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  • 1.
    Adlard, Kirsten N.
    et al.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Devin, James L.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Jenkins, David G.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Bolam, Kate A.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Aitken, Joanne F.
    Griffith Univ, Menzies Hlth Inst Queensland, Gold Coast, Qld, Australia.;Canc Council Queensland, Canc Res Ctr, Brisbane, Qld, Australia..
    Chambers, Suzanne K.
    Griffith Univ, Menzies Hlth Inst Queensland, Gold Coast, Qld, Australia.;Canc Council Queensland, Canc Res Ctr, Brisbane, Qld, Australia.;Prostate Canc Fdn Australia, Sydney, NSW, Australia.;Edith Cowan Univ, Hlth & Wellness Inst, Perth, WA, Australia.;Univ Queensland, Clin Res Ctr, Brisbane, Qld, Australia..
    Dunn, Jeffrey C.
    Griffith Univ, Menzies Hlth Inst Queensland, Gold Coast, Qld, Australia.;Canc Council Queensland, Canc Res Ctr, Brisbane, Qld, Australia.;Univ Queensland, Sch Social Sci, Brisbane, Qld, Australia..
    Skinner, Tina L.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    THE INFLUENCE OF EXERCISE INTENSITY ON FATIGUE IN COLORECTAL CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL2016In: Asia-Pacific Journal of Clinical Oncology, ISSN 1743-7563, E-ISSN 1743-7563, Vol. 12, no S5, p. 78-78, article id 44Article in journal (Other academic)
  • 2.
    Alfvén, Gösta
    et al.
    Clintec, Karolinska Institutet.
    Andersson, Eva
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control. Institutionen för Neurovetenskap, Karolinska Institutet.
    Barn med stressutlöst smärta hade kraftigare startle-reflex2017In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, article id 114:ERZXArticle in journal (Other academic)
    Abstract [sv]

    Återkommande stressutlöst smärta är ett närmast vardagligt fenomen. Avsaknaden av enkla test inom sjukvården för att diagnostisera stressutlöst smärta medför diagnostiska svårigheter och därmed svårigheter med handläggning. Ett grundläggande problem är att förståelse för den patofysiologiska processen bakom långvarig stressutlöst smärta saknas.

    Tidigare studier från samma forskare har visat att barn och tonåringar med långvarig stressutlöst smärta diagnostiserad enligt fastställda kriterier utvecklar ett karakteristiskt mönster av ömma punkter (tender points) i muskler på platser för bland annat huvudvärk, skuldersmärtor och buksmärtor nära naveln. Dessa muskler ingår i startle-reflexen, en neuromuskulär försvarsreaktion som utlöses från en kärna i hjärnstammen. Startle-reflexen startar med en blinkreflex och följs på mindre än en tiondels sekund av framåtböjning av huvudet och en nedstigande böjningsreaktion av kroppen, som sträcker sig ned till benen. Stress kan bland annat via amygdala leda till förstärkt och lättare utlöst startle-reflex.

    Vår hypotes var att startle-reflexen hos individer med stressutlöst smärta är mer lättutlöst och ger ett högre svar än hos friska. I en kontrollerad studie ingick 19 individer i åldern 10–17 år som hade stressutlöst återkommande smärta enligt fastställda kriterier. Gruppen jämfördes med 23 friska i jämförbar ålder, av motsvarande kön och utan smärtbesvär. Under likvärdiga, lugna förhållanden utlöstes startle-reflex vid upprepade starka auditiva signaler på 105 dB via hörlurar, och EMG registrerades från ögonblinkningsmuskeln (orbicularis oculi), tinningmuskel (temporalis), nacknära skuldermuskel (trapezius), stora bröstmuskeln (pectoralis major), bukmuskel (rectus abdominis) samt ryggmuskel (lumbala erector spinae).

    I smärtgruppen var muskelspänningen signifikant förhöjd i ovan nämnda muskler. Startle-reflexen utlöstes också lättare och tidigare, var kraftigare och varade längre. Muskel­aktivitetsgraden efter ljudstimuli visade i smärtgruppen signifikant högre medelamplitud än i kontrollgruppen för alla sex muskler och de åtta upprepade startle-responserna sammantagna. Aktuell forskning om möjliga muskulära och centralnervösa smärtmekanismer presenteras i artikeln.

    För första gången har ökad muskelspänning och förstärkt startle-reaktion påvisats med EMG hos barn/ungdomar med återkommande stressutlöst smärta i ett mönster som sammanfaller med mönstret av ömma punkter och smärtlokalisation. Vår förhoppning är att dessa fynd ska stimulera till fortsatt forskning och förbättra klinisk praxis.

    Alfvén, G, Grillner, S, Andersson E. Eur J Pain. Epub 4 maj 2017. doi: 10.1002/ejp.1057

  • 3.
    Anborg, Robyn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Estetisk kirurgi: En kvantitativ studie om hur subjektiva upplevelser kring familj påverkar intresse av estetisk kirurgi2011Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    Aim

    The purpose of this study is to explain how subjective experiences around the family affect interest in esthetic surgery. Specific questions were made to investigate this:

    - How is the interest in esthetic surgery affected by family members who has been talking about undergoing or have been undergoing esthetic surgery?

    - How is the interest in esthetic surgery affected by the experience of divorce during childhood and growing up with a single parent?

    - How is the interest in esthetic surgery affected by physical or psychological absence of mother or father, during childhood?

    - How is the interest in esthetic surgery affected by at least one person who has been supported and loving, during childhood?

    - How is the interest in esthetic surgery affected by family functions that are unmet?

    - How is the interest in esthetic surgery affected by the experience of a family crisis?

    Method

    This thesis has used a quantitative research method, with a survey. An own survey was made, and handed out in Stockholm. 60 surveys was handed out, of which 58 was answered. The survey was managed anonymously, and at first consolidated in spreadsheets of Excel and then analyzed in SPSS, trough Mann-Whitney and Chi-2 test, and also logistic regression.

    Results

    The predictors of interest in esthetic surgery are parents who talked about undergoing esthetic surgery (P = 0.049), lower estimates of mental presence of the mother (P = 0.029), lower estimates of mental presence of father (P = 0.042), lower estimate of that the father has given respect of the own person´s value (P = 0.001) and lower estimation of that the family have provided a good basis for a stable and harmonious childhood (P = 0.003). None of these could individually explain the dependent variable's variation, but all of them interacted. By gradually exclude the predictors in a logistic regression, the main predictor of interest in esthetic surgery was identified, which was the last one mentioned.

    Conclusions

    The conclusion is that certain subjective experiences around the family affect interest in cosmetic surgery, while the influence of others has shown no significant differences.

     

  • 4.
    Andersson, Eva
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Hovland, Anders
    Kjellman, Bengt
    Taube, Jill
    Martinsen, Egil W.
    Fysisk aktivitet är lika bra som läkemedel eller samtalsterapi vid depression2016In: Idrottsmedicin, ISSN 2001-3302, Vol. 35, no 1, p. 4-7Article in journal (Other academic)
  • 5. Angenete, E
    et al.
    Angerås, U
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekelund, J
    Gellerstedt, M
    Thorsteinsdottir, T
    Steineck, G
    Haglind, E
    Physical activity before radical prostatectomy reduces sick leave after surgery - results from a prospective, non-randomized controlled clinical trial (LAPPRO).2016In: BMC Urology, ISSN 1471-2490, E-ISSN 1471-2490, Vol. 16, no 1, article id 50Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Studies have reported that early physical rehabilitation after surgical procedures is associated with improved outcome measured as shorter hospital stay and enhanced recovery. The aim of this study was to explore the relationship between the preoperative physical activity level and subsequent postoperative complications, sick-leave and hospital stay after radical prostatectomy for prostate cancer in the setting of the LAPPRO trial (LAParoscopic Prostatectomy Robot Open).

    METHODS: LAPPRO is a prospective controlled trial, comparing robot-assisted laparoscopic and open surgery for localized prostate cancer between 2008 and 2011. 1569 patients aged 64 or less with an occupation were included in this sub-study. The Gleason score was <7 in 52 % of the patients. Demographics and the level of self-assessed preoperative physical activity, length of hospital stay, complications, quality of life, recovery and sick-leave were extracted from clinical record forms and questionnaires. Multivariable logistic regression, with log-link and logit-link functions, was used to adjust for potential confounding variables.

    RESULTS: The patients were divided into four groups based on their level of activity. As the group with lowest engagement of physical activity was found to be significantly different in base line characteristics from the other groups they were excluded from further analysis. Among patients that were physically active preoperativelly (n = 1467) there was no significant difference between the physical activity-groups regarding hospital stay, recovery or complications. However, in the group with the highest self-assessed level of physical activity, 5-7 times per week, 13 % required no sick leave, compared to 6.3 % in the group with a physical activity level of 1-2 times per week only (p < 0.0001).

    CONCLUSIONS: In our study of med operated with radical prostatectomy, a high level of physical activity preoperatively was associated with reduced need for sick leave after radical prostatectomy compared to men with lower physical activity.

    TRIAL REGISTRATION: The trial is registered at the ISCRTN register. ISRCTN06393679 .

  • 6.
    Askling, Carl
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Akut hamstringsskada vanlig inom svensk elitfotboll2013In: Idrottsmedicin, ISSN 2001-3302, no 2, p. 26-27Article in journal (Other academic)
  • 7.
    Askling, Carl
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Are exercises the best medicine?2017Conference paper (Refereed)
  • 8.
    Askling, Carl
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Nilsson, Johnny
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Thorstensson, Alf
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    A new hamstring test to complement the common clinical examination before return to sport after injury2010In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 18, no 12, p. 1788-1803Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim was to introduce and evaluate the reliability and validity of an active hamstring flexibility test as a complement to common clinical examination when determining safe return to sport after hamstring injury.

