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  • 251. Gerber, Markus
    et al.
    Jonsdottir, IH
    Börjesson, Mats
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Lindwall, Magnus
    Lindegård, A gneta
    Changes in Mental Health in Compliers and Non-Compliers with Physical Activity Recommendations in Patients with Stress-Related Exhaustion2015Ingår i: Proceedings of the 2015 AIESEP International Conference. Revista Española de Educación Física y Deportes, 410 (Supl.), 3er trimestre., 2015, 2015, Vol. 410 (Supl.), s. 300-301Konferensbidrag (Refereegranskat)
  • 252.
    Godhe, Manne
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Ekblom, Maria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC). Karolinska Institutet.
    Pontén, Marjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Andersson, Eva
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC). Karolinska Institutet.
    Improved daily movement patterns in an accelerometer-assessed 8-weeks exercise project in older adults2019Ingår i: British Journal of Sports Medicine Vol 53, suppl 1, BMJ Publishing Group Ltd, 2019, Vol. 53, s. A2-Konferensbidrag (Övrigt vetenskapligt)
  • 253.
    Godhe, Manne
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp. Militärmedicinska forskningsgruppen, Åstrandlaboratoriet.
    Helge, Torbjörn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp. Militärmedicinska forskningsgruppen, Åstrandlaboratoriet.
    Mattsson, C. Mikael
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap. Militärmedicinska forskningsgruppen, Åstrandlaboratoriet.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp. Militärmedicinska forskningsgruppen, Åstrandlaboratoriet.
    Att bära tungt - en fysiologisk analys: Kvinnor: Rapport 8.2016Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Sjutton kvinnliga vältränade försökspersoner, åtta stycken med vana att bära tungt och nio stycken utan sådan vana, genomförde gång på löpband och mjukt underlag i hastigheterna 3 och 5 km/tim med bärvikter i ryggsäck på 20, 35 och 50 kg.Mjukt underlag i form av blå gymnastikmattor, indikerande gång i lätt terräng, ökade energiomsättningen under både hastigheterna mellan 10 och 15 %, jämfört med hårt underlag (löpband) med en grads lutning. Energiomsättningen ökade i genomsnitt lika mycket med ökad hastighet som med ökad bärvikt. Den individuella variationen vid en given bärvikt och hastighet är mycket stor. Beroende på bärvikt och hastighet kan energiomsättningen variera med 100 %. Dessa stora variationer i energiomsättning bör uppmärksammas vid beräkning av energitilldelning via kosten vid längre militära operationer.Energiomsättningen vid tyngsta belastningen – 50 kilo bärvikt och hastigheten 5 km/tim – belastade försökspersonerna på i genomsnitt 57 % av maximal syreupptagningsförmåga. I individuella fall var belastningen 72 % av maximal syreupptagningsförmåga. Dessa höga belastningar är oacceptabelt höga för transporter under längre tid och kan vara en orsak till belastningsskador.Förmågan att bära tungt sammanfaller med ökad kroppsvikt och benmuskelstyrka. Bärförmåga för mindre vikter, högst 35 kg, sammanfaller inte med någon av ovanstående faktorer. Således, för tyngre bärvikter vid förflyttningar bör selektion av soldater ske enligt de uppmätta parametrarna, medan vad gäller lättare vikter föreligger inte samma selektionskriterier.En slutsats från resultaten av denna undersökning är den ursprungliga uttagningen till tunga arbetsuppgifter inom försvaret bör genomföras med tunga arbetsbelastningar, motsvarande de i denna undersökning. I kommande rapport sammanfattas studierna på män och kvinnors bärförmåga, likheter och olikheter mellan könen, möjliga selektionskriterier samt rekommendationer med utgångspunkt från genomförda undersökningar och resultat från olika andra undersökningar.

  • 254.
    Godhe, Manne
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Helge, Torbjörn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Mattsson, C. Mikael
    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.
    Physiological factors of importance for load carriage2017Ingår i: ICSPP Abstracts: Journal of Science and Medicine in Sport, November 2017 20 Supplement 2:S105, 2017, Vol. 20, nr Supplement 2, s. S105-, artikel-id 176Konferensbidrag (Övrigt vetenskapligt)
  • 255.
    Godhe, Manne
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Helge, Torbjörn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Mattsson, C Mikael
    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.
    Physiological factors of importance for load carriageManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    The energy expenditure during carrying no load, 20, 35 and 50 kg at two walking speeds, 3 and 5 km/h, was studied in 36 healthy participants, 19 men (30 ± 6 yrs, 82.5 ± 7.0 kg) and 17 women (29 ± 6 yrs, 66.1 ± 8.9 kg). Anthropometric data, leg muscle strength as well as trunk muscle endurance and muscle fibre distribution of the thigh were also obtained. To load the participant a standard backpack filled with extra weight according to the carrying weight tested was used. Extra Load Index (ELI), the oxygen uptake (VO2) during total load over no-load-exercise, was used as a proxy for load carrying ability. In addition to analyzing factors of importance for the ELI values, we also conducted mediator analyzes using sex and long term carrying experience as causal variables for ELI as the outcome value. For the lowest load (20 kg), ELI20, was correlated with body mass but no other factors. Walking at 5 km/h body mass, body height, leg muscle strength and absolute VO2max were correlated to ELI35 and ELI50, but relative VO2max, trunk muscle endurance and leg muscle fibre distribution were not. Sex as causal factor was evaluated in a mediator analyses with ELI50 as outcome. ELI50 at 5 km/h differed between the sexes. The limit for acceptable body load, 40% of VO2max (according to Astrand, 1967), was nearly reached for women carrying 35 kg (39%) and surpassed at 50 kg at 3 km/h, and for men carrying 50 kg at 5 km/h. This difference was only mediated by difference in body mass. Neither muscle fibre distribution, leg muscle strength, trunk muscle endurance and body height nor did absolute or relative VO2max explain the difference. Participants with long term experience of heavy load carrying had significant lower ELI20 and ELI50 values than those with minor or non-experience, but none of the above studied factors could explain this difference. The study showed that body mass and experience of carrying heavy loads are important factors for the ability to carry heavy loads.

  • 256.
    Gray, Stuart R
    et al.
    Strathclyde inst of pharmacy and biomedical sciences, university of strathclyde, Glasgow UK.
    Söderlund, Karin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Ferguson, Richard A
    ATP and phosphocreatine utilization in single human muscle fibres during the development of maximal power output at elevated muscle temperatures.2008Ingår i: Journal of Sports Sciences, ISSN 0264-0414, E-ISSN 1466-447X, Vol. 26, nr 7, s. 701-7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In this study, we examined the effect of muscle temperature (Tm) on adenosine triphosphate (ATP) and phosphocreatine utilization in single muscle fibres during the development of maximal power output in humans. Six male participants performed a 6-s maximal sprint on a friction-braked cycle ergometer under both normal (Tm = 34.3 degrees C, s = 0.6) and elevated (T(m) = 37.3 degrees C, s = 0.2) muscle temperature conditions. During the elevated condition, muscle temperature of the legs was raised, passively, by hot water immersion followed by wrapping in electrically heated blankets. Muscle biopsies were taken from the vastus lateralis before and immediately after exercise. Freeze-dried single fibres were dissected, characterized according to myosin heavy chain composition, and analysed for ATP and phosphocreatine content. Single fibres were classified as: type I, IIA, IIAX25 (1 - 25% IIX isoform), IIAX50 (26 - 50% IIX), IIAX75 (51 - 75% IIX), or IIAX100 (76 - 100% IIX). Maximal power output and pedal rate were both greater (P < 0.05) during the elevated condition by 258 W (s = 110) and 22 rev . min(-1) (s = 6), respectively. In both conditions, phosphocreatine content decreased significantly in all fibre types, with a greater decrease during the elevated condition in type IIA fibres (P < 0.01). Adenosine triphosphate content was also reduced to a greater (P < 0.01) extent in type IIA fibres during the elevated condition. The results of the present study indicate that after passive elevation of muscle temperature, there was a greater decrease in ATP and phosphocreatine content in type IIA fibres than in the normal trial, which contributed to the higher maximal power output.

  • 257.
    Gray, Stuart R
    et al.
    Institute of medical sciences, University of Aberdeen, Skottland.
    Söderlund, Karin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Watson, Moira
    Ferguson, Richard A
    Skeletal muscle ATP turnover and single fibre ATP and PCr content during intense exercise at different muscle temperatures in humans.2011Ingår i: Pflügers Archiv: European Journal of Physiology, ISSN 0031-6768, E-ISSN 1432-2013, Vol. 462, nr 6, s. 885-893Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The effect of temperature on skeletal muscle ATP turnover, pulmonary oxygen uptake and single fibre ATP and PCr content was studied during intense cycling exercise. Six healthy male subjects performed 6-min intense (Δ50%LT-VO(2peak)) cycling, at 60 rpm, under conditions of normal (N) and elevated muscle temperature (ET). Muscle biopsies obtained from the vastus lateralis at rest, 2 and 6 min were analysed for homogenate ATP, PCr, lactate and glycogen, allowing estimation of anaerobic ATP turnover. Freeze-dried single fibres from biopsies were characterised according to their myosin heavy chain composition (type I, IIA or IIAX) and analysed for ATP and PCr content. Pulmonary gas exchange was measured throughout. There was no difference in pulmonary oxygen uptake between the trials. The elevation of muscle temperature resulted in a lower (P < 0.05) PCr content, higher (P < 0.05) lactate content and greater (P < 0.05) anaerobic ATP turnover after 2 min of exercise. There was no effect of temperature on these measures at 6 min. In single fibres it was observed that in ET, there was a lower (P < 0.05) PCr content in type I fibres after 2 min with no differences between conditions after 6 min. The present study demonstrates that elevation of muscle temperature results in a greater anaerobic ATP turnover and type I fibre PCr degradation during the initial 2 min of intense exercise.

