European Journal of Pain 9 (2005) 653–660

www.EuropeanJournalPain.com

Delayed onset muscle soreness in neck/shoulder muscles

Hongling Nie, Adam Kawczynski, Pascal Madeleine *, Lars Arendt-Nielsen
Laboratory for Experimental Pain Research, Center for Sensory-Motor Interaction, Aalborg University,
Fredrik Bajers Vej 7D-3, DK-9220 Aalborg, Denmark

Available online 2 February 2005

Abstract

The aim of the present study is to: (1) induce delayed onset muscle soreness (DOMS) in the neck and shoulder muscles; (2) com-
pare the pressure pain sensitivity of muscle belly with that of musculotendinous tissue after DOMS; (3) examine the gender differ-
ences in the development of DOMS. An eccentric shoulder exercise was developed to induce DOMS on neck/shoulder muscles using
a specially designed dynamometer. Eccentric shoulder contraction consisted of 5 bouts, each bout lasted 3 min, with 3 min rest per-
iod between each bout. The right shoulder was elevating against a downward pressure force of 110% maximal voluntary contraction
force exerted by the dynamometer. Pressure pain thresholds (PPT) of 11 sites (seven sites measured were muscle belly and four sites
were myotendinous area) on neck/shoulder region were measured before, immediately after, 24 and 48 h after exercise. Pain inten-
sity, pain area and index of McGill pain questionnaire were assessed and all were increased after exercise. DOMS was induced in the
shoulder muscles. PPT was significantly decreased and reached lowest values at 24 h. The muscle belly sites are more sensitive to
pain than the musculotendinous sites. No gender differences were found in any of the parameters used to assess the development
of DOMS. DOMS did not distribute evenly in the neck/shoulder region. Soreness after exercise in the neck and shoulder seems
not to be among the conditions that produce predominant musculoskeletal pain in females.

2004 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All
rights reserved.

Keywords: Pressure pain threshold; Musculotendinous site; Muscle pain; Delayed onset muscle soreness; Gender differences

1. Introduction the underlying mechanisms of DOMS are not clearly

Work related musculoskeletal disorders are a signifi-
cant problem in the working populations (Buckle and
Devereux, 2002). Musculoskeletal disorders commonly
affect the neck and shoulder region with sign of muscle
pain and soreness (Armstrong et al., 1993). Delayed on-
set muscle soreness (DOMS) which occurs after unac-
customed exercise enables to study mechanisms related
to neck and shoulder pain. Previous studies show that
eccentric exercise, i.e. lengthening of the contracting
muscle, produces prominent soreness (Bajaj et al.,
2001; Jones et al., 1987; Newham et al., 1987). Although
*
Corresponding author. Tel.: +45 96 35 88 33; fax: +45 98 15 40 08.
E-mail address: pm@smi.aau.dk (P. Madeleine).
understood, it has been suggested that soreness may
due to the damage of muscle structure during exercise;
furthermore, it may be exacerbated and maintained by
the subsequently acute inflammatory reaction in muscle
evoked by the release of biochemical substances after
disruption of the muscle fibres and connective tissue
(Armstrong, 1984; Newham et al., 1987). Delayed mus-
cle soreness usually develops 24–48 h following exercise
and is described as dull and tender (Armstrong, 1984;
Armstrong et al., 1983). The sensation usually subsides
within 5–7 days after exercise (Ebbeling and Clarkson,
1989). Biceps brachii (Dannecker et al., 2002; Jones
et al., 1987), quadriceps femoris (Baker et al., 1997;
Newham et al., 1983) and dorsal interosseous muscle
(Bajaj et al., 2001) are the most targeted muscles in the