    METHODS: Eleven healthy subjects (28 years) were tested on repeated occasions, and 11 athletes (21 years) with MRI-verified acute hamstring strain were tested when common clinical examination revealed no signs of remaining injury, i.e. there was no differences between the legs in palpation pain, manual strength tests, and passive straight leg raise. Flexibility, i.e. highest range of motion of three consecutive trials, was calculated from electrogoniometer data during active ballistic hip flexions and conventional passive slow hip-flexions in a supine position. A VAS-scale (0-100) was used to estimate experience of insecurity during active tests.

    RESULTS: No significant test-retest differences were observed. Intra-class correlation coefficients ranged 0.94-0.99 and coefficients of variation 1.52-4.53%. Active flexibility was greater (23%) than passive flexibility. In the athletes, the injured leg showed smaller (8%) active, but not passive, flexibility than the uninjured leg. Average insecurity estimation was 52 (range 28-98) for the injured and 0 for the uninjured leg, respectively.

    CONCLUSION: The new test showed high reliability and construct validity; furthermore, it seems to be sensitive enough to detect differences both in active flexibility and in insecurity after acute hamstring strains at a point in time when the commonly used clinical examination fails to reveal injury signs. Thus, the test could be a complement to the common clinical examination before the final decision to return to sport is made.

  • 9.
    Bakkman, Linda
    et al.
    Karolinska institutet.
    Fernström, Maria
    Karolinska institutet.
    Loogna, Peter
    Sophiahemmet.
    Rooyackers, Olav
    Brandt, Lena
    Karolinska institutet.
    Lagerros, Ylva Trolle
    Karolinska institutet.
    Reduced respiratory capacity in muscle mitochondria of obese subjects.2010In: Obesity Facts, ISSN 1662-4025, E-ISSN 1662-4033, Vol. 3, no 6, p. 371-5Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/AIMS: The extent of weight gain varies among individuals despite equal calorie overconsumption. Furthermore, weight gain is often less than expected from energy excess. This suggests differences in metabolic efficiency and basal metabolism. Since mitochondrial uncoupling accounts for a substantial portion of the basal metabolic rate, we compared skeletal muscle mitochondrial respiration in obese subjects to normal-weight reference groups with various degrees of physical activity.

    METHODS: Muscle biopsies were taken from the vastus lateralis muscle of 9 healthy obese subjects (BMI 40 ± 3). Mitochondria were isolated and analyzed for coupled (state 3) and uncoupled (state 4) respirations as well as mitochondrial efficiency (P/O ratio) using pyruvate as a substrate. Respiratory data were compared to reference groups A, normal-weight untrained (BMI 24 ± 0.7), and B, normal-weight trained (BMI 24 ± 0.6).

    RESULTS: Obese subjects had a decreased respiratory capacity per mitochondrial volume compared to the reference groups: this was evident in state 4 (65% and 35% of reference group A and B, respectively) and state 3 (53% and 29% of A and B, respectively) (p < 0.05).

    CONCLUSION: Obese subjects had a low capacity for fuel oxidation, which may play a role in the predisposition of obesity. However, whether lower mitochondrial capacity is a cause or a consequence of obesity requires further research.

  • 10.
    Bendrik, R., Jr.
    et al.
    Uppsala Univ, Deparment Publ Hlth & Caring Sci, Uppsala, Sweden.;Uppsala Univ, Ctr Res & Dev, Gavle, Sweden.;Reg Gavleborg, Gavle, Sweden..
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group. Uppsala Univ, Deparment Publ Hlth & Caring Sci, Uppsala, Sweden..
    Broms, K., Sr.
    Uppsala Univ, Deparment Publ Hlth & Caring Sci, Uppsala, Sweden.;Uppsala Univ, Ctr Res & Dev, Gavle, Sweden.;Reg Gavleborg, Gavle, Sweden..
    Emtner, M., Sr.
    Uppsala Univ, Dept Neurosci, Uppsala, Sweden..
    MAXIMAL STEP-UP TEST A NEW FUNCTIONAL TEST IN HIP OR KNEE OSTEOARTHRITIS2016In: Osteoarthritis and Cartilage, ISSN 1522-9653, Vol. 24, no S1, p. S471-S471Article in journal (Refereed)
  • 11.
    Bergström, Göran
    et al.
    Göteborgs universitet.
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Schmidt, Caroline
    Göteborgs universitet.
    Self-efficacy regarding physical activity is superior to self-assessed activity level, in long-term prediction of cardiovascular events in middle-aged men2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 820Article in journal (Refereed)
    Abstract [en]

    Background

    Self-efficacy has been determined to be a strong predictor of who will engage in physical activity. We aimed to evaluate the associations between self-efficacy to perform physical activity, self-reported leisure-time physical activity and cardiovascular events in a population-based cohort of middle-aged Swedish men with no previous cardiovascular disease, or treatment with cardiovascular drugs.

    Methods

    Analyses are based on 377 men randomly selected and stratified for weight and insulin sensitivity from a population sample of 58-year-old men (n = 1728) and who had answered a question about their competence to perform exercise (as an assessment of physical self-efficacy). The Saltin-Grimby Physical Activity Level Scale was used to assess self-reported levels of leisure-time physical activity. Cardiovascular events were recorded during 13-years of follow-up.

    Results

    The group with poor self-efficacy to perform physical activity had a significantly higher incidence of cardiovascular events compared with the group with good physical self-efficacy (32.1 % vs 17.1 %, p < 0.01). Multivariate analyses showed that poor physical self-efficacy was associated with an increased relative risk of 2.0 (95 % CI 1.2 to 3.0), of having a cardiovascular event during follow-up also after adjustments for co-variates such as waist to hip ratio, heart rate, fasting plasma glucose, serum triglycerides, systolic blood pressure, apoB/apoA-I ratio and leisure-time physical activity.

    Conclusion

    Self-efficacy to perform physical activity was strongly and independently associated with cardiovascular events and was superior to self-assessed physical activity in predicting cardiovascular events during 13-years of follow-up in a group of middle-aged men, without known CVD or treatment with cardiovascular drugs.

  • 12.
    Bjerkefors, Anna
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Squair, J W
    Malik, R
    Lam, T
    Chen, Z
    Carpenter, M G
    Diagnostic accuracy of common clinical tests for assessing abdominal muscle function after motor-complete spinal cord injury above T6.2015In: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 53, p. 114-119Article in journal (Refereed)
    Abstract [en]

    Study design:Diagnostic study.Objectives:The objective of this study was to compare patterns of electromyography (EMG) recordings of abdominal muscle function in persons with motor-complete spinal cord injury (SCI) above T6 and in able-bodied controls, and to determine whether manual examination or ultrasound measures of muscle activation can be accurate alternatives to EMG.Setting:Research center focused on SCI and University laboratory, Vancouver, Canada.Methods:Thirteen people with SCI (11 with American Spinal Injury Association Impairment Scale (AIS) A and 2 AIS B; C4-T5), and 13 matched able-bodied participants volunteered for the study. Participants completed trunk tasks during manual examination of the abdominal muscles and then performed maximal voluntary isometric contractions, while EMG activity and muscle thickness changes were recorded. The frequency of muscle responses detected by manual examination and ultrasound were compared with detection by EMG (sensitivity and specificity).Results:All individuals with SCI were able to elicit EMG activity above resting levels in at least one abdominal muscle during one task. In general, the activation pattern was task specific, confirming voluntary control of the muscles. Ultrasound, when compared with EMG, showed low sensitivity but was highly specific in its ability to detect preserved abdominal muscle function in persons with SCI. Conversely, manual examination was more sensitive than ultrasound but showed lower specificity.Conclusion:The results from this study confirm preserved voluntary abdominal muscle function in individuals classified with motor-complete SCI above T6 and highlight the need for further research in developing more accurate clinical measures to diagnose the level of trunk muscle preservation in individuals with SCI.Spinal Cord advance online publication, 25 November 2014; doi:10.1038/sc.2014.202.

  • 13.
    Bjerkefors, Anna
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Squair, J W
    Malik, R
    Lam, T
    Chen, Z
    Carpenter, M G
    Response to 'Diagnostic accuracy of common clinical tests for assessing abdominal muscle function after motor-complete spinal cord injury above T6'.2015In: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 53, no 12, p. 892-892Article in journal (Other academic)
  • 14.
    Bjerkefors, Anna
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Squair, Jordan W
    Chua, Romeo
    Lam, Tania
    Chen, Zhen
    Carpenter, Mark G
    Assessment of abdominal muscle function in individuals with motor-complete spinal cord injury above T6 in response to transcranial magnetic stimulation.2015In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 2, p. 138-146Article in journal (Refereed)
    Abstract [en]

    Objective: To use transcranial magnetic stimulation and electromyography to assess the potential for preserved function in the abdominal muscles in individuals classified with motor-complete spinal cord injury above T6. Subjects: Five individuals with spinal cord injury (C5-T3) and 5 able-bodied individuals. Methods: Transcranial magnetic stimulation was delivered over the abdominal region of primary motor cortex during resting and sub-maximal (or attempted) contractions. Surface electromyography was used to record motor-evoked potentials as well as maximal voluntary (or attempted) contractions in the abdominal muscles and the diaphragm. Results: Responses to transcranial magnetic stimulation in the abdominal muscles occurred in all spinal cord injury subjects. Latencies of muscle response onsets were similar in both groups; however, peak-to-peak amplitudes were smaller in the spinal cord injury group. During maximal voluntary (or attempted) contractions all spinal cord injury subjects were able to elicit electromyography activity above resting levels in more than one abdominal muscle across tasks. Conclusion: Individuals with motor-complete spinal cord injury above T6 were able to activate abdominal muscles in response to transcranial magnetic stimulation and during maximal voluntary (or attempted) contractions. The activation was induced directly through corticospinal pathways, and not indirectly by stretch reflex activations of the diaphragm. Transcranial magnetic stimulation and electromyography measurements provide a useful method to assess motor preservation of abdominal muscles in persons with spinal cord injury.

