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  • 1.
    Björkman, Frida
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Bohman, Tony
    Ekblom-Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    The ability of a submaximal cycle ergometer test to detect changes in VO2maxManuskript (preprint) (Övrigt vetenskapligt)
  • 2.
    Björkman, Frida
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Edin, Fredrik
    University of Gothenburg.
    Mattsson, C Mikael
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Larsen, Filip
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Regular moist snuff dipping does not affect endurance exercise performance.2017Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, nr 7, artikel-id e0181228Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Physiological and medical effects of snuff have previously been obtained either in cross-sectional studies or after snuff administration to non-tobacco users. The effects of snuff cessation after several years of daily use are unknown. 24 participants with >2 years of daily snuff-use were tested before and after >6 weeks snuff cessation (SCG). A control group (CO) of 11 snuff users kept their normal habits. Resting heart rate (HR) and blood pressure (BP) were significantly lower in SCG after snuff cessation, and body mass was increased by 1.4 ± 1.7 kg. Total cholesterol increased from 4.12 ± 0.54 (95% CI 3.89-4.35) to 4.46 ± 0.70 (95% CI 4.16-4.75) mM L-1 in SCG, due to increased LDL, and this change was significantly different from CO. Resting values of HDL, C-reactive protein, and free fatty acids (FFA) remained unchanged in both groups. In SCG group, both HR and BP were reduced during a four-stage incremental cycling test (from 50 to 80% of VO2max) and a prolonged cycling test (60 min at 50% of VO2max). Oxygen uptake (VO2), respiratory exchange ratio, blood lactate (bLa) and blood glucose (bGlu) concentration, and rate of perceived exertion (RPE) were unchanged. In CO group, all measurements were unchanged. During the prolonged cycling test, FFA was reduced, but with no significant difference between groups. During the maximal treadmill running test peak values of VO2, pulmonary ventilation (VE), time to exhaustion and bLa were unchanged in both groups. In conclusion, endurance exercise performance (VO2max and maximal endurance time) does not seem to be affected by prolonged snuff use, while effects on cardiovascular risk factors are contradictory. HR and BP during rest and submaximal exercise are reduced after cessation of regular use of snuff. Evidently, the long-time adrenergic stress on circulation is reversible.

  • 3.
    Björkman, Frida
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Edin, Fredrik
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Mattsson, C. Mikael
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Larsen, Filip
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Regular oral moist snuff dipping does not impair physical performanceArtikel i tidskrift (Refereegranskat)
  • 4.
    Björkman, Frida
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Eggers, Andrea
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Stenman, Adam
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Bohman, Tony
    Karolinska institutet.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Sex and maturity status affected the validity of a submaximal cycle test in adolescents.2018Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, nr 1, s. 126-133Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: This study assessed the validity and reliability of the Ekblom-Bak (EB) submaximal cycle test in adolescents and identified any sex- or maturity-related factors for prediction errors.

    METHODS: We recruited 50 healthy subjects through a public announcement in Stockholm, Sweden, in 2016. The 27 boys and 23 girls were aged 10-15 years and in Tanner stages I-IV. They performed an EB test and incremental treadmill running test for direct measurement of maximal oxygen uptake (VO2 max).

    RESULTS: The estimation error of VO2 max was 0.09 L/min. The correlation (r) was 0.86, and the standard error of the estimate (SEE) was 0.29 L/min. The largest overestimation was seen in prepubertal boys (0.49 L/min). The best precision of the EB test was achieved when boys in Tanner stages I and II were re-calculated using the prediction equation developed for adult women. This yielded a mean difference of -0.05 L/min, r = 0.92 and SEE 0.23 L/min, in the entire sample. The prediction error was lowered in boys, but not girls, with increasing pubertal maturity.

    CONCLUSION: The EB test was reasonably valid in adolescents, seemed to be related to sex and maturity status, and our findings support its use.

  • 5.
    Björkman, Frida
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Ekblom-Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Validity of the revised Ekblom Bak cycle ergometer test in adults.2016Ingår i: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 116, nr 9, s. 1627-1638Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To further develop the Ekblom Bak-test prediction equation for estimation of VO2max from submaximal cycle ergometry.

