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  • 1.
    Andersson, Eva
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    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.
    Hultgren, Staffan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Kraepelien Strid, Eva
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Hälsopedagogprogrammet2014In: Från Kungl. Gymnastiska Centralinstitutet till Gymnastik- och idrottshögskolan: en betraktelse av de senaste 25 åren som del av en 200-årig historia / [ed] Suzanne Lundvall, Stockholm: Gymnastik- och idrottshögskolan, GIH , 2014, p. 108-116Chapter in book (Other (popular science, discussion, etc.))
  • 2.
    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)
  • 3.
    Bendrik, Regina
    et al.
    Centrum för forskning och utveckling Uppsala universitet/Region Gävleborg .
    Kallings, Lena V
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Bröms, Kristina
    Centrum för forskning och utveckling Uppsala universitet/Region Gävleborg .
    Emtner, Margareta
    Uppsala Universitet.
    Maximalt step-up test - ett funktionellt klivtest vid höft- och knäartros2015Conference paper (Refereed)
  • 4.
    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.2018In: Clinical Research in Cardiology, ISSN 1861-0684, E-ISSN 1861-0692Article 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.

  • 5.
    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.

     

  • 6.
    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.

  • 7.
    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 and Mats Börjesson'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 and Mats Börjesson's research group.
    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.
    Promoting physical activity - an established part of the clinical practice?2015In: 23rd International Conference on Health Promoting Hospitals and Health Services: "Person-oriented health promotion in a rapidly changing world:Co-production – continuity – new media & technologies", 2015Conference paper (Refereed)
    Abstract [en]

    Introduction

    Insufficient physical activity is a considerable risk factor for mortality and premature death. The healthcare has a unique role in health promotion as they reach a large part of the population. The evidence based recommendation is that the healthcare sector should offer “counseling with the adjunct of exercise on prescription or a pedometer, as well as special follow-up” to promote patients physical activity. Despite this, physical activity is underutilized in prevention and treatment of disease, for reasons not fully known.

     

     

    Purpose/Method

    We aimed to study the attitudes of different healthcare professionals in the hospital setting, towards the importance of physical activity and its clinical use at different levels.

    The study comprised 264 (78% women) health care professionals at the cardiac department/outpatient cardiac center in Stockholm (response rate 91%). Data was obtained in 2013, by questionnaire. Containing 28 multiple choice questions on participants attitudes towards physical activity behavior change, the perceived importance of such measures, practical implementation and possible barriers for implementation.

     

    Results

    All participants stated importance of physical activity promotion within healthcare. Forty-seven percent reported that they promoted physical activity in clinical practice, however only a minority fulfilled the evidence based recommendations (n=65), as brief advice (n=165) or counseling (n=111) were most common. Sixty-one percent aimed to improve the use of physical activity promotion, factors hampering were inadequate knowledge, follow-up possibilities and length of patient visits. Less than half group reported insufficient routines (46%), goals (37%) and lack of management support (42%).

     

    Conclusion         

    Although health professionals generally are positive towards promoting physical activity, just a small proportion actually use the evidence based methods in clinical practice. To improve the promotion of physical activity in patients there is need for further implementation strategies at all levels to create a well-functioning structure, clear goals and routines. Our study suggests, that implementation should focus at education, logistics for follow-up and increased amount of time with direct patient care. 

     

  • 8.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    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.
    Olsson, Gustav
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Bolan, Kate
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Björn
    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.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Svenskar rör sig för lite2015In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 24, no 2, p. 30-31Article in journal (Other academic)
    Abstract [sv]

    För den som betraktar svenskarna som ett aktivt folk är det dags att tänka om. Bara sju procent av 50-65 åringarna är tillräckligt fysiskt aktiva, visar  resultat från den stora SCAPIS-studien.