  • 258. Grimby, Agneta
    et al.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Sätt änkorna i rörelse - för hälsans skull!2002Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 99, nr 1-2, s. 78-80Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

    Sorg är ingen sjukdom, men kan förvisso ge sådan. Ensamhet, isolering, inaktivitet, dåliga matvanor, ökad konsumtion av alkohol och tobak minskar avsevärt ambitionen att röra på sig – bildligt och bokstavligt – och är vanligt bland nyblivna änkepersoner. Kommunal hälso- och psykosocial intervention i form av tidigt stöd  och uppmuntran i sorgen – som skulle kunna bryta negativa mönster – är idag nästan obefintlig. Denna grupp människor kan ha svårt att ta till sig folkuppmaningen »Sätt Sverige i rörelse«, trots vetskapen om att regelbunden lågintensiv motion och muskelträning kan ge stora positiva hälsoeffekter. Vem antar utmaningen att  sätta änkorna i rörelse – och vem bekostar?

  • 259. Grimby, G
    et al.
    Börjesson, Mats
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Jonsdottir, I H
    Schnohr, P
    Thelle, D S
    Saltin, Bengt
    The "Saltin-Grimby Physical Activity Level Scale" and its application to health research.2015Ingår i: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 25, nr Suppl 4, s. 119-125Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The use of a four-level questionnaire to assess leisure time physical activity (PA) and its validation is reviewed in this paper. This questionnaire was first published in 1968 and has then been used by more than 600 000 subjects, especially in different population studies in the Nordic countries. A number of modifications to the questionnaire have been published. These are mostly minor changes, such as adding practical examples of activities to illustrate the levels of PA. Some authors have also added duration requirements that were not included for all levels of PA in the original version. The concurrent validity, with respect to aerobic capacity and movement analysis using objective measurements has been shown to be good, as has the predictive validity with respect to various risk factors for health conditions and for morbidity and mortality.

  • 260.
    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
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Bergström, Göran
    University of Gothenburg.
    Börjesson, Mats
    University of Gothenburg.
    Concomitant Associations of Healthy Food Intake and Cardiorespiratory Fitness With Coronary Artery Calcium.2018Ingår i: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 122, nr 4, s. 560-564, artikel-id S0002-9149(18)31060-9Artikel i tidskrift (Refereegranskat)
    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.

  • 261. Gullstrand, Lennart
    et al.
    Lindberg, Thomas
    Cardinale, Daniele
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Tarassova, Olga
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Bjerkefors, Anna
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Validation of a kayak ergometer power output2013Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction

    It is of a significant interest that ergometers used for evaluating elite athletes are valid and reliable. In this study the aim was to investigate how well displayed power output on a widely used kayak ergometer, DS, (Dansprint ApS, DK) related to a validation setup. Previously Gore et al. (2013) described the accuracy of 12 of the same ergometer using a motor driven calibration rig simulating power between 50 up to 450 W. They found that the ergometers underestimated true mean power with 21-23%. The reference rig simulated a 1 dimensional (1D) movement; this study however, is based on 3D analysis, which was hypothesized to better describe real paddling movement’s and allow more precise power calculations.

    Methods

    Two male national team kayakers took part in the study performing workloads from 70 up to 500 W (+30 W/stage) two times with 3 days between the measurement sessions. They were instructed to target the desired workloads displayed during 35 s bouts. The reference method included a ProReflex optoelectronic system (Qualisys AB, Gothenburg, Sweden) and force transducers (LCM 200, Futek Inc, Ca, US). The force transducers were connected with the rope from ergometer flywheel close to each end of the ergometer paddle to continuously measure force during the bouts of work. The kinematic set-up included eight cameras placed around the ergometer and two reflective markers were attached close to each force transducer.

    Results

    The reference method used here showed that the validated ergometer underestimated power with 37.7 % over the whole measured range compared to the reference method. The difference was systematic (r2=0.989) and the linear regression model could be applied (DS power = -2.362+0.628*x). When applying a 1D analysis of the collected data, it coincided with the results from Gore et al. (2013).

    Discussion

    The data suggest that 1. The measurement solution and/or calculation for describing power output in the DS have limitations. 2. The testing rig referred to in the Introduction (Gore et al. 2013) do not fully estimate true power and 3. The reference method used here is suggested to more exactly represent true paddling power as it includes a 3D movement analysis and close to original paddling simulation set-up. Both reference methods (1D and 3D analysis) show linear differences vs. the DS ergometer, giving an option to adjust the displayed power to a true power produced by elite-athletes.

  • 262.
    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
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet. 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.2018Ingår i: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, nr 1, artikel-id 196Artikel i tidskrift (Refereegranskat)
    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.

  • 263. Haglind, Charlotte
    et al.
    Ask, Sara
    von Döbeln, Ulrika
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Stenlid, Maria
    Nordenström, Anna
    Energy expenditure and lipid metabolism in very long-chain Acyl-CoA dehydrogenase (VLCAD) deficiency2015Ingår i: Molecular Genetics and Metabolism (ISSN 1096-7192), 2015, Vol. 114, nr 3, s. 333-333Konferensbidrag (Refereegranskat)
  • 264.
    Hallgren, Mats
    et al.
    Karolinska institutet.
    Andersson, Victoria
    Center for Psychiatric Research, Stockholm.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Andréasson, Sven
    Karolinska institutet.
    Physical activity as treatment for alcohol use disorders (FitForChange): study protocol for a randomized controlled trial.2018Ingår i: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 19, nr 1, artikel-id 106Artikel i tidskrift (Refereegranskat)
    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.

  • 265. Hallgren, Mats
    et al.
    Herring, Matthew P
    Owen, Neville
    Dunstan, David
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    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.2016Ingår i: Frontiers in Psychiatry, ISSN 1664-0640, E-ISSN 1664-0640, Vol. 7, artikel-id 36Artikel i tidskrift (Refereegranskat)
    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.

  • 266. Hallgren, Mats
    et al.
    Nakitanda, Olivia Aya
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Herring, Matthew P
    Owen, Neville
    Dunstan, David W
    Helgadottir, Björg
    Forsell, Yvonne
    Habitual physical activity levels predict treatment outcomes in depressed adults: A prospective cohort study.2016Ingår i: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 88, s. 53-58Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Exercise is an efficacious stand-alone therapy for mild-to-moderate depression, but little is known about the influence of physical activity levels on responses to depression treatment. This study aimed to prospectively assess the association between self-reported habitual physical activity levels and depression severity following a 12-week intervention.

    METHOD: 629 adults (75% women; aged 18-71years) with mild-to-moderate depression were recruited from primary care centres across Sweden and treated for 12weeks. The interventions included internet-based cognitive behavioural therapy (ICBT) and 'usual care' (CBT or supportive counselling). One third of all participants were taking anti-depressant medication. The primary outcome was the change in depression severity assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS). Habitual physical activity levels were self-rated and based on the estimated frequency, duration and intensity of total physical activity, including planned exercise, 'during a typical week'. Prospective associations were explored using linear regression models (percentage change) with 95% confidence intervals (CI's).

    RESULTS: Following adjustment for relevant covariates, high levels of habitual physical activity were associated with larger relative reductions in depression severity compared to low physical activity (β=-9.19, 95% CI=-18.46, -0.09, p=0.052) and moderate physical activity (β=-10.81, 95% CI=-21.09, -0.53, p<0.05), respectively.

    CONCLUSION: Adults who routinely engage in high levels of physical activity respond more favourably to CBT-focused depression treatments than adults who engage in low-to-moderate levels of activity. The optimal level of physical activity associated with reductions in depression severity corresponds to consensus recommendations for maximizing general health. One limitation is the use of self-reported physical activity data.

  • 267.
    Hallgren, Mats
    et al.
    Karolinska institutet.
    Skott, Maria
    Karolinska institutet.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Firth, Joseph
    Western Sydney University, Australia.
    Schembri, Adrian
    Cogstate Pty Ltd, Melbourne, Australia..
    Forsell, Yvonne
    Karolinska institutet.
    Exercise effects on cognitive functioning in young adults with first-episode psychosis: FitForLife.2019Ingår i: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 49, nr 3, s. 431-439Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Exercise has mood-enhancing effects and can improve cognitive functioning, but the effects in first-episode psychosis (FEP) remain understudied. We examined the feasibility and cognitive effects of exercise in FEP.

    METHOD: Multi-center, open-label intervention study. Ninety-one outpatients with FEP (mean age = 30 years, 65% male) received usual care plus a 12-week supervised circuit-training program, consisting of high-volume resistance exercises, aerobic training, and stretching. Primary study outcome was cognitive functioning assessed by Cogstate Brief Battery (processing speed, attention, visual learning, working memory) and Trailmaking A and B tasks (visual attention and task shifting). Within-group changes in cognition were assessed using paired sample t tests with effect sizes (Hedges' g) reported for significant values. Relationships between exercise frequency and cognitive improvement were assessed using analysis of covariance. Moderating effects of gender were explored with stratified analyses.

    RESULTS: Participants exercised on average 13.5 (s.d. = 11.7) times. Forty-eight percent completed 12 or more sessions. Significant post-intervention improvements were seen for processing speed, visual learning, and visual attention; all with moderate effect sizes (g = 0.47-0.49, p < 0.05). Exercise participation was also associated with a positive non-significant trend for working memory (p < 0.07). Stratified analyses indicated a moderating effect of gender. Positive changes were seen among females only for processing speed, visual learning, working memory, and visual attention (g = 0.43-0.69). A significant bivariate correlation was found between total training frequency and improvements in visual attention among males (r = 0.40, p < 0.05).

    CONCLUSION: Supported physical exercise is a feasible and safe adjunct treatment for FEP with potential cognitive benefits, especially among females.

