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  • 1.
    Andersson, Dan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Exploring Perceptions of Route Environments in Relation to Walking2024Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Every walk takes place in a route environment, which can play an important role in deterring or facilitating walking. The focus of this thesis is on the perceptions of environmental variables, and how they relate to appraisals of route environments as hindering – stimulating for walking and unsafe – safe for reasons of traffic, in two metropolitan environments. Another focus is to expand the state of knowledge concerning the criterion-related validity of the Active Commuting Route Environment Scale (ACRES).

    Methods: Commuting pedestrians in Greater Stockholm, Sweden, were recruited via advertisements. From the inner urban area there were 294 participants (77% women), aged 49.5 years, and from the suburban areas there were 233 participants (82% women), aged 50.0 years. 77 individuals walked in both areas. The participants evaluated their commuting route environments using the ACRES. Correlation, multiple regression, and mediation analyses were used to explore the relationships between the variables. Comparisons of environmental ratings between groups and settings were performed with t-tests. Studies 1 and 2 focused on the inner urban area and studies 3 and 4 on the suburban areas. Studies 1 and 3 focused exclusively on the relations between the four motorized traffic variables (vehicle speed, vehicle flow, noise, and exhaust fumes), and their relations to the outcome variables (hinders – stimulates walking and unsafe – safe traffic). Studies 2 and 4 utilised proxies from studies 1 and 3 and combined them with other environmental variables to further the understanding of route environmental variables in relation to walking.

    Results: In both areas, aesthetics and greenery were positively related to stimulating walking, whereas noise, a proxy for motorized traffic, was negatively related. Aesthetics was also positively related to unsafe – safe traffic in the inner urban area, whereas greenery had the corresponding role in suburbia. Another important finding was that greenery also influenced aesthetics positively in both areas. Thus, greenery had both a direct and an indirect positive effect. On the other hand, noise influenced aesthetics negatively in the inner urban area, whereas vehicle flow had the corresponding role in suburbia. A number of variables conjointly influenced the outcome unsafe – safe traffic negatively in both areas (speeds of motor vehicles, noise, conflicts, congestion: pedestrians, red lights, and course of the route). The route environment profiles differed distinctly between the two areas.

    Conclusions: Several route environmental variables appear to be particularly influential in relation to pedestrian commuting, e.g., aesthetics, greenery, and noise. An important finding is that both positive and negative interactions, between certain predictor variables, were disclosed. The contrasting route environment profiles in the different settings strengthen the criterion-related validity of the ACRES. The findings expands the state of knowledge concerning the relations between the environment and walking. If implemented, these findings can influence public health positively.

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  • 2.
    Björkman, Frida Maria Eleonora
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Validity and reliability of a submaximal cycle ergometer test for estimation of maximal oxygen uptake2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

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

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

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

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

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

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

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

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

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  • 3.
    Bojsen-Møller, Emil
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Movement Behaviors and Cognitive Health for Office Workers2022Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    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. 

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  • 4.
    Cardinale, Daniele A.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    The significance of mitochondrial respiratory function in regulating oxygen uptake and performance in humans2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The mitochondrion is one of the most fascinating organelles of our cells which has kept and keeps researchers busy in studying its origin, the complex morphology, the numerous functions, the rapid adaptations to a variety of stimuli and its role in health and disease. Exercise challenges cellular homeostasis and skeletal muscle mitochondria greatly adapt to repeated bouts of exercise by increasing mitochondrial respiratory function and content to match energy requirements and to better sustain future perturbations induced by muscle contractions. The oxidative capacity of mitochondria has been shown to exceed the capacity of the cardiorespiratory system to supply oxygen to active muscle at maximal exercise intensity. Despite this, exercise training further increases this overcapacity. Little is known about the role of this excess oxidative capacity of mitochondria in regulating oxygen consumption, the role of oxygen delivery in determining exercise-induced skeletal muscle adaptations, and whether any sex-related differences exist. The assessment of mitochondrial respiratory function in high resolution respirometer is largely used for clinical and scientific purposes. However, the reliability of this method has not been systematically investigated and warrant further investigation.

    With this background, specific measures of reliability associated with repeated determination of maximal mitochondrial oxidative phosphorylation in saponin-permeabilized fibres, comparison of the right and left legs, variability with measurements at different time-points and over time, as well as influence of the local anesthetic and wet weight of the fiber bundle on determined maximal mitochondrial oxidative phosphorylation were investigated in paper I. The importance of having the same technicians in preparing the samples, and that the major source of variation in measuring mitochondrial oxidative capacity is the sample preparation per se were shown. Furthermore, other factors such as the possible difference between left and right limbs, two time points of sample collection, fibres bundle weight, time that elapsed after collection of the biopsy, and the use of an anesthetic have only a minor impact on the standard error of the measurement.

    In paper II the physiological significance of having a mitochondrial oxidative capacity in excess of the capacity of the central circulation to deliver oxygen to the tissue was shown by integrating measures of ex vivo mitochondrial respiratory function with direct in vivo measure of oxygen consumption when performing two-legged cycling and one-legged knee extension exercise while inspiring atmospheric air and oxygen enriched air in the same participants. Excess capacity of mitochondria allows submaximal mitochondrial activation at maximal oxygen delivery, thereby maintaining a high mitochondrial oxygen affinity and a high oxygen extraction peripherally. Considering the widespread and increasing sedentary behavior in a society plagued by diseases often linked to mitochondrial dysfunction, these results suggest the importance of preserving a high muscle oxidative capacity throughout life, which can be of significance in patients with heart, circulatory, and overall metabolic diseases.

    Despite known sex-specific metabolic differences in human skeletal muscle and that animal models have consistently shown females having a superior mitochondrial function compare to males, data in humans are lacking. In paper III the first evidence that women possess higher mitochondrial quality compared to men with equal cardiorespiratory fitness and endurance performance was provided. Mitochondrial oxygen affinity varied with the degree of mitochondrial respiration rate and was lower in women compared to men. These results indicate that the higher mitochondrial quality in women may be an important physiological adaptation that compensates for the lower mitochondrial oxygen affinity allowing a higher oxygen extraction peripherally. Moreover, these results could possibly be linked to the difference in life expectancy, disease occurrence and aging between women and men.

    Lastly, in paper IV it was shown that increasing oxygen delivery and exercise intensity by means of breathing hyperoxia during high-intensity exercise did not enhance cardiorespiratory fitness and exercise-induced skeletal muscle adaptations but still resulted in a small beneficial effect on performance in trained cyclists. This small positive effect on performance can be exploited in elite athletes; however, considering the cost/benefit, the unknown health-related problems, and ethical issues of performing hyperoxic-supplemented endurance training, it is arguable if the use of this strategy to maximize endurance performance is worthwhile.