    METHODS: The model group (117 men and 100 women, aged 48.3 ± 15.7 and 46.1 ± 16.8 years, VO2max 46.6 ± 11.1 and 40.4 ± 9.6 mL kg(-1) min(-1), respectively) and the cross-validation group (60 men and 55 women, aged 40.6 ± 17.1 and 41.6 ± 16.7 years, VO2max 49.0 ± 12.1 and 43.2 ± 8.9 mL min(-1) kg(-1), respectively) performed 4 min of cycling on a standard work rate (30 W) directly followed by 4 min on a higher work rate. Heart rate (HR) at each work rate was recorded. Thereafter, participants completed a graded maximal treadmill test for direct measurement of oxygen uptake. The new prediction equation was cross-validated and accuracy compared with the original Ekblom Bak equation as well as by the Åstrand test method.

    RESULTS: The final sex-specific regression models included age, change in HR per-unit change in power (ΔHR/ΔPO), the difference in work rates (ΔPO), and HR at standard work rate as independent variables. The adjusted R (2) for the final models were 0.86 in men and 0.83 in women. The coefficient of variation (CV) was 8.7 % and SEE 0.28 L min(-1). The corresponding CV and SEE values for the EB-test2012 and the Åstrand tests were 10.9 and 18.1 % and 0.35 and 0.48 L min(-1), respectively.

    CONCLUSION: The new EB-test prediction equation provides an easy administered and valid estimation of VO2max for a wide variety of ages (20-86 years) and fitness levels (19-76 mL kg(-1) min(-1)).

  • 6.
    Björkman, Frida
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Holm, Karin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Fysisk status hos pojkar med typ 1 diabetes2008Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats
    Abstract [sv]

    Sammanfattning

    Syftet med studien var att kartlägga fysisk status hos pojkar med typ 1 diabetes. Resultaten jämfördes mot en kontrollgrupp bestående av friska pojkar som har genomfört samma tester i tidigare forskningsstudier. För att uppfylla syftet användes följande frågeställningar:

    1. Hur förhåller sig BMI mellan pojkar med typ 1 diabetes och friska pojkar?

    2. Hur förhåller sig graden av fysisk aktivitet mellan pojkar med typ 1 diabetes och friska pojkar?

    3. Hur förhåller sig konditionsvärde (VO2max), gripstyrka och balans mellan pojkar med typ 1 diabetes och friska pojkar?

    Metod

    Försökspersonerna rekryterades i samarbete med Astrid Lindgrens Barnsjukhus. Längd, vikt, VO2max, gripstyrka, balans och mätning av aktivitetsgrad med accelerometer var data som samlades in hos fem pojkar med typ 1 diabetes. Deras resultat jämfördes sedan mot friska pojkars resultat. Jämförelsedata hämtades från tidigare genomförda studier där samma tester hade utförts. Insamlad data presenteras i form av z-värden.

    Resultat

    Två försökspersoners testresultat avvek mer än marginellt från medelvärdet hos friska pojkars resultat. De två som avvek från medelvärdet presterade i det ena fallet sämre i några av testerna och i det andra fallet var prestationen sämre i samtliga tester. Endast två av försökspersonerna fick en fullständig registrering av aktivitetsgrad som kunde jämföras mot kontrollgruppen. En av försökspersonerna uppvisade där en markant lägre aktivitetsgrad än vad de friska pojkarna gjorde, medan den andra försökspersonen uppvisade en högre aktivitetsgrad.

    Slutsats

    Den undersökta gruppen med typ 1 diabetes kan inte anses vara representativ för hela populationen diabetessjuka pojkar, vilket innebär att inga generella slutsatser kan dras utifrån resultaten. Dock finns en tendens att de försökspersoner som avvek mycket från medelvärdet i något av testen även avvek stort i de övriga testerna.

  • 7.
    Björkman, Frida Maria Eleonora
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Validity and reliability of a submaximal cycle ergometer test for estimation of maximal oxygen uptake2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Maximal oxygen uptake (VO2max) is the highest obtained rate of oxygen consumption during a physically intense dynamic whole-body activity. VO2max is an important factor for many types of physical performance, as well as a strong independent predictor of health and longevity. Thus, it is important to have accurate and precise methods for assessment of VO2max.