  • 268. Hassmén, Peter
    et al.
    Blomstrand, Eva
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Eva Blomstrands forskningsgrupp.
    Mood change and marathon running: a pilot study using a Swedish version of the POMS test.1991Ingår i: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 32, nr 3, s. 225-32Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Regular exercise is said to have positive effects on mood, especially if the exercise intensity is low to moderate. However, the acute effects resulting from participation in a strenuous competition, such as a marathon race, have been studied less. The present investigation used the Profile of Mood States (POMS) test to measure mood, before and after the 1989 Stockholm Marathon. A total of 106 male runners (mean age 40.0 years), with finishing times between 3h and 3h 45 min participated as subjects. Results showed great changes between pre- and post-marathon scores, most of them significant at the p less than 0.001 level. Furthermore, differences between a faster and a slower group of runners were demonstrated with regard to mood states, even though plasma glucose levels were comparable. It is concluded that participation in a marathon race greatly effects mood, mainly in a more negative way than low to moderately intense exercise does.

  • 269.
    Hassmén, Peter
    et al.
    Stockholms universitet.
    Blomstrand, Eva
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Eva Blomstrands forskningsgrupp.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Newsholme, E A
    Branched-chain amino acid supplementation during 30-km competitive run: mood and cognitive performance.1994Ingår i: Nutrition (Burbank, Los Angeles County, Calif.), ISSN 0899-9007, E-ISSN 1873-1244, Vol. 10, nr 5, s. 405-10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    It has been suggested that an elevated concentration of the neurotransmitter serotonin (5-hydroxytryptamine, 5-HT) in specific areas of the brain may contribute to the development of central/mental fatigue during and after sustained exercise. Supplementation with branched-chain amino acids (BCAAs) should prevent the exercise-induced increase in the plasma concentration ratio of free tryptophan to other large neutral amino acids (including BCAAs) and thereby prevent an elevation in the level of 5-HT in the brain. In this study, subjects were given either a mixture of BCAAs in a carbohydrate solution or a placebo drink that contained only carbohydrates during a 30-km cross-country race. Several tasks to measure cognitive performance were performed before and after the race. When subjects were supplied with BCAAs, their performance in the different parts of the color-word test (words, colors and color words) was improved by an average of 3-7% (p < 0.05) after exercise, whereas there was no difference in performance before and after exercise in the subjects who were given the placebo. Furthermore, the experimental group, supplied with BCAAs, maintained their performance in the shape-rotation and figure-identification tasks, whereas an impairment in performance in these tests by 25% (p < 0.05) and 15% (p < 0.05), respectively, was found in the subjects who received the placebo. Thus, BCAA supplementation seemed to have an effect on the more complex tasks, whereas no effect could be detected on the less demanding tasks. However, an intake of BCAAs during exercise modified only slightly the exercise-induced changes in mood.

  • 270. Hattel, H. B.
    et al.
    Saltin, Bengt
    Boushel, Robert
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Lifelong endurance training keeps the mitochondria young.2014Ingår i: Proceedings of the Physiological Society 2014, 2014, s. 276P-277PKonferensbidrag (Refereegranskat)
    Abstract [en]

    It is an ongoing debate whether mitochondrial function deteriorates with aging. Some studies demonstrate metabolic dysfunction and increased ROS production (Squier, 2001) while others find no bioenergetics alterations (Rasmussen, et al., 2003). The extent to which exercise maintains or restores mitochondrial function is unknown. Methods: A unique group of elderly lifelong trained males (64±2 yr, BMI=24.5±0.4 kg/m2, VO2max=3.5±0.07 L/min), who maintained road cycling training ~250 km/week 50 years were recruited for the experiment (group ET) along with a group of healthy age matched untrained males (age 65±2 yr, BMI=27±1, VO2max=2.4±0.1), who lived a sedentary lifestyle (group UT). A biopsy was obtained from Vastus lateralis under local anaesthesia. 15-25 mg muscle was immediately prepared and permeabilized for High Resolution Respirometry as previously described (Boushel, et al., 2011). LEAK respiration was assessed by addition of malate (2 mM) and octanoyl-carnitine (0.2 mM). Coupled ADP-stimulated respiration (OXPHOS) of complex I was assessed with pyruvate (5mM) and glutamate (10 mM), and ADP (5 mM). Maximal OXPHOS was determined by addition of succinate (10 mM) for convergent electron input to both complexes I and II. The isolated activity of cytochrome c oxidase (COX), was determined in a redox reaction with TMPD (N,N,N,N-tetramethyl-p-phenylenediamine dihydrochloride) (0.5 mM) and ascorbate (2mM) after blockade of electron flow through complex III with antimycin A (2.5μM) followed by sodium azide (100 mM). Findings: All values are mean±S.E.M. Preliminary findings show that mitochondrial OXPHOS capacity for CI (PI) is substantially higher (50±3 vs. 30±1 pmol.sec-1.mg-1, p<0.0001) in the ET compared to the UT, and maximal OXPHOS with CI+CII (PI+PII) was 2-fold higher (103±3 vs. 51±2 pmol.sec-1.mg-1, p<5*10-5). The higher substrate control ratio (CI+II/CI) in ET (2.05±0.09) compared to UT (1.7±0.06) suggests less substrate competition at the mitochondrial level. These findings indicate that exercise training throughout life induces both regulatory and mitochondrial density changes that optimize mitochondrial function. The observed OXPHOS capacities in the ET subjects are fully comparable to values reported in young elite trained subjects (Jacobs & Lundby, 2013), illustrating no mitochondrial age-related deteriorating in these subjects.

  • 271. Helgadottir, B.
    et al.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Forsell, Y.
    Physical Activity Patterns of People Affected by Depressive and Anxiety Disorders: A Descriptive Study2014Ingår i: Journal of Mental Health Policy and Economics, 17, (Suppl 1), S9., 2014, Vol. 17, nr Suppl 1, s. S9-Konferensbidrag (Refereegranskat)
  • 272.
    Helgadottir, Björg
    et al.
    Karolinska Institutet.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Forsell, Yvonne
    Karolinska Insitutet.
    Impact of expectations on the effects of exercise on psychological distress2014Ingår i: American Journal of Health Behavior, ISSN 1087-3244, E-ISSN 1945-7359, Vol. 38, nr 5, s. 560-565Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:

    To evaluate the influence of expectations on effectiveness of exercise in reducing psychological distress.

    METHOD:

    Data came from a Swedish longitudinal population-based study consisting of 4631 people aged 20-64 years. Psychological distress was measured with the Major Depressive Inventory. Expectations (positive expectations or indifference) towards exercise were combined with exercise (regular exercise: yes or no).

    RESULTS:

    Indifferent non-exercisers had increased risk of psychological distress. Regular exercisers who were indifferent towards exercise as a self-help method were less likely to be psychologically distressed compared to exercisers with positive expectations.

    CONCLUSION:

    The results encourage systematic use of exercise in prevention and rehabilitation of persons suffering from psychological distress. People's personal expectations might not be needed for treatment effect.

  • 273.
    Helgadottir, Björg
    et al.
    PHS, EPHIR Karolinska Institutet.
    Forsell, Yvonne
    PHS, EPHIR Karolinska Institutet.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Physical activity patterns of people affected by depressive and anxiety disorders as measured by accelerometers: a cross-sectional study2015Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 1, s. e0115894-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Exercise can relieve both depressive and anxiety disorders and it is therefore of importance to establish movement patterns of mildly to moderately affected sufferers to estimate the treatment potential. The aim is to describe the physical activity patterns of people affected by mild to moderate depressive and/or anxiety symptoms using objective measures of physical activity.

    METHODS:

    The design of the study was cross-sectional using data from 165 people aged 18-65 years, with mild to moderate depressive and/or anxiety disorder symptoms (scoring ≥10 on the PHQ-9). Diagnoses were made using Mini International Neuropsychiatric Interview (MINI) and symptom severity was measured with the Montgomery-Åsberg Depression Rating Scale (MADRS). The participants wore accelerometers for a week to evaluate physical activity patterns.

    RESULTS:

    No statistically significant differences were detected between different diagnoses, though depressed participants tended to be less active and more sedentary. Only one-fifth of the sample followed public health guidelines regarding physical activity. Each one point increase in MADRS was associated with a 2.4 minute reduction in light physical activity, independent of moderate-to-vigorous physical activity and sedentary time. MADRS was positively associated with number of sedentary bouts.

    CONCLUSIONS:

    The physical activity pattern of people with depressive and/or anxiety disorders was characterized by large amounts of sedentary time and low fulfillment of physical activity guidelines. There is therefore a large treatment potential for this group by increasing exercise. The results suggest that instead of focusing exclusively on high intensity exercise for treating depressive and anxiety disorders, health care providers might encourage patients to reduce sedentary time by increasing light physical activity and decreasing the number of sedentary bouts, though further studies are needed that can determine directionality.

  • 274. Helgadóttir, Björg
    et al.
    Dunstan, David
    Owen, Neville
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Hallgren, Mats
    Forsell, Yvonne
    Changes in Physical Activity and Sedentary Behavior Associated with Exercise Interventions in Depressed Adults: 2109 Board #261 June 2, 3: 30 PM - 5: 00 PM.2016Ingår i: Medicine And Science In Sports And Exercise 2016 May; Vol. 48 (5S Suppl 1), pp. 594., 2016, Vol. 48, nr 5S Suppl 1, s. 594-594Konferensbidrag (Refereegranskat)
    Abstract [en]

    PURPOSE: Exercise training programs are beneficial for depression, but less is known about their impact on non-intervention physical activity patterns and sedentary behavior patterns in depressed adults. We determined the extent to which participation in light-, moderate- and vigorous-intensity exercise intervention programs influenced the habitual physical activity and sedentary behavior patterns in depressed adults.

    METHODS: Accelerometer data were collected pre- and post-treatment from a subset of depressed participants randomized to one of three 12-week exercise intervention programs: light (n=21), moderate (n=25) and vigorous (n=22) exercise. Mixed models examined changes in accelerometer-measured overall time spent in sedentary, light and moderate-to-vigorous physical activity (MVPA); accumulated sedentary and MVPA bouts; and number of MVPA bouts and interruptions in sedentary time.

