Gymnastik- och idrottshögskolan, GIH

Retirement is a major life transition that involves changes to everyday routines, roles, and habits. Previous studies suggest that retirement may influence drinking habits. Many natural inhibitors of alcohol consumption disappear with the removal of work constraints. The potential impact depends on both individual and contextual factors. Women in the cohorts undergoing retirement now have been more active on the labor market, including the occupation of higher status jobs, which indicates more financial resources as well as a larger role loss after retirement. Also, the current cohorts who retire have had more liberal drinking habits throughout their lives compared to previous cohorts. We therefore examined changes in alcohol consumption surrounding retirement in different education groups among women and men undergoing retirement using annual data from the Health, Aging and Retirement Transitions in Sweden (HEARTS) study, a longitudinal national study of 60- to 66-year-olds (n = 5,913), from 2015 to 2018. Latent growth curve models were used to estimate trajectories of alcohol consumption. Results showed that those who retired during the follow-up increased their usual weekly alcohol consumption while those who worked or were retired throughout the period had stable drinking habits. Those who were retired reported the highest alcohol consumption. The increase surrounding retirement was driven by people with higher education. Women with tertiary education and men with intermediate or tertiary education increased their weekly alcohol intake after retirement, while those with low education had unchanged drinking habits. Mechanisms and motivations that may fuel increased alcohol intake among people with higher education should be further investigated.

Chronic negative stress may be the start of a progress of illness, that may end in serious troubles for the affected. In this Perspective we highlight the steps in such a progress, what we call a staircase of stress. This underlines the importance of recognition, understanding and therapeutic measures at an early stage of the stress disorders. 

Background: Headache of stress etiology is a common, worldwide medical problem with high sick leave and large economic consequences. There is a need to improve the understanding of underlying neurobiological processes. Research show that headache of stress etiology often is one symptom in a complex of multiple pains and augmented widespread muscular tension with a specific pattern of tender points (1). 

Objective and Method: We will present in children with recurrent stress related pain, some hormonal changes and electromyography (EMG) data, showing a novel and a missing link, regarding central and peripheral neurophysiological changes of significant importance for better understanding recurrent multiple pain including headache. 

Results: During high acoustic signals, the startle reaction was shown, via EMG, to be potentiated, more easily and more often elicited in several muscles related to the pain, in 19 children with recurrent stress related pain in the head, neck and abdomen, diagnosed according to strict defined criteria (2), and compared to 21 matched controls. Also, higher resting muscle activity was found in these children as well as increased cortisol and decreased oxytocin. 

Conclusion. Stressors evoke stress response for example in the amygdala, which can trigger and potentiate the startle reaction with amplified muscle excitability and tonus. These reactions and the increased cortisol and decreased oxytocin in those children are in accordance with findings of the right dominance of stress in the bi-cameral brain (3). These neurophysiological facts can be of importance for the understanding of clinical manifestation of headache and other pain and must be heeded in the treatment of patients with pain related to stress.  

1.Alfven G, Grillner S, Andersson E. Review of childhood pain highlights the role of negative stress. Acta Paediatr.2019;Jun4.doi:10.1111/apa.14884.

2.Alfvén G, Grillner S, Andersson E. Children with chronic stress-induced recurrent muscle pain have enhanced startle reaction. Eur J Pain.2017;21:1561-1570.

3.Strigo IA, Craig AD. Interoception, homeostatic emotions and sympathovagal balance. 

Philos Trans R Soc Lond B Biol Sci.2016;Nov19;371(1708).

For better understanding and better care of psychosomatic pain valid and reliable diagnostic criteria is a prerequisite. The startle reflex is of importance for the understanding of the stress induced pain and the increased excitability in several muscles. The pattern of increased muscle tension and tenderness that can be found in these patterns can be of valuable diagnostic support. Decreased oxytocin and increased cortisol is a sign of right brain dominance in stress and indicate psuchosomatic pain. The omega-3 and omega-6 changes are in indication metabolic pain mechanism of interest for future study. Treatment is reccomended to be guided by the knowledge here described.

We discuss the aetiology of recurrent abdominal pain of non-organic origin, according to the Rome Criteria for Functional Gastrointestinal Disorders and a psychogenic hypothesis. Stress activates the brain-gut axis, which is important for local gut symptoms, such as abdominal pain, but it also causes pain in other areas, including the head, back and chest. Our research has indicated that the startle reflex plays a dominant role in this stress-induced pain pattern, which is manifested in the whole body. Localised abdominal pain can be part of a general negative stress reaction that causes multiple pains in other areas of the body.

G. Alfvén1, E. Andersson2, 3

1. Clintec, Karolinska Institute, Stockholm, Sweden. 2. The Department of Neuroscience, Karolinska institute, Stockholm, Sweden. 3. The Swedish School of Sport and Health Sciences, Stockholm, Sweden.

Corresponding author:  G Alfvén (gosta.alfven@slmk.org) Karolinska Institute, Sweden

ABSTRACT 

Background: Recurrent pain of stress etiology is a common, worldwide problem with impaired quality of life and decreased school attendance. Research show that pain of stress etiology, often called psychosomatic pain, often is a complex of multiple pains, other symptoms and augmented widespread muscular tension with a specific pattern of tender points (1). 

Objective and Method: We will in a clinical context present electromyography (EMG) data, showing a novel and a missing link, regarding central and peripheral neurophysiological changes of significant importance for better understanding recurrent multiple pain. 

Results: During high acoustic signals, the startle reaction was shown, via EMG, to be potentiated, more easily and more often elicited in several muscles related to the pain, in 19 children with recurrent stress related pain in the head, neck and abdomen, diagnosed according to strict defined criteria (2), and compared to 23 matched controls. Also, higher resting muscle activity was shown. We will also present data showing increased cortisol and decreased oxytocin and increased risk for developing fibromyalgia in children with psychosomatic pain. 

Conclusion. Stressors potentiated the startle reaction with increased muscle activity in rest and increased excitability. These reactions and increased cortisol and decreased oxytocin in those children are in accordance with findings of the right dominance of stress in the bi-cameral brain (3). These neurophysiological facts can be of importance for the understanding of clinical manifestation of recurrent pain and must be heeded in the treatment of patients with pain related to stress.  

1. Alfven G, Grillner S, Andersson E. Review of childhood pain highlights the role of negative stress. Acta Paediatr.2019; Jun4.doi:10.1111/apa.14884.

2. Alfvén G, Grillner S, Andersson E. Children with chronic stress-induced recurrent muscle pain have enhanced startle reaction. Eur J Pain.2017;21:1561-1570.

3. Strigo IA, Craig AD. Interoception, homeostatic emotions and sympathovagal balance. 

Philos Trans R Soc Lond B Biol Sci.2016;Nov19;371(1708).

G. Alfvén1, E. Andersson2, 3

1. Clintec, Karolinska Institute 2. Department of Neuroscience, Karolinska institute, 3. Swedish School of Sport and Health Sciences, -all Stockholm, Sweden.

Corresponding author:  G Alfvén (gosta.alfven@slmk.org) 

ABSTRACT 

Background: Negative stress is very common, always affecting brain and body resulting in different symptoms often called psychosomatic. To better understand stress, it is important to overcome the mind-body dichotomy and explore how they are connected. 