  • 9.
    Ekblom, Maria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Nooijen, Carla F J
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Fysisk aktivitet och hjärnhälsa2018In: Fysioterapi, ISSN 1653-5804, no 5, p. 32-35Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Psykisk ohälsa är den vanligaste orsaken till sjukskrivning. Fysisk aktivitet kan förebygga många former av ohälsa, men vilka fysiska aktivitetsmönster som gynnar psykisk hälsa och kognitiva förmågor är fortfarande okänt. Denna typ av forskning är komplex och kräver samarbete med många olika aktörer i samhället.

  • 10.
    Gustavsson, Catharina
    et al.
    Uppsala University, Dalarna University, Mälardalen University.
    Nordqvist, Maria
    Uppsala University, Mälardalen University.
    Bröms, Kristina
    Uppsala University.
    Jerdén, Lars
    Uppsala University, Dalarna University.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Uppsala University.
    Wallin, Lars
    Dalarna University, Karolinska Institutet, University of Gothenburg.
    What is required to facilitate implementation of Swedish physical activity on prescription? - interview study with primary healthcare staff and management.2018In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, no 1, article id 196Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The method, Swedish Physical Activity on Prescription (SPAP), has been launched in Swedish healthcare to promote physical activity for prevention and treatment of lifestyle related health disorders. Despite scientific support for the method, and education campaigns, it is used to a limited extent by health professionals. The aim of the study was to describe the views of health professionals on perceived facilitators, barriers and requirements for successful implementation of SPAP in primary healthcare.

    METHODS: Eighteen semi-structured interviews with stakeholders in SPAP, i.e. ten people working in local or central management and eight primary healthcare professionals in two regional healthcare organisations, were analysed using qualitative content analysis.

    RESULTS: We identified an overarching theme regarding requirements for successful implementation of SPAP: Need for knowledge and organisational support, comprising four main categories: Need for increased knowledge and affirmative attitude among health professionals; Need for clear and supportive management; Need for central supporting structures; Need for local supporting structures. Knowledge of the SPAP method content and core components was limited. Confidence in the method varied among health professionals. There was a discrepancy between the central organisation policy documents declaring that disease preventive methods were prioritised and a mandatory assignment, while the health professionals asked for increased interest, support and resources from management, primarily time and supporting structures. There were somewhat conflicting views between primary healthcare professionals and managers concerning perceived barriers and requirements. In contrast to some of the management's beliefs, all primary healthcare professionals undisputedly acknowledged the importance of promoting physical activity, but they lacked time, written routines and in some cases competence for SPAP counselling.

    CONCLUSION: The study provides knowledge regarding requirements to facilitate the implementation of SPAP in healthcare. There was limited knowledge among health professionals regarding core components of SPAP and how to practise the method, which speaks for in-depth training in the SPAP method. The findings highlight the importance of forming policies and guidelines and establishing organisational supporting structures, and ensuring that these are well known and approved in all parts of the healthcare organisation.

  • 11.
    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.
    Hur ska vi fråga om fysisk aktivitet?2016In: Idrottsmedicin, ISSN 2001-3302, Vol. 35, no 3, p. 20-23Article in journal (Other academic)
  • 12.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Metoder för att reducera ett stillasittande beteende2013In: Långvarigt stillasittande: en hälsofara i tiden / [ed] Elin Ekblom Bak, Studentlitteratur, 2013, p. 113-130Chapter in book (Other academic)
  • 13.
    Kallings, Lena V
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Att främja fysisk aktivitet – riktlinjer och FaR.2012Conference paper (Other academic)
  • 14.
    Kallings, Lena V
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    FaR® - Individanpassad skriftlig ordination av fysisk aktivitet.2012Conference paper (Other academic)
  • 15.
    Kallings, Lena V
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    FaR® - Individanpassad skriftlig ordination av fysisk aktivitet.2012Conference paper (Other academic)
  • 16.
    Kallings, Lena V
    Statens folkhälsoinstitut.
    FaR® -Individanpassad skriftlig ordination av fysisk aktivitet.2011Book (Other academic)
    Abstract [sv]