  • 15.
    Björkman, Frida
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Holm, Karin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Fysisk status hos pojkar med typ 1 diabetes2008Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim

    The aim of this study was to survey the physical fitness in boys with type 1 diabetes (IDDM). The results were compared to a control group with healthy boys that have preformed the same tests in other studies. Our questions were:

    1. How does BMI relate between IDDM-children and healthy peers?

    2. How does physical activity level relate between IDDM-children and healthy peers?

    3. How does aerobic fitness (VO2max), grip strength and balance relate between IDDM-children and healthy peers?

    Method

    Subjects were recruited in cooperation with Astrid Lindgrens Barnsjukhus. Height, body mass, VO2max, grip strength, balance and measurement of physical activity level with accelerometry were data collected from five boys with type 1 diabetes. The results were compared to data found in healthy subjects. The collected data were presented as z scores.

    Results

    Two subjects showed a main difference in their test results compared to the mean value of healthy boys. The subjects that were deviated from mean values performed poor results in some or all of the tests. Only two subjects provided sufficiently registration of physical activity level for comparison with the control group. Data showed a lower activity level in one subject compared to healthy controls and a higher activity level in the other subject.

    Conclusions

    The examined group cannot be proven to be a representative selection, and no general conclusion regarding children with type 1 diabetes and their physical status could be drawn. No statistic significant differences could be found based on the data of this study. One notable tendency was that the subjects that differs a lot from mean values in some test also show the same discrepancy in the other tests.

  • 16.
    Björkman, Frida
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Mattsson, C. Mikael
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Hur farlig är multisport?2011In: Svensk IdrottsMedicin, ISSN 1103-7652, Vol. 30, no 4, p. 8-11Article in journal (Other academic)
    Abstract [sv]

    Den övervägande delen av deltagarna i större multisporttävlingar drabbas av någon typ av skada som i de flesta fall är lindrig. Men det är ändå ingen tvekan om att multisport kan vara farligt. Det ställs höga krav på medicinsk personal att kunna hantera en mångfald av skador och sjukdomar.

  • 17.
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    The Role Of The Ecg In Cardiovascular Screening Of Athletes2015In: European Journal of Sports Medicine, 3(2015):Suppl. 1 / [ed] Konstantinos Natsis, 2015, Vol. 3, p. 27-28Conference paper (Refereed)
    Abstract [en]

    INTRODUCTION: Sudden cardiac arrest (SCA) in an athlete, is an uncommon event (1/50 000), caused by inherited/congenital cardiovascular disease (in younger athletes, >35 years), while in the older athletes, the cause is most often  underlying coronary artery disease (CAD). Cardiac societies, Sports Medicine Associations and subsequently international sporting bodies have developed cardiac screening programmes to prevent SCA in athletes. In addition, increased  awareness and recommendations regarding arena safety procedures (external automated defibrillators, medical action plans), have been introduced in recent years, to increase the chance of survival in case of a SCA. However, the most appropriate cardiac screening protocol and specifically, the role of the ECG in cardiovascular screening of athletes, is still debated.

    AIM: This talk will discuss the sensitivity and specificity issues, connected with using the ECG or not, as part of cardiovascular screening of athletes.

    MATERIALS AND METHODS: Both the American Heart Association (AHA) and the European Society of Cardiology (ESC) (1) as well as the International Olympic Committee (IOC) recommend regular screening of competitive athletes, including personal and family history and physical examination. However, the AHA does not recommend the routine use of the ECG in screening. In recent years, more evidence has emerged, making it possible to scrutinize the literature regarding sensitivity/specificity for screening with/without ECG.

    RESULTS: Firstly, the available literature show that cardiovascular screening including an ECG will have much superior sensitivity for finding underlying relevant cardiac abnormalities. Traditionally, ECG has been found to also have a large number of false-positives, making the specificity of including the ECG low. However, in recent years, the international consensus-statements on ECG interpretation in athletes, have been repeatedly updated, due to scientific progress, making the specificity of cardiac screening with the ECG much higher, with unchanged high sensitivity (2). On the contrary, cardiac screening without the ECG has been shown to have a very low sensitivity, but more importantly will probably have also a low specificity, since many athletes do have a variety of often diffuse symptoms, which will necessitate further investigation, most readily an ECG. The few available cost-effectiveness studies worldwide, have shown that screening with the ECG is more cost-effective than screening without, but more high quality studies, are needed on cost-effectiveness.

    CONCLUSION: Cardiovascular screening of athletes aims to prevent sudden cardiac arrest (and death) of athletes. The inclusion of an ECG in regular screening, will be accompanied by higher sensitivity, while the specificity using this approach has increased considerably in recent years. All in all, ECG should be an integral part of cardiovascular screening of athletes, and is also recommended by EFSMA in its latest statement on pre-participation examination in sports (3).

  • 18.
    Börjesson, Mats
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Onerup, Aron
    Sahlgrenska universitetssjukhuset, Göteborg.
    Lundqvist, Stefan
    Primärvården Göteborg.
    Dahlöf, Björn
    Sahlgrenska akademin, Göteborg.
    Fysisk aktivitet vid hypertoni2016In: FYSS 2017: fysisk aktivitet i sjukdomsprevention och sjukdomsbehandling, Läkartidningen förlag , 2016, p. 412-425Chapter in book (Other academic)
    Abstract [sv]

    Sammanfattande rekommendation

    Personer med hypertoni bör rekommenderas aerob fysisk aktivitet för att sänka blodtrycket. Måttligt starkt vetenskapligt underlag (evidensstyrka +++).

    Personer med hypertoni kan som tillägg rekommenderas isometrisk träning för att sänka blodtrycket. Begränsat vetenskapligt underlag (evidensstyrka ++).

    Personer med hypertoni bör även rekommenderas muskelstärkande fysisk aktivitet enligt de allmänna rekommendationerna om fysisk aktivitet.

    Personer med hypertoni bör rekommenderas regelbunden fysisk aktivitet som en av flera åtgärder för att sänka blodtrycket.

  • 19.
    Börjesson, Mats
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Solberg, Erik Ekker
    Diakonhjemmets sykehus, Oslo.
    Nylander, Eva
    Universitetssjukhuset Linköping.
    Plötslig hjärtdöd vid fysisk aktivitet2016In: FYSS 2017: fysisk aktivitet i sjukdomsprevention och sjukdomsbehandling, Läkartidningen förlag , 2016, p. 241-249Chapter in book (Other academic)
    Abstract [sv]

    Sammanfattning

    Regelbunden fysisk aktivitet har positiva effekter på såväl riskfaktorer för hjärtkärlsjukdom som etablerad hjärt-kärlsjukdom. Aerob fysisk aktivitet på måttlig intensitet rekommenderas allmänt. Mer fysisk aktivitet på hög intensitet har potentiellt ännu större effekt, men kan också medföra ökade risker för personer med bakomliggande hjärt-kärlsjukdom.

    Plötslig hjärtdöd i samband med fysisk aktivitet bland individer > 35 år orsakas nästan uteslutande av kranskärlssjukdom. För äldre idrottare (> 35 år), liksom för icke elitaktiva, saknas i dag svenska rekommendationer om hjärtscreening. Självskattningsformulär, i utvalda fall kompletterat med hjärtundersökning hos ordinarie läkare, har föreslagits kunna minska risken i denna grupp.

    Plötsliga dödsfall under idrottsutövning bland unga (< 35 år) beror vanligen på tidigare odiagnostiserade medfödda eller ärftliga hjärtsjukdomar. Riksidrottsförbundet (RF) och Socialstyrelsen rekommenderar riktade hjärtkontroller av unga elitidrottare från 16 års ålder, bestående av familjehistoria, symtom, fysikalisk undersökning och vilo-EKG.

  • 20.
    Börjesson, Mats
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Vanhees, Luc
    Leuven University.
    Cardiovascular evaluation of middle-aged/senior leisure time athletes2013In: Cardiac Electrophysiology Clinics, ISSN 1877-9182, Vol. 5, no 1, p. 33-42Article, review/survey (Refereed)
  • 21. Calbet, J A L
    et al.
    Mortensen, S P
    Munch, G D W
    Curtelin, D
    Boushel, Robert
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Constant infusion transpulmonary thermodilution for the assessment of cardiac output in exercising humans.2016In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 26, no 5, p. 518-527Article in journal (Refereed)
    Abstract [en]

    To determine the accuracy and precision of constant infusion transpulmonary thermodilution cardiac output (CITT-Q) assessment during exercise in humans, using indocyanine green (ICG) dilution and bolus transpulmonary thermodilution (BTD) as reference methods, cardiac output (Q) was determined at rest and during incremental one- and two-legged pedaling on a cycle ergometer, and combined arm cranking with leg pedaling to exhaustion in 15 healthy men. Continuous infusions of iced saline in the femoral vein (n = 41) or simultaneously in the femoral and axillary (n = 66) veins with determination of temperature in the femoral artery were used for CITT-Q assessment. CITT-Q was linearly related to ICG-Q (r = 0.82, CITT-Q = 0.876 × ICG-Q + 3.638, P < 0.001; limits of agreement ranging from -1.43 to 3.07 L/min) and BTD-Q (r = 0.91, CITT-Q = 0.822 × BTD + 4.481 L/min, P < 0.001; limits of agreement ranging from -1.01 to 2.63 L/min). Compared with ICG-Q and BTD-Q, CITT-Q overestimated cardiac output by 1.6 L/min (≈ 10% of the mean ICG and BTD-Q values, P < 0.05). For Q between 20 and 28 L/min, we estimated an overestimation < 5%. The coefficient of variation of 23 repeated CITT-Q measurements was 6.0% (CI: 6.1-11.1%). In conclusion, cardiac output can be precisely and accurately determined with constant infusion transpulmonary thermodilution in exercising humans.