Objective and Method: We will present in children with recurrent stress related pain, some hormonal changes and electromyography (EMG) data, showing a novel and a missing link, regarding central and peripheral neurophysiological changes of significant importance for better understanding recurrent multiple psychosomatic pain (1).  

Results: During high acoustic signals, the startle reaction was shown, via EMG, to be potentiated, more easily and more often elicited in several muscles related to the pain, in 19 children with recurrent stress related pain in the head, neck and abdomen, diagnosed according to strict defined criteria (2), and compared to 21 matched controls. Also, higher resting muscle activity was found in these children as well as increased cortisol and decreased oxytocin. 

Conclusion. Stressors evoke stress response for example in the amygdala, which can trigger and potentiate the startle reaction with amplified muscle excitability and tonus. These reactions and the increased cortisol and decreased oxytocin in those children are in accordance with findings of the right dominance of stress in the bi-cameral brain (3). These neurophysiological facts can be of importance for the understanding of clinical manifestation of psychosomatic pain and must be heeded in the treatment of patients with pain related to stress.  

1.Alfven G, Grillner S, Andersson E. Review of childhood pain highlights the role of negative stress. Acta Paediatr.2019;Jun4.doi:10.1111/apa.14884.

2.Alfvén G, Grillner S, Andersson E. Children with chronic stress-induced recurrent muscle pain have enhanced startle reaction. Eur J Pain.2017;21:1561-1570.

3.Strigo IA, Craig AD. Interoception, homeostatic emotions and sympathovagal balance. 

Philos Trans R Soc Lond B Biol Sci.2016;Nov19;371(1708).

Background: In Paralympic sports, classification of athletes based on the impact of impairments on the ability to perform is needed, to prevent a one-sided and predictable outcome of the competition in which the least impaired athlete has the best chance to win. Classification is developing from expert opinion based to evidence based. In wheelchair court sports, there is evidence to support the impact of impairment on wheeled mobility, but not on ball handling. To assess the impact of impairment on the ability to perform ball-handling activities, standardised tests for ball handling are needed.

Purpose: To assess if reliable and valid standardised tests for the measurement of ball-handling proficiency in a wheelchair or able-bodied court sports exist; to assist in the development of Evidence-Based Classification (EBC) in wheelchair court sports according to the guidelines of the International Paralympic Committee (IPC).

Methods: The review was conducted according to the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) statement. Search terms used were "wheelchair," "ball," "ball sports," "test," and "performance." Databases searched were Medline, Embase, PubMed, and Sport Discus. Study quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist.

Results: Twenty-two articles were included. Foundational Movement Skills in ball-handling proficiency were assessed. Tests for throwing maximal distance showed sufficient reliability and validity. Precision in throwing showed low-to-moderate reliability and conflicting results in validity. Throwing techniques differed between studies. Dribbling the ball showed high reliability, but conflicting results in validity.

Conclusions: Tests for throwing maximal distance, throwing precision, and dribbling the ball can be used in standardised tests for activity limitation in wheelchair court sports. However, tests need to be adapted and standardised and then reassessed for reliability and validity in athletes with and without arm impairment.

BACKGROUND: Healthy lifestyle habits, including physical activity (PA), are associated with a broad range of positive psychosocial and physical health benefits. However, there are challenges involved in reaching vulnerable groups in socioeconomically disadvantaged areas. There is a lack of research on family-based PA interventions, specifically considering psychosocial health. The purpose of this study was to explore how families experienced psychosocial aspects of health after participation in a family-based programme, A Healthy Generation.

METHODS: A Healthy Generation is a health-promoting, family-based programme delivered in collaboration with local municipalities and sport associations in socioeconomically disadvantaged areas in Sweden. Families with children in grade 2 (8-9 years), including siblings, participate in health-promoting activities, including activity sessions, healthy meals, health information and parental support groups. Data was collected through interviews with parents and children (n = 23) from a controlled pilot trial of the programme. Interviews were audio recorded, transcribed and analysed using a phenomenological hermeneutical method.

RESULTS: Three themes and seven sub-themes emerged. The themes were: "A sense of belonging", "Awareness of one's role as a parent" and "Inspiration towards new and healthier behaviours". In terms of A sense of belonging, participation in the programme was the families own free zone, where they also had the opportunity of being together with other families in the programme. For participants that were isolated and lacked a social network, their participation helped them towards social participation. During the programme, parents created an Awareness of one's role as a parent, with new insights on how to act as a parent and they also negotiated differences between each other. Participation in the programme contributed to Inspiration towards new and healthier behaviours such as experience-based insights and healthy lifestyle changes.

CONCLUSIONS: This study highlights the importance of co-participation in family-based health-promoting programmes to enhance psychosocial health among families in socioeconomically disadvantaged areas. The results give new insights into participants' experiences of psychosocial aspects of health after participation in a family-based PA programme. This knowledge can contribute to the understanding of how to design health-promoting, family-based interventions to promote psychosocial health in socioeconomically disadvantaged areas.

TRIAL REGISTRATION: ISRCTN ISRCTN11660938 . Retrospectively registered 23 September 2019.

Boken handlar huvudsakligen om forskarparet Irma och Per-Olof Åstrand och deras insatser inom det arbetsfysiologiska fältet. Dessutom uppmärksammas olika aktörer som varit verksamma i anslutning till de båda. Författarna beskriver Åstrandtestet, dess bakgrund, grundläggande principer och genomförande. Därutöver presenteras en del av den utveckling som har skett inom svensk idrottsfysiologisk forskning och testning genom tiderna. Bilder, diagram och tabeller kompletterar texten och speglar det förflutna med fokus på bland annat laborationer och publikationer. Åstrandtestet vänder sig till studerande inom hälso- och sjukvård, folkhälsa, idrottsvetenskap, idrotts- och vetenskapshistoria samt yrkesverksamma inom dessa områden.

Innehåll:

• Minnen från vår uppväxt med Irma och Per-Olof, av Elin Rundqvist & Peje Åstrand
• Det biologiska arvet
• Fysisk aktivitet och hälsa
• Ett idrottsligt paradigmskifte
• Idrottsfysiologisk forskning, träning och tävling i praktiken
• Aeroba tester
• Irma Åstrand - en kvinnlig pionjär inom arbetsfysiologin, av Daniel Svensson & Peter Schantz
• Åstrandtestets bakgrund och grundläggande principer
• Åstrandtestet - förberedelser, genomförande och beräkning av konditionsnivå
• Den notoriske ergometercyklisten

Background 

It is important to examine how motorized traffic variables affect pedestrians along a gradient from rural to inner urban settings.

Methods

Relations between pedestrians´ perceptions of four traffic variables and appraisals of route environments as hindering – stimulating for walking as well as unsafe – safe for reasons of traffic, were therefore studied in the inner urban area of Stockholm, Sweden (n = 294). The pedestrians rated their perceptions and appraisals with the Active Commuting Route Environment Scale (ACRES). Correlation, multiple regression, and mediation analyses were used to study the relationships between the traffic variables and the outcome variables. 