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2004 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights
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doi:10.1016/j.ejpain.2004.12.009
654 H. Nie et al. / European Journal of Pain 9 (2005) 653–660
induction of DOMS because of convenience of exercise.
It has been suggested that DOMS may be a result of
muscle allodynia to pressure, hence indicating neural
plastic change and hyperexcitability develop and con-
tribute to DOMS (Barlas et al., 2000). An endogenous
model inducing pain in the neck–shoulder region might
be helpful to gain knowledge about the transduction,
transmission and processing of muscle pain and to test
the efficacy of interventional studies.
With respect to the localization of DOMS in muscle,
the area of the musculotendinous attachment of quadri-
ceps muscle are thought to be the main site of pain and
tenderness during the initial phase of DOMS (Newham
et al., 1983). The pain spreads to the centre of the muscle
by 48 h (Bobbert et al., 1986). It has been found that the
PPT of muscle belly in the forearm was more sensitive to
DOMS than adjacent musculotendinous sites (Slater
et al., 2003). It is therefore not known if the soreness
is distributed generally throughout the muscle or iso-
lated to specific areas.
Women are more likely to suffer more from musculo-
skeletal pain than men (Strazdins and Bammer, 2004). It
appears that women are more sensitive to pain and
incline to report greater pain to experimental muscle
pain conditions (Ge et al., 2004; Riley et al., 1998). Some
previous studies found no significant difference between
male and female in the sensation and development of
DOMS after high-force eccentric exercise of elbow flex-
or (High et al., 1989; Rinard et al., 2000). Others found
females tended to report less pain at 48 h after exercise
than males (Dannecker et al., 2003). It is not known if
there are gender differences in DOMS on the neck/shoul-
der muscles.
With a newly designed shoulder dynamometer (Mad-
eleine et al., 2004), it is possible to perform eccentric exer-
cise in the shoulder muscles. The aim of the present
Fig. 1. The shoulder dynamometer (left) and the PPT test sites (site 1–11; description see method) on the right neck/shoulder region (right).
human quantitative experimental study was to: (1)
induce DOMS in the neck and shoulder muscles (i.e.
upper, middle and lower trapezius muscle; supraspinatus;
infraspinatus; levator scapulae; cervical muscle); (2) com-
pare the pressure pain sensitivity of muscle belly with that
of musculotendinous tissue after DOMS; (3) examine for
gender differences in development of DOMS.
2. Material and methods
2.1. Subjects
A total of 12 male and 12 female healthy volunteers
without musculoskeletal problems during the last 3
months participated in the study. The average age
(mean ± SD) was 24.6 ± 3.4 years for the males and
24.1 ± 3.6 years for the females; the average height
(mean ± SE) was 183.3 ± 2.0 cm for the males and
169.3 ± 2.0 cm for the females; the average weight
(mean ± SE) was 78.9 ± 3.18 kg for the males and
61.4 ± 3.18 kg for the females. Informed consent was
obtained from each subject. None had participated in
weight training in the past month. The study was ap-
proved by the local ethics committee and conducted in
accordance with the Declaration of Helsinki.
2.2. Protocol
A shoulder dynamometer (Aalborg University, Aal-
borg, Denmark) was used in the present experiment.
In addition, a plastic vest was worn by the subject to
protect the low back muscles (Fig. 1). The experiment
consisted of three sessions (i.e. in three sequential days).
The right shoulder was exercised and the left shoulder
acted as control side. In the first session, pressure pain
 H. Nie et al. / European Journal of Pain 9 (2005) 653–660 655