    Fysisk aktivitet på recept (FaR) är en metod för att främja fysisk aktivitet som utgår från hälso- och sjukvården. Detta är den första läroboken i ämnet och bokens syfte är att ge en samlad bild av FaR. Den samlade kunskapen syftar även till att stödja och underlätta implementering av metoden FaR. Läroboken har en bred målgrupp; studenter på hälso- och sjukvårdsutbildningar, utbildningar inom folkhälsovetenskap, hälsopedagogik, idrottslärare med flera. Boken vänder sig också till yrkesverksamma såsom hälso- och sjukvårdspersonal som förskriver FaR eller arbetar med implementering av metoden, aktivitetsarrangörer som stöttar individen till fysisk aktivitet och folkhälsoplanerare som arbetar med strukturerna för att implementera FaR. Givetvis vänder sig boken även till kursansvariga och lärare på relevanta utbildningar och kurser.

  • 17.
    Kallings, Lena V
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Fysisk aktivitet på recept – en underutnyttjad resurs2012In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 109, no 51-52, p. 2348-50Article in journal (Refereed)
    Abstract [sv]

    Fysik aktivitet på recept (FaR) är en effektiv metod för att främja fysisk aktivitet. FaR inkluderar rådgivande samtal, skriftlig ordination och uppföljning, vilket rekommenderas i Socialstyrelsens nya riktlinjer för sjukdomsförebyggande metoder.

    Drygt 49 000 FaR skrevs ut i Sverige under 2010 – en tredubbling sedan 2007.

    I genomsnitt förskrevs ca 5 FaR per 1 000 invånare, med en variation på 2–15 FaR per 1 000 invånare i olika landsting och regioner.

    Det förskrevs 0,8 (0,5–2) FaR per 1 000 besök inom hälso- och sjukvården, eller motsvarande 1,2 (0,5–3) FaR per 1 000 besök inom primärvården.

    Variationerna är stora mellan olika landsting/regioner, och FaR är en underutnyttjad resurs som behöver implementeras bättre.

  • 18.
    Kallings, Lena V
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Fysisk aktivitet på recept FaR till äldre.2013Conference paper (Other academic)
  • 19.
    Kallings, Lena V
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Senaste nytt om FaR (Fysisk aktivitet på recept). Utvärderade enkätfrågor om fysisk aktivitet och stillasittande2016Conference paper (Other academic)
  • 20.
    Kallings, Lena V
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    The organisation of promoting physical activity in health care – examples from the Nordic countries.2016In: Clinical Health Promotion - research and best practice for patients, staff and community., ISSN 2226-5864, Vol. 6, no Suppl 2, p. 27-30Article in journal (Other academic)
  • 21.
    Kallings, Lena V
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    The Swedish approach on physical activity on prescription2016In: Clinical Health Promotion - research and best practice for patients, staff and community, ISSN 2226-5864, Vol. 6, no Suppl 2, p. 31-33Article in journal (Other academic)
  • 22.
    Kallings, Lena V
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    The Swedish PAP Physical activity on prescription (FaR®).2015Conference paper (Other academic)
  • 23.
    Kallings, Lena V
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    What have we achieved? – clinical examples - The Swedish experience of Physical Activity on Prescription.2013Conference paper (Other academic)
  • 24.
    Kallings, Lena V
    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.
    Hellénius, M-L
    Karolinska Institutet.
    Physical activity on prescription reduces sedentary behaviour for 6 months, without long term effect2014Conference paper (Refereed)
    Abstract [en]

    Objectives

    There is a lack of knowledge regarding methods to reduce sedentary behaviour. The aim of this study was to evaluate the efficacy of physical activity on prescription (PAP) in patients with overweight and abdominal obesity. PAP decrease sitting time at 6-months follow-up in this population, and data is now further analysed to study the longterm effect.

    Methods

    Six month randomised controlled study in 101 women and men (57% female, 67-68 year). All participants received a minimal intervention with brief general information on physical activity and measurement of PAL. The intervention group received in addition an individualized PAP that consisted of a patient centred counselling and a written agreement. Focus of the intervention was to reduce sedentary behaviour as well as to promote an increased PAL. Sedentary behaviour was assessed by questionnaire, the sitting item from IPAQ.