Results 

Noise related negatively to both hindering – stimulating for walking, and to unsafety – safety for traffic reasons. Vehicle speed related negatively to unsafety – safety for traffic reasons. Furthermore, vehicle speed protruded as an important origin of the deterring effects of traffic among those who commute by foot. 

Conclusion

The study shows the value of both partial and simultaneous analyses of the effect of all four traffic variables in relation to outcome variables relevant for walking. 

Background and Methods

Relations between pedestrians´ perceptions of traffic variables and appraisals of route environments as hindering – stimulating for walking as well as unsafe – safe for reasons of traffic, were studied in the inner urban area of Stockholm, Sweden (n = 294). The pedestrians used the Active Commuting Route Environment Scale (ACRES). Correlation, multiple regression, and mediation analyses were used to study the relationships between the traffic variables and the outcome variables.

Results

Traffic noise relates negatively to both hindering – stimulating for walking, and to unsafety – safety for traffic reasons. Vehicle speed related negatively to unsafety – safety for traffic reasons. Furthermore, vehicle speed protrudes as an important origin of the deterring effects of traffic among those who commute by foot.

Conclusion

The study shows the value of both partial and simultaneous analyses of the effect of all four traffic variables in relation to outcome variables relevant for walking. 

Background

Every walk takes place in a route environment, and it can play an important role in deterring or facilitating walking, and will always affect the environmental unwell – wellbeing of pedestrians. The aim of this study is to illuminate which the important route environmental variables are in this respect. The focus is therefore on pedestrians´ perceptions of route environmental variables and how they relate to overall appraisals of route environments as hindering – stimulating for walking and unsafe – safe for reasons of traffic. 

Methods

Commuting pedestrians in the inner urban area of Stockholm, Sweden (n = 294, 49.5 ± 10.4 years, 77% women), were recruited via advertisements. They evaluated their own commuting route environments using a self-report tool, the Active Commuting Route Environment Scale (ACRES). Correlation, multiple regression, and mediation analyses were used to study the relationships between the variables and the outcome variables.

Results

Aesthetics and greenery appear to strongly stimulate walking, whereas noise, a proxy for motorized traffic, hinders it. Furthermore, aesthetics is positively related to traffic safety, whereas conflicts have the opposite role. Conflicts is an intermediate outcome, representing several basic environmental variables, whereof some were directly and negatively related to unsafe – safe traffic.

Conclusion 

Route environmental variables appear to be potent factors in deterring or facilitating walking. This knowledge is of importance for policymakers and urban planners when designing route environments with the aim of attracting new pedestrians, and simultaneously stimulating those who already walk to keep on.

Bakgrund

Regelbunden fysisk aktivitet har positiva hälsoeffekter, och många vill vara fysiskt aktiva, men upplever inte sällan olika hinder för det, till exempel tidsbrist. Att gå eller cykla till arbetet är därför en intressant möjlighet i detta sammanhang, då fysiskt aktiv arbetspendling ofta är tidseffektivt. Dessutom krävs sällan någon specialutrustning, startsträckan är kort och avstånden kan anpassas så att man går, cyklar hela eller delar av sträckan mellan hem och arbetsplats. Om färdvägsmiljön dessutom upplevs som stimulerande och trygg kan den sannolikt bidra till att upprätthålla ett beteende, och på så vis medverka till att många individer får en angelägen ”dos” fysisk aktivitet.  

Studier av hur olika trafikvariabler samspelar, och hur dessa i sin tur påverkar vår uppfattning om en färdvägsmiljö ger inga entydiga svar. Syftet med denna studie var därför att studera de interna sambanden mellan fyra olika variabler relaterade till motortrafik: hastighet, flöde, buller och avgaser samt hur dessa, i olika kombinationer, inverkar på uppfattningen om en miljö är hindrande eller stimulerande respektive trygg eller otrygg för arbetspendling till fots.

Metod

294 arbetspendlande fotgängare (49.5 ± 10.4 år, 77 % kvinnor) rekryterades via annonser, och deras upplevelser av sina färdvägsmiljöer i Stockholms innerstad har nyttjats i våra analyser. Upplevelserna skattades med färdvägsmiljöskalan ”The Active Commuting Route Environment Scale” (ACRES). Den innehåller utfallsvariablerna hindrande-stimulerande färdvägsmiljö och otrygghet-trygghet i trafiken, samt ett antal miljöprediktorer, varav vi har nyttjat de fyra som är relaterade till motortrafik: flöde av motorfordon, hastighet, buller och avgaser.  Såväl trafikvariabler som utfallsvariabler skattades med 15-gradiga skalor. För att analysera sambanden mellan trafikvariablerna och utfallsvariablerna användes multipla regressionsanalyser. 

Resultat

Alla trafikvariabler var i sig själva negativt relaterade de båda utfallsvariablerna hindrande-stimulerande färdvägsmiljö och otrygghet-trygghet i trafiken. När istället de fyra trafikvariablerna analyserades samtidigt i förhållande till om miljön upplevdes som hindrande eller stimulerande samt otrygg eller trygg var det enbart buller som var negativt relaterad till de båda utfallsvariablerna. Hastighet hade en negativ roll i förhållande till trygghetsvariabeln. Analyserna visade dessutom att både flöde av motorfordon och hastighet förutspådde buller.

Slutsatser

Samtidigt som varje trafikvariabel är negativt relaterad till hur färdvägsmiljöer upplevs av fotgängare, framträder motorfordons buller och hastigheter som de variabler som är mest bekymmersamma för fotgängare. Studier som denna kan utgöra ett underlag för arbetet med att skapa attraktiva miljöer för fotgängare, och därmed bidra till bättre folkhälsa, förändrade pendlingsmönster i urbana miljöer samt ökad ekologisk hållbarhet.

Ambitionen med detta kapitel är att på ett enkelt, sakligt och inspirerande sätt beskriva akuta sjukdoms- och skadetillstånd (inkl. missbruk) som kan förekomma i samband med fysisk aktivitet, och vilken eller vilka åtgärder som ska sättas in när olikan är framme.

Walking Football (WF) is one type of recreational football increasing in popularity, targeting older adults. Further knowledge on the intensity and physical workload of WF, characteristics of the players, the social context, and reasons for playing WF is needed. Thus, the aim of the study was to characterize the individuals that regularly play WF and their experience of WF, and the physiological characteristics of the sport. Sixty-three players from three clubs taking part in organised WF in Sweden were included. The players participated in up to four WF-games and underwent performance tests and answered a questionnaire. The participants mean age was 70.9 years, ranging from 63 to 85 years with 71% (n = 27) of the men and 68% (n = 13) of the women having a BMI > 25. Fifty-one percent (n = 27) of the players had hypertension, and 73% (n = 39) regularly used prescription drugs due to illness. During WF, the players covered on average 2,409 m (2,509 m for men and 2,205 m for women, p = .001). Expressed in percentage of their age-estimated maximal heart rate, mean heart rate represented 80 ± 9 and 80 ± 8% of max for men, and 78 ± 9 and 79 ± 9% of max for women in the first and second halves, respectively, hence WF can be considered a moderate intensity activity for older adults. The main reason for WF participation was to socialize. WF includes a considerable number of accelerations and decelerations, making it more energetically and mechanically demanding than walking.