thresholds (PPT) were measured twice from the 13 test diameter of the contact tip was 10 mm and covered with
sites. Subjects familiarized themselves with the experi- 2 mm thick rubber. A standardized speed of pressure in-
mental procedures, including the static and dynamic crease of 30 kPa/s was kept constant during pressure
contraction (abduction, flexion of upper limb and shrug) application. The pain threshold was defined when the
and pain rating procedures. perception changed from pressure to pain. The instru-
ment was calibrated at the start of each session. All
2.2.1. Exercise procedure
the measurements were performed by the same person.
The subject sat upright with both arms resting in the
The subject sat on a seat without backrest. The PPT test
neutral position. The contact point between the dyna-
sites were located and marked. PPT was measured twice
mometer and the shoulder was 3 cm medial to acro-
at each test site. The mean of two measurements at the
mion. The subject was then fixed securely to the seat
test site was considered as PPT for this site. The PPT
by Velco strips. The subject raised both shoulders in
measurement started from dominant side following the
exercise in order to minimize lateral bending. (1) The
order of site number and continuing on the non-domi-
subject elevated his shoulder as high as possible without
nant side with same order, this procedure was then re-
lateral bend, and then the height was measured as top
peated to get two measurements from each site
position. The subject lowered his shoulder as low as pos-
(Fig. 1). The PPT after exercise was normalized to
sible; the height was measured as bottom position. The
PPT before exercise by subtraction to indicate the
distance between top and bottom position was defined
change after exercise.
as the range of shoulder elevation. (2) The maximum
voluntary contraction (MVC) force was measured by
asking the subject to exert the maximal force by elevat-
2.3.1. Localization of PPT test sites
ing his shoulder in neutral position (isometric contrac-
tion) against the dynamometer for 3 s. The maximal
1. Occiput: at the suboccipital muscle insertions.
value within 3 s was computed as MVC. Three repeated
2. Cervical muscle: processus transversus C5.
measures were done to get the mean value of MVC. (3)
3. Cervical myotendinous spot: processus transversus
The shoulder eccentric exercise was conducted by asking
C7.
the subject to elevate his shoulder against the downward
4. Upper trapezius: middle point of processus spinosus
moving force of 110% MVC. The dynamometer moved
C7 and acromion.
in the previously defined range of shoulder elevation
5. Levator scapulae: 2 cm superior to the angulus supe-
during exercise. Five 3 min eccentric exercise bouts with
rior scapulae.
3 min rest in between were performed.
6. Angulus superior scapulae.
Immediately after exercise, the PPT was measured
7. 1 cm medial to the acromioclavicular joint.
again. The pain intensity for the right shoulder during
8. Supraspinatus: 3 cm superior to the middle of spina
the static and dynamic contractions was rated. The static
scapulae.
contraction included: bilateral arm abduction at 90, arm
9. Infraspinatus: 3 cm distal to the middle of spina
flexion at 90 and shrug for 30 s. The dynamic contrac-
scapulae.
tion included arm abduction from 0 to 90, arm flexion
10. Middle trapezius: middle point of processus spino-
0 to 90 and repetitive shrug for five times during 10 s.
sus T4 and medial border of spina scapulae.
The visual analogue scale (VAS) was used to rate the
11. Lower trapezius: middle point of processus spinosus
intensity of pain. The mean pain intensity ratings for sta-
T6 and medial border of spina scapulae.
tic and dynamic contractions were used in the analysis.
12. 3 cm lateral of processus L3.
The McGill pain questionnaire was completed to assess
13. Tibialis anterior: 10 cm proximal to the lower rim of
the pain quality during contraction. The pain area
patella.
in the neck/shoulder region during shoulder muscle con-
traction was drawn on the body chart.
Sites 1, 3, 6, 7 were musculotendinous sites and sites 2, 4,
In the second and third sessions, PPT, pain ratings,
5, 8 were corresponding muscle belly sites. Site 12 was
McGill pain questionnaire and pain area drawings were
measured to examine the influence of load on the lum-
assessed.
bar muscle during shoulder exercise. Site 13 was a con-
All measurements were performed before exercise
trol site for repeated measure.
(pre), immediately after exercise (0 h), 24 h after exercise
(24 h) and 48 h after exercise (48 h).
2.3.2. Pain area drawing