    RESULTS: Overall sedentary time decreased while overall light activity increased across all intervention groups but neither significantly so. The light exercise intervention group reduced their MVPA minutes (-8.22, 95% CI: -16.44, -0.01), time in MVPA bouts (-8.44, 95% CI: -14.27, -2.62), and number of activity bouts (-0.43, 95% CI: -0.77, -0.09). The moderate exercise intervention group reduced the time in MVPA bouts (-6.27, 95% CI: -11.71, -0.82) and number of sedentary interruptions (-5.79, 95% CI: -9.11, -2.46). No changes were observed for the vigorous exercise intervention group.

    CONCLUSIONS: On the whole, participating in a structured exercise intervention did not lead people who are affected by depression to significantly reduce their overall light physical activity nor to increase their sedentary time. Participation in the light and moderate exercise intervention programs was associated with reductions in overall MVPA, but this was not evident for the vigorous exercise intervention program.

  • 275.
    Helgadóttir, Björg
    et al.
    Karolinska institutet.
    Forsell, Y
    Karolinska institutet.
    Hallgren, M
    Karolinska institutet.
    Möller, J
    Karolinska institutet.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Exercise for depression: What are the long-term effects of different exercise intensities?2017Ingår i: European Journal of Public Health, Volume 27, Issue suppl_3, 1 November 2017, 2017, Vol. 27, nr Suppl. 3, artikel-id ckx187.168Konferensbidrag (Refereegranskat)
    Abstract [en]

    Key messages:

    • As all exercise conditions had at least a comparable effect to treatment as usual, exercise at any intensity can be recommended as treatment for mild-to-moderate depression.
    • Light intensity exercise should be emphasised more in treatment guidelines than it currently is, as its effects are potentially even greater than that of treatment as usual.
  • 276.
    Helgadóttir, Björg
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Forsell, Yvonne
    Karolinska Institutet, Stockholm, Sweden.
    Hallgren, Mats
    Karolinska Institutet, Stockholm, Sweden.
    Möller, Jette
    Karolinska Institutet, Stockholm, Sweden.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Long-term effects of exercise at different intensity levels on depression: A randomized controlled trial.2017Ingår i: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 105, s. 37-46, artikel-id S0091-7435(17)30294-3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Previous research has shown positive effects of exercise on depression but studies have mainly focused on the short-term effects; few have examined the long-term effect, especially with regard to differences in intensity. The aim of this study was to examine the long-term effects of prescribed exercise on depression, performed at three intensity levels. People aged 18-67years with mild to moderate depression (Patient Health Questionnaire-9 score of ≥10) participated in a single-blind, parallel randomized control trial lasting 12weeks (Sweden 2011-2013). Four arms were included: Treatment as usual (TAU, n=310), light (n=106), moderate (n=105) and vigorous exercise (n=99). Severity of depression was measured at baseline, post-treatment and 12-month follow-up using the Montgomery-Åsberg Depression Rating Scale (MADRS). Coefficients (β) and odds ratios were estimated using linear mixed models with time×group interactions. The results showed that at the 12month follow-up the light exercise group had significantly lower depression severity scores than the TAU (-1.9, 95% CI: -3.7, -0.04) and the moderate exercise group (-2.94 95% CI: -5.2, -0.7). The vigorous exercise group had significantly lower scores than the moderate exercise group only (-2.7, 95% CI: -4.9, -0.4). In conclusion, compared to usual care for depression, only light exercise resulted in significantly lower depression severity at 12-month follow-up. Both light and vigorous exercise was more effective than moderate exercise.

    TRIAL REGISTRATION: The study was registered with the German Clinical Trial Register (DRKS study ID: DRKS00008745).

  • 277.
    Helgadóttir, Björg
    et al.
    Karolinska Institutet.
    Hallgren, Mats
    Karolinska Institutet.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Forsell, Yvonne
    Karolinska Institutet.
    Training fast or slow? Exercise for depression: A randomized controlled trial2016Ingår i: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 91, s. 123-131Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Exercise can be used to treat depression but there is a lack of evidence regarding the optimal intensity and mode. Our aim was to compare the effects of different exercise intensities on post-treatment depression severity. People aged 18–67years with mild-to-moderate depression (Patient Health Questionnaire-9 score of ≥10) participated in a single-blind, parallel randomized control trial lasting 12-weeks (Sweden 2011–2013). Four treatment arms were included: treatment as usual (TAU) (n=310), light exercise (yoga or similar n=106), moderate exercise (aerobic conditioning, n=105) and vigorous exercise (aerobic conditioning, n=99). Depression severity was measured at baseline and post-treatment using the Montgomery-Åsberg Depression Rating Scale (MADRS). Differences between the groups in depression severity at post-treatment were analysed using linear regression. Differences in exercise intensity were confirmed by heart rate monitoring. At post-treatment, the light (−4.05 Confidence Interval (CI)=−5.94, −2.17), moderate (−2.08 CI=−3.98, −0.18) and vigorous exercise groups (−3.13 CI=−5.07, −1.19) had reduced their MADRS scores significantly more than TAU. No significant differences were found between the exercise groups, and no significant interaction effect was observed between group and gender. In conclusion, exercise, whether performed at a low (yoga or similar), moderate or vigorous intensity (aerobic training) is effective in treating mild-to-moderate depression and is at least as effective as treatment as usual by a physician.

  • 278. Helgadóttir, Björg
    et al.
    Owen, Neville
    Dunstan, David W.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Hallgren, Mats
    Forsell, Yvonne
    Changes in physical activity and sedentary behavior associated with an exercise intervention in depressed adults2017Ingår i: Psychology of Sport And Exercise, ISSN 1469-0292, E-ISSN 1878-5476, Vol. 30, s. 10-18Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Exercise is beneficial for depression, but less is known about its impact on post-intervention physical activity and sedentary behavior. The aim of this paper was to determine the extent to which participation in light-, moderate- and vigorous-intensity exercise intervention influenced habitual physical activity and sedentary behavior patterns in depressed adults. Methods Accelerometer data was collected pre- and post-intervention from depressed participants randomized to one of three 12-week intervention groups: light (n = 21), moderate (n = 25) and vigorous (n = 22) exercise. Mixed models examined changes in time spent sedentary and in light and moderate-to-vigorous physical activity (MVPA); time accumulated in sedentary and MVPA bouts; and, number of MVPA bouts and interruptions in sedentary time. Results Overall sedentary time decreased while light activity time increased across all intervention groups but not significantly so. The light exercise intervention group reduced MVPA minutes (−8.22, 95% CI: −16.44, −0.01), time in MVPA bouts (−8.44, 95% CI: −14.27, −2.62), and number of activity bouts (−0.43, 95% CI: −0.77, −0.09). The moderate exercise intervention group reduced time in MVPA bouts (−6.27, 95% CI: −11.71, −0.82) and number of sedentary interruptions (−6.07, 95% CI: −9.30, −2.84). No changes were observed for the vigorous exercise intervention group. Conclusions The exercise intervention led to an increase in overall light physical activity and decrease in sedentary time, though neither change was statistically significant. Participation in the light and moderate exercise intervention groups was associated with reductions of time in MVPA bouts, but this was not evident for the vigorous exercise intervention group.

  • 279.
    Helge, Torbjörn
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Godhe, Manne
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Mattsson, Mikael
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Att bära tungt: en fysiologisk analys2015Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Nitton manliga vältränade försökspersoner, 9 st med vana att bära tungt och 10 st utan sådan vana, genomförde gång på mjukt underlag i hastigheterna 3 och 5 km/tim med bärvikter i ryggsäck på 20, 35 och 50 kg.

    Energiomsättningen ökade i genomsnitt lika mycket med ökad hastighet som med ökad bärvikt. Mjukt underlag, indikerande gång i lätt terräng, ökade energiomsättningen under både hastigheterna med c:a 20 %, jämfört med hårtunderlag (löpband). Den individuella variationen vid en given bärvikt och hastighet är mycket stor. Beroende på bärvikt och hastighet kan energiomsättningen variera med 100%.  Dessa stora variationer i energiomsättning bör uppmärksammas vid beräkning av energitilldelning via kosten vid längre militära operationer.

    Energiomsättningen vid tyngsta belastningen – 50 kilo bärvikt och hastigheten 5 km/tim – belastade försökspersonerna på i genomsnitt 44 % av maximal syreupptagningsförmåga. I individuella fall var belastningen 60%. Dessa höga belastningar är oacceptabelt höga för transporter under längre tid och kan vara en orsak till belastningsskador.

    Förmågan att bära tungt sammanfaller med ökad kroppsstorlek – både längd och vikt – ålder, maximal syreupptagningsförmåga mätt i L/min men inte i ml/min och kg kroppsvikt, benmuskelstyrka men inte bålmuskelstyrka samt andelen muskelfibrer i lårmuskeln av typ 1. Flera men inte alla av dessa förmågor kan säkert till viss del tränas upp. Bärförmåga för mindre vikter, högst 35 kg, sammanfaller inte med några av ovanstående faktorer, bortsett från ålder. Således, för tyngre bärvikter vid förflyttningar bör selektion av soldater ske enligt de uppmätta parametrarna, medan vad gäller lättare vikter föreligger inte samma selektionkriterier.

    En slutsats från resultaten av denna undersökning är den ursprungliga uttagningen till tunga arbetsuppgifter inom försvaret bör genomföras med tunga arbetsbelastningar, motsvarande de i denna undersökning. Avsikten i fortsättningen av denna undersökningsserie är att fastställa ny testmetodik och procedur för denna selektion samt genomföra tester på kvinnor.