  • 22. Calbet, Jose A L
    et al.
    Boushel, Robert C
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Assessment of cardiac output with transpulmonary thermodilution during exercise in humans.2015In: Journal of applied physiology, ISSN 8750-7587, E-ISSN 1522-1601, Vol. 118, no 1, p. 1-10Article in journal (Refereed)
    Abstract [en]

    The accuracy and reproducibility of transpulmonary thermodilution (TPTd) to assess cardiac output (Q) in exercising men was determined using indocyanine green (ICG) dilution as a reference method. TPTd has been utilized for the assessment of Q and preload indices of global end-diastolic volume (GEDV) and intrathoracic blood volume (ITBV), as well as extravascular lung water (EVLW) in resting humans. It remains unknown if this technique is also accurate and reproducible during exercise. Sixteen healthy men underwent catheterization of the right femoral vein (for iced saline injection), an antecubital vein (ICG injection) and femoral artery (thermistor) to determine their Q by TPTd and [ICG] during incremental 1 and 2-legged pedaling on a cycle ergometer, and combined arm cranking with leg pedaling to exhaustion. There was a close relationship between Td-Q and ICG-Q (r=0.95, n=151, SEE: 1.452 L/min, P<0.001; mean difference of 0.06 L/min; limits of agreement -2.98 to 2.86 L/min), and TPTd-Q and ICG-Q increased linearly with VO2 with similar intercepts and slopes. Both methods had mean coefficients of variation (CV) close to 5% for Q, GEDV and ITBV. The mean CV of EVLW, assessed with both indicators (ICG and thermal) was 17%, and was sensitive enough as to detect a reduction in EVLW of 107 ml when changing from resting supine to upright exercise. In summary, transpulmonary thermodilution with bolus injection into the femoral vein is an accurate and reproducible method to assess cardiac output during exercise in humans.

  • 23.
    Christenson, Anne
    et al.
    Obesity Center, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden.
    Johansson, Eva
    Karolinska Institutet, Stockholm, Sweden.
    Reynisdottir, Signy
    Obesity Center, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden.
    Torgerson, Jarl
    Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    “…or else I close my ears” How women with obesity want to be approached and treated regarding gestational weight management: A qualitative interview study.2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 9, p. 1-17Article in journal (Refereed)
    Abstract [en]

    Introduction: The importance of helping pregnant women maintain a healthy lifestyle and prevent excessive gestational weight gain is well recognized, but pregnant women do not always perceive communication about body weight as respectful or helpful. Furthermore, fear of inducing shame or guilt can prohibit some midwives from talking about body weight, especially if the woman has obesity. We aimed to explore what women of reproductive age with obesity regard to be the most important and relevant aspects when discussing gestational weight management. Methods: Qualitative interview study using focus groups and individual semi-structured interviews with 17 women of reproductive age (19–39 y) with obesity. Thematic analysis was used to analyze the data. Results: We identified three themes: 1) Importance of obtaining vital medical information; 2) A wish to feel understood and treated with respect; 3) Midwives’ approach is crucial in sensitive key situations, which include bringing up the subject of body weight, weighing, providing weight-related information, coaching lifestyle modification, dealing with emotional reactions and ending a conversation. Conclusions: A majority of the interviewed women wished to receive information about risks about obesity and gestational weight gain, and recommendations on weight management. However, the risk of midwives offending someone by raising the topic may be increased if the pregnant woman believe that gestational weight gain is uncontrollable by the individual. Also, several situations during maternity care meetings can be stigmatizing and make women less receptive to advice or support. Women suggest that a good working alliance is likely to be achieved if midwives have knowledge about the causes of obesity, take interest in the patients’ background, have a non-judgmental approach and refrain from giving unsolicited advice. 

  • 24.
    Christenson, Anne
    et al.
    Karolinska institutet.
    Johansson, Eva
    Karolinska institutet.
    Reynisdottir, Signy
    Karolinska institutet.
    Torgerson, Jarl
    Göteborgs universitet.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Shame and avoidance as barriers in midwives’ communication about body weight with pregnant women: A qualitative interview study2018In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 63, p. 1-7Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION:

    Excessive gestational weight gain, regardless of initial BMI, is associated with perinatal risks for both mother and offspring and contributes to obesity in women. Studies report that healthcare professionals find it difficult to communicate about weight and pregnant women perceive healthcare professionals as unconcerned, leaving many women uninformed about weight recommendations and risks. We aimed to explore how midwives approach communication about gestational weight gain recommendations, and to characterize communication barriers and facilitators.

    METHODS:

    Seventeen midwives from different areas in Sweden were interviewed by a therapist using semi-structured interviews. Interviews were transcribed verbatim and analysed by three researchers using latent content analysis. Recurrent themes were identified and formulated.

    RESULTS:

    The main theme identified in the latent part of the analysis was "midwives use avoidant behaviours to cope with fear of inflicting worries, shame or feelings of guilt in pregnant women". Avoidant behaviours include: adjusting weight recommendations, toning down risks and avoid talking about weight. Subthemes identified were (I) Conflicting responsibilities in midwives' professional identity (II) Perceived deficiencies in the working situation.

    CONCLUSION:

    Midwives' empathy and awareness of weight stigma strongly affects communication about weight with pregnant women, and midwives' use of avoidant behaviours constitutes salient information barriers. More research is needed on whether gestational weightguidelines and weighing routines for all women, resources for extra visits, training in specific communication skills and backup access to other professions can facilitate for midwives to initiate and communicate about healthy gestational weight development, enabling more pregnant women to make well-informed lifestyle choices.

  • 25. Cornish, Rahchell S
    et al.
    Bolam, Kate A
    School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
    Skinner, Tina L
    Effect of caffeine on exercise capacity and function in prostate cancer survivors.2015In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 47, no 3, p. 468-75Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study aimed to examine the acute effect of caffeine on exercise capacity, exercise-related fatigue, and functional performance in prostate cancer survivors.

    METHODS: In this randomized, placebo-controlled, double-blind crossover study, 30 prostate cancer survivors (age, 70.3 ± 7.7 yr; body mass, 80.5 ± 13.0 kg; mean ± SD) consumed 6.04 ± 0.16 mg·kg(-1) of anhydrous caffeine or a placebo 1 h before completing a battery of exercise capacity and functional performance tests. Testing sessions were separated by 3-4 wk. Immediate fatigue and perceived exertion were measured directly pre- and postexercise at both testing sessions.

    RESULTS: Caffeine increased exercise capacity by 7.93 s (+3.0%; P = 0.010); however, postexercise fatigue and perception of exertion were comparable with the placebo session (P = 0.632 and P = 0.902, respectively). Increases in isometric grip strength trended toward significance in both dominant (+2.9%; P = 0.053) and nondominant (+2.1%; P = 0.061) hands in the caffeine trial compared with placebo. Caffeine ingestion did not result in improvements in performance for any of the remaining functional measures, including the timed up-and-go test, repeated chair stands, 6-m fast walk, and 6-m backward tandem walk. Systolic blood pressure and HR were significantly increased (P = 0.006 and P = 0.040, respectively) upon completion of the testing battery when compared with placebo.

    CONCLUSIONS: Consumption of caffeine 1 h before exercise induced improvements in exercise capacity and muscular strength in prostate cancer survivors. However, there was no change in exercise-related fatigue when compared with placebo despite reduction in timed performance of the 400-m walk. Caffeine seems to enhance exercise tolerance through improved performance with no subsequent increase in fatigue or perception of exertion and may be an appropriate strategy to promote exercise participation in prostate cancer survivors.

  • 26. Dal Maso, Fabien
    et al.
    Raison, Maxime
    Lundberg, Arne
    Arndt, Anton
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Allard, Paul
    Begon, Mickaël
    Glenohumeral translations during range-of-motion movements, activities of daily living, and sports activities in healthy participants.2015In: Clinical Biomechanics, ISSN 0268-0033, E-ISSN 1879-1271, Vol. 30, no 9, p. 1002-1007Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Glenohumeral translations have been mainly investigated during static poses while shoulder rehabilitation exercises, activities of daily living, and sports activities are dynamic. Our objective was to assess glenohumeral translations during shoulder rehabilitation exercises, activities of daily living, and sports activities to provide a preliminary analysis of glenohumeral arthrokinematics in a broad range of dynamic tasks.

    METHODS: Glenohumeral translations were computed from trajectories of markers fitted to intracortical pins inserted into the scapula and the humerus. Two participants (P1 and P2) performed full range-of-motion movements including maximum arm elevations and internal-external rotations rehabilitation exercises, six activities of daily living, and five sports activities.