2.3. Pressure pain threshold (PPT) The human body chart consisted of the whole body-
line diagrams. The circumference of the drawing on the
An electronic pressure algometer (Somedic Algom- chart was scanned and processed (ACECAD D9000+
eter type 2, Sweden) was used to measure PPTs. The digitizer, Taiwan), then the area was calculated.
656 H. Nie et al. / European Journal of Pain 9 (2005) 653–660
2.3.3. McGill pain questionnaire (MPQ)
All subjects were asked to describe the quality of pain
with the validated Danish or English version of the
McGill pain questionnaire (MPQ). The total pain rating
index (PRI) was calculated from the rank of words cho-
sen for the sensory, affective, evaluative and miscella-
neous sub-groups (Melzack, 1975).
2.3.4. Muscle pain intensity
The muscle pain intensity during shoulder muscle
contraction was assessed by using the VAS. The VAS
consists of a 10 cm line anchored with ‘‘no pain’’ on
the left end and ‘‘extreme pain’’ on the right end. Sub-
jects rated the perceived pain following static and dy-
namic contractions.
3. Statistical analysis
The data are presented as mean and standard error
(±SE). The MVC force was tested using one-way analy-
sis of variance (ANOVA). The PPT data were analysed
by a mixed model repeated-measures ANOVA with the
within group factors: time (pre, 0, 24 and 48 h), side
(exercise and control) and site (13 test sites); the between
group factor: gender (male and female). The repeated-
measures ANOVA was used to analyse PPT for the 13
test sites of the exercise side (factors: time and sites),
the PRI value (factors: time and sub-group) and the pain
area (factors: side and time) with genders as the between
group factor. The pain intensity was analysed by Fried-
man test and Wilcoxon Signed Ranks Test as the post
hoc test. The normalized PPT data for musculotendi-
nous and muscle sites was evaluated by the two-way
ANOVA (test sites; gender) in order to compare sensi-
tivity of different site to DOMS and gender differences.
The Student–Newman–Keuls (SNK) test was used as
the post hoc test in case of significant factors. P < 0.05
was considered significant.
4. Results
4.1. Maximal voluntary contraction force
The MVC for males (743.2 ± 61.7 N) was signifi-
cantly higher than that for females (341.2 ± 61.7 N)
(ANOVA: F1,22 = 21.25, P < 0.001). There was no differ-
ence in MVC between three sessions.
4.2. Pressure pain threshold
There was a significant difference between exercise
and control side (ANOVA: F1,22 = 16.86, P < 0.001).
There was a significant decrease of PPT after exercise,
peaking at 24 h after exercise for the exercise side (main
effect of time: F3,66 = 4.88, P < 0.01) but not for the con-
trol side. There was no significant difference in the gen-
der factor and interaction with other factors. PPT for
the exercise side was not significantly different from
the control side before exercise. PPT change for the exer-
cise side was significantly different from the control side
(time · side: F3,69 = 17.01, P < 0.001). The post hoc test
showed that there was significant decrease in PPT at 24
and 48 h for the exercise side but not for the control side
(SNK: P < 0.01; Fig. 2). There were significant differ-
ences between the test sites at the exercise side (main
effect of site: F12,276 = 15.16, P < 0.001). Significant de-
crease in PPT values was found in the site 1–8 compared
to pre-exercise (SNK: P < 0.05). PPT had no difference
between the musculotendinous and the muscle belly sites
before exercise. The normalized PPT data analysis
showed that PPTs for the muscle belly sites decreased
more than those for the musculotendinous sites at 24 h
(ANOVA: F1,190 = 5.85, P = 0.016; Fig. 3).
4.3. Pain area
There was a significant increase of pain area after
exercise (24 h: 98 ± 15; 48 h: 38 ± 8 AU) (ANOVA:
F2,46 = 21.06, P < 0.001) and between the exercise and
the control side (24 h: 17 ± 9; 48 h: 8 ± 4 AU)
(F1,23 = 49.85, P < 0.001). The post hoc test showed that
there was no increase of the pain area in the control side.
The pain areas of the exercise side at 0, 24 and 48 h were
significantly larger than those of the control side (Fig. 4;
SNK: P < 0.05). There was no significant difference be-
tween males and females.
Fig. 2. Mean PPT of eight test sites on the exercise side and the control
side at before, immediately after, 24 and 48 h after exercise (n = 24, 12
male and 12 female). (*) Significant difference compared with pre-
exercise (P < 0.05). (+) Significant difference between the exercise side
and the control side (P < 0.05).
 H. Nie et al. / European Journal of Pain 9 (2005) 653–660 657