    Overall, this thesis provides useful information for future research on various factors influencing the error of the measurement when assessing mitochondrial respiratory function. Moreover, this thesis sheds light on novel factors that regulate oxygen consumption during exercise, highlighting the importance of maintaining a good mitochondrial function. This thesis also provides possible directions for future studies on mitochondrial function, metabolism and exercise-induced adaptations.  

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  • 5.
    Downing, Charlotte
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Early specialising aesthetic performers: An investigation of conceptualisation, motivation, and context2023Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This doctoral research project is situated within the wider debate of talent development in so-called early sports, where early specialisation is often normalised. The overarching aim is to investigate early specialisation within the context of Swedish aesthetic activities. Two research questions guided this research: 1) what characterises early specialisation, and 2) in what ways are aspects of early specialisation related to motivation?

    This doctoral research project includes four individual papers. The first paper is a systematic review that investigated the contextual underpinnings of recommendations regarding early specialisation and psychological aspects (e.g., motivation, burnout). The second paper outlines the development of a measurement tool for capturing degrees of early specialisation within the context of Swedish aesthetic activities. The third paper is a cross-sectional questionnaire-based study which used this measurement tool to explore the relationship between degrees of early specialisation and motivation (autonomous motivation, controlled motivation, and dropout intentions), and explored perceptions of parental influence as a moderator. The fourth paper is a qualitative interview-based study that investigated reflections on motivation throughout the training history of high-level gymnasts and figure skaters who specialised early. Additional data regarding perfectionism and parental participation in sport, collected in relation to this research but not included within the four papers, is also outlined and discussed in this thesis. 

    Results highlight the complexity of early specialisation in terms of how it is defined, measured, and conceptualised, as well as the possible relationship to psychological aspects (e.g., motivation, perfectionism). Overall, the results do not align with the notion that early specialisation leads to lower quality motivation and an increased risk of dropout. 

    While this research has made methodological, theoretical and empirical contributions to this research area, it is also clear that more research is needed to better understand and explain the possible outcomes often associated with early specialisation.

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  • 6.
    Edman, Sebastian
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Skeletal muscle fiber types in man: With special reference to anabolic signaling and mitochondrial bioenergetics2022Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Human skeletal muscle consists of a mixture of slow-twitch (type I) and fast-twitch (type II) fibers. The type I fibers are endurance-oriented, with a metabolic system and infrastructure that supports aerobic metabolism. This entails a well-developed capillary grid and a mitochondrial network proportioned to the number of contractile units within the fiber. These fibers generally have slower and less forceful contraction mechanics and more limited muscle growth as a resource-efficient metabolic energy system is prioritized over increasing the number of contractile units. By contrast, type II fibers prioritize contractile capabilities and force generation at the cost of resource efficiency. These fibers have a substantially lower mitochondrial volume but prioritize structures and organelles that benefit muscle contraction instead. 

    It is well known that resistance exercise combined with dietary protein intake stimulates the growth of contractile proteins leading to an increased muscle mass over time. Muscle mass accumulation is primarily driven by the amplification of muscle protein synthesis, which in turn is largely governed by the mTORC1 signaling pathway within the muscle cell. Little is known about how mTORC1 signaling regulates growth in the different fiber types. Furthermore, it is unknown whether blunted anabolic signaling in type II fibers of the elderly may explain why losses of muscle mass occur primarily in these fibers with advancing age.

    Endurance exercise, on the other hand, primarily stimulates a prioritization to synthesize new mitochondria to support the high demand for sustainable aerobic energy output. However, it remains to be determined if mitochondria created within type I and type II fibers are equal, or whether they have adapted to their respective milieu in any way. 

    Therefore, the aim of the current thesis was to investigate how the mTORC1 pathway in type I and type II fibers responds to resistance exercise and nutritional stimuli in the form of essential amino acids (EAA), and to determine if this response is influenced by age. Fiber type-specific mitochondrial populations, including their respiratory capacity, were also investigated. To facilitate these investigations, a new and improved method for muscle fiber type identification was developed.

    In paper I, the phosphorylation of mTORC1 in response to resistance exercise and EAA intake was examined in 684 individual muscle fibers. Unsurprisingly, a significant increase in mTORC1 signaling was seen following the combination of resistance exercise and EAA intake, whereas the rise following resistance exercise alone was more modest. However, no evidence of a discrete response in the different fiber types was found. 

    In paper II, a new method was developed to facilitate the work surrounding fiber type-specific muscle physiology by limiting the extreme time requirements of fiber type identification of large sample sets of muscle fibers. The novel method, which was named THRIFTY, allows an experienced technician to classify over 800 fibers in under 11h.

    Paper III utilizes the high throughput of the THRIFTY method described in paper II to create the most extensive study to date on individually dissected muscle fibers with 27 602 included fibers. Here, the aim was to investigate whether the fiber type-specific muscle atrophy of the type II fibers in aging could be explained by an onset of anabolic resistance in these fibers. For this investigation, ten young and ten elderly men were recruited to perform a unilateral resistance exercise session followed by ingestion of EAA. This paper showed a slightly elevated mTORC1 signaling response in type I fibers. However, there were no signs of blunted mTORC1 signaling in the elderly. 

    In paper IV, the high speed of the THRIFTY method was utilized to analyze the mitochondrial respiratory function of permeabilized type I and type II muscle fibers. In addition, the intrinsic protein expression of mitochondria in the type I and type II muscle fibers was analyzed. As expected, a higher volume of mitochondria and a greater respiratory rate in the type I fibers were found. However, on a per mitochondria basis, a higher maximal respiratory rate was observed in type II fibers together with increased levels of proteins in the electron transport chain. Likewise, proteins regulating mitochondrial fission and fusion were more highly expressed in the type II fiber mitochondria, which may be a compensatory mechanism for the low volume. 

    In conclusion, both fiber types show robust increases in mTORC1 signaling in response to exercise and EAA ingestion. The results indicate that the response is slightly stronger in the type I fibers, which is contrary to what was predicted. Moreover, the highly specific type II fiber atrophy seen with aging cannot be explained by a blunted anabolic response in these fibers. Surprisingly, the mitochondria of type II fibers possess a higher respiratory capacity. However, this discrepancy is concealed by the vast difference in mitochondrial volume favoring type I fibers, ultimately leading to an overall greater respiratory rate in the type I fibers.