    Results

    Both groups reduced sitting time from baseline to 6-months follow-up, intervention group by 114 min/day and control group by 86 min/day. However, the changes disappeared at the long term follow-ups (Figure). There were no significant differences between the groups at either time point.

    Conclusions

    It is possible to reduce sitting time in overweight individuals. An individualized prescription of physical activity reduces sedentary behaviour for 6 months, but had no long term effects. There was no significant better effect of PAP compared to a minimal intervention. Studies with more subjects and objective methods are needed.

  • 25.
    Kallings, Lena V
    et al.
    Karolinska institutet.
    Leijon, M
    Hellénius, M-L
    Ståhle, A
    Physical activity on prescription in primary health care: a follow-up of physical activity level and quality of life.2008In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 18, no 2, p. 154-161Article in journal (Refereed)
    Abstract [en]

    To examine whether physical activity on prescription in routine primary care patients would influence physical activity level and quality of life 6 months later. In 2001-2003, 13 Swedish primary health care units took part in an uncontrolled clinical study. If a patient in primary health care needed physical activity preventively or for treatment of a disease and patient-centered motivational counseling found physical activity to be suitable, individualized physical activity could be prescribed. Patients (n=481) of both sexes and all ages [75% women, mean age 50 (12-81)] participated in the study. Self-reported physical activity, readiness to change to a more physically active lifestyle and quality-of-life data were collected through questionnaires. The follow-up rate was 62% at 6 months. Intention-to-treat analysis showed a significant increase (P<0.01) in self-reported physical activity level, the stages of action and maintenance of physical activity as well as quality of life. Physical activity level, stages of change and quality of life increased analogically, indicating that physical activity on prescription may be suitable as a conventional treatment in an ordinary primary health care setting to promote a more physically active lifestyle.

  • 26.
    Kallings, Lena V
    et al.
    Karolinska institutet.
    Sierra Johnson, Justo
    Fisher, Rachel M
    Faire, Ulf de
    Ståhle, Agneta
    Hemmingsson, Erik
    Karolinska institutet.
    Hellénius, Mai-Lis
    Beneficial effects of individualized physical activity on prescription on body composition and cardiometabolic risk factors: results from a randomized controlled trial.2009In: European Journal of Cardiovascular Prevention & Rehabilitation, ISSN 1741-8267, E-ISSN 1741-8275, Vol. 16, no 1, p. 80-4Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Insufficient physical activity (PA), overweight and abdominal obesity are increasing global public health problems.

    DESIGN: Randomized controlled 6-month intervention study.

    METHODS: One hundred and one 68-year-old individuals (57% female) with low PA, overweight (BMI 25-40 kg/m) and abdominal obesity (waist circumference >88 cm in women and >102 cm in men), were randomized to PA on prescription (PAP) or a minimal intervention. PA measured by several methods, anthropometric parameters, body composition and cardiometabolic risk factors were measured at baseline and after intervention.

    RESULTS: Favourable changes in anthropometrics, body composition, S-glucose, glycosolated haemoglobin (HbA1c), blood lipids and apolipoproteins were seen in the PAP group. In the control group, however, some positive changes were also noted. Bodyweight, neck circumference, fat mass, S-cholesterol and HbA1c decreased significantly more in the PAP group.

    CONCLUSION: Individualized PAP improves body composition and cardiometabolic risk factors in sedentary older overweight individuals. PAP might be useful in clinical practice to counteract the epidemic of sedentary lifestyle and concomitant cardiometabolic disorders.

