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Holmlund, T., Ekblom Bak, E., Franzén, E., Hultling, C. & Wahman, K. (2020). Defining accelerometer cut-points for different intensity levels in motor-complete spinal cord injury.. Spinal Cord, 58, 116-124
Open this publication in new window or tab >>Defining accelerometer cut-points for different intensity levels in motor-complete spinal cord injury.
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2020 (English)In: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 58, p. 116-124Article in journal (Refereed) Published
Abstract [en]

STUDY DESIGN: Descriptive.

OBJECTIVE: The present aim was to define accelerometer cut-point values for wrist-worn accelerometers to identify absolute- and relative-intensity physical activity (PA) levels in people with motor-complete paraplegics (PP) and tetraplegics (TP).

SETTINGS: Rehabilitation facility in Sweden.

METHODS: The participants were 26 (19 men, 7 women) with C5-C8, AIS A and B (TP) and 37 (27 men, 10 women) with T7-T12 (PP), AIS A and B. Wrist-worn accelerometer recordings (Actigraph GT3X+) were taken during seven standardized activities. Oxygen consumption was measured, as well as at-rest and peak effort, with indirect calorimetry. Accelerometer cut-points for absolute and relative intensities were defined using ROC-curve analyses.

RESULTS: The ROC-curve analyses for accelerometer cut-points revealed good-to-excellent accuracy (AUC >0.8), defining cut-points for absolute intensity (2, 3, 4, 5, 6, 7 METs for PP and 2 to 6 METs for TP) and relative intensity (30, 40, 50, 60, 70, and 80% for PP and 40-80% for TP). The cut-points for moderate-to-vigorous physical activity was defined as ≥9515 vector magnitude counts per minute (VMC) for PP and ≥4887 VMC/min for TP.

CONCLUSION: This study presents cut-points for wrist-worn accelerometers in both PP and TP, which could be used in clinical practice to describe physical activity patterns and time spent at different intensity levels.

Place, publisher, year, edition, pages
Nature Publishing Group, 2020
National Category
Physiotherapy
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5806 (URN)10.1038/s41393-019-0308-y (DOI)31243318 (PubMedID)
Projects
Energiomsättning hos ryggmärgsskadade
Note

Correction to article published 4 December 2019

Available from: 2019-08-14 Created: 2019-08-14 Last updated: 2020-01-16Bibliographically approved
Salier Eriksson, J., Ekblom, B., Kallings, L., Hemmingsson, E., Andersson, G., Wallin, P., . . . Ekblom Bak, E. (2019). Active commuting in Swedish workers between 1998 and 2015 - trends, characteristics and cardiovascular disease risk.. Scandinavian Journal of Medicine and Science in Sports
Open this publication in new window or tab >>Active commuting in Swedish workers between 1998 and 2015 - trends, characteristics and cardiovascular disease risk.
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2019 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Trend analyses of active commuting and potential variations in trends and association with cardiovascular disease (CVD) risk within sub-groups are unknown.

OBJECTIVES: To a) describe trends in active commuting between 1998 to 2015 and b) to study the association between different amounts of active commuting and the incidence risk of CVD in a large sample of Swedish workers, and analyses of potential variations across sub-groups of socio-demographics, physical activity and BMI.

METHODS: A total of 318,309 participants (47% women, 18-74 years) who participated in a nationwide occupational health service screening between 1998 and 2015 were included. Commuting habits were self-reported, and data on first-time CVD events were derived from national registers.

RESULTS: Self-reported passive commuters decreased between 1998 and 2015 (64% to 56%), transferring to an increase in mainly moderate/high-dose active commuters (12% to 19%). Changes were seen in all subgroups. The characteristics and life-style habits of the typical passive and active commuter changed little over the study period. Low- and moderate/high-dose active commuters had significantly decreased risks for a first time CVD during follow-up. This was accentuated in men, middle-aged and in participants with light physical work situations, irregular exercise habits, being overweight/obese and with low fitness.