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    Avhandling Sebastian Edman
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  • 7.
    Ek, Amanda
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Physical activity among patients with cardiovascular disease: a predictor of hospital care utilisation and mortality in clinical work2020Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Guidelines highlight the importance of physical activity (PA) in secondary prevention of cardiovascular disease (CVD) within the healthcare sector. Previous studies have mainly focused on the effects of PA at moderate-vigorous intensity performed within exercise-based cardiac rehabilitation (CR). However, only a minority of patients with CVD participate in exercise-based CR, and it is not known to what extent the guidelines for PA are implemented in clinical work. This leads to a knowledge gap in PA levels among patients with CVD, and the potential association of PA with hospital care utilisation and all-cause mortality. The overall aim of this thesis was to investigate PA and its importance for patients with CVD, and to what extent it is promoted during clinical work. The associations between self-rated PA level, changes in self-rated PA level, and sedentary time (SED) with hospital care utilisation and all-cause mortality were explored in three cohort studies (Studies I-III). Data were collected via questionnaires, medical records and national registers. Study I explored everyday PA, physical exercise and SED among patients with CVD (n=1148) prior to admittance to a cardiac ward at two of the hospitals in Stockholm. Studies II and III explored PA (of at least moderate intensity) post hospitalisation, and included 30 644 and 22 227 patients with myocardial infarction (MI), respectively, from the national SWEDHEART registry. Finally, in Study IV, healthcare professionals’ (n=251) stated importance and clinical work to promote healthy lifestyle habits (alcohol consumption, eating habits, physical activity, and smoking) were explored in a cross-sectional study. All healthcare professionals working on cardiac departments in two hospitals in Stockholm were included.

    The main findings were:

    • PA level (everyday PA, physical exercise, total PA level) and SED pre and post hospitalisation for cardiac events were found to be significant predictors of hospital care duration, readmission and mortality. The effects of high PA level and low SED did not differ between CVD diagnosis, sex, age, or comorbid states such as individuals with and without diabetes mellitus type II, kidney dysfunction, hypertension or dyslipidaemia.

    • There were no differences between individuals reporting a moderate or high level of PA or a medium or low level of SED, illustrating that “a little activity is better than nothing” and that the greatest health benefits would be achieved by increasing PA among the most inactive patients with CVD.

    • Changes in PA level during the first year post MI are important. Increased PA lowered the risk of mortality, and decreased PA increased the risk of mortality in patients post MI.

    • Healthcare professionals considered it important to promote lifestyle habits among patients within the healthcare sector in general, as well as in their own clinical work. However, there was a difference between stated importance and clinical practice as only a minority of healthcare professionals asked or provided counselling on healthy lifestyle habits. Our results indicated a relationship between promoting patients’ lifestyle habits in clinical work, and if they perceived clear organisational routines and objectives.

    In conclusion, the results of this thesis have a clinical impact. Firstly, asking patients on a cardiac department about their PA level and SED may identify individuals in need of behavioural changes. By identifying and supporting individuals who need to increase their PA level, clinicians may potentially decrease the utilisation of inpatient care and also lower the risk of all-cause mortality among individuals with a CVD diagnosis. Secondly, this information is of great predictive value, and PA can be seen as an additional marker of disease severity.

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  • 8.
    Engdahl, Christopher
    Swedish School of Sport and Health Sciences, GIH, Department of Movement, Culture and Society.
    Indetermination in creative dance: On creative dance teaching in physical education teacher education2024Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis is to explore how creative dance in Swedish physical education teacher education (PETE) can be taught and experienced. PETE holds a responsibility to extend preservice teachers’ movement repertoires and plays a crucial role to provide opportunities for the future physical education (PE) teachers to gain experience and knowledge of dance teaching. Creative dance is part of the teaching area of dance in PE and often a new experience for students when entering PETE programs. The research literature is scarce, in a Scandinavian context as well as internationally, about creative dance teaching in PETE. 

    This doctoral project, guided by Deleuzian scholarship, includes three studies, a literature review, an interview study and a pedagogical intervention study. These three studies resulted in one article in the form of an unpublished manuscript and three published articles. The first article, the manuscript, explores how theoretical approaches are used in studies of creative dance teaching in PE and PETE. The second article explores how PE teacher educators describe their teaching of creative aspects of dance in PETE. The third article explores what PETE students express and experience when participating in mirror assignments during creative dance lessons and what insights can be made regarding creative dance teaching. The fourth article explores how human and non-human materialities play a part in movement exploration in creative dance in PETE and pedagogical implications in creative dance teaching.  

    The thesis offers four key insights. The first insight is that PE teacher educators have specific ideas about creative aspects of dance and about teaching creative dance. The second insight is that inspiration from Deleuze’s philosophy can support and extend ideas about teaching mirror assignments in creative dance lessons in PETE. The third insight is that teaching mirror assignments in creative dance lessons in PETE can make students’ expressions and experiences involve indetermination. The fourth insight is that a post-anthropocentric and Deleuzian approach can be seen to extend notions of creative dance teaching in PETE. My thesis shows various ways how teaching can encourage PETE students to engage with a teaching area that can be unfamiliar to them. The pedagogical insights presented in this thesis can support PE teacher educators and PE teachers when considering teaching creative dance.

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    Dissertation Christopher Engdahl (kappa)
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  • 9.
    Flockhart, Mikael
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Exercising on the edge: mitochondrial and metabolic responses to intense training2022Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Exercise and exercise training induces several physiological adaptations that increase the oxidative capacity of the muscles and improve glucose regulation. While the positive metabolic adaptations and effects on glucose regulation after exercise and exercise training have been extensively studied, negative outcomes have not. This thesis aims to address these questions and investigate possible negative effects of intensified training on mitochondrial parameters and glucose regulation.

    In two separate interventions, we studied these outcomes after progressive exercise training, and after different intensities of exercise. Mitochondrial respiration was assessed in muscle biopsies taken from m. vastus lateralis 14 hours after exercise and oral glucose tolerance tests were performed at the same time point.

    In paper I, we demonstrate that there is an upper limit of training load that can be tolerated without the manifestation of negative outcomes. After administrating almost daily sessions of high-intensity interval training, mitochondrial function and glucose control were impaired. In paper II, we used mitochondrial function as a novel biomarker of maladaptive training loads and constructed a diagnostic model that can be used for the early detection of maladaptations to exercise training. In paper III, we further demonstrated that endurance-trained athletes can have decreased glucose tolerance and increased insulin resistance the day after three hours of continuous cycling whereas these responses were not accentuated in healthy controls. Our results indicate that a metabolic switch in favor of lipid metabolism is the probable cause of this phenomenon. In paper IV, we briefly commented on a publication that described changes in whole-body VO2 responses to work rates in the athlete with the highest recorded VO2max. We provided arguments that the observed changes in VO2 and gross efficiency can in part have their origin in the mitochondria.