  • 27.
    Kallings, Lena V
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Sundberg, Carl Johan
    Karolinska institutet.
    Eriksson, Margareta
    Luleå tekniska universitet.
    FaR - patientcentrerad metod som främjar fysisk aktivitet2015In: Svensk Idrottsmedicin, ISSN 1103-7652, Vol. 34, no 2, p. 7-10Article in journal (Other academic)
  • 28. Leijon, M.
    et al.
    Kallings, Lena
    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.
    Faskunger, J.
    Lärum, G.
    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.
    Ståhle, A.
    Thúc đẩy hoạt động thể lực Chương 4. [Promoting physical activity. Chapter 4].2012In: HOạT ĐộNG THể LựC TRONG PHÒNG VÀ ĐIềU TRị BệNH. [Professional associations for physical activity YFA. Physical Activity in the Prevention and Treatment of Disease (In Vietnamese)]., Nhà xuất bản Y học Hà Nội, năm , 2012, p. 93-114Chapter in book (Other academic)
  • 29.
    Nooijen, Carla F J
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences. Karolinska Institutet.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group. Karolinska Institutet.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Forsell, Yvonne
    Karolinska Institutet.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control. Karolinska Institutet.
    Common Perceived Barriers and Facilitators for Reducing Sedentary Behaviour among Office Workers.2018In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 4, article id E792Article in journal (Refereed)
    Abstract [en]

    Qualitative studies identified barriers and facilitators associated with work-related sedentary behaviour. The objective of this study was to determine common perceived barriers and facilitators among office workers, assess subgroup differences, and describe sedentary behaviour. From two Swedish companies, 547 office workers (41 years (IQR = 35–48), 65% women, 66% highly educated) completed questionnaires on perceived barriers and facilitators, for which subgroup differences in age, gender, education, and workplace sedentary behaviour were assessed. Sedentary behaviour was measured using inclinometers (n = 311). The most frequently reported barrier was sitting is a habit (67%), which was reported more among women than men (X2 = 5.14, p = 0.03) and more among highly sedentary office workers (X2 = 9.26, p < 0.01). The two other most reported barriers were that standing is uncomfortable (29%) and standing is tiring (24%). Facilitators with the most support were the introduction of either standing- or walking-meetings (respectively 33% and 29%) and more possibilities or reminders for breaks (31%). The proportion spent sedentary was 64% at the workplace, 61% on working days, and 57% on non-working days. This study provides a detailed understanding of office workers’ ideas about sitting and means to reduce sitting. We advise to include the supported facilitators and individualized support in interventions to work towards more effective strategies to reduce sedentary behaviour.

  • 30.
    Olsson, Sven Johan Gustav
    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.
    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.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Hemmingsson, Erik
    Karolinska Institutet.
    Hellénius, Mai-Lis
    Karolinska Institutet.
    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.
    Effects of the Swedish physical activity on prescription model on health-related quality of life in overweight older adults: a randomised controlled trial2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 687Article in journal (Refereed)
    Abstract [en]

    Background

    The effects of physical activity on prescription (PAP) on health-related quality of life (HRQoL) in overweight adults are unclear. We therefore aimed to explore the effects of the Swedish PAP model on HRQoL in overweight older adults.

    Methods

    Participants were recruited from a cohort of men and women born between 1937 and 1938, and living in Stockholm County. Inclusion criteria were; insufficiently physically active, i.e. <30 min of at least moderate intensity physical activity (PA) per day; body mass index >25 kg/m 2 ; and waist circumference ≥102 cm (men) or ≥88 cm (women). Altogether, 101 individuals, aged 67 years, were randomly assigned to two parallel groups: intervention group (n = 47) receiving individualised PAP or control group (n = 54). The 36-item Short Form Health Survey (SF-36) was administered before and after the six months intervention. Main outcomes were the SF-36 physical component summary (PCS) and mental component summary (MCS) scores. Intention to treat analysis was utilised. Regression analysis was performed to assess whether changes in PA and body weight affected changes in HRQoL.

    Results

    At the six months follow-up, regarding the MCS score, the intervention group had improved significantly more (median: 4.4 [interquartile range (IQR): −2.4 to 23.3]) vs (median: 0.0 [IQR: −4.0 to 4.9]); p < 0.05) and a higher proportion of participants had attained relevant improvements (OR 2.43 (95 % CI 1.00–5.88) p < 0.05) compared to the controls. A within group improvement in the PCS score (median: 3.8 [IQR: −1.9 to 19.5] p < 0.05) was found in the intervention group. Changes in PA and body weight had a small, but significant, mediating effect on the changes in HRQoL.