  • 280.
    Hellénius, Mai-Lis
    et al.
    Karolinska institutet.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Epidemiologi och mekanismer2013Ingår i: Långvarigt stillasittande: en hälsofara i tiden / [ed] Elin Ekblom Bak, Studentlitteratur, 2013, s. 19-45Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 281. Hendo, Gina
    et al.
    Jakobsson, Madeleine
    Mattsson, C. Mikael
    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.
    Flockhart, Mikael
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Pontén, Marjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Slutövning GMU: "Aldrig ge upp", Amf1, Berga örlogsbas: Muskelfysiologiska resultat2014Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Energistatus, muskelfysiologiska data och fysiskt stridsvärde studerades före och efter en 8 dygn långa grundmilitär slutövning (GMU) vid AMF-1 Berga Örlogsskolor i månadsskiftet oktober november 2013.

    Totalt deltog 105 soldater i övningen, fördelat på 3 plutoner om vardera 35 soldater. En subgrupp på 24 soldater (8 kvinnor) bestående av 8 soldater från vardera pluton studerades mer ingående.

    Medelhjärtfrekvensen för de 6 soldater (2 kvinnor) som hade i stort sett kompletta mätningar från den 187 timmar långa övningen, inklusive viloperioder, var 88 ± 7 slag/minut. Utifrån hjärtfrekvensdata beräknades den totala energiomsättningen till i genomsnitt 44 000 ± 6 600 kcal, vilket motsvarar 5 600 ± 840 kcal per dygn och 235 ± 35 kcal/tim. Total energiförbrukning var i genomsnitt 39 000 kcal för kvinnorna och 46 500 kcal för männen. I övrigt noterades inte några betydande skillnader mellan kvinnor och män. Däremot var det stora individuella variationer i energiutgift, vilka till ca hälften berodde på skillnader i kroppsvikt. Med hänsyn till kroppsvikt och buren vikt var energiförbrukningen ca 3,1 ± 0,23 kcal per timme per kg totalvikt. Den individuella variationen beror på skillnad i buren vikt, på olika uppgifter och på individuella fysiologiska skillnader.

    Utifrån beräknat energiintag blev det totala energiunderskottet under övningen 12 000-15 000 kcal, vilket är ca 1 500-2 000 kcal per dygn. Viktminskningen under övningen var 2,9 kg för kvinnor och 3,7 kg för män. Denna viktminskning på >4 % leder troligen till försämrad uthållighetsförmåga.

    Den maximala muskelstyrkan i armar och ben var i stort sett oförändrade efter övningen, liksom den beräknade maximala syreupptagningsförmågan. Däremot upplevdes ett lågintensivt cykelarbete som betydligt tyngre efter övningen. Muskeluthållighet mättes inte i denna studie.

    Ett skjutprov om 5 skott i liggande på 100 m mot en tredjedelsfigur visade 64 deltagande soldater på en försämrad träffprocent från 90,5% före till 79,4 % efter övningen. Alla soldater hade minst en träff före medan 6 soldater hade alla bom efter övningen.

    Slutsatsen från studien är att GMU-övningen resulterade i ett stort energiunderskott. Stridsvärdet, bedömt från skjutprovet var klart försämrat. Maximala fysiologiska parametrar var i stort sett oförändrade, medan skattad ansträngning och därmed uthållighetsförmåga, försämrades.

  • 282. Henriksson, Jan
    et al.
    Rosdahl, Hans
    Gymnastik- och idrottshögskolan, GIH.
    Schantz, Peter
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, FoU-gruppen för rörelse, hälsa och miljö.
    Wallberg, Harriet
    Per-Olof Åstrand: Nekrolog2015Övrigt (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

    Nekrolog över Per-Olof Åstrand

    Professor emeritus Per-Olof Åstrand har avlidit i en ålder av 92 år. Hans närmaste anhöriga är makan Irma och barnen Elin och Per med familjer.

    Per-Olof Åstrand föddes i Bredaryd i Småland den 21 oktober 1922, och avled den 2 januari 2015 i Näsby Park norr om Stockholm. Efter värnplikt och beredskapstjänstgöring i pansartrupperna under andra världskriget kom han 1944 till Kungl. Gymnastiska Centralinstitutet (GCI/GIH) för studier till gymnastiklärare. Vid sluttentamen i fysiologi var hans svar så avancerade att den ansvarige läraren bad professorn, Erik Hohwü Christensen, att rätta dem. Kort därefter fick GCI:s fysiologiska institution en ny amanuens.

    Efter gymnastikdirektörsexamen 1946 följde läkarstudier, och parallellt med dessa inleddes avhandlingsarbetet  ”Experimental studies of physical working capacity in relation to sex and age”, som försvarades 1952. Genom detta utvecklades en metodik för att mäta maximal syreupptagning. Det blev en avgörande variabel att relatera till i hans senare forskning om den cirkulatoriska och respiratoriska anpassningen till fysiskt arbete och träning. Det submaximala konditionstest som P.-O., och hans blivande hustru Irma Ryhming, publicerade år 1954 bidrog till att göra GCI känt över världen. Det finns fog att benämna honom som ”den vetenskapligt baserade konditionsträningens fader”. 1970 blev han professor i kroppsövningarnas fysiologi vid GIH.

    P.-O. visade tidigt ett stort intresse för undervisning, och många mötte honom i populärvetenskapliga skrifter såsom ”Kondition och hälsa” och ”Bättre kondition”, men det var genom den omfattande läroboken ”Textbook of Work Physiology: Physiological Bases for Exercise”, skriven tillsammans med Kaare Rodahl, som han blev det riktigt stora namnet inom internationell arbetsfysiologi. Där framträdde holisten Åstrand med en bredd och ett djup som ingen förr hade fångat och skrivit fram. Denna bok, P.-O:s pedagogiska förmåga och engagemang har haft avgörande betydelse för många studenter och kolleger.

    Hans gärningar gjorde honom till ledamot i många lärda sällskap och hedersdoktor vid ett antal universitet ute i världen. Därtill var han en hedersman, med en personlighet präglad av en stor omtanke, slagkraftig humor och generös spiritualitet, ofta med inslag av en särpräglad musikalisk förmåga. För oss som studenter och lärare vid GIH kom samvaron med P.-O. ofta att formas till högtidsstunder. En legendar har nu lämnat oss i djupaste sorg, men också i tacksamhet över allt han bidrog med i våra liv.

    Jan Henriksson

    Hans Rosdahl

    Peter Schantz

    Harriet Wallberg

  • 283. Hey-Mogensen, M
    et al.
    Højlund, K
    Vind, B F
    Wang, Li
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Dela, F
    Beck-Nielsen, H
    Fernström, Maria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Sahlin, Kent
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Effect of physical training on mitochondrial respiration and reactive oxygen species release in skeletal muscle in patients with obesity and type 2 diabetes.2010Ingår i: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 53, nr 9, s. 1976-85Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM/HYPOTHESIS: Studies have suggested a link between insulin resistance and mitochondrial dysfunction in skeletal muscles. Our primary aim was to investigate the effect of aerobic training on mitochondrial respiration and mitochondrial reactive oxygen species (ROS) release in skeletal muscle of obese participants with and without type 2 diabetes. METHODS: Type 2 diabetic men (n = 13) and control (n = 14) participants matched for age, BMI and physical activity completed 10 weeks of aerobic training. Pre- and post-training muscle biopsies were obtained before a euglycaemic-hyperinsulinaemic clamp and used for measurement of respiratory function and ROS release in isolated mitochondria. RESULTS: Training significantly increased insulin sensitivity, maximal oxygen consumption and muscle mitochondrial respiration with no difference between groups. When expressed in relation to a marker of mitochondrial density (intrinsic mitochondrial respiration), training resulted in increased mitochondrial ADP-stimulated respiration (with NADH-generating substrates) and decreased respiration without ADP. Intrinsic mitochondrial respiration was not different between groups despite lower insulin sensitivity in type 2 diabetic participants. Mitochondrial ROS release tended to be higher in participants with type 2 diabetes. CONCLUSIONS/INTERPRETATION: Aerobic training improves muscle respiration and intrinsic mitochondrial respiration in untrained obese participants with and without type 2 diabetes. These adaptations demonstrate an increased metabolic fitness, but do not seem to be directly related to training-induced changes in insulin sensitivity.

  • 284.
    Hirschberg, Angelica Lindén
    et al.
    Karolinska institutet, Stockholm, Sweden.
    Elings Knutsson, Jona
    Karolinska universitetssjukhuset, Stockholm, Sweden.
    Helge, Torbjörn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Godhe, Manne
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Ekblom, Maria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Bermon, Stephane
    Monaco Institute of Sports Medicine, Monaco.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Effects of moderately increased testosterone concentration on physical performance in young women: a double blind, randomised, placebo controlled study2019Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective To investigate the effects of a moderate increase in serum testosterone on physical performance in young, physically active, healthy women.Methods A double blind, randomised, placebo controlled trial was conducted between May 2017 and June 2018 (ClinicalTrials.gov ID: NCT03210558). 48 healthy, physically active women aged 18–35 years were randomised to 10 weeks of treatment with 10 mg of testosterone cream daily or placebo (1:1). All participants completed the study. The primary outcome measure was aerobic performance measured by running time to exhaustion (TTE). Secondary outcomes were anaerobic performance (Wingate test) and muscle strength (squat jump (SJ), counter movement jump (CMJ) and knee extension peak torque). Hormone levels were analysed and body composition assessed by dual energy X-ray absorptiometry.Results Serum levels of testosterone increased from 0.9 (0.4) nmol/L to 4.3 (2.8) nmol/L in the testosterone supplemented group. TTE increased significantly by 21.17 s (8.5%) in the testosterone group compared with the placebo group (mean difference 15.5 s; P=0.045). Wingate average power, which increased by 15.2 W in the testosterone group compared with 3.2 W in the placebo group, was not significantly different between the groups (P=0.084). There were no significant changes in CMJ, SJ and knee extension. Mean change from baseline in total lean mass was 923 g for the testosterone group and 135 g for the placebo group (P=0.040). Mean change in lean mass in the lower limbs was 398 g and 91 g, respectively (P=0.041).Conclusion The study supports a causal effect of testosterone in the increase in aerobic running time as well as lean mass in young, physically active women.