    We here combine measurements in muscle tissue with physiological measurements in an applied context. Using this integrated approach, we investigated the effects of intensified training on health-related and performance outcomes, thereby presenting insights into what maladaptations to exercise can constitute. We hope that our results and conclusions can help to further understand the complex relationship between exercise and health and to guide athletes and coaches to optimize training outcomes.

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  • 10.
    Gago, Paulo
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Post activation potentiation: Modulating factors and mechanisms for muscle performance2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: Acute enhancements of muscle contractile properties and performance subsequent to a maximal or near maximal conditioning contraction are often termed post activation potentiation (PAP). Although still controversial, PAP is commonly linked to enhancements in the myosin regulatory light chain phosphorylation, leading to improvements in the excitation–contraction coupling. The PAP seen after a conditioning task often coexists with fatigue and is known to depend on strength level, muscle fiber type and age. Less is known about how factors such as static and dynamic changes in muscle length affect PAP, and on the relative contribution of contractile and tensile components to PAP.

    Aim: To enhance our understanding of how, and under what conditions, a single maximal isometric contraction affects plantar flexor muscle contractile performance, and other muscle tendon properties, in power athletes.

    Methods: Supramaximal twitches were evoked via electrical stimulation of the tibial nerve of athletes before and on several occasions after a 6-second maximal voluntary isometric contraction (6-s MVIC) in both static muscle, and during passive muscle lengthening and shorting at different angular velocities. Several contractile variables were measured from the twitches. The effects of a 6-s MVIC on Achilles tendon stiffness was calculated from torque and ultrasonography based measurements of tendon length at two submaximal contraction intensities. Overall stiffness index was calculated by analyzing the passive lengthening torque/angle curve.Results: A single MVIC enhanced muscle contractile properties and electromechanical delay for up to 5 minutes. Plantar flexor twitch variables such as peak twitch, rate of torque development and rate of torque relaxation were enhanced during shortening compared to lengthening muscle actions, and in an extended as compared to a flexed knee position. Achilles tendon stiffness and overall stiffness index were not significantly modulated by a single 6-s MVIC.

    Conclusion: The results of this thesis imply that functional enhancements from a 6-s conditioning MVIC would mainly come from improvements in contractile rather than tensile components. Stiffness changes should be monitored in future PAP-related studies since they may still occur after more extensive conditioning protocols than the current one. Improvements in contractile components subserving muscle strength after a conditioning MVIC suggests that enhancements in muscle power after a conditioning task should be greatest in fast concentric muscle actions, though still present in muscle lengthening. Conditioning should be performed in a position where full activation is easy to achieve and tailored to mach an athlete or group of athlete’s current status and characteristics, maximizing performance in a specific sport event.

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  • 11.
    Hammarström, Daniel
    Swedish School of Sport and Health Sciences, GIH. Inland Norway University of Applied Sciences, Lillehammer, Norway..
    Determinants of intra-individual variation in adaptability to resistance training of different volumes2021Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Systematic resistance training positively affects skeletal muscle mass and functional characteristics of the neuro-muscular system. By varying exercise variables such as training volume, the training can be individualized. On what indications such variations should be performed are not clear since individuals vary with regards to volume-dependence in training outcomes such as muscle mass and strength.

    The primary aim of this thesis was to relate the adaptive response of low and moderate volume resistance training to individual characteristics in untrained individuals. Secondary aims were to characterize exercise-volume dependence in muscle characteristics and determine a time course profile of ribosomal biogenesis-markers in response to resistance training.

    In Study I (Paper I), young, healthy, and previously untrained male and female participants (n = 34) trained for 12 weeks (2-3 sessions x week-1) with low (a single set per exercise) or moderate volume (three sets per exercise) allocated to either leg in a contralateral fashion. Muscle cross-sectional area and strength measurements were made before and after the intervention. Biopsy sampling from m. vastus lateralis was performed before and after the intervention and before and one hour after the fifth session.

    Training-induced muscle hypertrophy and strength gains were shown to be volume dependentas both variables increased to a greater extent in response to moderate-volume training. These effects coincided with greater activation of mTORC1 signaling, higher abundance of markers related to ribosomal biogenesis, and greater reduction in fiber-type IIX proportions. Thirteen and sixteen participants, respectively, were identified as having additional benefits of moderate- over low-volume training on muscle hypertrophy and strength. The additional benefit of moderate-volume training for muscle hypertrophy and strength gains was associated with greater accumulation of total RNA at Week 2 in the moderate-volume leg, indicating that the ability to differentiate ribosomal biogenesis in the initial phase predicted long-term benefits of moderate over low training volume.

    Based on RNA quality, a subset (n = 25) of participants originally included in Study I was used in a follow-up analysis of transcriptome characteristics (Paper II). Accumulation of RNA due to increased ribosomal biogenesis in response to resistance training led to different amounts of tissue being used in analyses as a fixed amount of total RNA was used in sample preparation. When this was accounted for through normalization strategies, dose-dependent increased expression of genes primarily related to the extracellular matrix was identified after two weeks of training in rested-state muscle. In contrast, after the intervention, no dose-dependencies were observed. When not accounting for the amount of tissue used, results indicated counter intuitive increased expression of genes in the low-volume condition.

    Given the apparent importance of ribosomal biogenesis identified in Study I,  Study II (Paper III) aimed to describe a time course of accumulation of markers of ribosomal abundance in response to resistance training. Furthermore, it was hypothesized that fluctuations in training volume and training cessation would be reflected in markers of ribosomal biogenesis.

    Eighteen participants were allocated to either a training group (n = 11) or a control group (n = 7). The training group performed unilateral knee extension with constant (6 sets) or variable volume (6, 3, and 9 sets in sessions 1-4, 5-8, and 9-12, respectively). Muscle biopsies were sampled from m vastus lateralis in the training group before and 48 hours after the first session and 48 hours after sessions 4, 5, 8, 9, 12, and after eight days of de-training. Biopsies were also sampled in the control group at baseline, after 48 hours, and after 2-4 weeks.

    Twelve resistance-training sessions led to muscle growth and gains in strength in the training group compared to the control group. Training also led to increases in total RNA, ribosomal RNA, increased protein levels of upstream binding factor (UBF), and ribosomal protein S6 (rpS6). Total RNA increased in a curve-linear fashion, most rapidly in response to the first four sessions, followed by a plateau and peak values of ∼50% above baseline values after eight sessions. Variations in training volume did not affect the observed increase in either total RNA or any ribosomal RNA. UBF protein levels were related to total RNA levels after controlling for time. Increases in total RNA levels, in turn, predicted training-induced muscle hypertrophy. After eight days of no training, total RNA and specific ribosomal RNA species decreased without muscle mass changes, indicating reduced concentrations and biosynthesis of ribosomes in response to de-training. These results underline a determinant role for ribosomal biogenesis in resistance training-induced muscle hypertrophy and that ribosomal biogenesis is sensitive to training cessation.