Aim and research questions: The aim of this study is to investigate and describe the gender norms that Finnish middle school students experience in PE lessons. The purpose is also to investigate and interpret students’ experiences of gender equality in PE. The research questions were: - How do middle school students describe a PE lesson?- What kind of gender norms appear in these descriptions?- How do middle school students experience gender equality in PE?

Method: The study was conducted with a qualitative method where data was collected through students' descriptions of PE lessons. 36 students in the 8th grade from a middle school in Helsinki were given a task by their teacher to describe a PE lesson in their school. 20 students and their legal guardians gave their consent to participate in the study. The task was to write a text anonymously about their experiences of a PE lesson. This data collection method was used to find out how students experience PE and what gender norms appeared. A qualitative content analysis was applied to the material. 

Results: The results of the study showed that there are gender norms that can limit students' participation in various activities during PE lessons. Both girls and boys liked PE, but several girls had negative experiences of the subject. Several girls experienced themselves not good enough at different activities in PE and several boys described themselves as good at different activities in PE. Furthermore, the results show that there are gender hierarchies in PE, which affect gender equality. PE is not perceived as equal, especially not by girls. It emerged from girls' descriptions that boys have a greater influence on the content in PE and dominate in various activities during the lessons.

Conclusions: From the results, it can be interpreted that the content of PE benefits especially sports-interested students with masculine traits, because PE contains values generally perceived as masculine, such as competition and ball sports. The content of the lessons should be as diverse as possible. The lessons should consist of activities that can be considered both masculine and feminine as well as gender neutral. Students should have an opportunity to participate on equal terms. The results suggest that the school and PE teachers should develop students’ self-esteem, especially that of girls. Students should have an opportunity to see themselves as equally good regardless of their gender. The school and teachers need more knowledge of gender norms and gender power structures to create a more equality-based teaching where both girls and boys feel that the content of PE is fair.

Aim: The purpose of this study was to investigate how a 2-year intervention with a choice of specialization in physical education in upper secondary school related to students' goal attainment and grades. The research questions were: What potential differences in goal attainment and grades can be observed among students in the intervention group compared to other students in the same course? Additional research questions were whether this differed for students in vocational preparatory programs versus higher education preparatory programs and for girls versus boys. 

Method: Five classes in year 1 of upper secondary school were given a choice of specialization in the course physical education 1. Five different specializations were offered: “strength training”, “dance and exercise to music”, “health, exercise and mental training”, and “ball, stroke and net games”. Grade data was collected after the completion of the course, and Pearson's χ2 and Mann Whitney U were used for data analysis.

Results: The analyses showed no significant differences between the intervention and control groups in either goal attainment or grades in the intervention as a whole. However, a significant difference (p = 0.002 and 0.028, respectively) was observed at the program level, where students in vocational preparatory programs in the intervention group had lower goal attainment as well as lower grades compared to other students in vocational preparatory programs. Among students in higher education preparatory programs, a significant difference (p = 0.010) was observed in grades (more A's and higher average grades in the intervention group) but no difference in goal attainment. No significant differences were found between girls and boys in and outside of the intervention.

Conclusion: No differences in goal attainment and grades were observed between the intervention and control groups in the intervention as a whole. The group that benefitted positively from the intervention was composed of students enrolled in higher education preparatory programs, whereas students in vocational programs were instead disadvantaged. Offering students only a choice of specialization in physical education is not sufficient to increase goal attainment and grades in the course for students in general. Other aspects of autonomy support are also of great importance. Based on the results of the study, there may be reason to design options for specialization choice in physical education in a different way than through an intervention with a choice of specialization.

BACKGROUND: There is a lack of a methodological standard to process accelerometer data to measures of physical activity, which impairs data quality and comparability. This study investigated the effect of different combinations of settings of multiple processing components, on the measure of physical activity and the association with measures of cardiometabolic health in an unselected population of middle-aged individuals.

METHODS: Free-living hip accelerometer data, aerobic fitness, body mass index, HDL:total cholesterol ratio, blood glucose, and systolic blood pressure were achieved from 4391 participants 50-64 years old included in The Swedish CArdioPulmonary bioImage Study (SCAPIS) baseline measurement (cross-sectional). Lab data were also included for calibration of accelerometers to provide comparable measure of physical activity intensity and time spent in different intensity categories, as well as to enhance understanding. The accelerometer data processing components were hardware recalibration, frequency filtering, number of accelerometer axes, epoch length, wear time criterium, time composition (min/24 h vs. % of wear time). Partial least regression and ordinary least regression were used for the association analyses.

RESULTS: The setting of frequency filter had the strongest effect on the physical activity intensity measure and time distribution in different intensity categories followed by epoch length and number of accelerometer axes. Wear time criterium and recalibration of accelerometer data were less important. The setting of frequency filter and epoch length also showed consistent important effect on the associations with the different measures of cardiometabolic health, while the effect of recalibration, number of accelerometer axes, wear time criterium and expression of time composition was less consistent and less important. There was a large range in explained variance of the measures of cardiometabolic health depending on the combination of processing settings, for example, 12.1%-20.8% for aerobic fitness and 5.8%-14.0% for body mass index.

CONCLUSIONS: There was a large variation in the physical activity intensity measure and the association with different measures of cardiometabolic health depending on the combination of settings of accelerometer data processing components. The results provide a fundament for a standard to process hip accelerometer data to assess the physical activity in middle-aged populations.

Forskning visar att det vi aktivt ägnar oss åt - våra medvetna livsstilsval - kan påverka så mycket som 40 % av vårt välbefinnande. Vi har med andra ord stora möjligheter att själva göra en skillnad i hur vi mår. Hälsosegrarna är inom räckhåll!

Här presenteras den allra senaste forskningen om hur rörelse, mat och återhämtning påverkar vår hälsa. Vi får veta vad som händer i kroppen och i hjärnan när vi till exempel stressar för mycket, sover dåligt, sitter för länge eller inte får i oss tillräckligt med näring. Men också hur vi faktiskt kan omsätta den kunskapen i praktiken och ändra våra beteenden. Hur vilar man hjärnan? Vad är egentligen "nyttig" mat? Och vilken funktion fyller vardagsmotionen? Fokus ligger på de vardagliga utmaningarna och de små men hållbara förändringar som kan göra stor skillnad.

Med gedigen kunskap och ett motiverande tilltal varvar de tre författarna vetenskapliga fakta och studier med konkreta tips. Sammantaget blir det ett inspirerande smörgåsbord av fullt genomförbara livsstilsförändringar som kan göra stor skillnad för hur vi mår.

[Text från förlaget]

OBJECTIVE: To evaluate whether physical activity on prescription, comprising five sessions, was more effective in increasing physical activity than a one-hour advice session after six months.

DESIGN: Randomized, assessor-blinded, controlled trial.

SETTING: Primary care.

SUBJECTS: Patients with clinically verified osteoarthritis of the hip or knee who undertook less than 150 minute/week of moderate physical activity, and were aged 40-74 years.

INTERVENTIONS: The advice group (n = 69) received a one-hour session with individually tailored advice about physical activity. The physical activity on prescription group (n = 72) received individually tailored physical activity recommendations with written prescription, and four follow-ups during six months.