  • 285.
    Holm, Lars
    et al.
    Institute of Sports Medicine and Department of Orthopedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark.
    Dideriksen, Kasper
    Institute of Sports Medicine and Department of Orthopedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark.
    Nielsen, Rie H
    Institute of Sports Medicine and Department of Orthopedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark.
    Doessing, Simon
    Institute of Sports Medicine and Department of Orthopedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark.
    Bechshoeft, Rasmus L
    Institute of Sports Medicine and Department of Orthopedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark.
    Højfeldt, Grith
    Institute of Sports Medicine and Department of Orthopedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark.
    Moberg, Marcus
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Eva Blomstrands forskningsgrupp.
    Blomstrand, Eva
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Eva Blomstrands forskningsgrupp. Karolinska institutet.
    Reitelseder, Søren
    Institute of Sports Medicine and Department of Orthopedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark.
    van Hall, Gerrit
    University of Copenhagen, Denmark.
    An exploration of the methods to determine the protein-specific synthesis and breakdown rates in vivo in humans.2019Ingår i: Physiological Reports, E-ISSN 2051-817X, Vol. 7, nr 17, artikel-id e14143Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The present study explores the methods to determine human in vivo protein-specific myofibrillar and collagenous connective tissue protein fractional synthesis and breakdown rates. We found that in human myofibrillar proteins, the protein-bound tracer disappearance method to determine the protein fractional breakdown rate (FBR) (via 2 H2 O ingestion, endogenous labeling of 2 H-alanine that is incorporated into proteins, and FBR quantified by its disappearance from these proteins) has a comparable intrasubject reproducibility (range: 0.09-53.5%) as the established direct-essential amino acid, here L-ring-13 C6 -phenylalanine, incorporation method to determine the muscle protein fractional synthesis rate (FSR) (range: 2.8-56.2%). Further, the determination of the protein breakdown in a protein structure with complex post-translational processing and maturation, exemplified by human tendon tissue, was not achieved in this experimentation, but more investigation is encouraged to reveal the possibility. Finally, we found that muscle protein FBR measured with an essential amino acid tracer prelabeling is inappropriate presumably because of significant and prolonged intracellular recycling, which also may become a significant limitation for determination of the myofibrillar FSR when repeated infusion trials are completed in the same participants.

  • 286. Holm, Lennart
    et al.
    Schantz, Peter
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, FoU-gruppen för rörelse, hälsa och miljö.
    Inledning2002Ingår i: Nationalstadsparken – ett experiment i hållbar utveckling: Studier av värdefrågor, lagtillämpning och utvecklingslinjer. / [ed] Holm, Lennart & Schantz, Peter, Stockholm: Forskningsrådet Formas, 2002, s. 9-20Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 287. Holm, Lennart
    et al.
    Schantz, PeterGymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, FoU-gruppen för rörelse, hälsa och miljö.
    Nationalstadsparken: ett experiment i hållbar utveckling: studier av värdefrågor, lagtillämpning och utvecklingslinjer2002Samlingsverk (redaktörskap) (Övrigt vetenskapligt)
    Abstract [sv]

    Det historiska landskapet Ulriksdal-Haga-Brunnsviken-Djurgården är Sveriges äldsta och mest besökta tätortsnära frilufts- och rekreationsområde. Det ligger mitt i Stor-Stockholm vid gränsen mellan skärgården och Mälardalen, är rikt på kulturella minnen och har en intressant biologisk mångfald.

    Närheten till storstaden gör detta landskap lätt tillgängligt för allmänheten. Men närheten gör det också attraktivt för olika slag av exploateringar. 1995 fick området därför skydd som Sveriges första nationalstadspark genom ett enhälligt beslut i riksdagen.

    Syftet med lagstiftningen är att förstärka områdets natur-, kultur- och rekreationsvärden samt att värna den biologiska mångfalden. Och regeringen menade att dess förslag kunde förväntas "medföra en stor samhällsekonomisk vinst för Stockholmsregionen genom att främja en uthållig samhällsutveckling och en god livsmiljö för boende och företag i regionen".

    I denna bok belyses hur lagstiftningen har tillämpats och vilka lärdomar som kan dras efter nationalstadsparkens första sju år. Här diskuteras också frågor kring natur- och kulturvärden och behov av utvecklingslinjer vad gäller såväl förvaltning, rättstillämpning som lagstiftning.

    Nationalstadsparken har liknats vid ett experiment i hållbar utveckling och är på så sätt av intresse för alla dem som intresserar sig för och brottas med frågor om hur en hållbar samhällsutveckling ska kunna uppnås. Boken vänder sig därför till såväl allmänheten, tjänstemän och politiker som till studerande och forskare i alla ämnen.

    (Baksidestext)

  • 288.
    Holmberg, HC
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet. Karolinska institutet, Institutionen för fysiologi och farmakologi / Department of Physiology and Pharmacology.
    The physiology of cross-country skiing: With special emphasis on the role of the upper body2005Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Cross-country skiing has been of great interest for exercise physiologists during the last century and is regarded as one of the most demanding endurance sports. Of special interest is that the athletes have extraordinary high aerobic power and that both upper and lower body muscles are involved to various degrees in the different skiing techniques. The overall objective of the present thesis has been to examine and possibly extend the understanding of the physiology in cross-country skiing. In addition, elite cross country skiers with highly trained arms and leg muscles enabled us to study some more general physiological questions. Eight articles are included in the thesis, divided into three major parts: 1) Contribution of the upper body in cross-country skiing (Study I-III), 2) Lung function (Study IV-V) and 3) Oxygen delivery and oxygen uptake (Study VI-VII). The biomechanical data in Study I revealed that pole force, in contrast to poling frequency, is related to double poling (DP) velocity and is influenced by specific muscle activation patterns and a specific characteristic flexion-extension pattern in the elbow, hip and ankle joints with the angle minima occurring around the peak pole force. Moreover, that the muscles during DP are engaged in a sequential order starting with trunk and hip flexors, followed by shoulder and elbow extensors. Finally, that the best skiers use a special technical strategy with specific characteristics related to DP velocity. Study II and III demonstrated that specific DP training has a substantial effect on DP performance and improvements in DP performance were related to biomechanical as well as physiological parameters, shown in Study III by a parallel muscle adaptation in factors of importance for production of force as well as endurance and a bilateral transformation of MHC isoforms towards MHC IIA isoform. Study IV demonstrated that the measured lung function variables in elite skiers are only about 5-20% higher compared to sedentary persons, supporting the notion of a substantially larger trainability of cardiovascular and metabolic as compared to pulmonary functions. Furthermore, by using pulse oximetry, elite c.c. skiers are able to maintain their arterial 02 saturation fairly well during submaximal exercise. During exhaustive exercise using diagonal skiing, double poling and running, the degree of desaturation was relatively low and less than what have earlier been reported in some highly trained endurance athletes. Furthermore, the ventilatory response was different in the exercise modes examined. These data were supported by invasive results from Study V performed with a similar cardiac output. Of special note was that the use of the DP technique demonstrated a better pulmonary gas exchange, and consequently a less degree of desaturation, compared to the other examined skiing techniques. Half of the reduction in the arterial saturation, during the different exercise modes during submaximal exercise, was accounted to the rightward-shift of the oxygen dissociation curve of the haemoglobin. In Study VI vascular conductance and blood pressure were adjusted to match 02 delivery with the local tissue demand. Limb vascular conductance was linearly related to limb V02 during submaximal exercise. Moreover, the results support that maximal vasodilatory response during maximal whole body exercise has to be restrained. If not, the systemic vascular conductance would overwhelm the maximal pumping capacity of the heart and hypotension would ensue. In Study VII, the torso received ~80% of the cardiac output at rest and consumed more than 85% of the resting V02. During exercise the share of the systemic blood flow and the V02 was 25% or less which only represented a 3-fold elevation in absolute values, although cross-country skiing quite intensely involves all muscles of the torso. Altogether, these data point at a most efficient interaction between the torso muscles involved in force development for propulsion and the respiratory muscles, and the respiratory aerobic energy turnover was estimated to be ~5% of pulmonary oxygen uptake during moderate to intense exercise. Finally, in Study VIII, the oxygen extraction, in the arms but not in the legs, was closely related to the in vivo P50 during arm exercise in the cross-country skiers with highly endurance trained arm and leg muscles and that the arms, for a given P50 value, had a lower O2 extraction and lower capillary muscle O2 conductance values compared to the leg muscles. Sincethe conditions for the O2 off-loading from the haemoglobin were similar in leg and arm muscles, the observed differences in maximal arm and leg O2 extraction is suggested to be due to a higher diffusing distance and higher heterogeneity in the distribution of blood flow between and within muscles, shorter mean transit time, and smaller diffusing area in the arms compared to the leg muscles.

  • 289.
    Holmberg, H-C
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Rosdahl, Hans
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC). Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för tillämpad idrottsvetenskap (LTIV).
    Svedenhag, J
    Lung function, arterial saturation and oxygen uptake in elite cross country skiers: influence of exercise mode.2007Ingår i: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 17, nr 4, s. 437-44Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Arterial desaturation during exercise is common in endurance-trained athletes, a phenomenon often more pronounced when the muscle mass engaged in the exercise is large. With this background, the present study monitored seven international-level cross country skiers performing on a treadmill while running (RUN), double poling (DP; upper body exercise) and diagonal skiing (DIA; arm and leg exercise). Static and dynamic lung function tests were performed and oxygen uptake was measured during submaximal and maximal exercise. Lung function variables (including the diffusion capacity) were only 5-20% higher than reported in sedentary men. Vital capacity was considerably lower than expected from the skiers' maximal oxygen uptake (VO(2max)), but the maximal ventilation followed a linear relationship with VO(2max). None or only a mild desaturation was observed in DP, RUN and DIA. Blood lactate concentration was slightly higher in DIA than in DP but not different from RUN. In DIA, VO(2max) was 6.23 +/- 0.47 L/min (mean +/- SD), which was 3.8% and 13.9% higher than in RUN and DP, respectively, with similar peak heart rates for the three exercise modes. No relationships were present either between the degree of desaturation and pulmonary functions tests, or with peak oxygen uptakes. The low blood lactate accumulation during the exhaustive efforts contributed to the arterial oxygen saturation being mild in spite of the very high oxygen uptake observed in these skiers.