CONCLUSION: Increases in active commuting were observed between 1998 and 2015, however still leaving a majority who do not actively commute. As active commuting, regardless dose, is associated with a lower CVD risk, encouraging more people to actively commute may provide an easily accessible and time-efficient possibility to increase physical activity and health in the general population.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
active commuting, cardiovascular disease, cycling, physical activity, trends, walking, working population
National Category
Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5889 (URN)10.1111/sms.13581 (DOI)000499749900001 ()31631386 (PubMedID)
Projects
HPI-gruppen
Available from: 2019-10-28 Created: 2019-10-28 Last updated: 2019-12-18Bibliographically approved
Väisänen, D., Ekblom, Ö., Ekblom Bak, E., Andersson, E., Nilsson, J. & Ekblom, M. (2019). Criterion validity of the Ekblom-Bak and the Åstrand submaximal test in an elderly population.. European Journal of Applied Physiology
Open this publication in new window or tab >>Criterion validity of the Ekblom-Bak and the Åstrand submaximal test in an elderly population.
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2019 (English)In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327Article in journal (Refereed) Epub ahead of print
Abstract [en]

PURPOSE: The aim of this study was to validate the submaximal Ekblom-Bak test (EB-test) and the Åstrand test (Å-test) for an elderly population.

METHODS: Participants (n = 104), aged 65-75 years, completed a submaximal aerobic test on a cycle ergometer followed by an individually adjusted indirect calorimetry VO2max test on a treadmill. The HR from the submaximal test was used to estimate VO2max using both the EB-test and Å-test equations.

RESULTS: The correlation between measured and estimated VO2max using the EB method and Å method in women was r = 0.64 and r = 0.58, respectively and in men r = 0.44 and r = 0.44, respectively. In women, the mean difference between estimated and measured VO2max was - 0.02 L min-1 (95% CI - 0.08 to 0.04) for the EB method and - 0.12 L min-1 (95% CI - 0.22 to - 0.02) for the Å method. Corresponding values for men were 0.05 L min-1 (95% CI - 0.04 to 0.14) and - 0.28 L min-1 (95% CI - 0.42 to - 0.14), respectively. However, the EB method was found to overestimate VO2max in men with low fitness and the Å method was found to underestimate VO2max in both women and men. For women, the coefficient of variance was 11.1%, when using the EB method and 19.8% when using the Å method. Corresponding values for men were 11.6% and 18.9%, respectively.

CONCLUSION: The submaximal EB-test is valid for estimating VO2max in elderly women, but not in all elderly men. The Å-test is not valid for estimating VO2max in the elderly.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Cardiorespiratory fitness, Elderly, Oxygen uptake, Public health, Submaximal test, Validity
National Category
Sport and Fitness Sciences
Research subject
Medicine/Technology; Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5960 (URN)10.1007/s00421-019-04275-7 (DOI)31820103 (PubMedID)
Available from: 2019-12-18 Created: 2019-12-18 Last updated: 2019-12-18
Ekblom Bak, E., Ekblom, Ö., Andersson, G., Wallin, P., Söderling, J., Hemmingsson, E. & Ekblom, B. (2019). Decline in cardiorespiratory fitness in the Swedish working force between 1995 and 2017.. Scandinavian Journal of Medicine and Science in Sports, 29(2), 232-239
Open this publication in new window or tab >>Decline in cardiorespiratory fitness in the Swedish working force between 1995 and 2017.
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2019 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 29, no 2, p. 232-239Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Long-term trend analyses of cardiorespiratory fitness (VO2 max) in the general population are limited.

OBJECTIVES: To describe trends in VO2 max from 1995 to 2017 in the Swedish working force and to study developments across categories of sex, age, education, and geographic regions.

METHODS: 354.277 participants (44% women, 18-74 years) who participated in a nationwide occupational health service screening between 1995 and 2017 were included. Changes in standardized mean values of absolute (L·min-1 ) and relative (ml·min-1 ·kg-1 ) VO2 max, and the proportion with low (<32) relative VO2 max are reported. VO2 max was estimated using a submaximal cycle test.