    FINDINGS: During range-of-motion movements, maximum upward translation was 7.5mm (P1) and 4.7mm (P2). Upward translation during elevations was smaller with the arm internally (3.6mm (P1) and 2.9mm (P2)) than neutrally (4.2mm (P1) and 3.7mm (P2)) and externally rotated (4.3mm (P1) and 4.3mm (P2)). For activities of daily living and sports activities, only anterior translation during reach axilla for P1 and upward translation during ball throwing for P2 were larger than the translation measured during range-of-motion movements (108% and 114%, respectively).

    INTERPRETATION: While previous electromyography-based studies recommended external rotation during arm elevation to minimize upward translation, measures of glenohumeral translations suggest that internal rotation may be better. Similar amplitude of translation during ROM movement and sports activities suggests that large excursions of the humeral head may be caused not only by fast movements, but also by large amplitude movements.

  • 27.
    Devin, James L.
    et al.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Jenkins, David G.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Sax, Andrew T.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Hughes, Gareth I.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Aitken, Joanne F.
    Canc Council Queensland, Canc Res Ctr, Brisbane, Qld, Australia.;Griffith Univ, Menzies Hlth Inst Queensland, Gold Coast, Qld, Australia..
    Chambers, Suzanne K.
    Canc Council Queensland, Canc Res Ctr, Brisbane, Qld, Australia.;Griffith Univ, Menzies Hlth Inst Queensland, Gold Coast, Qld, Australia.;Prostate Canc Fdn Australia, Sydney, NSW, Australia.;Edith Cowan Univ, Hlth & Wellness Inst, Perth, WA, Australia.;Univ Queensland, Clin Res Ctr, Brisbane, Qld, Australia..
    Dunn, Jeffrey C.
    Canc Council Queensland, Canc Res Ctr, Brisbane, Qld, Australia.;Griffith Univ, Menzies Hlth Inst Queensland, Gold Coast, Qld, Australia.;Univ Queensland, Sch Social Sci, Brisbane, Qld, Australia..
    Bolam, Kate A.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Skinner, Tina L.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    THE INFLUENCE OF EXERCISE INTENSITY AND FREQUENCY ON CARDIORESPIRATORY FITNESS AND BODY COMPOSITION IN COLORECTAL CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL2016In: Asia-Pacific Journal of Clinical Oncology, ISSN 1743-7563, E-ISSN 1743-7563, Vol. 12, no S5, p. 109-109, article id 191Article in journal (Other academic)
  • 28. Devin, James L
    et al.
    Sax, Andrew T
    Hughes, Gareth I
    Jenkins, David G
    Aitken, Joanne F
    Chambers, Suzanne K
    Dunn, Jeffrey C
    Bolam, Kate A
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Skinner, Tina L
    The influence of high-intensity compared with moderate-intensity exercise training on cardiorespiratory fitness and body composition in colorectal cancer survivors: a randomised controlled trial.2016In: Journal of cancer survivorship, ISSN 1932-2259, E-ISSN 1932-2267, Vol. 10, no 3, p. 467-479Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Following colorectal cancer diagnosis and anti-cancer therapy, declines in cardiorespiratory fitness and body composition lead to significant increases in morbidity and mortality. There is increasing interest within the field of exercise oncology surrounding potential strategies to remediate these adverse outcomes. This study compared 4 weeks of moderate-intensity exercise (MIE) and high-intensity exercise (HIE) training on peak oxygen consumption (V̇O2peak) and body composition in colorectal cancer survivors.

    METHODS: Forty seven post-treatment colorectal cancer survivors (HIE = 27 months post-treatment; MIE = 38 months post-treatment) were randomised to either HIE [85-95 % peak heart rate (HRpeak)] or MIE (70 % HRpeak) in equivalence with current physical activity guidelines and completed 12 training sessions over 4 weeks.

    RESULTS: HIE was superior to MIE in improving absolute (p = 0.016) and relative (p = 0.021) V̇O2peak. Absolute (+0.28 L.min(-1), p < 0.001) and relative (+3.5 ml.kg(-1).min(-1), p < 0.001) V̇O2 peak were increased in the HIE group but not the MIE group following training. HIE led to significant increases in lean mass (+0.72 kg, p = 0.002) and decreases in fat mass (-0.74 kg, p < 0.001) and fat percentage (-1.0 %, p < 0.001), whereas no changes were observed for the MIE group. There were no severe adverse events.

    CONCLUSIONS: In response to short-term training, HIE is a safe, feasible and efficacious intervention that offers clinically meaningful improvements in cardiorespiratory fitness and body composition for colorectal cancer survivors.

    IMPLICATIONS FOR CANCER SURVIVORS: HIE appears to offer superior improvements in cardiorespiratory fitness and body composition in comparison to current physical activity recommendations for colorectal cancer survivors and therefore may be an effective clinical utility following treatment.

  • 29.
    Dreber, Helena
    et al.
    Karolinska University Hospital.
    Thorell, Anders
    Karolinska Institutet.
    Torgerson, Jarl
    Karolinska University Hospital.
    Reynisdottir, Signy
    Karolinska University Hospital.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Weight loss, adverse events, and loss to follow-up after gastric bypass in young versus older adults: A Scandinavian Obesity Surgery Registry study.2018In: Surgery for Obesity and Related Diseases, ISSN 1550-7289, E-ISSN 1878-7533, Vol. 14, no 9, p. 1319-1326, article id S1550-7289(18)30324-1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Young adults display particularly poor weight loss in behavioral obesity treatment; nonetheless, they have seldom been included in bariatric research.

    OBJECTIVES: To compare weight loss, adverse events, and loss to follow-up in young (18-25 yr) versus older (≥26 yr) adults up to 5 years after Roux-en-Y gastric bypass.

    SETTING: Nationwide, register-based study, Sweden.

    METHODS: Prospective registry data (Scandinavian Obesity Surgery Register) were analyzed in young (22.2 yr [standard deviation (SD): 2.1], 81.6% women, mean body mass index 43.7 kg/m2 [SD: 5.4]) and older (42.6 years [SD: 9.6], 82.0% women, mean body mass index 43.4 kg/m2 [SD: 5.0]) adults undergoing Roux-en-Y gastric bypass. Groups were matched for body mass index, sex, and year of surgery. Regression analyses and mixed models were used to compare outcomes between groups.

    RESULTS: A total of 369 young (37.0% of eligible) and 2210 older (46.1%) adults attended the 5-year follow-up. At this time, weight loss was 31.8% in young and 28.2% in older adults (P < .001), with a serious adverse event (Clavien-Dindo ≥3b) being reported in 52 (14.1%) young and 153 (6.9%) older adults (odds ratio = 2.06, 95% confidence interval: 1.45-2.92, P < .001). Loss to follow-up was higher in young versus older adults throughout the study period (range of relative risk = 1.16-1.89, P < .001).

    CONCLUSIONS: While young adults displayed at least equal weight loss as older adults, rates of adverse events were approximately doubled, and loss to follow-up rates were higher. Future studies on the significance of and the etiology behind the higher incidence of serious adverse events are needed. Intensified clinical contact post Roux-en-Y gastric bypass should have the potential to further improve outcomes in young adults.

  • 30.
    Ek, Amanda
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Karolinska University Hospital.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Hambraeus, Kristina
    Falun Hospital.
    Cider, Åsa
    Gothenburg University and Sahlgrenska University Hospital.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Uppsala University.
    Börjesson, Mats
    Gothenburg University and Sahlgrenska University Hospital.
    Physical inactivity and smoking after myocardial infarction as predictors for readmission and survival: results from the SWEDEHEART-registry.2019In: Clinical Research in Cardiology, ISSN 1861-0684, E-ISSN 1861-0692, Vol. 108, no 3, p. 324-332Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Physical activity (PA) and smoking cessation are included in the secondary prevention guidelines after myocardial infarction (MI), but they are still underutilised. This study aims to explore how PA level and smoking status (6-10 weeks post-MI) were associated with 1-year readmission and mortality during full follow-up time, and with the cumulative 5-year mortality.

    METHODS: A population-based cohort of all hospitals providing MI-care in Sweden (SWEDEHEART-registry) in 2004-2014. PA was expressed as the number of exercise sessions of ≥ 30 min in the last 7 days: 0-1 (low), 2-4 (medium) and 5-7 (high) sessions/week. Individuals were categorised as smokers, former smokers or never-smokers. The associations were analysed by unadjusted and adjusted logistic and Cox regressions.

    RESULTS: During follow-up (M = 3.58 years), a total of 1702 deaths occurred among 30 644 individuals (14.1 cases per 1000 person-years). For medium and high PA, the hazard ratios (HRs) for mortality were 0.39 and 0.36, respectively, compared with low PA. For never-smokers, the HR was 0.45 and former smokers 0.56 compared with smokers. Compared with low PA, the odds ratios (ORs) for readmission in medium PA were 0.65 and 0.59 for CVD and non-CVD causes, respectively. For high PA, the corresponding ORs were 0.63 and 0.55. The association remained in adjusted models. There were no associations between smoking status and readmission.

    CONCLUSIONS: The PA level and smoking status are strong predictors of mortality post-MI and the PA level also predicts readmission, highlighting the importance of adherence to the secondary prevention guidelines.