  • 290.
    Holmlund, Tobias
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Ekblom Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Franzén, Erika
    Karolinska Institutet, Stockholm, Sweden.
    Hultling, Claes
    Karolinska Institutet, Stockholm, Sweden.
    Wahman, Kerstin
    Karolinska Institutet, Stockholm, Sweden.
    Defining accelerometer cut-points for different intensity levels in motor-complete spinal cord injury.2019Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    STUDY DESIGN: Descriptive.

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

    SETTINGS: Rehabilitation facility in Sweden.

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

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

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

  • 291.
    Holmlund, Tobias
    et al.
    Karolinska institutet.
    Ekblom Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Franzén, Erika
    Karolinska institutet.
    Hultling, Claes
    Karolinska institutet.
    Wahman, Kerstin
    Karolinska institutet.
    Energy expenditure after spinal cord injury in people with motor-complete tetraplegia or motor-complete paraplegia.2018Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 56, nr 3, s. 274-283Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    STUDY DESIGN: Cross-sectional.

    OBJECTIVES: This study aimed to describe and compare VO2 and energy expenditure at rest (REE) and during standardized sedentary, non-exercise physical activity, and exercise activities, in people with motor-complete tetraplegia (C5-C8). Further, REE and energy expenditure (EE) for the different activities were compared to data from a reference group of people with motor-complete paraplegia (T7-T12).

    SETTING: Sweden.

    METHODS: The sample of people with motor-complete tetraplegia consisted of 26 adults (seven women) with SCI, C5-C8 AIS A-B. REE and EE for the different activities were measured with indirect calorimetry. The results were further compared to people with motor-complete paraplegia.

    RESULTS: Resting VO2 was 2.57 ml O2 kg-1 min-1, 2.54 for men and 2.60 for women. The VO2 or activity energy expenditure related to body weight increased three to four times during non-exercise physical activity compared to sedentary activities for the people with motor-complete tetraplegia, and up to six times during exercise activity. No significant differences were seen in resting or sedentary activity VO2 between the people with motor-complete tetraplegia and those with motor-complete paraplegia. Activities of daily life revealed no or small differences in VO2, except for setting a table, while the people with tetraplegia had ∼50% lower VO2 during exercise activities.

    CONCLUSIONS: Non-exercise physical activities of daily life may be significant for increasing total daily EE in people with motor-complete tetraplegia. This might act to motivate the individual, and might be clinically important when designing adapted lifestyle intervention programs for the target group.

  • 292.
    Holmlund, Tobias
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Ekblom Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Franzén, Erika
    Karolinska Institutet, Stockholm, Sweden.
    Hultling, Claes
    Karolinska Institutet, Stockholm, Sweden.
    Wahman, Kerstin
    Karolinska Institutet, Stockholm, Sweden.
    Intensity of physical activity as a percentage of peak oxygen uptake, heart rate and Borg RPE in motor-complete para- and tetraplegia.2019Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, nr 12, artikel-id e0222542Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

    DESIGN: Cross sectional.

    SETTING: Rehabilitation facility and laboratory environment.

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

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

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

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

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

  • 293.
    Holmlund, Tobias
    et al.
    Karolinska institutet.
    Ekblom-Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Franzén, E
    Karolinska institutet.
    Hultling, C
    Karolinska institutet.
    Wikmar, L Nilsson
    Karolinska institutet.
    Wahman, K
    Karolinska institutet.
    Energy expenditure in people with motor-complete paraplegia.2017Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 55, nr 8, s. 774-781Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    STUDY DESIGN: The present descriptive clinical and laboratory study is cross-sectional in design.

    OBJECTIVES: The primary aim is to describe and compare resting energy expenditure (REE) and energy expenditure (EE) during different standardized sedentary, non-exercise and exercise activities in people with motor-complete paraplegia (Th7 to Th12.). A secondary aim was to compare men and women.

    METHODS: Thirty-eight adults (10 women) with SCI, T7-T12 AIS A-B, were recruited. All the data were collected through indirect calorimetry. REE was measured in supine for 30 min after 8 h of overnight fasting. Activity energy expenditure (AEE) for activities was measured for seven minutes during sedentary, non-exercise physical activity (NEPA) and exercise activities.

    RESULTS: AEE increased four to eight times when engaging in NEPA compared to that in sedentary activities. Men had significantly higher resting oxygen uptake compared to women, 0.19 vs 0.15 l min(-1) (P=0.005), REE per 24 h, 1286 vs 1030 kcal (P=0.003) and EE during weight-bearing activities. However, these became nonsignificant after adjustment for body weight and speed of movement, with a mean resting oxygen uptake of 2.47 ml O2 per kg min(-1) for the whole group (women 2.43 and men 2.57 ml O2 kg(-1) min(-1), P=0.49).

    CONCLUSIONS: NEPA increases AEE up to eight times compared to sedentary activities. Gender differences in oxygen uptake during both rest and weight-bearing activities were diminished after adjustment for body weight. The mean resting oxygen uptake for the whole group was 2.47 ml O2 kg(-1) min(-1). These results highlight the importance, especially of NEPA, for increasing total daily EE in the target population.

  • 294. Iaia, F Marcello
    et al.
    Hellsten, Ylva
    Nielsen, Jens Jung
    Fernström, Maria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Sahlin, Kent
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Bangsbo, Jens
    Four weeks of speed endurance training reduces energy expenditure during exercise and maintains muscle oxidative capacity despite a reduction in training volume.2009Ingår i: Journal of applied physiology, ISSN 8750-7587, E-ISSN 1522-1601, Vol. 106, nr 1, s. 73-80Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We studied the effect of an alteration from regular endurance to speed endurance training on muscle oxidative capacity, capillarization, as well as energy expenditure during submaximal exercise and its relationship to mitochondrial uncoupling protein 3 (UCP3) in humans. Seventeen endurance-trained runners were assigned to either a speed endurance training (SET; n = 9) or a control (Con; n = 8) group. For a 4-wk intervention (IT) period, SET replaced the ordinary training ( approximately 45 km/wk) with frequent high-intensity sessions each consisting of 8-12 30-s sprint runs separated by 3 min of rest (5.7 +/- 0.1 km/wk) with additional 9.9 +/- 0.3 km/wk at low running speed, whereas Con continued the endurance training. After the IT period, oxygen uptake was 6.6, 7.6, 5.7, and 6.4% lower (P < 0.05) at running speeds of 11, 13, 14.5, and 16 km/h, respectively, in SET, whereas remained the same in Con. No changes in blood lactate during submaximal running were observed. After the IT period, the protein expression of skeletal muscle UCP3 tended to be higher in SET (34 +/- 6 vs. 47 +/- 7 arbitrary units; P = 0.06). Activity of muscle citrate synthase and 3-hydroxyacyl-CoA dehydrogenase, as well as maximal oxygen uptake and 10-km performance time, remained unaltered in both groups. In SET, the capillary-to-fiber ratio was the same before and after the IT period. The present study showed that speed endurance training reduces energy expenditure during submaximal exercise, which is not mediated by lowered mitochondrial UCP3 expression. Furthermore, speed endurance training can maintain muscle oxidative capacity, capillarization, and endurance performance in already trained individuals despite significant reduction in the amount of training.

  • 295.
    Ivarsson, Niklas
    et al.
    Karolinska Institutet.
    Mattsson, C. Mikael
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Cheng, Arthur J
    Karolinska Institutet.
    Bruton, Joseph D
    Karolinska Institutet.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Lanner, Johanna T
    Karolinska Institutet.
    Westerblad, Håkan
    Karolinska Institutet.
    SR Ca2+ leak in skeletal muscle fibers acts as an intracellular signal to increase fatigue resistance.2019Ingår i: The Journal of General Physiology, ISSN 0022-1295, E-ISSN 1540-7748, Vol. 151, nr 4, s. 567-577, artikel-id jgp.201812152Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Effective practices to improve skeletal muscle fatigue resistance are crucial for athletes as well as patients with dysfunctional muscles. To this end, it is important to identify the cellular signaling pathway that triggers mitochondrial biogenesis and thereby increases oxidative capacity and fatigue resistance in skeletal muscle fibers. Here, we test the hypothesis that the stress induced in skeletal muscle fibers by endurance exercise causes a reduction in the association of FK506-binding protein 12 (FKBP12) with ryanodine receptor 1 (RYR1). This will result in a mild Ca2+ leak from the sarcoplasmic reticulum (SR), which could trigger mitochondrial biogenesis and improved fatigue resistance. After giving mice access to an in-cage running wheel for three weeks, we observed decreased FKBP12 association to RYR1, increased baseline [Ca2+]i, and signaling associated with greater mitochondrial biogenesis in muscle, including PGC1α1. After six weeks of voluntary running, FKBP12 association is normalized, baseline [Ca2+]i returned to values below that of nonrunning controls, and signaling for increased mitochondrial biogenesis was no longer present. The adaptations toward improved endurance exercise performance that were observed with training could be mimicked by pharmacological agents that destabilize RYR1 and thereby induce a modest Ca2+ leak. We conclude that a mild RYR1 SR Ca2+ leak is a key trigger for the signaling pathway that increases muscle fatigue resistance.