RESULTS: Absolute VO2 max decreased by -6.7% (-0.19 L·min-1 ) in the total population. Relative VO2 max decreased by -10.8% (-4.2 ml·min-1 ·kg-1 ) with approximately one-third explained by a simultaneous increase in body mass. Decreases in absolute fitness were more pronounced in men vs. women (8.7% vs. 5.3%), in younger vs. older (6.5% vs 2.3%), in short (11.4%) vs. long (4.5%) education, and in rural vs. urban regions (6.5% vs 3.5%), all p<0.001. The proportions with low VO2 max increased from 27% to 46% (p<0.001).

CONCLUSION: Between 1995 and 2017, there was a steady and pronounced decline in mean cardiorespiratory fitness in Swedish adults. Male gender, young age, short education and living in a rural area were predictive of greater reductions. The proportion with low cardiorespiratory fitness almost doubled. Given the strong associations between cardiorespiratory fitness and multiple morbidities and mortality, preventing further decreases is a clear public health priority, especially for vulnerable groups. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
Maximal oxygen consumption, VO2max, aerobic capacity, population, secular trend
National Category
Physiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5460 (URN)10.1111/sms.13328 (DOI)30351472 (PubMedID)
Projects
HPI-gruppen
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2019-01-18Bibliographically approved
Fridolfsson, J., Börjesson, M., Buck, C., Ekblom, Ö., Ekblom Bak, E., Hunsberger, M., . . . Arvidsson, D. (2019). Effects of Frequency Filtering on Intensity and Noise in Accelerometer-Based Physical Activity Measurements.. Sensors, 19(9), Article ID E2186.
Open this publication in new window or tab >>Effects of Frequency Filtering on Intensity and Noise in Accelerometer-Based Physical Activity Measurements.
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2019 (English)In: Sensors, ISSN 1424-8220, E-ISSN 1424-8220, Vol. 19, no 9, article id E2186Article in journal (Refereed) Published
Abstract [en]

In objective physical activity (PA) measurements, applying wider frequency filters than the most commonly used ActiGraph (AG) filter may be beneficial when processing accelerometry data. However, the vulnerability of wider filters to noise has not been investigated previously. This study explored the effect of wider frequency filters on measurements of PA, sedentary behavior (SED), and capturing of noise. Apart from the standard AG band-pass filter (0.29-1.63 Hz), modified filters with low-pass component cutoffs at 4 Hz, 10 Hz, or removed were analyzed. Calibrations against energy expenditure were performed with lab data from children and adults to generate filter-specific intensity cut-points. Free-living accelerometer data from children and adults were processed using the different filters and intensity cut-points. There was a contribution of acceleration related to PA at frequencies up to 10 Hz. The contribution was more pronounced at moderate and vigorous PA levels, although additional acceleration also occurred at SED. The classification discrepancy between AG and the wider filters was small at SED (1-2%) but very large at the highest intensities (>90%). The present study suggests an optimal low-pass frequency filter with a cutoff at 10 Hz to include all acceleration relevant to PA with minimal effect of noise.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
ActiGraph, Axivity, I.Family, LIV-2013, adults, calibration, children
National Category
Medical Laboratory and Measurements Technologies Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5745 (URN)10.3390/s19092186 (DOI)000469766800230 ()31083538 (PubMedID)
Projects
Mätning av det dagliga aktivitetsmönstret
Available from: 2019-05-20 Created: 2019-05-20 Last updated: 2019-08-20
Lidin, M., Hellénius, M.-L., Ekblom Bak, E. & Rydell Karlsson, M. (2019). Experiences from individuals with increased cardiovascular risk participating in a one-year lifestyle program.. European Journal of Cardiovascular Nursing, 18(7), 554-561, Article ID 1474515119848967.
Open this publication in new window or tab >>Experiences from individuals with increased cardiovascular risk participating in a one-year lifestyle program.
2019 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 7, p. 554-561, article id 1474515119848967Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The purpose of the current study was to describe the participants' experiences of a structured lifestyle program for persons with high cardiovascular risk.