  • 31.
    Ek, Amanda
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Hambraeus, Kristina
    Cardiologkliniken, Falu lasarett.
    Börjesson, Mats
    Göteborgs Universitet.
    Association between physical activity level and risk of all-cause mortality after myocardial infarction2017In: European Journal of Preventive Cardiology, Vol 24, Issue 1 Suppl, April 2017: Abstract Book EuroPrevent 2017 Malaga, Spain, 2017, Vol. 24, article id 45Conference paper (Refereed)
    Abstract [en]

    Background/Introduction: There is little knowledge of the association between physical activity (PA) level and the mortality risk post myocardial infarction (MI). Steffen/Batey et al (2000), concluded in a smaller study, that individuals who remained active or increased their level of PA after MI had a lower risk of death. However, in order to confirm this and adjust for confounders larger studies are needed.

    Purpose: Explore any association between PA level after MI and all-cause mortality during follow-up in a large MI-cohort.

    Methods: A national cohort study including all patients <75 years of age, with a diagnosis of MI between 1991-2014 (Swedish MI register SWEDEHEART). From the register self-reported PA, 6-10 weeks post MI, (i.e. number of sessions during the past seven days with moderate and/or vigorous PA lasting ≥30 minutes) was obtained. The answers were grouped into 0-1 sessions (inactive), 2-4 sessions (moderately active) and 5-7 sessions (regularly active). Associations were first assessed unadjusted, stratified by potential confounders (sex, age, smoking status, ejection fraction, ST-elevation and quality of life). Thereafter, a multiple logistic regression was performed to control for possible confounders.

    Results: Complete data was obtained from 37 655 individuals (median 63 years, 74 % men). A total of 2512 deaths occurred during a mean of 4.1 years of follow-up. The mortality rate was 17.0 cases/1000 person-years. Moderate and regular activity, was associated with a lower risk of all-cause mortality (OR 0,356 95 %, CI 0,320-0,396 and OR 0,334, 95 % CI 0,305-0,366) compared to being physically inactive. The OR´s remained largely unchanged when stratifying for age, sex, NSTEM/STEMI and ejection fraction. However, active smokers had a lower OR, for subsequent death, as had patients with a low EQ5D. The associations persisted in the multiple logistic regression, after adjustment for confounders (Figure 1).

    Conclusion(s): A higher level of physical activity seems to be associated with a lower risk of all-cause mortality. These results suggest that physical activity assessment is important post MI, not least as an important predictor.

     

  • 32.
    Ek, Amanda
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Hambraeus, Kristina
    Cardiologkliniken, Falu lasarett.
    Börjesson, Mats
    Göteborgs Universitet.
    Samband mellan fysisk aktivitetsnivå efter hjärtinfarkt och risken för mortalitet: Association between physical activity level and risk of all-cause mortality after myocardial infarction2017In: Fria föredrag, nr 025, 2017, article id 025Conference paper (Refereed)
    Abstract [en]

    Background: There is little knowledge of the association between physical activity (PA) level and the mortality risk post myocardial infarction (MI)Steffen/Batey et al (2000), concluded in a smaller study, that individuals who remained active or increased their level of PA post-MI had a lower risk of death. This study aimed to explore any association between PA level post-MI and all-cause mortality during follow-up in a large MI-cohort.

    Methods: A national cohort study including patients <75 years of age, with a diagnosis of MI between 2005-2014 (SWEDEHEART, SEPHIA-register). Self-reported PA, 6-10 weeks post-MI, (i.e. number of sessions during the past seven days with moderate and/or vigorous PA lasting ≥30 minutes) was obtained. The answers were grouped into 0-1 sessions (inactive), 2-4 sessions (moderately active) and 5-7 sessions (regularly active). First, stratified unadjusted associations were investigated. Thereafter, a multiple logistic regression was performed to control for possible confounders.

    Results: Complete data was obtained from 37 655 individuals (median age 63 years, 74 % men). A total of 2512 deaths occurred during a mean of 4.1 years of follow-up. The mortality rate was 17.0 cases/1000 person-years. Moderate and regular activity, was associated with a lower risk of all-cause mortality (OR 0.36, 95 % CI: 0.32-0.40 and OR 0.33, 95 % CI: 0.31-0.37) compared to being physically inactive. The OR´s remained largely unchanged when stratifying for age, gender, NSTEM/STEMI and ejection fraction. However, compared to inactive patients, physically active smokers and patients with ≤ 0.85 Eq5D had a higher OR, for subsequent death. The associations persisted in the multiple logistic regression, after adjustment for confounders (Figure 1).

    Conclusions: A higher level of PA, post-MI was associated with a lower risk of all-cause mortality. These results suggest that PA assessment is important post-MI, not least as an important predictor for risk of death.

  • 33.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    En reparativ ortopedisk kirurgi kan ge fantastiska resultat2005In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, no 40, p. 2889-Article in journal (Other academic)
  • 34.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Hade artrosen kunnat förebyggas?2004In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, no 40, p. 3098-Article in journal (Other academic)
  • 35.
    Ekblom, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Ståhlberg, Linda
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Hur förhåller sig Fysisk aktivitet och Vo2max till riskfaktorer för hjärt- kärlsjukdomar?2007Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte och frågeställning

    Syftet med denna studie var att studera hur olika nivåer av fysisk aktivitet och maximal syreupptagning (VO2max) förhåller sig till olika riskfaktorer för förtida död i hjärt-kärlsjukdom (CVD). Därutöver var syftet att, om möjligt, utifrån erhållna resultat sammanställa rekommendationer för fysisk aktivitet och VO2max för att erhålla reducerad risk för de studerade riskfaktorerna för CVD.

    Är det VO2max-värdet i sig, som både kan vara genetiskt-, tränings- och sjukdomsbetingat, eller är det den fysiska aktiviteten bakom ett visst VO2max-värde som är av större betydelse för olika riskfaktorer för CVD?

    Metod

    Studien baserades på 1851 svenska kvinnor och män i åldrarna 20-65 år utvalda från ett redan insamlat datamaterial från tre tidigare vetenskapliga studier; LIV90, LIV2000 och Vasaloppsstudien. Den fysiska aktiviteten bestämdes genom en enkätfråga i respektive studie och delades in i tre nivåer. VO2max beräknades via ett submaximalt cykeltest eller mättes via ett maximalt löptest. Tolv välkända riskfaktorer för CVD erhölls utifrån enkätsvar eller medicinska testresultat. För analys av den fysiska aktivitetens och VO2max betydelse för varje riskfaktor, gjordes en binär regressionsanalys med kontroll för fysisk aktivitetsgrad, VO2max samt olika kontrollvariabler. Vid varje analys erhölls en oddskvot med 95 % konfidensintervall som beskrev hur risken att erhålla respektive riskfaktor varierade mellan de olika fysiska aktivitetsgrupperna då VO2max hölls konstant.

    Resultat

    Huvudresultaten i denna studie visade att VO2max hade ett starkare samband än fysisk aktivitet med minskad risk för utfall av enskilda riskfaktorer för CVD. Däremot hade en hög fysisk aktivitetsgrad, motsvarande en belastning som bibehöll/ökade VO2max, liknande betydelse som VO2max för reducering av den generella risken för riskfaktorer för CVD. Fysisk aktivitet på lägre belastningsnivåer uppvisade inte samma signifikanta resultat.

    Slutsats

    Både högre nivåer av fysisk aktivitet och ett högre värde på VO2max har betydelse för reducerad risk för de studerade riskfaktorerna för CVD och i förlängningen utfall av sjukdom i främst CVD. Därför bör hänsyn tas till båda variablerna då hälsopreventiva och hälsopromotiva rekommendationer utformas.

  • 36.
    Ekblom, Örjan
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ek, Amanda
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Cider, Åsa
    University of Gothenburg.
    Hambraeus, Kristina
    Falun Hospital.
    Börjesson, Mats
    University of Gothenburg.
    Increased Physical Activity Post-Myocardial Infarction Is Related to Reduced Mortality; Results From the SWEDEHEART Registry2018In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 7, no 24, article id e010108Article in journal (Refereed)
    Abstract [en]

    Background

    With increasing survival rates among patients with myocardial infarction (MI), more demands are placed on secondary prevention. While physical activity (PA) efforts to obtain a sufficient PA level are part of secondary preventive recommendations, it is still underutilized. Importantly, the effect of changes in PA after MI is largely unknown. Therefore, we sought to investigate the effect on survival from changes in PA level, post‐MI.

    Methods and Results

    Data from Swedish national registries were combined, totaling 22 227 patients with MI. PA level was self‐reported at 6 to 10 weeks post‐MI and 10 to 12 months post‐MI. Patients were classified as constantly inactive, increased activity, reduced activity, and constantly active. Proportional hazard ratios were calculated. During 100 502 person‐years of follow‐up (mean follow‐up time 4.2 years), a total of 1087 deaths were recorded. Controlling for important confounders (including left ventricular function, type of MI, medication, smoking, participation in cardiac rehabilitation program, quality of life, and estimated kidney function), we found lower mortality rates among constantly active (hazard ratio: 0.29, 95% confidence interval: 0.21–0.41), those with increased activity (0.41, 95% confidence interval: 0.31–0.55), and those with reduced activity (hazard ratio: 0.56, 95% confidence interval: 0.45–0.69) during the first year post‐MI, compared with those being constantly inactive. Stratified analyses indicated strong effect of PA level among both sexes, across age, MI type, kidney function, medication, and smoking status.

    Conclusions

    The present article shows that increasing the PA level, compared with staying inactive the first year post‐MI, was related to reduced mortality.