  • 296. Jensen, Line
    et al.
    Gejl, Kasper D
    Ørtenblad, Niels
    Nielsen, Jakob L
    Bech, Rune D
    Nygaard, Tobias
    Sahlin, Kent
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Frandsen, Ulrik
    Carbohydrate restricted recovery from long term endurance exercise does not affect gene responses involved in mitochondrial biogenesis in highly trained athletes.2015Ingår i: Physiological Reports, E-ISSN 2051-817X, Vol. 3, nr 2Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to determine if the metabolic adaptations, particularly PGC-1α and downstream metabolic genes were affected by restricting CHO following an endurance exercise bout in trained endurance athletes. A second aim was to compare baseline expression level of these genes to untrained. Elite endurance athletes (VO2max 66 ± 2 mL·kg(-1)·min(-1), n = 15) completed 4 h cycling at ~56% VO2max. During the first 4 h recovery subjects were provided with either CHO or only H2O and thereafter both groups received CHO. Muscle biopsies were collected before, after, and 4 and 24 h after exercise. Also, resting biopsies were collected from untrained subjects (n = 8). Exercise decreased glycogen by 67.7 ± 4.0% (from 699 ± 26.1 to 239 ± 29.5 mmol·kg(-1)·dw(-1)) with no difference between groups. Whereas 4 h of recovery with CHO partly replenished glycogen, the H2O group remained at post exercise level; nevertheless, the gene expression was not different between groups. Glycogen and most gene expression levels returned to baseline by 24 h in both CHO and H2O. Baseline mRNA expression of NRF-1, COX-IV, GLUT4 and PPAR-α gene targets were higher in trained compared to untrained. Additionally, the proportion of type I muscle fibers positively correlated with baseline mRNA for PGC-1α, TFAM, NRF-1, COX-IV, PPAR-α, and GLUT4 for both trained and untrained. CHO restriction during recovery from glycogen depleting exercise does not improve the mRNA response of markers of mitochondrial biogenesis. Further, baseline gene expression of key metabolic pathways is higher in trained than untrained.

  • 297. Jeppesen, Jacob
    et al.
    Mogensen, Martin
    Prats, Clara
    Sahlin, Kent
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Madsen, Klavs
    Kiens, Bente
    Copenhagen University.
    FAT/CD36 is localized in sarcolemma and in vesicle-like structures in subsarcolemma regions but not in mitochondria.2010Ingår i: Journal of Lipid Research, ISSN 0022-2275, E-ISSN 1539-7262, Vol. 51, nr 6, s. 1504-12Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The primary aim of the present study was to investigate in which cellular compartments fatty acid trans-locase CD36 (FAT/CD36) is localized. Intact and fully functional skeletal muscle mitochondria were isolated from lean and obese female Zucker rats and from 10 healthy male individuals. FAT/CD36 could not be detected in the isolated mitochondria, whereas the mitochondrial marker F(1)ATPase-beta was clearly detected using immunoblotting. Lack of markers for other membrane structures indicated that the mitochondria were not contaminated with membranes known to contain FAT/CD36. In addition, fluorescence immunocytochemistry was performed on single muscle fibers dissected from soleus muscle of lean and obese Zucker rats and from the vastus lateralis muscle from humans. Costaining against FAT/CD36 and MitoNEET clearly show that FAT/CD36 is highly present in sarcolemma and it also associates with some vesicle-like intracellular compartments. However, FAT/CD36 protein was not detected in mitochondrial membranes, supporting the biochemical findings. Based on the presented data, FAT/CD36 seems to be abundantly expressed in sarcolemma and in vesicle-like structures throughout the muscle cell. However, FAT/CD36 is not present in mitochondria in rat or human skeletal muscle. Thus, the functional role of FAT/CD36 in lipid transport seems primarily to be allocated to the plasma membrane in skeletal muscle.

  • 298.
    Johansson, Christer
    et al.
    Department of Environmental Science and Analytical Chemistry, Stockholm University, SE-10691 Stockholm, Sweden.
    Lövenheim, Boel
    Environment and Health Administration, SLB, Stockholm, Sweden.
    Schantz, Peter
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, FoU-gruppen för rörelse, hälsa och miljö.
    Wahlgren, Lina
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, FoU-gruppen för rörelse, hälsa och miljö.
    Almström, Peter
    WSP Civils, Stockholm, Sweden.
    Markstedt, Anders
    WSP Civils, Stockholm, Sweden.
    Strömgren, Magnus
    Department of Geography and Economic History, Umeå University, Umeå, Sweden .
    Forsberg, Bertil
    Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Nilsson Sommar, Johan
    Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Impacts of air pollution and health by changing commuting from car to bicycle2017Ingår i: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 584-585, s. 55-63Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Our study is based on individual data on people’s home and work addresses, as well as their age, sex and physical capacity, in order to establish realistic bicycle-travel distances. A transport model is used to single out data on commuting preferences in the County Stockholm. Our analysis shows there is a very large potential for reducing emissions and exposure if all car drivers living within a distance corresponding to a maximum of a 30 minute bicycle ride to work would change to commuting by bicycle. It would result in more than 111 000 new cyclists, corresponding to an increase of 209% compared to the current situation.

    Mean population exposure would be reduced by about 7% for both NOx and black carbon (BC) in the most densely populated area of the inner city of Stockholm. Applying a relative risk for NOx of 8% decrease in all-cause mortality associated with a 10 µg m-3 decrease in NOx, this corresponds to more than 449 (95% CI: 340 - 558) years of life saved annually for the Stockholm county area with 2.1 million inhabitants. This is more than double the effect of the reduced mortality estimated for the introduction of congestion charge in Stockholm in 2006. Using NO2 or BC as indicator of health impacts, we obtain 395 (95% CI: 172 - 617) and 185 (95% CI: 158 - 209) years of life saved for the population, respectively. The calculated exposure of BC and its corresponding impacts on mortality are likely underestimated. With this in mind the estimates using NOx, NO2 and BC show quite similar health impacts considering the 95% confidence intervals.

  • 299. Johnson, Urban
    et al.
    Ivarsson, Andreas
    Karlsson, Jón
    Hägglund, Martin
    Waldén, Markus
    Börjesson, Mats
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Rehabilitation after first-time anterior cruciate ligament injury and reconstruction in female football players: a study of resilience factors.2016Ingår i: BMC Sports Science, Medicine And Rehabilitation, ISSN 2052-1847, Vol. 8, artikel-id 20Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Most of the research in the area of psychosocial factors in rehabilitation after sports injuries has focused on risk behaviors, while relatively few studies have focused on behaviors that facilitate rehabilitation. The objective of our study was to understand the psychosocial features that characterize elite female football players who express a resilient behaviour during rehabilitation after a first-time anterior cruciate ligament (ACL) injury and reconstruction.; Methods: A qualitative method was used based on individual in-person interviews and video communication of players who incurred a first-time ACL tear during the 2012 season of the Swedish Women's Elite Football League. In total, 13 players had a first-time ACL and were interviewed post-season. The interviews were followed by a thematic content analysis. Based on this, eight players were identified as showing resilient behaviors during their rehabilitation and were included in the final analysis.; Results: Three core themes representing psychosocial factors that help players cope successfully with rehabilitation were identified: (I) constructive communication and rich interaction with significant others; (II) strong belief in the importance and efficacy of one's own actions; and (III) the ability to set reasonable goals.; Conclusions: The findings suggest three core themes of psychosocial factors that characterize first-time ACL-injured elite female football players showing resilience during rehabilitation after ACL reconstruction. Suggestions for medical teams about ways to support communication, self-efficacy, and goal-setting during the rehabilitation process, are provided.;

  • 300.
    Kaldo, Viktor
    et al.
    Huddinge Hospital, Stockholm, Sweden..
    Lundin, Andreas
    Karolinska Institutet, Stockholm, Sweden.
    Hallgren, Mats
    Karolinska Institutet, Stockholm, Sweden.
    Kraepelien, Martin
    Huddinge Hospital, Stockholm, Sweden..
    Strid, Catharina
    Lund University, Lund, Sweden.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Lavebratt, Catharina
    Karolinska Institutet, Stockholm, Sweden.
    Lindefors, Nils
    Huddinge Hospital, Stockholm, Sweden..
    Öjehagen, Agneta
    Lund University, Lund, Sweden.
    Forsell, Yvonne
    Karolinska Institutet, Stockholm, Sweden.
    Effects of internet-based cognitive behavioural therapy and physical exercise on sick leave and employment in primary care patients with depression: two subgroup analyses.2018Ingår i: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 75, nr 1, s. 52-58, artikel-id oemed-2017-104326Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: Depression can negatively impact work capacity, but treatment effects on sick leave and employment are unclear. This study evaluates if internet-based cognitive behavioural therapy (ICBT) or physical exercise (PE), with already reported positive effects on clinical outcome and short-term work ability, has better effects on employment, sick leave and long-term work ability compared with treatment as usual (TAU) for depressed primary care patients (German clinical trials: DRKS00008745).

    METHODS: After randomisation and exclusion of patients not relevant for work-related analysis, patients were divided into two subgroups: initially unemployed (total n=118) evaluated on employment, and employed (total n=703) evaluated on long-term sick leave. Secondary outcomes were self-rated work ability and average number of sick days per month evaluated for both subgroups. Assessments (self-reports) were made at baseline and follow-up at 3 and 12 months.

    RESULTS: For the initially unemployed subgroup, 52.6% were employed after 1 year (response rate 82%). Both PE (risk ratio (RR)=0.44; 95% CI 0.23 to 0.87) and ICBT (RR=0.37; 95% CI 0.16 to 0.84) showed lower rates compared with TAU after 3 months, but no difference was found after 1 year (PE: RR=0.97; 95% CI 0.69 to 1.57; ICBT: RR=1.23; 95% CI 0.72 to 2.13). For those with initial employment, long-term sick leave (response rate 75%) decreased from 7.8% to 6.5%, but neither PE (RR=1.4; 95% CI 0.52 to 3.74) nor ICBT (RR=0.99; 95% CI 0.39 to 2.46) decreased more than TAU, although a temporary positive effect for PE was found. All groups increased self-rated work ability with no differences found.

    CONCLUSIONS: No long-term effects were found for the initially unemployed on employment status or for the initially employed on sick leave. New types of interventions need to be explored.

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