    Conclusions

    PAP had a positive effect on HRQoL, measured by the SF-36 MCS, but no significant between group effect was seen on the PCS in overweight older adults. These effects were, to some extent, mediated by changes in PA and body weight. Our findings support clinical use of the Swedish PAP model.

    Trial registration

    ClinicalTrials.gov NCT02320760.

  • 31.
    Olsson, Sven Johan Gustav
    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.
    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.
    Andersson, Eva
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    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. Department of Medicine, Unit of Cardiology, Karolinska University Hospital, Solna.
    Kallings, Lena
    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.
    Categorical answer modes provides superior validity to open answers when asking for level of physical activity: A cross-sectional study2016In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 1, p. 70-76, article id 1403494815602830Article in journal (Refereed)
    Abstract [en]

    AIMS:

    Physical activity (PA) used as prevention and treatment of disease has created a need for effective tools for measuring patients' PA level. Our aim was therefore to assess the validity of two PA questions and their three associated answer modes.

    METHODS:

    Data on PA according to the PA questions and Actigraph GT3X+ accelerometers, aerobic fitness (VO2max), cardiovascular biomarkers, and self-rated general health were collected in 365 Swedish adults (21-66 years). The PA questions ask about weekly PA via categories (Categorical), an open-ended answer (Open), or specified day by day (Table).

    RESULTS:

    The Categorical mode, compared with the Open mode, correlated (Spearman's rho) significantly more strongly (p<0.05) with accelerometer PA (0.31 vs. 0.18) and VO2max (0.27 vs. 0.06), and the level of BMI (-0.20 vs. -0.02), waist circumference (-0.22 vs. -0.03), diastolic blood pressure (-0.16 vs. 0.08), glucose (-0.18 vs. 0.04), triglycerides (-0.31 vs. -0.07), and general health (0.35 vs. 0.19). The validity of the Categorical and Table modes were similar regarding VO2max and accelerometry, but the Categorical mode exhibited more significant and stronger correlations with cardiovascular biomarkers. The capacity of the PA questions to identify insufficiently physically active individuals ranged from 0.57 to 0.76 for sensitivity and from 0.47 to 0.79 for specificity.

    CONCLUSIONS:

    The Categorical mode exhibits the strongest validity and Open mode the weakest. The PA questions may be used on a population level, or as a tool for determining patents' appropriateness for treatment.

  • 32.
    Olsson, Sven Johan Gustav
    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-Bak, Elin
    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, Björn
    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 V
    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.
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Göteborg University.
    Association of perceived physical health and physical fitness in two Swedish national samples from 1990 and 2015.2018In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 28, no 2, p. 717-724Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Perceived health and physical fitness have been shown to correlate, and low levels of either variable increase the risk for future illness and mortality. However, risk factors and their interrelationship may vary between societies and over time. In this study, the associations of physical fitness and perceived health were therefore assessed in two Swedish national samples 25 years apart.

    METHODS: Perceived physical health, dichotomized as "good" or "bad", maximal oxygen uptake (VO2 max), counter movement jump (CMJ), balance (one-legged 60 second stance), and self-reported demographics and lifestyle were recorded in two cross-sectional samples (sample size, number of eligible participants) of Swedish adults, aged 20 - 65 years, in 1990 - 1991 (2203, 1365), and 2013 - 2015 (3357, 422).

    RESULTS: The odds for good perceived physical health increased by 5% per mL · kg(-1) · min(-1) of VO2 max, 3% per cm CMJ height, and decreased by 4% per 1 time of overbalancing, in both samples. Mutually adjusted regression models showed that perceived physical health was best predicted by VO2 max and chronic illness in 1990 and by age, BMI, and educational level in 2015.

    CONCLUSION: Perceived physical health was related to physical fitness in two samples of Swedish adults from 1990 and 2015. However, multivariate, and mutually adjusted models, indicate that the most important covariates of perceived physical health may have changed from VO2 max and chronic illness in 1990, to age, BMI, and educational level in 2015. This article is protected by copyright. All rights reserved.