  • 37.
    Ekblom-Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Hellénius, Mai-Lis
    Minskat stillasittande lika viktigt som ökad fysisk aktivitet: [Less sitting as important as increased physical activity]2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 9, p. 587-8Article in journal (Other academic)
    Abstract [en]

    There is clear evidence for the benefits of regular physical activity for several major health diseases. Meanwhile, sedentary behaviour, resulting in limited everyday life nonexercise activity and muscular inactivity, is increasing in Sweden. Recent observational studies suggest that prolonged bouts of sitting and lack of whole body muscular movement are independently of additional regular physical activity, strongly associated with common public health diseases and total mortality. This indicates that we are dealing with two distinct behaviours and their effects; a) the benefits of regular physical activity and b) the risks of too much sitting and limited nonexercise everyday life activity.The focus in clinical practice and for guidelines should be to promote and prescribe regular physical activity as well as avoidance of sedentary behaviour.

  • 38.
    Ekblom-Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Hellénius, Mai-Lis
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Are we facing a new paradigm of inactivity physiology?2010In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 44, no 12, p. 834-5Article in journal (Refereed)
    Abstract [en]

    Evidence for the benefits of regular physical activity for several major health diseases is clear and unanimous. Current public health guidelines are promoting at least 150 minutes per week of moderate to vigorousintensity leisure-time physical activity.

    Recent, observational studies have suggested that prolonged bouts of sitting time and lack of whole-body muscular movement are strongly associated with obesity, abnormal glucose metabolism, diabetes, metabolic syndrome, cardiovascular disease (CVD) risk and cancer, as well as total mortality independent of moderate to vigorous-intensity physical activity.1,–,5 Accordingly, a possible new paradigm of inactivity physiology is suggested, separate from the established exercise physiology, that is, molecular and physiological responses to exercise.6 This new way of thinking emphasises the distinction between the health consequences of sedentary behaviour, that is, limiting everyday life non-exercise activity and that of not exercising. Until now, the expression “sedentary behaviour” has misleadingly been used as a synonym for not exercising. Sedentary time should be defined as the muscular inactivity rather than the absence of exercise.

  • 39. Fakhrai-Rad, H
    et al.
    Nikoshkov, A
    Kamel, A
    Fernström, Maria
    Karolinska institutet.
    Zierath, J R
    Norgren, S
    Luthman, H
    Galli, J
    Insulin-degrading enzyme identified as a candidate diabetes susceptibility gene in GK rats.2000In: Human Molecular Genetics, ISSN 0964-6906, E-ISSN 1460-2083, Vol. 9, no 14, p. 2149-58Article in journal (Refereed)
    Abstract [en]

    Genetic analysis of the diabetic GK rat has revealed several diabetes susceptibility loci. Congenic strains have been established for the major diabetes locus, Niddm1, by transfer of GK alleles onto the genome of the normoglycemic F344 rat. Niddm1 was dissected into two subloci, physically separated in the congenic strains Niddm1b and Niddm1i, each with at least one disease susceptibility gene. Here we have mapped Niddm1b to 1 cM by genetic and pathophysiological characterization of new congenic substrains for the locus. The gene encoding insulin-degrading enzyme (IDE:) was located to this 1 cM region, and the two amino acid substitutions (H18R and A890V) identified in the GK allele reduced insulin-degrading activity by 31% in transfected cells. However, when the H18R and A890V variants were studied separately, no effects were observed, demonstrating a synergistic effect of the two variants on insulin degradation. No effect on insulin degradation was observed in cell lysates, indicating that the effect is coupled to receptor-mediated internalization of insulin. Congenic rats with the IDE: GK allele displayed post-prandial hyperglycemia, reduced lipogenesis in fat cells, blunted insulin-stimulated glucose transmembrane uptake and reduced insulin degradation in isolated muscle. Analysis of additional rat strains demonstrated that the dysfunctional IDE: allele was unique to GK. These data point to an important role for IDE: in the diabetic phenotype in GK.

  • 40.
    Fernberg, Ulrika
    et al.
    Örebro University, Örebro, Sweden.
    Op 't Roodt, Jos
    Maastricht University Medical Center, Maastricht, The Netherlands..
    Fernström, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Hurtig-Wennlöf, Anita
    Örebro University, Örebro, Sweden.
    Body composition is a strong predictor of local carotid stiffness in Swedish, young adults - the cross sectional Lifestyle, biomarkers, and atherosclerosis study.2019In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 19, no 1, article id 205Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Obesity has nearly tripled worldwide during the last four decades, especially in young adults, and is of growing concern since it is a risk factor for cardiovascular diseases (CVD). We explored how different body composition measurements are associated with intima media thickness (cIMT) and local stiffness in the common carotid artery, in a subsample of healthy, young women and men, from the Swedish Lifestyle, Biomarkers, and Atherosclerosis (LBA) Study.

    METHODS: From the LBA study, a subsample of 220 randomly selected, self-reported healthy individuals, 18-25 years old, were collected for the automatized local stiffness measurements; arterial distensibility, Young's elastic modulus, and β stiffness index. Blood pressure and mean arterial pressure (MAP) was measured using automatic blood pressure equipment. Body mass index (BMI) was calculated, waist circumference was measured, and percentage of body fat assessed using an impedance body composition analyzer. The carotid artery was scanned by ultrasound and analyzed using B-mode edge wall tracking. cIMT was measured and local stiffness measurements were calculated with carotid blood pressure, measured with applanation tonometry.

    RESULTS: No association was found between cIMT and body composition. Local carotid stiffness was associated with body composition, and women had less stiff arteries than men (p < 0.001). Of the local stiffness measurements, arterial distensibility had the strongest associations with body composition measurements in both women and men (p < 0.05). Multiple regression analyses showed that BMI in women and BMI and percentage of body fat in men had the highest impact on arterial distensibility (p < 0.01 in both women and men).

    CONCLUSIONS: Arterial distensibility was the local stiffness measurement with the strongest associations to different body composition measurements, in both women and men. In this age group, body composition measurements seem to be stronger predictors of common carotid arterial stiffness than MAP, and is a convenient way of detecting young adults who need cardiovascular risk follow-up and lifestyle counseling.

  • 41.
    Fernström, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Hög aerob uthållighet förenat med låg risk för hjärt-kärlsjukdom hos svenska unga vuxna2018In: BestPractice, no SeptArticle in journal (Other academic)
  • 42.
    Fernström, Maria
    et al.
    Örebro University.
    Bakkman, Linda
    Karolinska institutet.
    Loogna, Peter
    Sophiahemmet.
    Rooyackers, Olav
    Karolinska institutet.
    Svensson, Madeleine
    Karolinska institutet.
    Jakobsson, Towe
    Karolinska institutet.
    Brandt, Lena
    Örebro University.
    Lagerros, Ylva Trolle
    Karolinska institutet.
    Improved Muscle Mitochondrial Capacity Following Gastric Bypass Surgery in Obese Subjects.2016In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 26, no 7, p. 1391-7Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Weight loss resulting from low-calorie diets is often less than expected. We hypothesized that energy restriction would influence proton leakage and improve mitochondrial efficiency, leading to reduced energy expenditure, partly explaining the difficulties in weight loss maintenance.

    METHODS: Eleven women with a median BMI of 38.5 kg/m(2) (q-range 37-40), and referred to gastric bypass surgery participated. Before surgery, and at 6 months of follow-up, muscle biopsies were collected from the vastus lateralis muscle. Mitochondria were isolated and analyzed for coupled (state 3) and uncoupled (state 4) respiration and mitochondrial capacity (P/O ratio).

    RESULTS: At follow-up, the participants had a median BMI of 29.6 kg/m(2) (28.3-32.0). State 3 increased from 20.6 (17.9-28.9) to 34.9 nmol O2/min/U citrate synthase (CS) (27.0-49.0), p = 0.01, while state 4 increased from 2.8 (1.8-4.2) to 4.2 nmol O2/min/U CS (3.1-6.1), although not statistically significant. The P/O ratio increased from 2.7 (2.5-2.8) to 3.2 (3.0-3.4), p = 0.02, indicating improved mitochondrial efficiency.

    CONCLUSIONS: Six months after gastric bypass surgery, the mitochondrial capacity for coupled, i.e., ATP-generating, respiration increased, and the P/O ratio improved. Uncoupled respiration was not enhanced to the same extent. This could partly explain the decreased basal metabolism and the reduced inclination for weight loss during energy restriction.

  • 43.
    Fernström, Maria
    et al.
    Örebro University.
    Fernberg, Ulrika
    Örebro University.
    Eliason, Gabriella
    Örebro University.
    Hurtig-Wennlöf, Anita
    Örebro University.
    Aerobic fitness is associated with low cardiovascular disease risk: the impact of lifestyle on early risk factors for atherosclerosis in young healthy Swedish individuals - the Lifestyle, Biomarker, and Atherosclerosis study.2017In: Vascular Health and Risk Management, ISSN 1176-6344, E-ISSN 1178-2048, Vol. 13, p. 91-99Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The progression of cardiovascular disease (CVD) and atherosclerosis is slow and develops over decades. In the cross-sectional Swedish Lifestyle, Biomarker, and Atherosclerosis study, 834 young, self-reported healthy adults aged 18.0-25.9 years have been studied to identify early risk factors for atherosclerosis.

    PURPOSE: The aims of this study were to 1) assess selected cardiometabolic biomarkers, carotid intima-media thickness (cIMT) as a marker of subclinical atherosclerosis, and lifestyle-related indicators (food habits, handgrip strength, and oxygen uptake, VO2 max); 2) analyze the associations between cIMT and lifestyle factors; and 3) identify subjects at risk of CVD using a risk score and to compare the characteristics of subjects with and without risk of CVD.