    A direct measurement of VO2max is often conducted via indirect calorimetry during maximal exercise. The demand for maximal effort from an individual, along with the need for laboratory equipment, makes direct measurements unsuitable in the general, non-athlete population. There are also a number of contraindications that limit the possibility to conduct direct measurements of VO2max in many settings. Instead, several other exercise tests have been developed in order to facilitate the procedure of determination and evaluation of cardiorespiratory fitness in different populations. These tests can be either of submaximal or maximal character. Commonly used work modes are stepping, walking, and cycling. The overall aim of this thesis was to describe the background to, and the development of, submaximal cycle ergometer tests for estimation of VO2max.

    The present thesis focuses on the validity and reliability of a new submaximal cycle ergometer test – the Ekblom-Bak test (EB test). The first study described the test procedure for the new cycle ergometer test and the creation of an accompanying mathematical model (prediction equation) for estimation of VO2max. The development of the test and its associated prediction equation was continued in study II, while it was further validated in adults and adolescents in study II and IV. Study III examined the ability to use a submaximal cycle ergometer test in order to detect changes in VO2max over time.

    The EB test comprises of 8 minutes of continuous cycling – 4 minutes at 0.5 kp, followed by 4 minutes at a higher, individually chosen work rate – with a pedalling rate of 60 revolutions per minute. The test measures the change in HR (ΔHR) between the two different work rates (ΔPO), and the variable ΔHR/ΔPO was obtained and linked to measured VO2max. In study I, the validity and reliability of the EB test and the associated prediction equation was tested in a mixed population with regard to sex, age, and physical activity status. The subjects performed repeated submaximal cycle ergometer tests and maximal running tests for direct determination of VO2max (reference value). There was a strong correlation between estimated and measured VO2max, with an adjusted R2 of 0.82 and a corresponding coefficient of variation (CV) of 9.3%. Although there was a relatively high precision in the estimation of VO2max by the prediction equation, it was evident that individuals with high VO2max were underestimated and individuals with low VO2max were overestimated. This issue was further addressed in study II.

    In study II, the size of the study population was increased, in order to broaden the valid range and evaluate the use of sex-specific prediction equations. The estimation error was slightly decreased, and the sex-specific prediction equations resulted in an adjusted R2 of 0.91 and a CV of 8.7% in the whole group. The new models were also evaluated in a cross-validation group, where the adjusted R2 was 0.90 and CV 9.4%.

    The relation between the estimation error and changes in VO2max over time was investigated in study III. Follow-up tests were conducted in 35 subjects, in order to examine the conformity between changes in measured and estimated VO2max over a timespan of 5 to 8 years. Results showed a moderate correlation between change in measured VO2max and change in estimated VO2max (r = 0.75). Changes in body mass or changes in work efficiency did not relate to the change in assessment error. 

    In study IV, the aim was to determine the applicability and validity of the EB test in pre-pubertal and pubertal adolescents. Medical examinations and assessment of sexual maturity (according to the stages of Tanner) were performed in addition to the physical tests. The included subjects (n = 50) were 10 to 15 years old and in Tanner stages I–IV. The measurement error (the difference between measured and estimated VO2max) was related to maturity in boys, but not in girls. The measurement error decreased for the whole group when the equation developed for women was used for the boys in Tanner I and II. This modification in the calculations of VO2max resulted in an adjusted R2 of 0.83 and SEE 0.23 L/min. Hence, the most accurate prediction of VO2max from the EB test is generated if the test result is accompanied by ratings of sexual maturity in adolescents. Analysis of the test-retest values showed no significant change in estimated VO2max from repeated tests within two weeks of each other. 

    In summary, the EB test proved to be a reliable and valid test throughout a wide range of ages (20 to 85 years) and fitness levels (1.33 to 3.94 L/min in women, and 1.67 to 5.97 L/min in men). The test was also found to be useful and reasonably valid for determination of VO2max in pre-pubertal and pubertal adolescents, preferably after adjustment for sexual maturity status in boys. Furthermore, it was shown that the EB test captured fairly well an actual change in VO2max during a period of 5 to 8 years. However, it is still unknown whether the test has an acceptable sensitivity for detection of a training-induced increase in VO2max. Further studies are needed to evaluate if the test can be used in diseased individuals with or without different medications. The EB test can be used in health-related clinical settings, sports and fitness clubs.