Fig. 3. Decrease of PPT in the musculotendinous sites (site 1, 3, 6, 7)

and the muscle belly sites (site 2, 4, 5, 8) at before, immediately after,
24 and 48 h after exercise (n = 24, 12 male and 12 female). (+)
Significant difference between the musculotendinous sites and the
muscle belly sites (P < 0.05).

4.4. McGill pain questionnaire ratings

Before the exercise no pain descriptors were chosen in

the MPQ. Statistical analysis showed increase in the PRI
for the sub-groups (ANOVA: F3,66 = 46.29, P < 0.001;
Fig. 4), time levels (F2,44 = 6.31, P < 0.01) and the inter-
action between PRI and the time levels (F6,132 = 4.74,
P < 0.001). The PRI ratings were higher at 0 h than
those at all the other times in sensory sub-group
(SNK: P < 0.001). The PRI sensory ratings increased
at 24 and 48 h compared to pre-exercise (SNK:
P < 0.001). The PRI sensory ratings were higher than
those of the affective, evaluative and miscellaneous
sub-groups at all times after exercise (SNK:
P < 0.001). The most chosen word was ‘‘tiring’’ (45.8%
of subjects) at 0 h, ‘‘sore’’ (58.3% of subjects) at 24 h
and ‘‘tender’’ (33.3%) at 48 h. There was no significant
difference between males and females.