    METHOD: Blood samples were taken in a fasting state, and food habits were reported through a questionnaire. cIMT was measured by ultrasound, and VO2 max was measured by ergometer bike test. The risk score was calculated according to Wildman.

    RESULT: cIMT (mean ± standard deviation) was 0.50±0.06 mm, and VO2 max values were 37.8±8.5 and 42.9±9.9 mL/kg/min, in women and men, respectively. No correlation was found between aerobic fitness expressed as VO2 max (mL/kg/min) and cIMT. Using Wildman's definition, 12% of the subjects were classified as being at risk of CVD, and 15% had homeostasis model assessment of insulin resistance. A total of 35% of women and 25% of men had lower high-density lipoprotein cholesterol than recommended. Food habits did not differ between those at risk and those not at risk. However, aerobic fitness measured as VO2 max (mL/kg/min) differed; 47% of the subjects at risk had low aerobic fitness compared to 23% of the nonrisk subjects (P<0.001).

    CONCLUSION: High aerobic fitness is associated with low CVD risk in Swedish young adults. The high prevalence of young adults observed with unfavorable levels of high-density lipoprotein cholesterol and homeostasis model assessment of insulin resistance raises concerns about future CVD risk.

  • 44.
    Fernström, Maria
    et al.
    Karolinska institutet.
    Song, Xiao Mei
    Karolinska institutet.
    Galuska, Dana
    Karolinska institutet.
    Fiedler, Maj
    Pharmacia & UpJohn.
    Rincon, Jorge
    Karolinska institutet.
    Ryder, Jeffrey W
    Karolinska institutet.
    Liang, Yin
    Pharmacia & UpJohn.
    Krook, Anna
    Karolinska institutet.
    Zierath, Juleen R
    Karolinska institutet.
    AICAR-treatment improves glucose homeostasis in ob/ob mice2000In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 50, no Suppl 1, p. 396-396Article in journal (Refereed)
  • 45.
    Fiedler, Maj
    et al.
    Pharmacia.
    Liang, Yin
    Pharmacia.
    Song, Xiao Mei
    Karolinska institutet.
    Fernström, Maria
    Karolinska institutet.
    Zierath, Juleen R
    Karolinska institutet.
    Selén, Göran
    Pharmacia.
    Klingström, Gunnel
    Pharmacia.
    Sakariassen, Kjell S
    Pharmacia.
    AICAR (5-aminoimidazole-4-carboxamide ribonucleoside) ameliorates hyperglycemia and hyperinsulinemia in type 2 diabetic mice2000In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 50, no Suppl 1, p. 397-397Article in journal (Refereed)
  • 46. Fridén, Jan
    et al.
    Seger, Jan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Sjöström, Michael
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Adaptive Response in Human Skeletal Muscle Subjected to Prolonged Eccentric Training1983In: International Journal of Sports Medicine, ISSN 0172-4622, E-ISSN 1439-3964, no 4, p. 177-183Article in journal (Refereed)
    Abstract [en]

    The peripheral adaptation process associated with repeating eccentric training over a longer period of time was studied in m. vastus lateralis of eleven healthy males aged 24 +/- 4 years. The maximal dynamic concentric muscle strength was only slightly improved after 8 weeks of training. However, eccentric work capacity was dramatically increased (375%). A maximal eccentric stint immediately after fulfilled 8 weeks of training caused a selective glycogen depletion from the type 28 fibers. An increased number of type 2C fibers was observed. The ultrastructure analysis showed an essentially well-preserved fine structure. Volume density of mitochondria was somewhat higher in all fiber types after training. Z-band widths were not affected by eccentric training. It is concluded that skeletal musculature adapts itself in a functional manner to the extreme tension demands put on them. Improved coordination and reorganization of the contractile apparatus of muscle fibers are the determining mechanisms of this adaptation.

  • 47.
    Fröberg, Åsa
    et al.
    Karolinska Institutet.
    Cisse, Ann-Sophie
    Karolinska Institutet.
    Larsson, Matilda
    KTH Royal Inst Technol.
    Mårtensson, Mattias
    KTH Royal Inst Technol.
    Peolsson, Michael
    Swedish ICT Res Inst, SICS.
    Movin, Tomas
    Karolinska Institutet.
    Arndt, Anton
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control. Karolinska Institutet.
    Altered patterns of displacement within the Achilles tendon following surgical repair2017In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 25, no 6, p. 1857-1865Article in journal (Refereed)
    Abstract [en]

    Ultrasound speckle tracking was used to compare tendon deformation patterns between uninjured and surgically repaired Achilles tendons at 14-27-month follow-up. The hypothesis was that the non-homogenous displacement pattern previously described in uninjured tendons, where displacement within deep layers of the tendons exceeds that of superficial layers, is altered following tendon rupture and subsequent surgical repair. In the first part of this study, an in-house-developed block-matching speckle tracking algorithm was evaluated for assessment of displacement on porcine flexor digitorum tendons. Displacement data from speckle tracking were compared to displacement data from manual tracking. In the second part of the study, eleven patients with previous unilateral surgically treated Achilles tendon rupture were investigated using ultrasound speckle tracking. The difference in superficial and deep tendon displacement was assessed. Displacement patterns in the surgically repaired and uninjured tendons were compared during passive motion (Thompson's squeeze test) and during active ankle dorsiflexion. The difference in peak displacement between superficial and deep layers was significantly (p < 0.01) larger in the uninjured tendons as compared to the surgically repaired tendons both during Thompson's test (-0.7 +/- 0.2 mm compared to -0.1 +/- 0.1 mm) and active dorsiflexion (3.3 +/- 1.1 mm compared to 0.3 +/- 0.2 mm). The evaluation of the speckle tracking algorithm showed correlations of r ae<yen> 0.89 between displacement data acquired from speckle tracking and the reference displacement acquired from manual tracking. Speckle tracking systematically underestimated the magnitude of displacement with coefficients of variation of less than 11.7%. Uninjured Achilles tendons display a non-uniform displacement pattern thought to reflect gliding between fascicles. This pattern was altered after a mean duration of 19 +/- 4 months following surgical repair of the tendon indicating that fascicle sliding is impaired. This may affect modulation of the action between different components of the triceps surae, which in turn may affect force transmission and tendon elasticity resulting in impaired function and risk of re-rupture.

  • 48.
    Gripeteg, Lena
    et al.
    University of Gothenburg.
    Arvidsson, Daniel
    University of Gothenburg.
    Johannesson, Elias
    University of Gothenburg.
    Larsson, Christel
    University of Gothenburg.
    Sjöberg, Agneta
    University of Gothenburg.
    Angerås, Oskar
    University of Gothenburg.
    Fagman, Erika
    University of Gothenburg.
    Brandberg, John
    University of Gothenburg.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Bergström, Göran
    University of Gothenburg.
    Börjesson, Mats
    University of Gothenburg.
    Concomitant Associations of Healthy Food Intake and Cardiorespiratory Fitness With Coronary Artery Calcium.2018In: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 122, no 4, p. 560-564, article id S0002-9149(18)31060-9Article in journal (Refereed)
    Abstract [en]

    Conflicting findings remain regarding associations between lifestyle behaviors and coronary artery calcium (CAC). We investigated concomitant associations of healthy food intake and cardiorespiratory fitness (CRF) with CAC. Data from 706 men and women 50 to 64 years old from the Swedish SCAPIS pilot trial were analyzed. A CAC score was calculated using the Agatston method. A Healthy Food Index (HFI) was established using data from a web-based food frequency questionnaire. CRF was assessed from a bike exercise test. Regression analyses were performed with occurrence of CAC (dichotomous) and level of CAC score in patients with CAC (continuous) as outcomes. 58% had 0 CAC score. HFI was significantly associated with having no CAC (standardized coefficient β = 0.18, p <0.001) but not with level of CAC score (β = -0.09, p = 0.34). CRF showed no significant association with having no CAC (β = -0.08, p = 0.12) or with the level of CAC score (β = -0.04, p = 0.64). However, there was an interaction between HFI and CRF (β = -0.23, p = 0.02); for increasing levels of CRF there was stronger negative association between HFI and level of CAC score, reaching β = -0.48, p = 0.045 for the highest CRF level. In conclusion, these results emphasize the importance of a healthy food intake in combination with higher CRF to counteract CAC development.

  • 49. Haglind, Charlotte
    et al.
    Ask, Sara
    von Döbeln, Ulrika
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Stenlid, Maria
    Nordenström, Anna
    Energy expenditure and lipid metabolism in very long-chain Acyl-CoA dehydrogenase (VLCAD) deficiency2015In: Molecular Genetics and Metabolism (ISSN 1096-7192), 2015, Vol. 114, no 3, p. 333-333Conference paper (Refereed)
  • 50. Hallgren, Mats
    et al.
    Herring, Matthew P
    Owen, Neville
    Dunstan, David
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Helgadottir, Björg
    Nakitanda, Olivia Aya
    Forsell, Yvonne
    Exercise, Physical Activity, and Sedentary Behavior in the Treatment of Depression: Broadening the Scientific Perspectives and Clinical Opportunities.2016In: Frontiers in Psychiatry, ISSN 1664-0640, E-ISSN 1664-0640, Vol. 7, article id 36Article in journal (Refereed)
    Abstract [en]

    Research exploring links between exercise and depression now span several decades, yet several clinically relevant research questions remain unanswered. This opinion article briefly describes the status of selected research issues from the exercise depression literature and offer insights into research areas that are currently lacking. We draw particular attention to the potential of research exploring links between sedentary behavior and depression.

123 1 - 50 of 124
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