METHOD: Sixteen participants with high cardiovascular risk participating in a one-year structured lifestyle intervention program were interviewed regarding their experiences of the program. The interviews were analyzed using content analyses.

RESULTS: The participants' (mean age 58 ± 9) experiences were categorized into three categories: "How to know," based on the participants' experience from both individual counselling and group sessions with tools to strengthen self-care; "Staff who know how," based on experience from the meeting with, and the importance of, competent health professionals; "Why feedback is essential," based on the participants' experience and effects of person-centered feedback. Several factors were deemed important in the structure of the program: an individual visit with shared goal setting, a group education session with interactive discussion, a competent, educated, and respectful health professional who gives continuous feedback, and the right tools to support self-care at home between visits.

CONCLUSION: Individuals participating in a structured lifestyle program experienced several factors as important: an individual visit with shared goal setting, a group education session with interactive discussion, a competent, educated, and respectful healthcare professional who gives continuous feedback, and the right tools to support self-care at home between visits.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Structured lifestyle program, cardiovascular risk, experience, feedback, health professionals, self-care
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5749 (URN)10.1177/1474515119848967 (DOI)000487801400005 ()31067978 (PubMedID)
Projects
Livsstilsmottagningen på Karolinska universitetssjukhuset, Solna
Available from: 2019-05-20 Created: 2019-05-20 Last updated: 2019-10-29Bibliographically approved
Lönnberg, L., Ekblom Bak, E. & Damberg, M. (2019). Improved unhealthy lifestyle habits in patients with high cardiovascular risk: results from a structured lifestyle programme in primary care. Upsala Journal of Medical Sciences, 124(2), 94-104
Open this publication in new window or tab >>Improved unhealthy lifestyle habits in patients with high cardiovascular risk: results from a structured lifestyle programme in primary care
2019 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 124, no 2, p. 94-104Article in journal (Refereed) Published
Abstract [en]

Background. Physical activity, healthful dietary habits, and not smoking are associated with reduced cardiovascular morbidity and mortality. However, few studies have examined how counselling to improve poor lifestyle habits might be carried out in clinical practice. In Swedish primary care, structured lifestyle counselling is still not integrated into everyday clinical practice. The aim of the present study was two-fold: (1) to describe a novel lifestyle intervention programme in primary care; and (2) to evaluate change in unhealthy lifestyle habits over 1 year in men and women with high cardiovascular risk who participated in the lifestyle intervention programme. Method. A single-group study with a 1-year follow-up was carried out. A total of 417 people was enrolled, median age 62 years (54% women), with either hypertension (69%), type 2 diabetes mellitus, or impaired glucose tolerance. The 1-year intervention included five counselling sessions that focused on lifestyle habits, delivered by a district nurse with postgraduate credits in diabetes care and the metabolic syndrome. All patients were offered in-depth counselling for one or more lifestyle habits when needed. Lifestyle habits were assessed by a questionnaire at baseline and 1-year follow-up. Total change was assessed using a nine-factor unhealthy lifestyle habit index. Results. Favourable, significant changes were observed for physical activity, dietary habits, smoking, and stress over 1 year. Similar improvements were seen for both sexes and type of diagnosis. Conclusions. The results support the utility of a multifactorial, structured approach to change unhealthy lifestyle habits for cardiovascular risk prevention in a primary care setting.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Cardiovascular prevention, general practice, hypertension, lifestyle habits, structured lifestyle programme, type 2 diabetes mellitus
National Category
Cardiac and Cardiovascular Systems
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5800 (URN)10.1080/03009734.2019.1602088 (DOI)000470479000001 ()31063003 (PubMedID)
Projects
Livsstilsmottagningen på Citypraktiken, Västerås
Available from: 2019-08-13 Created: 2019-08-13 Last updated: 2019-11-06
Holmlund, T., Ekblom Bak, E., Franzén, E., Hultling, C. & Wahman, K. (2019). Intensity of physical activity as a percentage of peak oxygen uptake, heart rate and Borg RPE in motor-complete para- and tetraplegia.. PLoS ONE, 14(12), Article ID e0222542.
Open this publication in new window or tab >>Intensity of physical activity as a percentage of peak oxygen uptake, heart rate and Borg RPE in motor-complete para- and tetraplegia.
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 12, article id e0222542Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The aims were to describe VO2peak, explore the potential influence of anthropometrics, demographics and level of physical activity within each cohort; b) to define common, standardized activities as percentages of VO2peak and categorize these as light, moderate and vigorous intensity levels according to present classification systems, and c) to explore how clinically accessible methods such as heart-rate monitoring and Borg rating of perceived exertion (RPE) correlate or can describe light, moderate and vigorous intensity levels.