4.5. Muscle pain intensity

The pain intensity significantly increased after eccen-

tric exercise from 0 to 48 h (Friedman: v2 = 19.8,
P < 0.001; Wilcoxon: P < 0.05; Fig. 4). There was no
difference in the VAS score between immediately after
and 24 h. The pain intensity was higher at 24 h com-
pared with 48 h (P < 0.05). There was no significant dif-
ference between males and females. No pain sensation
was reported during rest at 0, 24 and 48 h.
Fig. 4. The pain area of exercise side and control side assessed during
contraction (upper), pain rating index of the McGill pain questionnaire
sub-groups (middle) and mean pain intensity (VAS: 0–100 mm) during
contraction (lower) at before, immediately after, 24 and 48 h after
exercise (n = 24, 12 male and 12 female). (*) Significant difference
compared with pre-exercise (P < 0.05). (+) Significant difference
between the exercise side and the control side or between the sensory
group and the other groups (P < 0.05).

5. Discussion
crease of pressure pain threshold after exercise was
The present study showed that DOMS could be in- prominent in muscle belly sites compared with myoten-
duced specifically in the neck/shoulder region. The de- dinous sites. There was no gender differences in any of
658 H. Nie et al. / European Journal of Pain 9 (2005) 653–660
the parameters used to assess the development of
DOMS.
6. DOMS in the neck/shoulder region
The PPT is an effective index in measuring the extend
of muscle tenderness and validated as a diagnostic method
for the musculoskeletal disorders (Madeleine et al.,
1998; Nakata et al., 1993). An early subjective symptom
of a pathophysiologic alteration of a skeletal muscle is
increased tenderness (Mense, 1990). In the present study
the PPT decreased after exercise and reached its lowest
level at 24 h. Correspondingly, the PRI of MPQ, pain
area and pain intensity showed maximal response. All
of these data supported the conclusion that DOMS
was induced and located in the neck/shoulder region.
It is consistent with the previous observation that
DOMS develops usually in the first 24–48 h after unac-
customed exercise (Ebbeling and Clarkson, 1989). The
significant decreases of PPTs were found in 8 of 11 test
sites situated on the upper and middle trapezius, levator
scapulae and supraspinatus muscles. There was no de-
crease in PPT on the scapula spine, infraspinatus and
lower trapezius, indicating that these muscles were prob-
ably not substantially involved under the current eccen-
tric shoulder exercise setting. The eccentric shoulder
exercise without raising arms resulted in elevation and
upward rotation of scapula. The main agonist in these
movements are levator scapulae and upper trapezius
(Brukner and Khan, 1993) although other muscles con-
tribute to a lower extent. The increased tenderness may
due to the acute damage to the muscle fibres during
exercise, causing mechanical disruption of the ultra-
structural elements within the muscle fibres such as the
Z-line and contractile filaments (Friden et al., 1983;
Waterman-Storer, 1991). Release of the inflammatory
mediators in the acute inflammation resulting from an
immune response to the initial injury may sensitize mus-
cle nociceptors and lower their threshold to mechanical
stimuli leading to increased pain sensation. (Mense,
1990; Smith, 1991). Barlas et al. (2000) suggested that
muscle allodynia observed in DOMS may relate to a
central mechanism besides sensitization of the peripheral
nociceptors. The pain following eccentric exercise was
only present when the muscles were stretched or con-
tract or palpated but not in rest. The most chosen words
in the MPQ were ‘‘sore’’ and ‘‘tender’’ which in the sen-
sory sub-group, showing the influence of DOMS was
mainly on the sensation aspect of pain. This is in agree-
ment with the observation of DOMS in the first interos-
seous muscle (Bajaj et al., 2001). It was found in the
present study that the relatively higher PRI and pain
intensity rating appeared immediately after exercise.
This phenomenon also occurred in elbow flexor after
eccentric contractions where most subjects reported that
the actual induction procedure produced more pain than
the delayed soreness (Barlas et al., 2000). This increased
pain may attribute to fatigue induced by the exercise
(Barlas et al., 2000). The relative low pain intensity
might due to the small range of shoulder motion and
small load during pain measurement. The range of the
shoulder eccentric exercise is not as large as that of the
biceps brachii or quadriceps femoris. The change of
muscle length was therefore small. It is believed that
the extent of muscle injury due to eccentric exercise is re-
lated more to the muscleÕs change in length rather than
the amount of force generated by the muscle (Lieber and
Friden, 1993). Eccentric exercise performed at longer
muscle lengths causes more damage to the muscle than
at shorter muscle lengths (Child et al., 1998; Newham
et al., 1988). The pain intensity measured without load
on the shoulder may diminish the pain sensation because
pain after DOMS is obvious during muscle contraction.
The lack of changes in MVC may due to the synergetic
effect of shoulder muscles (Halder et al., 2000).
7. Different sensitivity of muscle and myotendinous site to
DOMS
It is, to date, not clear whether the eccentric exercise
produces muscle damage and soreness uniformly over
the muscle or in the specific area of the muscle, due per-
haps to susceptible weaker structural components (Ba-
ker et al., 1997). In the present study, it was found
that the PPTs for the muscle belly sites decreased more
than the myotendinous sites after exercise. The results
are in contrast to those of Newham et al. (1983) where
the initial tenderness was primarily located at the distal,
medial and lateral parts of the quadriceps, but at peak
intensity of soreness the muscle-tendon region was not
more prone to soreness than others muscle sites. Cleak
and Eston (1992) reported that tenderness at the proxi-
mal myotendinous junction of the biceps was signifi-
cantly less than the distal myotendinous junction and
at the mid belly after strenuous eccentric exercise (Cleak
and Eston, 1992). Baker et al. (1997) reported that the
pressure pain tolerance of myotendinous sites was lower
than that of the muscle belly in the same quadriceps
femoris after eccentric down-hill running. Compared
to the pressure pain tolerance before the exercise, the
pressure pain tolerance decreased more in the muscle
belly site than in the myotendinous site when DOMS
reached the peak levels. The present results may due
to the discrete damage of eccentric exercise to the myo-
tendinous part and muscle belly. It has been found that
even in one muscle suffering from DOMS the decrease of
pain threshold was not distributed evenly (Weerakkody
et al., 2001), suggesting that the foci of damage underly-
ing the soreness were discrete and separated by regions
of the uninjured muscle.
 H. Nie et al. / European Journal of Pain 9 (2005) 653–660
8. Sex difference in DOMS
In the present study, no gender differences was found
in change of PPT, pain intensity rating, PRI of McGill
pain questionnaire and pain area. Previous studies
showed equivocal results with respect to sex difference
in DOMS. There was no difference between genders in
the soreness rating for eccentric exercise of the leg (High
et al., 1989; MacIntyre et al., 2000) and the elbow flexors
(Poudevigne et al., 2002; Rinard et al., 2000). Another
study found that females reported less pain than males
at 48 h after eccentric resistance exercise (Dannecker
et al., 2003). The differences in the pain intensity rating
between men and women may be due to different depen-
dent variables (soreness or pain) and different time peri-
ods of data collection (Dannecker et al., 2003).
Although different methodologies were used in those
studies, most of them tailored the exercise intensity to
personal maximum contraction strength level as done
in the present study. Therefore the damage to the muscle
after the exercise was likely to be similar between men
and women in the present study. The lack of difference
in decrease of PPT reflected that the tenderness of mus-
cle after DOMS was induced similarly in men and
women. These results were in agreement with results
of previous studies (Dannecker et al., 2003). The present
study used a novel apparatus to induce DOMS in the
neck/shoulder region and the results indicated that
males and females were equally susceptible to the exer-
cise-induced muscle damage in the neck/shoulder mus-
cles. The mechanisms underlying DOMS might be
different from that of chronic musculoskeletal pain in
the neck/shoulder region where females have a higher
prevalence of chronic pain. Too low pain intensity
evolved by DOMS in the present study might be an
alternative reason for the lack of gender differences.
The present endogenous model might in the future pro-
vide quantitative data regarding the efficacy of interven-
tion studies.
Acknowledgement
This work was financially supported by Norma og
Frode S. Jacobsens Fond.
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