MAIN MEASURES: Patients were assessed at baseline and six months: physical activity (accelerometer, questionnaires); fitness (six-minute walk test, 30-second chair-stand test, maximal step-up test, one-leg rise test); pain after walking (VAS); symptoms (HOOS/KOOS); and health-related quality of life (EQ-5D).

RESULTS: One hundred four patients had knee osteoarthritis, 102 were women, and mean age was 60.3 ± 8.3 years. Pain after walking decreased significantly more in the prescription group, from VAS 31 ± 22 to 18 ± 23. There was no other between groups difference. Both groups increased self-reported activity minutes significantly, from 105 (95% CI 75-120) to 165 (95% CI 135-218) minute/week in the prescription group versus 75 (95% CI 75-105) to 150 (95% CI 120-225) in the advice group. Also symptoms and quality of life improved significantly in both groups.

CONCLUSION: Individually tailored physical activity with written prescription and four follow-ups does not materially improve physical activity level more than advice about osteoarthritis and physical activity.

TRIAL REGISTRATION: ClinicalTrials.gov (NCT02387034).

BACKGROUND: The evaluative nature of high performance (HP) sport fosters performance expectations that can be associated with harsh scrutiny, criticism, and job insecurity. In this context, (HP) sport is described as a highly competitive, complex, and turbulent work environment. The aim of this longitudinal, quantitative study was to explore whether HP coaches' perceptions of job insecurity and job value incongruence in relation to work would predict their psychological well- and ill-being over time.

METHODS: HP coaches (n = 299) responded to an electronic questionnaire at the start, middle, and end of a competitive season, designed to measure the following: job insecurity, values, psychological well-being (vitality and satisfaction with work), and psychological ill-being (exhaustion and cynicism). Structural equation model analyses were conducted using Mplus.

RESULTS: Experiencing higher levels of job insecurity during the middle of the season significantly predicted an increase in coaches' psychological ill-being, and a decrease in their psychological well-being at the end of the season. However, value incongruence did not have a significant longitudinal impact.

CONCLUSIONS: These findings cumulatively indicate that coaches' perceptions of job insecurity matter to their psychological health at work. Consequently, it is recommended that coaches and organizations acknowledge and discuss how to handle job security within the HP sport context.

Syfte och frågeställningar

Syftet med uppsatsen är att undersöka hur hälsopedagoger arbetar inom offentlig och privat sektor och se hur deras utbildnings- och arbetslivserfarenheter har förberett dem för deras yrkesliv inom hälsa.

· Hur ser hälsopedagogers arbetslivs- och utbildningserfarenheter ut?

· Hur arbetar hälsopedagoger inom olika sektorer på arbetsmarknaden?

· Hur förbereder Hälsopedagogutbildningen hälsopedagogerna för deras kommande yrkesliv?

Metod

Studien har en kvalitativ ansats med semistrukturerade intervjuer. Urvalet består av fem verksamma hälsopedagoger som arbetar inom offentlig och/eller privat sektor. Hälsopedagogerna har studerat vid Gymnastik- och idrottshögskolan och avlagt examen som hälsopedagoger. Studiens teoretiska utgångspunkt är Bourdieus teori om kapital och humankapitalteorin.

Resultat 

Hälsopedagogerna har en bred utbildnings- och arbetslivserfarenhet. Majoriteten av de intervjuade hälsopedagogerna arbetade parallellt med sina studier i butik och började under sin studietid att arbeta som instruktörer. Efter Hälsopedagogutbildningen så har flera av hälsopedagogerna valt att studera vidare. Oberoende av vilken sektor de arbetar inom har de gemensamt att alla arbetar med fysisk aktivitet genom att vara instruktörer och arbetar med att administrera och planera. Inom ramen för alla hälsopedagogernas anställningar ingår internutbildning. Alla hälsopedagogerna ser ett stort värde i de praktiska delarna av utbildningen. Alla som haft arbete med Lotsmottagningen anser att momentet hade behövts ges större utrymme. Fler av hälsopedagogerna startade under sin praktik upp egna företag som de driver än idag.

Slutsats

Sammanfattningsvis har utbildningen på GIH bidragit till att hälsopedagogerna känner att de har bred kunskap inom hälsa och fysisk aktivitet. Det som har visat sig fördelaktigt för hälsopedagogerna i studien är att de har samlat på sig humankapital i form av utbildning och arbetslivserfarenhet och använt sitt sociala kapital för att förankra det och lyckats knyta an till kontakter som gett dem arbetsmöjligheter. En slutsats är dock att mycket ansvar vilar på individen själv gällande att samla på sig erfarenheter och knyta ett kontaktnät för att göra sig anställningsbar som hälsopedagog.

Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.

Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.

Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.

Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.

INTRODUCTION: Post-traumatic stress disorder (PTSD) is a cluster of physical and psychiatric symptoms following military or civilian trauma. The effect of exercise on PTSD symptoms has previously been investigated in several studies. However, it has not been fully determined what type of exercise most impacts PTSD symptoms. The aim of the present study was to systematically review the effects of different types of exercise on PTSD symptom severity and symptoms of coexisting conditions in adults.

MATERIALS AND METHODS: Electronic searches were conducted in the databases PubMed, APA PsycInfo, and SportDiscus, from database inception up until February 1, 2021. Inclusion criteria were randomized controlled trials published in English, participants having a PTSD diagnosis or clinically relevant symptoms, and participants randomly allocated to either a non-exercising control group or an exercise group. Data concerning the number of participants, age, exercise type and duration, PTSD symptom severity (primary outcome), and symptoms of coexisting conditions (secondary outcomes) were extracted. The subgroup analysis included high or low training dose, military trauma versus non-military trauma, the type of intervention (yoga versus other exercise), active or passive control condition, group training versus individual exercise, and study quality. The study quality and risk of bias were assessed using grading of recommendation assessment, development and evaluation (GRADE) guidelines. A meta-analysis was performed with a mixed-effects model and restricted maximum likelihood as model estimator, and effect size was calculated as the standardized difference in mean and 95% CI.

RESULTS: Eleven studies were included in the present review. Results showed a main random effect of exercise intervention (0.46; 95% CI: 0.18 to 0.74) and a borderline significant interaction between more voluminous (>20 hours in total) and less voluminous (≤20 hours in total) exercise interventions (P = .07). No significant findings from the subgroup analysis were reported. The secondary outcome analysis showed a small but significant effect of exercise on depressive symptoms (0.20, 95% CI: 0.01 to 0.38), and a larger effect on sleep (0.51, 95% CI: 0.29 to 0.73). For substance use (alcohol and drugs combined) and quality of life, we found significant effects of 0.52 (95% CI: 0.06 to 0.98) and 0.51 (95% CI: 0.34 to 0.69), respectively. No significant effect was found for anxiety (0.18, 95% CI: -0.15 to 0.51), and no sign of publication bias was found.

CONCLUSIONS: Exercise can be an effective addition to PTSD treatment, and greater amounts of exercise may provide more benefits. However, as there were no differences found between exercise type, possibly due to the inclusion of a low number of studies using different methodologies, further research should aim to investigate the optimal type, dose, and duration of activity that are most beneficial to persons with PTSD.