    Overall, this thesis demonstrates a determining role of ribosomal biogenesis in adaptations to resistance training. In addition, it broadly characterizes the effect of training volume on multiple aspects of skeletal muscle biology.

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  • 12.
    Hellström, John
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport History Research Group.
    Den svenska sporthjälten: Kontinuitet och förändring i medieberättelsen om den svenska sporthjälten från 1920-talet till idag2014Doctoral thesis, monograph (Other academic)
    Abstract [en]

    This thesis examines the media construction of five Swedish sports heroes, active from the 1920’s to the beginning of the 2000’s. The analyses are based on the assumption that sports heroes are social products that reflect the dominating ideals and values of a society or culture, and that the media plays an important role in this process. Firstly, the media provide the attention necessary for successful athletes to become publically known and, secondly, they create the stories in which some athletes are represented as heroes while others are represented as villains. The use of narrative theory in this thesis builds on the idea that a story is not merely a way of presenting information, but a way of creating meaning. A person becomes a hero when he or she is described as a hero in a heroic tale. To analyze the media construction of sports heroes is thus to analyze the media stories of them as heroes.

    In order to examine and compare the construction of sports heroes in the media, articles from daily press and magazines as well as broadcasts in radio and television have been analyzed. The results show that although each of the five heroes were valued and represented according to ideals and values specific of his or her time, there are similarities in the media representation of them that suggest that there is some degree of stability in the narrative of the Swedish sports hero over time. In many ways, the story of the Swedish sports hero is still intact since the 1920’s. However, this story is an ideal story and the process of constructing athletes as heroes has proved to be filled with compromise and contradictions. It can be argued that the media is more concerned with fitting the athletes into an already existing narrative of the Swedish sports hero than with representing them as individuals.

    Seen in a wider historical context, sports heroes represent an example of how national identity is constructed in the media. National identity is, as many theorists have shown, a dynamic and relational process. What is considered typically Swedish thus changes over time and in different contexts. In this process the social status of sports heroes helps to stabilize as well as legitimize dominating ideas of Swedish national identity.   

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  • 13.
    Jacques, Tiago Canal
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Bilateral kinetic, kinematic, neuromechanical, and muscle-tendon properties of habitual runners2021Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Achilles tendon overuse-related injuries are a frequent problem to habitual runners. Such injuries occur more often unilaterally and its etiology is associated to overloading of the tendon tissue. Inter-limb differences during running are a possible cause for overload due to eventual differences in the mechanical loading provided to each limb. Furthermore, inter-limb differences in Achilles tendon properties were found in athletes due to sport-induced differences in the mechanical loading and in non-athletes due to limb preference. Currently, inter-limb differences in the Achilles properties of habitual runners is unknown. The present thesis investigated the existence of inter-limb differences in biomechanical, neuromechanical and Achilles tendon properties in habitual runners. In Study I, thirteen triathletes performed a cycle-run simulation while vertical ground reaction force (GRFv), lower limb kinematics and triceps surae and tibialis anterior activation were evaluated bilaterally during the start, mid and end stages of the 5 km running segment. In Study II, GRFv, lower limb kinematics, triceps surae and tibialis anterior activation and Achilles tendon strain were evaluated bilaterally in habitual runners at two running speeds (2.7 m.s-1 and 4.2 m.s-1). In Study III, spatiotemporal variables, vertical (kVert) and limb (kLimb) stiffness and center of mass (COM) kinematics were evaluated bilaterally in habitual runners at the same running speeds adopted in Study II. In Study IV, maximal plantar flexion isometric force, triceps surae activation and activation ratios, and Achilles tendon morphological, mechanical and material properties were evaluated bilaterally in habitual runners. In Study I the Soleus activation was lower in the preferred limb from 53.4% to 75.89% of the stance phase (p<0.01, ES range = 0.59 to 0.80) at the end stage of running. In Study II, hip extension velocity was greater in the non-preferred limb from 71% to 93% of the stance phase (p<0.01) during running at 4.2 m.s-1 while no other inter-limb differences were observed. In Study III, no inter-limb differences were observed in spatiotemporal, kVert and kLimb at investigated running speeds. However, COM horizontal velocity was greater from 67% to 87.40% of stance the phase (p<0.05, ES >0.60) when the non-preferred limb was in contact with the ground. In Study IV, no inter-limb differences were observed in triceps surae activation or Achilles tendon properties. The activation ratios of MG and SOL, however, were observed to correlate in the preferred limb only.

    In summary, neuromuscular and kinematic inter-limb differences were observed when healthy, non-injured habitual runners performed in running conditions similar to their ecological conditions. Moreover, the Achilles tendon seem to adapt similarly among limbs of habitual runners, while triceps surae activation strategies might differ between limbs. Findings of inter-limb differences occurring during running may result in overload during running and therefore might be implicated in the etiology of Achilles tendon overuse-related injuries in habitual runners. Findings of similar tendon properties among limbs suggest both limbs have similar chances of incurring in the injury process.

    Coaches and clinicians might improve current preventive strategies for Achilles tendon overuse-related injuries by monitoring tendon properties and running biomechanical and neuromuscular variables bilaterally across the season.

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  • 14.
    Johansson, Susanne
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Sexual Relationships between Athletes and Coaches: Love, Sexual Consent, and Abuse2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Coach-athlete sexual relationships (CASR) and sexual harassment and abuse (SHA) in sport can profoundly impact athletes’ welfare and performance. Yet, it is often ignored due to sensitivity, secrecy, and lack of knowledge. There is no previous research on SHA in sport in Sweden, and legal, consensual, same-sex CASR is under-researched. The overall purpose of this doctoral thesis is to examine CASR in competitive sport in Sweden. More specifically: a) athletes’ experiences of CASR; b) prevalence of SHA in coach-athlete relationships; c) conceptual and theoretical issues to broaden the understanding of CASR and SHA, will be examined.

    Survey methodology is employed in Article I to explore the prevalence of SHA, coach-athlete relationship factors, and association between relationship factors and SHA. A random sample of current and former male and female Swedish athletes (n=477) aged 25 participated. Article II outlines critical issues of CASR, and theories and conceptualisations of romantic love, sexual consent, and female athlete sexual agency is further developed in the thesis research summary. Drawing on interviews with five female elite athletes aged 23-30, experiences of CASR are analysed in-depth using discourse analyses in Article III and narrative case study design in Article IV.