DESIGN: Cross sectional.

SETTING: Rehabilitation facility and laboratory environment.

SUBJECTS: Sixty-three individuals, thirty-seven (10 women) with motor-complete paraplegia (MCP), T7-T12, and twenty-six (7 women) with motor-complete tetraplegia (MCT), C5-C8.

INTERVENTIONS: VO2peak was obtained during a graded peak test until exhaustion, and oxygen uptake during eleven different activities was assessed and categorized using indirect calorimetry.

MAIN OUTCOME MEASURES: VO2peak, Absolute and relative oxygen consumption, Borg RPE.

RESULTS: Absolute VO2peak was significantly higher in men than in women for both groups, with fairly small differences in relative VO2peak. For MCP sex, weight and time spent in vigorous-intensity activity explained 63% of VO2peak variance. For MCT sex and time in vigorous-intensity activity explained 55% of the variance. Moderate intensity corresponds to 61-72% HRpeak and RPE 10-13 for MCP vs. 71-79% HRpeak, RPE 13-14 for MCT.

CONCLUSION: Using current classification systems, eleven commonly performed activities were categorized in relative intensity terms, (light, moderate and vigorous) based on percent of VO2peak, HRpeak and Borg RPE. This categorization enables clinicians to better guide persons with SCI to meet required physical activity levels.

Place, publisher, year, edition, pages
Public Library of Science, 2019
National Category
Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5946 (URN)10.1371/journal.pone.0222542 (DOI)31794548 (PubMedID)
Available from: 2019-12-05 Created: 2019-12-05 Last updated: 2019-12-05
Salier Eriksson, J., Ekblom Bak, E., Blom, V., Kallings, L., Ekblom, Ö., Hemmingsson, E., . . . Lindwall, M. (2019). Latent profiles of sedentary time, exercise and cardiorespiratory fitness in adults, and the associations with metabolic and percieved health. In: : . Paper presented at EuroPrevent 2019. 11-13 April 2019, Lisbon, Portugal.
Open this publication in new window or tab >>Latent profiles of sedentary time, exercise and cardiorespiratory fitness in adults, and the associations with metabolic and percieved health
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2019 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Health Sciences
Research subject
Medicine/Technology; Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-6000 (URN)
Conference
EuroPrevent 2019. 11-13 April 2019, Lisbon, Portugal
Available from: 2020-01-21 Created: 2020-01-21 Last updated: 2020-01-21Bibliographically approved
Hemmingsson, E., Ekblom, Ö., Kallings, L., Andersson, G., Wallin, P., Söderling, J., . . . Ekblom Bak, E. (2019). Objectively measured prevalence and time trends of obesity and severe obesity in 447 925 Swedish adults, 1995-2017. In: : . Paper presented at EuroPrevent 2019. 11-13 April 2019, Lisbon, Portugal.
Open this publication in new window or tab >>Objectively measured prevalence and time trends of obesity and severe obesity in 447 925 Swedish adults, 1995-2017
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2019 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Health Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5998 (URN)
Conference
EuroPrevent 2019. 11-13 April 2019, Lisbon, Portugal
Available from: 2020-01-20 Created: 2020-01-20 Last updated: 2020-01-20Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3901-7833

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