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  • 1. Forsell, Yvonne
    et al.
    Hallgren, Mats
    Mattson, Maria
    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.
    Lavebratt, Catharina
    FitForLife: study protocol for a randomized controlled trial.2015In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 16, no 1, article id 553Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Psychosis is a serious mental illness that typically emerges during early adulthood. The disorder is characterized by inactivity, cognitive deficits and the need for ongoing support. Regular exercise has mood enhancing and anxiolytic effects that could benefit this patient group. To date, few studies have examined the effects of prescribed exercise on autonomy, health and cognitive functioning in psychosis.

    METHODS/DESIGN: This is a single-center, randomized controlled trial (RCT) with a 3-month follow-up. Usual care plus a 12-week supervised exercise program will be compared to usual outpatient care alone. The primary outcome will be patient autonomy measured by the Camberwell Assessment of Need (CAN) schedule - clinician rated. Secondary outcomes include cardiovascular risk factors, cognitive functioning, substance abuse, body awareness, depression and mood state. Changes in inflammatory markers and microbiotica will be explored. The feasibility of using patients as exercise trainers will also be assessed.

    DISCUSSION: The treatment potential for exercise in psychosis is large because most individuals with the disorder are young and inactive. The study is one of the first to comprehensively assess the effects of regular exercise in young adults with psychosis. Sessions will be closely supervised and adjusted to meet patient needs. Both the feasibility and treatment effects of exercise interventions in psychosis will be discussed.

    TRIAL REGISTRATION: German Clinical Trials Register DRKS00008991 7 August 2015.

  • 2.
    Hallgren, Mats
    et al.
    Karolinska institutet.
    Andersson, Victoria
    Center for Psychiatric Research, Stockholm.
    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.
    Andréasson, Sven
    Karolinska institutet.
    Physical activity as treatment for alcohol use disorders (FitForChange): study protocol for a randomized controlled trial.2018In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 19, no 1, article id 106Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Help-seeking for alcohol use disorders (AUDs) is low and traditional treatments are often perceived as stigmatizing. Physical activity has positive effects on mental and physical health which could benefit this population. We propose to compare the effects of aerobic training, yoga, and usual care for AUDs in physically inactive Swedish adults.

    METHODS: This is a three-group, parallel, single-blind, randomized controlled trial (RCT). In total, 210 adults (aged 18-75 years) diagnosed with an AUD will be invited to participate in a 12-week intervention. The primary study outcome is alcohol consumption measure by the Timeline Follow-back method and the Alcohol Use Disorders Identification Test (AUDIT). Secondary outcomes include: depression, anxiety, perceived stress, sleep quality, physical activity levels, fitness, self-efficacy, health-related quality of life, and cognition. Blood samples will be taken to objectively assess heavy drinking, and saliva to measure cortisol. Acute effects of exercise on the urge to drink alcohol, mood, and anxiety will also be assessed.

    DISCUSSION: The treatment potential for exercise in AUDs is substantial as many individuals with the disorder are physically inactive and have comorbid health problems. The study is the first to assess the effects of physical activity as a stand-alone treatment for AUDs. Considerable attention will be given to optimizing exercise adherence. Both the feasibility and treatment effects of exercise interventions in AUDs will be discussed. The Ethical Review Board (EPN) at Karolinska Institutet has approved the study (DNR: 2017/1380-3).

    TRIAL REGISTRATION: German Clinical Trials Register, ID: DRKS00012311. Registered on 26 September 2017.

  • 3.
    Stavestrand, Silje Haukenes
    et al.
    University of Bergen, Norway.
    Sirevåg, Kristine
    University of Bergen, Norway.
    Nordhus, Inger Hilde
    University of Bergen, Norway.
    Sjøbø, Trond
    Solli DPS, Nesttun, Norway.
    Endal, Trygve Bruun
    Solli DPS, Nesttun, Norway.
    Nordahl, Hans M
    Norwegian University of Science and Technology, Trondheim, Norway..
    Specht, Karsten
    University of Bergen, Norway.
    Hammar, Åsa
    University of Bergen, Norway.
    Halmøy, Anne
    University of Bergen, Norway.
    Martinsen, Egil W
    University of Oslo, Norway.
    Andersson, Eva
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Hjelmervik, Helene
    University of Bergen, Norway.
    Mohlman, Jan
    William Paterson University, NJ, USA.
    Thayer, Julian F
    Ohio State University, OH, USA.
    Hovland, Anders
    University of Bergen, Norway.
    Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): study protocol for a randomized controlled trial.2019In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 20, no 1, article id 174Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Generalised anxiety disorder (GAD) is a frequent and severe anxiety disorder among older adults. GAD increases the risk of developing other disorders such as depression and coronary heart disease. Older adults with GAD exhibit a poorer response to cognitive behaviour therapy (CBT) compared to younger patients with GAD. The normal age-related cognitive decline can be a contributor to reduced treatment efficacy. One strategy for improving treatment efficacy is to combine CBT with adjunctive interventions targeted at improving cognitive functions. Physical exercise is a viable intervention in this regard. Increased levels of brain-derived neurotrophic factor may mediate improvement in cognitive function. The present study aims to investigate the proposed effects and mechanisms related to concomitant physical exercise.

    METHODS: The sample comprises 70 participants aged 60-75 years, who have GAD. Exclusion criteria comprise substance abuse and unstable medication; inability to participate in physical exercise; and conditions which precludes GAD as primary diagnosis. The interventions are individual treatment in the outpatient clinic at the local psychiatric hospital, with two experimental arms: (1) CBT + physical exercise and (2) CBT + telephone calls. The primary outcome measure is symptom reduction on the Penn State Worry Questionnaire. Other measures include questionnaires, clinical interviews, physiological, biological and neuropsychological tests. A subset of 40 participants will undergo magnetic resonance imaging (MRI). After inclusion, participants undergo baseline testing, and are subsequently randomized to a treatment condition. Participants attend five sessions of the add-on treatment in the pre-treatment phase, and move on to interim testing. After interim testing, participants attend 10 sessions of CBT in parallel with continued add-on treatment. Participants are tested post-intervention within 2 weeks of completing treatment, with follow-up testing 6 and 12 months later.

    DISCUSSION: This study aims to develop better treatment for GAD in older adults. Enhancing treatment response will be valuable from both individual and societal perspectives, especially taking the aging of the general population into account.

    TRIAL REGISTRATION: ClinicalTrials.gov, NCT02690441 . Registered on 24 February 2016.

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