    Results show that athletes’ experiences of CASR are positively and negatively diverse but potentially problematic because boundary ambiguity, secrecy, and isolation are common. Social and ethical dilemmas may also occur because CASR intersect contrasting discourses regarding elite sport, coach–athlete relationships, and romantic love. Moreover, CASR integrate professional and private contexts in which equality and power deviate. The research illustrates empirically and theoretically how female elite athletes exercise agency and recognise consensual, mutually desired CASR where romantic love is priority. However, sexual consent can be ambivalent rather than a mutually exclusive yes/no dualism. Socially, consent is a process of negotiation informed by contextual factors, sexual agency, and social structure. In addition, 5.5% prevalence of SHA perpetrated by male coaches is reported, distributed throughout the sampled athletes’ gender, age, sport performance levels, and individual/team sports in the sample.

    In conclusion, this thesis expands knowledge of athletes’ experiences of love, sexual consent, and abuse in CASR. Previous evidence of SHA in sport is confirmed to include sport in Sweden. Implications for sport and sport sciences are offered. 

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  • 15.
    Karlsson, Jesper
    Swedish School of Sport and Health Sciences, GIH, Department of Movement, Culture and Society.
    Barn- och ungdomsidrott till salu: Om begär, immateriellt arbete och kommersialisering2022Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In recent decades scholars have noted a trend in Swedish child and youth sport, namely that businesses are emerging parallel to the Swedish Sports Confederation (SSC), Sweden’s leading ideally driven sports organisation. Despite this recent trend of businesses starting to organise child and youth sport, research on the phenomenon is as yet scarce. This is also true for the overarching research area of the commercialisation of youth sport. Thus, the aim of this thesis is to analyse how commercially driven child and youth sport in Sweden functions and how leading representatives from child and youth sport businesses perceive Swedish child and youth sport.

    The thesis consists of four sub-studies. Three of the studies are based on data from different child and youth sport business websites, while the other is based on data from interviews with leading representatives from different child and youth sport businesses.

    The results identify four different commercial de-territorialisation processes that have been established, or territorialised, in Sweden. These four de-territorialisation processes consist of businesses that target their services to different potential customers groups. They also identify how the different businesses produce immaterial values regarding child and youth sport in order to attract potential customers. These values are enunciated differently depending on the kind of de-territorialisation processes the businesses stem from. Furthermore, the thesis illustrates that in their website images the businesses often visually represent their ideal customers as white boys and girls who are actively pursuing some kind of sport. It also shows that the leading business representatives position themselves and their services as passionate sport enthusiasts, child and youth sport actors and actors in a changing society.

    The conclusion is that the commercialisation of child and youth sport functions in four different ways and creates boundaries between ideally- and commercially driven sport. The challenge for ideally driven sport is to keep control over sport as a social and cultural product. This is especially important in a post-industrial society, where businesses aspire to take control of the social and cultural content of sport and make it profitable

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  • 16.
    Kempe-Bergman, Matthis
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Man talar om jämställd idrott: Om jämställdhetssamtal med manliga idrottsledare och förutsättningar för jämställd idrott2014Doctoral thesis, monograph (Other academic)
    Abstract [en]

    As a result of a historically anchored relationship between the Swedish state and the sports movement, gender equality has been a prioritized area of interest in Swedish sports since the 1970s. Despite long-term work in this field, research indicates a notable gap between what is said and done at the central level and locally. Research also indicates attitude problems; gender equality is often seen as an insignificant or unnecessary issue.

    This thesis seeks to relate to and analyze this development. Answers are sought via male sport coaches and leaders. This approach is motivated by the fact that gender equality-related sport research in Sweden seldom focuses on men and masculinities. At the same time men have been overrepresented as power holders and decision makers, and gender equality has consequently been constructed as a women’s issue. By means of a post-structural discourse analysis, the aim is to investigate constructions of gender equality in interviews with 47 leaders selected from seven sports. How is gender equality constructed in terms of meanings of and standpoints in relation to the concept, and which discourses set the frames for these constructions? Which subject positions are articulated?

    Results show that gender equality is given many different meanings in the interviews and that these meanings are produced in line with three discourses: a women’s rights discourse (semi-essentialism, structural feminism, a quantitative and qualitative support for women’s sport), a gender critical discourse (constructionism, structural feminism, “women can”, deconstructions of femininities) and a liberal discourse (“sport for all”, individualism, gender neutrality). Furthermore, four subject positions are distinguished: the skeptic, the cynic, the women rightist and the norm critic position. When the results are related to the production of gender equality policies four aspects are discussed, 1) relations between discourses (the discourses generate contradictory interpretations of sport, subjectivity, gender and equality), 2) men and gender equality, 3) the relatively substantial lack of interest in gender equality in the interviews and 4) sport and pluralism.

    One conclusion in the thesis is that the women’s rights discourse dominates and that the liberal discourse is marginalized in the interviews. Further, it is suggested that an elaboration and a more frequent practice of the gender critical discourse could be useful in the development of the gender equality project in Swedish sport. 

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  • 17.
    Larisch, Lisa-Marie
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Movement behavior and mental health in office workers: Associations and intervention effects2023Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Mental disorders pose a significant global health challenge. To effectively address this challenge, mental health promotion must be included in various sectors, including workplaces. Various strategies for promoting mental health in the workplace have been suggested, including interventions aimed at improving movement behavior, i.e., sitting less and moving more. Physical activity (PA) and sedentary behavior (SED) are established determinants of mental health. However, there are aspects of the relationship between movement behavior and mental health that are not well understood, for example, the combined effects of all movement behaviors occurring throughout the daily 24-hour cycle, i.e., time in bed, SED, light-intensity physical activity, and moderate to vigorous physical activity (MVPA), on mental health. In addition, only a few well-designed workplace interventions for improving movement and mental health outcomes have been tested. Office workers often spend extensive amounts of time being sedentary and might particularly benefit from such interventions. The aims of this thesis were (1) to investigate cross-sectional associations between 24-hour movement behavior and mental health among office workers and (2) to evaluate the efficacy, acceptability, feasibility, and fidelity of two cluster randomized controlled trial (RCT) interventions for improving movement behavior and mental health using quantitative and qualitative methods.

    In Paper I, we investigated cross-sectional associations between 24-hour movement behavior and mental health outcomes (symptoms of depression and anxiety, burnout, mental wellbeing, and stress) among office workers (N=345-370). Movement behavior was measured using accelerometers and sleep diaries. Mental health outcomes were assessed using validated questionnaires. Only the proportion of time spent in MVPA, relative to all other behaviors, was positively associated with mental wellbeing. 

