clinical trial…

This will investigate the effect of active rehabilitation on patients with degenerative meniscus lesions and compare exercise therapy with surgery/arthroscopy. We have just recruited the first patients for our new randomized controlled clinical trial which is being conducted by one of our PHD students and with Professor Ewa Roos, Southern Denmark University.

And your latest ongoing project?

This is another clinical trial and dGEMRIC study using MRI which will focus on the cartilage and the effect of exercise therapy on patients with articular cartilage injuries in the knee.

Do you play sport and if so have you suffered from any sports injury?

I am a recreational cross country skier and runner, but I do participate in long distance running   and cross-country skiing competitions. I have knee OA due to meniscus injuries when I was 20…… but keep my knee free from symptoms by exercising -  at least so far.

Many of us are looking forward to the ESSKA Congress in Oslo next year. The Physical Therapy Program which was launched in 2006 continues to develop as a multi-disciplinary platform to promote new research and techniques from around the world. As Chair of the PT Programme, what can delegates expect in 2010?
 
The PT Program is being organized in close collaboration with the Norwegian Sport Physical Therapy Organization (FFI) within the Norwegian Physical Therapy Association (NFF). Delegates can expect to learn about the most recent evidence on the effect of physical therapy interventions in knee injuries (ACL, Cartilage injuries and OA), shoulder dysfunctions, and musculo-tendon injuries. The PT Program is being extended to three days so in addition to presentations from some of the best international clinical researchers in this field, the delegates will also be able to participate in clinical workshops where they can experiment with some of the best rehabilitation programs.

Click here for more information

One of the reasons that we are able to extend our program this year is through sponsorship from DJO. We are delighted that DJO is engaged as a sponsor and are looking forward to our mutual collaboration.

Who has been your greatest inspiration in your career?

Professor Lynn Snyder-Mackler and Professor Lars Engebretsen and others…

If there was one innovation you would like to see in Physical Therapy, what would it be?

If I may, I have two innovations that are linked that I believe will really make a huge difference within the area of musculoskeletal injuries, for those that are affected (the patients), for Physical Therapists, and for society (economically) :

¹ Risberg MA, Holm I. The long-term effect of 2 postoperative rehabilitation programs after anterior cruciate ligament reconstruction: a randomized controlled clinical trial with two years of follow-up. Am J Sports Med. 2009 Oct; 37(10):1958-66

 ² Eitzen I, Holm I, Risberg MA. Preoperative quadriceps strength is a significant predictor of knee function two years after anterior cruciate ligament reconstruction. Br J Sports Med. 2009 May; 43(5): 371-6.
 ³ Risberg MA, Moksnes H, Storevold A, Holm I, Snyder-Mackler L. Rehabilitation after anterior cruciate ligament injury influences joint loading during walking but not hopping. Br J Sports Med. 2009 Jun; 43(6): 423-8.
 ⁴ Øiestad BE, Engebretsen L, Storheim K, Risberg MA. Knee osteoarthritis after anterior cruciate ligament injury: a systematic review. Am J Sports Med. 2009 Jul; 37(7): 1434-43.
 ⁵ Sagen A, Karesen R. Risberg MA. Physical activity lymph edema after breast cancer surgery. A prospective, randomized controlled trial with two years follow-up. Acta Oncol. 2009 June 23: 1-9.
 ⁶ Nilsson BB, Westheim A, Risberg MA. Long-term effects of a group-based high-intensity aerobic interval-training program in patients with chronic heart failure. Am J Cardiol. 2008 Nov 1; 102(9): 1220-4.

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