  • 33. Sjögren, Per
    et al.
    Fisher, Rachel
    Kallings, Lena
    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.
    Svenson, Ulrika
    Roos, Göran
    Hellénius, Mai-Lis
    Stand up for health-avoiding sedentary behaviour might lengthen your telomeres: secondary outcomes from a physical activity RCT in older people.2014In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 48, no 19, p. 1407-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Telomere length has been associated with a healthy lifestyle and longevity. However, the effect of increased physical activity on telomere length is still unknown. Therefore, the aim was to study the relationship between changes in physical activity level and sedentary behaviour and changes in telomere length.

    METHODS: Telomere length was measured in blood cells 6 months apart in 49, 68-year-old, sedentary, overweight individuals taking part in a randomised controlled physical activity intervention trial. The intervention group received individualised physical activity on prescription. Physical activity was measured with a 7-day diary, questionnaires and a pedometer. Sitting time was measured with the short version of The International Physical Activity Questionnaire.

    RESULTS: Time spent exercising as well as steps per day increased significantly in the intervention group. Reported sitting time decreased in both groups. No significant associations between changes in steps per day and changes in telomere length were noted. In the intervention group, there was a negative correlation between changes in time spent exercising and changes in telomere length (rho=-0.39, p=0.07). On the other hand, in the intervention group, telomere lengthening was significantly associated with reduced sitting time (rho=-0.68, p=0.02).

    CONCLUSIONS: Reduced sitting time was associated with telomere lengthening in blood cells in sedentary, overweight 68-year-old individuals participating in a 6-month physical activity intervention trial.

  • 34. Sjögren, Per
    et al.
    Sierra-Johnson, Justo
    Kallings, Lena V
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Cederholm, Tommy
    Kolak, Maria
    Halldin, Mats
    Brismar, Kerstin
    de Faire, Ulf
    Hellénius, Mai-Lis
    Fisher, Rachel M
    Functional changes in adipose tissue in a randomised controlled trial of physical activity.2012In: Lipids in Health and Disease, ISSN 1476-511X, E-ISSN 1476-511X, Vol. 11, p. 80-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A sedentary lifestyle predisposes to cardiometabolic diseases. Lifestyle changes such as increased physical activity improve a range of cardiometabolic risk factors. The objective of this study was to examine whether functional changes in adipose tissue were related to these improvements.

    METHODS: Seventy-three sedentary, overweight (mean BMI 29.9 ± 3.2 kg/m2) and abdominally obese, but otherwise healthy men and women (67.6 ± 0.5 years) from a randomised controlled trial of physical activity on prescription over a 6-month period were included (control n = 43, intervention n = 30). Detailed examinations were carried out at baseline and at follow-up, including fasting blood samples, a comprehensive questionnaire and subcutaneous adipose tissue biopsies for fatty acid composition analysis (n = 73) and quantification of mRNA expression levels of 13 candidate genes (n = 51), including adiponectin, leptin and inflammatory cytokines.

    RESULTS: At follow-up, the intervention group had a greater increase in exercise time (+137 min/week) and a greater decrease in body fat mass (-1.5 kg) compared to the control subjects (changes of 0 min/week and -0.5 kg respectively). Circulating concentrations of adiponectin were unchanged, but those of leptin decreased significantly more in the intervention group (-1.8 vs -1.1 ng/mL for intervention vs control, P < 0.05). The w6-polyunsaturated fatty acid content, in particular linoleic acid (18:2w6), of adipose tissue increased significantly more in the intervention group, but the magnitude of the change was small (+0.17 vs +0.02 percentage points for intervention vs control, P < 0.05). Surprisingly leptin mRNA levels in adipose tissue increased in the intervention group (+107% intervention vs -20% control, P < 0.05), but changes in expression of the remaining genes did not differ between the groups.

    CONCLUSIONS: After a 6-month period of increased physical activity in overweight elderly individuals, circulating leptin concentrations decreased despite increased levels of leptin mRNA in adipose tissue. Otherwise, only minor changes occurred in adipose tissue, although several improvements in metabolic parameters accompanied the modest increase in physical activity.

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