    Papers II-IV were based on a three-armed cluster RCT among office workers (N=263). During the 6-month intervention period, the iSED intervention group focused on reducing SED, and the iPA intervention group focused on increasing MVPA compared to a wait-list control group. The multi-level interventions were designed based on ecological models of health behavior, addressing the individual office workers as well as their physical, social, and organizational work environment. Paper II investigated intervention effects on accelerometer-measured 24-hour movement behavior and cardiorespiratory fitness. We considered overall 24-hour movement behavior and movement behavior during work versus non-work time. No intervention effects were found. Paper III was based on a qualitative study that was embedded in the RCT. It investigated the acceptability, feasibility, and fidelity of intervention components that addressed the individual, environmental and organizational level. Interviews and focus group discussions were performed with 38 key stakeholders after the 6-month intervention period. The study included office workers who received the interventions, health coaches who delivered counseling sessions, team leaders who were responsible for implementing group activities, and human resource and higher management staff who provided support at the organizational level. In general, the interventions were well appreciated, and components seemed to work as intended when delivered as intended. Many office workers experienced improvements in movement behavior and wellbeing and ascribed those to the interventions. Acceptability, feasibility, and fidelity of individual-level components were high but reduced for components depending on team leaders, mainly due to challenges associated with recruiting managers as team leaders and forming teams. Manager and team support were considered crucial for promoting more PA and less SED, yet many participants reported a lack of such support. Thus, identified challenges with these components might have reduced overall intervention efficacy. Paper IV investigated intervention effects on mental health outcomes (symptoms of depression or anxiety, mental wellbeing, and stress). In addition, we explored whether changes in mean PA intensity mediated or moderated intervention effects. The interventions improved mental wellbeing for the combined intervention groups and the iSED group but not for the iPA group compared to the control group. The interventions improved mean PA intensity, but mean PA intensity did not mediate intervention effects on any outcome. Mean PA intensity moderated intervention effects on mental wellbeing. Participants who reduced mean PA intensity reduced mental wellbeing compared to participants who did not change mean PA intensity. This highlights the importance of maintaining high levels of PA for mental wellbeing.

    This thesis contributes to existing knowledge by applying a rigorous investigation of cross-sectional associations between 24-h movement behavior and mental health among office workers and by conducting a comprehensive analysis of intervention effects. It offers valuable insights and considerations that may inform occupational health practitioners, employers, policy makers, and researchers and may contribute to developing future effective interventions.

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  • 18.
    Liljedahl, Johanna
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Towards evidence-based classification in para-cycling2022Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of classification in Paralympic sport is to minimize the impact of impairment on the outcome of competition. The aim of this thesis was to investigate the impact of different types of impairments on para-cycling performance to develop an evidence-based classification system in the para-cycling C (bicycling) and T (tricycling) divisions.

    This thesis is based on four articles. The first article examined differences in race performance between para-cycling classes by comparing track race results. The second article evaluated leg strength measures in para-cyclists with musculoskeletal impairments. The third article investigated leg coordination and leg strength and the association with para-cycling performance in para-cyclists with hypertonia, ataxia, or athetosis. The fourth article aimed to gather consensus on para-cycling classification issues and to identify research priorities within para-cycling, by consulting a panel with expertise within para-cycling and para-sport.

    This thesis has identified performance characteristics in para-cyclists with musculoskeletal and coordination impairments, and suggested tests with potential to be used in para-cycling classification to assess muscle strength and coordination. The results indicate that the classes for athletes with the least impairments, as well as the classes for athletes with impaired coordination, need to be further investigated.

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  • 19.
    Linghede, Eva
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Forskningsgruppen för pedagogisk idrottsforskning.
    Glitch i Idrottslandet: en kritiskkreativ undersökning av queeranden inom svensk idrott(svetenskap)2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The dominant story in critical sports research is that sport is characterised by heteronormativity and hegemonic masculinity norms. These norms are manifested in sexism, homophobia, homonegativity and racism which affect all athletes, regardless of identity. Although important, this is a story that risks reinforcing ideas of how all sport “is”. The thesis is a response to calls from feminist theorists and sport researchers who argue that we need to move away from a logic of negativity built into critical theory and instead put our analytical tools to the task of constructing alternative possible scenarios. The aim of the thesis is to explore what some major strands within contemporary feminist theory can accomplish in relation to dominating stories about gender, sexuality and scientific knowledge production in sport research. More specifically, I explore how the concepts of figuration and intra-action can open up for other possible sport (science) worlds.

    The thesis consists of a frame-story and four articles, which in turn are based on three substudies. In the first substudy I interviewed boys and men who engage with horses and in horse riding. By engaging in a sport, equestrianism, that in Sweden is dominated by girls/women and female coded, they transgress and challenge – glitch – ideas of how Real sports boys/men should be, live and act. The interview stories from this study are enacted in various ways in article I and IV. In the second substudy I interviewed elite athletes with experiences of living non-straight and who in that way glitch heteronormativity in sports (sometimes also homonormativity). These stories make up the heart of the figurations presented in article II. In the third substudy, I explored athletic bodies that, due to intersex variations, glitch the idea that the only way of being a body (in sport) is to be male or female. This analysis is presented in article III.

    The thesis is populated by horseguys who challenge stereotypical masculinity norms, sporting contexts that turn heteronormativity up-side-down and inside-out, athletic bodies that implode binary gender and a researcher I glitching a scientific (writing) genre. The figurations presented in the thesis open up for queering elsewheres, where engaging in sport can serve as a condition of possibility for same-sex attractions/relations and non-normative ways of being a boy/man, and where creative writing – in the form of fiction, poetry and genre mixing – can be used as a method of inquiry.

    Through the concept of intra-action, the thesis also makes visible that “matter matters”. Firstly, I show how engaging materially with horses allow and encourage boys/men to be less constrained by dominant gender norms – in other words, that human-horse relations are entangled with, and affect, boys’ and men’s doing of gender. Secondly, I make visible how athletic bodies “strike back” in relation to ideas of binary gender, glitching a dominant medico-scientific story (in sport) telling us that the only way of being a body is to be male or female. Thirdly, I enact – in form and content – how the researcher is always already entangled in scientific knowledge production.

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  • 20.
    Mikaels, Jonas
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Becoming-place: (Re)conceptualising friluftsliv in the Swedish physical education and health curriculum2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis aims to critically examine taken for granted assumptions underpinning friluftsliv and outdoor education as a learning area in the curriculum, and to explore the educational potential of a place-responsive pedagogy. A growing body of critical research in outdoor studies suggest that there has been a discursive shift away from an activity-based personal and social development discourse, in favour of more critical awareness in outdoor education research. This discursive shift includes a focus on place and educating for an environmentally sustainable future as the primary goal for outdoor education. The Swedish curriculum emphasizes that historical, environmental, ethical, and international perspectives should be addressed in all subjects, including physical education and health (PEH), in which friluftsliv is imbedded. However, the implementation of these overarching perspectives into pedagogical practice has been proven to be rather limited.