  • 8.
    Björkman, Frida
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Mattsson, C. Mikael
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Antiinflammatoriska medel troliga storsäljare i OS2012Ingår i: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, nr 2, s. 40-43Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

    Det är mycket vanligt att idrottare använder antiinflammatoriska läkemedel både för att behandla skador och döva smärta. Hur lämpligt är det att använda preparaten under hård träning och tävling, och vad kan medicineringen ha för konsekvenser?

  • 9.
    Björkman, Frida
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Mattsson, C. Mikael
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Hur farlig är multisport?2011Ingår i: Svensk IdrottsMedicin, ISSN 1103-7652, Vol. 30, nr 4, s. 8-11Artikel i tidskrift (Övrigt vetenskapligt)
    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.

  • 10.
    Ekblom-Bak, Elin
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Björkman, Frida
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Hellenius, Maj-Lis
    Karolinska Institutet.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    A new submaximal cycle ergometer test for prediction of VO(2max).2014Ingår i: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 24, nr 2, s. 319-326Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Maximal oxygen uptake (VO(2max) ) is an important, independent predictor of cardiovascular health and mortality. Despite this, it is rarely measured in clinical practice. The aim of this study was to create and evaluate a submaximal cycle ergometry test based on change in heart rate (HR) between a lower standard work rate and an individually chosen higher work rate. In a mixed population (n = 143) with regard to sex (55% women), age (21-65 years), and activity status (inactive to highly active), a model included change in HR per unit change in power, sex, and age for the best estimate of VO(2max) . The association between estimated and observed VO(2max) for the mixed sample was r = 0.91, standard error of estimate = 0.302 L/min, and mean measured VO(2max)  = 3.23 L/min. The corresponding coefficient of variation was 9.3%, a significantly improved precision compared with one of the most commonly used submaximal exercise tests, the Åstrand test, which in the present study was estimated to be 18.1%. Test-retest reliability analysis over 1 week revealed no mean difference in the estimated VO(2max) (-0.02 L/min, 95% confidence interval: -0.07-0.03). The new test is low-risk, easily administered, and valid for a wide capacity range, and is therefore suitable in situations as health evaluations in the general population.

  • 11.
    Mattsson, C. Mikael
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Björkman, Frida
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Edin, Fredrik
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Larsen, Filip
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Regular moist snuff dipping does not affect endurance exercise performance2013Konferensbidrag (Refereegranskat)
    Abstract [en]

    Physiological and medical effects of snuff have previously been obtained either in cross-sectional studies or after snuff administration to non-tobacco users, but the effects of snuff cessation (SC) after several years of daily use on individual level are unknown. 24 participants with >2 years of daily snuff-use were tested before and after >6 weeks SC (SCG), together with a control group (CO) of 11 snuff users who kept their normal habits. Resting heart rate (HR) was significantly lower in SCG after SC. Body mass in SCG group increased by 1.4 ± 1.7 kg and blood pressure (BP) were reduced, but without significant differences between groups. Total cholesterol increased from 4.12 ± 0.54 (95% CI 3.89–4.35) to 4.46 ± 0.70 (95% CI 4.16–4.75) mM/L in SCG, due to increased LDL, and this change was significantly different from CO. Resting values of HDL, C-reactive protein, and free fatty acids (FFA) remained unchanged in both groups. During a four-stage incremental (from 50 to 80% of VO2max) and a prolonged (60 min at 50% of VO2max) cycling test HR and BP were reduced in SCG, while oxygen uptake (VO2), respiratory exchange ratio, blood lactate (bLa) and blood glucose (bGlu) concentration, and rate of perceived exertion were unchanged. All measurements were unchanged in CO. During the prolonged exercise FFA was reduced but there was no significant difference between groups. During the maximal treadmill running test peak values of VO2, pulmonary ventilation (VE), time to exhaustion and bLa were unchanged in both groups. In conclusion, endurance exercise performance (VO2max and maximal endurance time) does not seem to be affected by prolonged snuff use, while effects on cardiovascular risk factors are contradictory.

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