BACKGROUND: The purpose of the present study was to examine the ability of a submaximal cycling test to detect longitudinal changes in maximal oxygen uptake (VO₂max) and examine the conformity between changes in measured and estimated VO₂max over a time span of 5-8 years.

METHODS: A total of 35 participants (21 men and 14 women), aged 29 to 63 years, performed the Ekblom-Bak (EB) submaximal cycle test for estimation of VO₂max and a maximal treadmill running test for direct measurement of VO₂max. The baseline tests were conducted between 2009 and 2012, and the follow-up tests were completed 5 to 8 years later. Pearson's coefficient of correlation (r) and paired sample t-test were used to analyse the association between change in measured and estimated VO₂max. Random and systematic errors between the measured and estimated VO₂max were evaluated using Bland-Altman plots. Repeated measures ANOVA were used to test differences between changes over time.

RESULTS: There was no significant change in mean measured VO₂max between baseline and follow-up (p = 0.91), however large individual variations were noted (- 0.78 to 0.61 L/min). The correlation between individual change in measured and estimated VO₂max was r = 0.75 (p < 0.05), and the unstandardised B-coefficient from linear regression modelling was 0.88 (95% CI 0.61 to 1.15), i.e., for each litre of change in estimated VO₂max, the measured value had changed 0.88 L. The correlation between baseline and follow-up errors (the difference between estimated-measured VO₂max at each occasion) was r = 0.84 (p < 0.05). With regard to the testing procedure, repeated measures ANOVA revealed that there was no significant difference between the group who exercised at the same work rates at baseline and follow-up (n = 25), and those who required a change in work rate (n = 10).

CONCLUSIONS: The EB test detected a change in VO₂max with reasonably good precision over a time span of 5-8 years. Further studies are needed to evaluate if the test can be used in clinical populations and in subjects with different medications.

CONTEXT: Muscle fiber composition is associated with peripheral insulin action.

OBJECTIVE: We investigated whether extreme differences in muscle fiber composition are associated with alterations in peripheral insulin action and secretion in young, healthy subjects who exhibit normal fasting glycemia and insulinemia.

METHODS: Relaxation time following a tetanic contraction was used to identify subjects with a high or low expression of type I muscle fibers: group I (n=11), area occupied by type I muscle fibers = 61.0 ± 11.8%; group II (n=8), type I area = 36.0 ± 4.9% (P<0.001). Biopsies were obtained from the vastus lateralis muscle and analyzed for mitochondrial respiration on permeabilized fibers, muscle fiber composition and capillary density. An intravenous glucose tolerance test was performed and indices of glucose tolerance, insulin sensitivity and secretion were determined.

RESULTS: Glucose tolerance was similar between groups, whereas whole-body insulin sensitivity was decreased by ~50% in group II vs group I (P=0.019). First phase insulin release (area under the insulin curve during 10 min after glucose infusion) was increased by almost 4-fold in group II vs I (P=0.01). Whole-body insulin sensitivity was correlated with % area occupied by type I fibers (r=0.54; P=0.018) and capillary density in muscle (r=0.61; P=0.005), but not with mitochondrial respiration. Insulin release was strongly related to % area occupied by type II fibers (r=0.93; P<0.001).

CONCLUSIONS: Assessment of muscle contractile function in young healthy subjects may prove useful in identifying individuals with insulin resistance and enhanced glucose stimulated insulin secretion prior to onset of clinical manifestations.

There is a debate on whether lipid-mediated insulin resistance derives from an increased or decreased capacity of muscle to oxidize fats. Here we examine the involvement of muscle fiber composition in the metabolic responses to a 3-day fast (starvation, which results in increases in plasma lipids and insulin resistance) in two groups of healthy young subjects: 1, area occupied by type I fibers = 61.0 ± 11.8%; 2, type I area = 36.0 ± 4.9% (P<0.001). Muscle biopsies and intravenous glucose tolerance tests were performed after an overnight fast and after starvation. Biopsies were analyzed for muscle fiber composition and mitochondrial respiration. Indices of glucose tolerance and insulin sensitivity were determined. Glucose tolerance was similar in both groups after an overnight fast and deteriorated to a similar degree in both groups after starvation. In contrast, whole-body insulin sensitivity decreased markedly after starvation in group 1 (P<0.01), whereas the decrease in group 2 was substantially smaller (P=0.06). Non-esterified fatty acids and β-hydroxybutyrate levels in plasma after an overnight fast were similar between groups and increased markedly and comparably in both groups after starvation, demonstrating similar degrees of lipid load. The capacity of permeabilized muscle fibers to oxidize lipids was significantly higher in group 1 vs. 2, whereas there was no significant difference in pyruvate oxidation between groups. The data demonstrate that loss of whole-body insulin sensitivity after short-term starvation is a function of muscle fiber composition and is associated with an elevated rather than a diminished capacity of muscle to oxidize lipids.

BACKGROUND: The importance of physical activity on health is clear, but changing behaviour is difficult. Successful interventions aiming to improve physical activity and reduce sedentary behaviour is therefore of importance. The aim of this study was to evaluate effects on motivation, self-efficacy and barriers to change behaviour from two different behavioural intervention focusing either on reducing sedentary behaviour or on increasing physical activity as compared to a waiting list control group.

METHODS: The study was designed as a cluster randomized control trial (RCT) within two private companies. Self-efficacy, motivation and perceived barriers were together with demographic variables assessed before and after a 6-month intervention. Participant cluster teams were randomly allocated to either the physical activity intervention (iPA), the sedentary behaviour intervention (iSED), or control group. The intervention was multi componential and included motivational counselling based on Cognitive behaviour therapy and Motivational interviewing, group activities and management involvement. Group differences were determined using Bayesian multilevel modelling (parameter estimate; credible interval (CI)), analysing complete cases and those who adhered to the protocol by adhering to at least 3 out of 5 intervention sessions.

RESULTS: After the intervention, the complete cases analysis showed that the iPA group had significantly higher autonomous motivation (0.33, CI: 0.05-0.61) and controlled motivation (0.27, CI: 0.04-0.51) for physical activity compared with the control group. The iSED group scored less autonomous and controlled motivation compared to the iPA group (0.38, CI: - 0.69- -0.087 respectively - 0.32, CI: - 0.57-0.07) but no significant differences compared with the control group. Among individuals that adhered to the protocol, the results showed higher scores on Exercise (3.03, CI: 0.28-6.02) and Sedentary self-efficacy (3.59, CI: 0.35-7.15) for individuals in the iPA group and on Sedentary self-efficacy (4.77, CI: 0.59-9.44) for the iSED group compared to the control group.

CONCLUSION: These findings indicate that the interventions were successful in increasing self-efficacy in each intervention group and autonomous motivation for exercise in the iPA group, in particular when actively participating in the motivational counselling sessions.

The COVID-19 pandemic has become a public health emergency of international concern, which may have affected lifestyle habits and mental health. Based on national health profile assessments, this study investigated perceived changes of lifestyle habits in response to the COVID-19 pandemic and associations between perceived lifestyle changes and mental health in Swedish working adults. Among 5599 individuals (50% women, 46.3 years), the majority reported no change (sitting 77%, daily physical activity 71%, exercise 69%, diet 87%, alcohol 90%, and smoking 97%) due to the pandemic. Changes were more pronounced during the first wave (April–June) compared to the second (October–December). Women, individuals &lt;60 years, those with a university degree, white-collar workers, and those with unhealthy lifestyle habits at baseline had higher odds of changing lifestyle habits compared to their counterparts. Negative changes in lifestyle habits and more time in a mentally passive state sitting at home were associated with higher odds of mental ill-health (including health anxiety regarding one’s own and relatives’ health, generalized anxiety and depression symptoms, and concerns regarding employment and economy). The results emphasize the need to support healthy lifestyle habits to strengthen the resilience in vulnerable groups of individuals to future viral pandemics and prevent health inequalities in society.

Introduction: ADHD is an attention-deficit/hyperactivity disorder, where 90% in Sweden is treated with the pharmacological drug Methylphenidate (MPH). People diagnosed with ADHD develop often psychiatric comorbidity in form of mental illness. The pathophysiology behind how MPH influence the brain is unknown and the treatment have been discussed as deficient due to side effects. Physical activity has been suggested as a healthier treatment option, as evidence shows that physical activity can improve ADHD-symptoms and comorbidity of mental illness. There are no studies that have invastigate how individuals with ADHD experience current- and desired treatment. The aim of this study was therefore to investigate the experiences of having ADHD and how the pharmacological treatment MPH and physical activity has affected the symptoms and mental health, and also find out what treatment the individuals want based on their life experiences. The method was derived from a phenomenological framework using a descriptive qualitative cross-sectional study. Data was analyzed with an inductive approach using an interpretive analysis. Participants was recruited through a snowball selection, where the inclusion criteria stated that participants been diagnosed with ADHD and have experience of MPH and physical activity. The results showed that the frequent occurring symptoms of ADHD were difficulties with concentration-, hyperactivity-, attention- and systematic symptoms, where symptoms had shown a negative effect on the mental health. It appeared that both MPH and physical activity made symptom improvement against concentration-, hyperactivity- and attention difficulties, while CBT (Cognitive Behavioral Therapy) improved systematic difficulties. MPH contributed to side effects that affected physiological-, psychological- and behavioral aspects, which all were perceived to have a negative influence on mental health. In contrast, physical activity improved mental health and showed no evidence of side effects, except when physical activity was absent from daily life. Inactivity appeard to be a central disadvantage for worsening symptoms and mental health. The participants desired that their treatment should be tailored to individual difficulties and health condition in a collaborative way and with follow-up from the health care worker. The study concluded that physical activity in combination with CBT would be a healthier as first treatment option to reduce symptoms of ADHD and improve mental heatlh. Additionally, the participants desired treatment with MPH in form of single doses for urgent need, and it is therefore to suggest development of such treatment option. Furthermore, the study proposes more services for sport science within healthcare and schools for containing applicable knowledge in physical activity for dose with ADHD.

Syfte: Syftet med den här studien var att undersöka sociala mediers eventuella samband  med den psykiska hälsan hos gymnasieelever. I undersökningen utreds om en ökad användning av skärmtid, tid på sociala medier och om sociala medie appar har något samband med psykisk hälsa. I studien undersöktes även hur deltagarna använder sociala medier och om de har eventuella samband med psykisk hälsa. Såväl undersöktes om tid på sociala medier har ett samband med koncentrationsvårigheter 

Metod: Studien gjordes som en tvärsnittsstudie. En webbaserad enkät gjordes med frågor om psykisk hälsa såväl som användande av sociala medier och skärmtid. Populationen för studien var gymnasieelever som hade medelåldern 16.5 år.   

Resultat: I studien uppmättes fyra resultat. Ett samband finns mellan koncentrationssvårigheter och tid på sociala medier (p=0.018 och r=0.240). Det andra sambandet var mellan psykisk ohälsa och de som tittar på sina vänners profiler  (r=0.405, p<0.001). Det tredje sambandet var mellan psykisk ohälsa och att tagga personer i foton (p=0.035, r=0.241). I studien så utmärktes även ett signifikant skillnad mellan män och kvinnors psykisk ohälsa där kvinnor hade mer psykisk ohälsa (p = 0.014).

Slutsats: I denna studie observerades inga samband mellan total skärmtid, användning av sociala medier och psykisk ohälsa. Däremot framkom samband med mer tid på sociala medier och koncentrationssvårigheter. Tagga foton och psykisk ohälsa visade sig ha ett samband. I undersökningen kan även ett samband med psykisk ohälsa och kvinnor som tittar mer frekvent på deras vänners profiler observeras. Studien kan bara visa samband då det är en tvärsnittsstudie.

The lifetime trajectories of movement behavior and cognitive functioning depend on complex interactions between genetic and environmental factors. There is substantial evidence suggesting that physical activity benefits cognitive functions. However, how sedentary behavior and the composition of movement behaviors (i.e., sleep, physical activity, and sedentary behavior) influences cognitive functions remains to be elucidated. 

Observational studies suggest that sedentary time is unfavorably related to cognitive functions in older adults, but the majority of evidence comes from self-reported estimates of movement behavior, which are rather weakly related to device-based measures. Furthermore, while evidence suggests that structured exercise can have protective effects on cognition in inactive older adults, much less is known about how midlife movement behavior is related to cognitive functions. Thus, knowledge of how midlife movement behavior relates to and possibly affects cognitive functions and its underlying mechanisms is much needed. 

This thesis is part of a larger research project investigating how movement behaviors relate to and influence cognitive function, mental health, and neurophysiological mechanisms underpinning these. The project specifically targets healthy office workers and is co-produced with employers of office workers and health-promoting companies. This thesis aimed to investigate how movement behaviors relate to and influence cognitive functions and neuroplasticity among office workers.

The first study investigated cross-sectional relationships between device-measured movement behavior and cognitive functions among 334 office workers. The results revealed no association between total time spent in moderate to vigorous physical activity or sedentary behavior and cognitive functions, suggesting that this association may not be as robust as previously suggested in older populations or as inferred from self-report. 

The second study investigated the extent to which corticospinal excitability is influenced by different movement behaviors. Sixteen sedentary office workers participated in a cross-over randomized controlled trial. We contrasted 3 hours of prolonged sitting with 3 hours of interrupted sitting and 2.5 hours sitting followed by a 25-minute bout of exercise. Acute changes in corticospinal excitability and long-term potentiation-like neuroplasticity were investigated using transcranial magnetic stimulation and paired associative stimulation. Changes in corticospinal excitability over time did not differ between conditions, suggesting that in inactive middle-aged office workers, a physical activity bout or frequently breaking up prolonged sitting does not induce immediate changes in corticospinal excitability or long-term potentiation-like neuroplasticity. 

The third and fourth studies are based on a 6-month cluster-randomized intervention conducted in 263 healthy office workers. An ecological model for behavior change was used to design two interventions aiming at reducing sedentary behavior or increasing physical activity relative to a passive control group, with the ultimate aim of improving cognitive functions and mental health. The third study investigated how effective each intervention was at changing the 24-hour movement behavior, and the fourth study examined intervention effects on cognitive functions. The results showed that the interventions were ineffective in reducing sedentary behavior and increasing physical activity, respectively, with no detected beneficial effects on cardiorespiratory fitness or cognitive functions relative to the control group. Changes in cognition from baseline to follow-up were not associated with changes in the composition of movement behaviors or cardiorespiratory fitness, but some associations between changes in movement behaviors and cognition were moderated by sex, age, and cardiorespiratory fitness. Thus, the third and fourth studies of the thesis have highlighted the challenges involved in successfully achieving movement behavior change to address the possible effects on cognitive improvements in an ecological setting.

In summary, the results presented in this thesis did not provide support for an association between movement behaviors and cognitive functions in healthy physically active office workers, demonstrated no acute effect of a single session of physical activity or breaking up prolonged sitting on corticospinal excitability in sedentary office workers, and revealed no evidence for successful movement behavior change or benefits for cognition in an ecological cluster-randomized intervention in healthy physically active office workers. The findings suggest that among physically active office workers, sedentary behavior may not be as detrimental for cognition and neuroplasticity as previously suggested and shows that changing movement behavior in office workers at the workplace represents a challenging endeavor. Still, these findings do not exclude the possibility that changes in movement behaviors might benefit cognitive functions in physically inactive office workers at higher cardiovascular risk, with lower cardiorespiratory fitness and/or lower daily cognitive stimulation. 

BACKGROUND: We previously reported the effects of two cluster-randomized 6-month multi-component workplace interventions, targeting reducing sedentary behavior or increasing physical activity among office workers, on movement behaviors and cardiorespiratory fitness. The primary aim of this study was to investigate the effects of these interventions on cognitive functions compared to a wait-list control group. The secondary aims were to examine if changes in cognition were related to change in cardiorespiratory fitness or movement behaviors and if age, sex, or cardiorespiratory fitness moderated these associations.

METHODS: Both interventions encompassed multi-components acting on the individual, environmental, and organizational levels and aimed to change physical activity patterns to improve mental health and cognitive function. Out of 263 included participants, 139 (mean age 43 years, 76% females) completed a neuropsychological test battery and wore accelerometers at baseline and 6-month follow-up. The intervention effect (aim 1) on cognitive composite scores (i.e., Executive Functions, Episodic Memory, Processing Speed, and Global Cognition) was investigated. Additionally, associations between changes in movement behaviors and cardiorespiratory fitness, and changes in cognition were examined (aim 2). Moreover, age, sex, and cardiorespiratory fitness level were investigated as possible moderators of change associations (aim 3).

RESULTS: Overall, cognitive performance improved from baseline to follow-up, but the change did not differ between the intervention groups and the control group. Changes in cardiorespiratory fitness or any movement behavior category did not predict changes in cognitive functions. The association between changes in time in bed and changes in both Executive Function and Global Cognition were moderated by age, such that a more positive relation was seen with increasing age. A less positive association was seen between changes in sedentary behavior and Processing Speed for men vs. women, whereas higher cardiorespiratory fitness was related to a more positive association between changes in moderate-intensity physical activity and Global Cognition.

CONCLUSION: The lack of an intervention effect on cognitive functions was expected since the intervention did not change movement behavior or fitness. Age, sex, and cardiorespiratory fitness level might moderate the relationships between movement behaviors and cognitive functions changes.

TRIAL REGISTRATION: ISRCTN92968402 . Registered 09/04/2018.

Aim

Research shows that adolescent girls tend to leave their club sports in their 13–16 years of age. The aim of this study was to examine individual and organizational factors regarding this behavior.

Method

A qualitative interview study in which six girls aged 14–15; three active members in club sports and three who left, were interviewed using a semi-structured interview guide, designed for each category. The interviews were recorded, transcribed and analyzed using the content analysis method where themes were identified and condensed based on an inductive and latent approach. 

Results

Individual factors that emerged were for the active; motivation, community/belonging, performance and health and for those who have left; lower self-esteem, lack of motivation and pressure from school. A prominent organizational factor was the leadership for both groups and for those who left, the specialization procedure had a negative impact. The specialization procedure affects young athletes differently where those in this study who are still active have an accepting attitude while those who quit experienced it as a demanding and pressing factor that contributed to lower their motivation. Leadership was generally perceived as positive, supportive and as an important motivating factor for those still active. However, it was not enough to counteract lower self-esteem, hence the lack of motivation that led to the girls finally choosing to quit.

Conclusion

The underlying factor that affects how girls generally experience their sports club environment is the motivational climate, which is affected by both organizational and individual factors such as leadership, specialization and how the team spirit is perceived. To get young people to continue with sports, sports clubs need to increase awareness of and work to reduce the negative effects of result-oriented climates. Leadership has benefits of being based on autonomy support and competence and leaders should also be aware of the physical and mental changes teenagers go through during these years.

Syfte och frågeställningar 

Syftet med studien var att undersöka om gymnasieelever når upp till rekommendationerna för fysisk aktivitet samt undersöka om det fanns några skillnader mellan eleverna. Den primära frågeställningen undersökte skillnader i fysisk aktivitet mellan könen. Det har också arbetats med två sekundära frågeställningar, dessa analyserar socioekonomi samt skillnader mellan årskurserna kan vara möjliga faktorer till gymnasieelevers fysiska aktivitetsnivå. 

Metod 

Under arbetet av studien har syftet och frågeställningarna undersökts och besvarats med hjälp av en kvantitativ tvärsnittsstudie med en enkätundersökning. Jämförelser har gjorts mellan grupper då det studerats om skillnader i fysisk aktivitet på elever i gymnasiet. Det var totalt 164 elever mellan åldrarna 15-19 år som deltog i studien där sju klasser var medverkande. Av deltagarna var 57,3% kvinnor och 42,7% män. Enkäten som konstruerades omfattar frågor kring fysisk aktivitet och tillhörande socioekonomiska frågor, två av Folkhälsomyndighetens enkäter står som grund för studiens enkät. 

Resultat 

Vid analyseringen och beräkningen av statistiken kunde fler signifikanta resultat visas. Det gjordes fynd där skillnader i fysisk aktivitet mellan könen kunde fastställas samt signifikanta skillnader mellan socioekonomi. Män var mer fysiskt aktiva än kvinnorna (p=0,004) där medelvärdet för männen låg på 280,4 min per vecka medan kvinnorna låg på 143,5 min per vecka. Elevernas hemkommuner visade sig vara avgörande när det kom till den fysiska aktivitetsnivån där signifikanta skillnader i fysisk aktivitet kunde fastställas mellan grupperna. 

Slutsats 

Forskningen som finns kring fysisk aktivitet visar på goda hälsoeffekter. Ungdomar har blivit allt mer inaktiva och det är något som bör lyftas upp och arbetas med för att främja ett hälsosamt levnadssätt och för en framtid där färre människor drabbas av vanligt förekommande folkhälsosjukdomar. Det finns inte tillräckligt med forskning mellan årskurserna, men det verkar finnas flera anledningar till att gymnasieelever inte är tillräckligt fysiskt aktiva.