    The thesis comprises four independent but connected articles. Empirically, this thesis draws on interviews with PE teachers in New Zealand, reflective journals from a month-long journey in the Canadian Rockies, and curriculum documents, interviews and workshop reflections from a yearlong case study with a group of PEH teachers in Sweden. Inspired by the work of Michel Foucault, Gilles Deleuze and Félix Guattari, relational materialism and posthuman perspectives have been employed in the analysis.

    Findings suggest that different ontological perspectives affect what is regarded as “normal” or “true” learning objectives in outdoor education and school-based friluftsliv. The overall findings from the thesis show that there is educational potential in place-responsive pedagogy. The case study demonstrates that place-responsiveness challenges the taken for granted people-centred practice focusing on personal and social development outcomes, which traditionally has dominated outdoor education and Swedish school-based friluftsliv. The decentring of humans, in favour of mutual and relational engagements with matter and the more-than-human, opens up new possibilities for embodied relations to place(s). 

    In conclusion, this thesis suggests the notion of engaging in a place-responsive pedagogy, in order to enable teachers to work within school-based friluftsliv in new and innovative ways. Place-responsiveness offer possibilities for working with the overarching perspectives and sustainability in pedagogical practice as well as for engaging in cross-curricular teaching and learning initiatives more locally.

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  • 21.
    Moberg, Marcus
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Eva Blomstrand's research group.
    Effects of exercise and amino acid intake on mechanisms regulating protein synthesis and breakdown in human muscle2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Skeletal muscle adapts differently to specific modes of exercise, where resistance training results in muscle growth and endurance training induces mitochondrial biogenesis. These are results of molecular events that occur after each exercise session, increasing the expression of specific genes and the rate of both synthesis and breakdown of protein. The rate of protein synthesis is controlled by the mTORC1 signaling pathway, which is potently stimulated by resistance exercise and amino acid, and their combined effect is needed for muscle growth. The essential amino acids (EAA) are responsible for the stimulation of protein synthesis and here leucine has been attributed specific attention, but its particular role among the EAA, and the involvement of the other branched-chain amino acids (BCAA) is unclear. Endurance exercise activates the protein AMPK which, in animal models, has been shown to inhibit mTORC1 signaling and protein synthesis.  Suggesting that concurrent endurance and resistance exercise could restrain muscle growth, but it is unknown if this mechanism is relevant in exercising human muscle. Little is known about the regulation of protein breakdown and although much attention has been given the proteins MuRF-1 and MAFbx which target proteins for degradation, their role requires further investigation. The aim of thesis was to address the mentioned uncertainties by examining how different modes of exercise and amino acids affect mTORC1 signaling, protein synthesis and markers of protein breakdown in human muscle.

    In study I, the influence of high intensity endurance exercise on subsequent resistance exercised induced mTORC1 signaling was examined. Despite robust activation of AMPK by the endurance exercise there was no inhibition of mTORC1 signaling or protein synthesis during recovery from resistance exercise. Study II utilized a similar set up, but with the difference that resistance exercise was performed with the triceps. The cycling exercise reduced the resistance exercise stimulated mTORC1 signaling immediately after the exercise, but during the recovery period mTORC1 signaling and protein synthesis was similar between trials. Concurrent exercise induced the mRNA expression of MuRF-1 and that of PGC-1α, the master regulator of mitochondrial biogenesis, in both studies, despite that the exercise modes in study II were separated between legs and arms. In study III, the effect of an EAA supplement with or without leucine, in the stimulation of mTORC1 signaling in connection with resistance exercise was examined. Intake of EAA robustly stimulated mTORC1 signaling after exercise, but this was only minor when leucine was excluded from the supplement. In study IV, subjects were supplied with leucine, BCAA, EAA or placebo in a randomized fashion during four sessions of resistance exercise. Leucine alone stimulated mTORC1 signaling after the exercise, but both the amplitude and extent of stimulation was substantially greater with EAA, an effect that was largely mediated by the BCAA as a group.

    In conclusion, endurance exercise prior to resistance exercise using the leg or arm muscles does not affect mTORC1 signaling or protein synthesis during the three hour recovery period from exercise, supporting compatibility between resistance- and endurance exercise induced signaling. Concurrent exercise increases the expression of the proteolytic marker MuRF-1 compared to resistance exercise only, which could indicate both and increased demand of cellular adaptive remodeling or a more direct detrimental proteolytic effect. Leucine is crucial among the EAA in the stimulation of mTORC1 signaling after exercise, its effect is however potentiated by intake of the remaining EAA. As a supplement a mixture of EAA must be regarded preferable, although the effect is largely mediated by the BCAA as a group.  

     

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  • 22.
    Olsson, Sven Johan Gustav
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Studies of physical activity in the Swedish population2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Cheap and effective tools for measuring patients’ physical activity (PA) level are needed. The first aim in this thesis was therefore to assess the validity of two PA -questions, and their three associated answer modes, that are used within the Swedish health care system. Sitting, light intensity PA (LIPA), and moderate and vigorous intensity PA (MVPA), are associated with health and longevity, but detailed population data assessed with objective methods is needed. The second aim was thus to assess the above with motion sensor technology, in a middle-aged Swedish sample. Low self-perceived health is a strong predictor of morbidity and mortality, but this association may vary over time with changes in the society and our lifestyle. The third aim was to assess secular trends in the interrelations between self-perceived health, physical fitness, and selected covariates. The effects of PA on prescription (PAP) on health-related quality of life (HRQoL) in overweight adults are unclear, thus the fourth aim was to explore this.

    Methods: All data was collected in the Swedish population. Data from the PA -questions and accelerometers, aerobic fitness, counter movement jump, and balance tests, blood samples, and self-rated general health were collected in 365 participants, 21–66 yrs. The PA pattern was assessed in 948 individuals, 50‒64 yrs, from the SCAPIS pilot study. Self-perceived physical health, and measured aerobic fitness, counter movement jump height, and balance, and demographic and lifestyle data, was assessed in three independent samples from 1990, 2000 and 2013, including 3564 adults, 20‒65 yrs. The effects of Swedish PAP on HRQoL was assessed in a randomized controlled trial including 101 men and women, 67‒68 yrs, that were inactive, overweight (BMI>25 kg/m2), and had a waist circumference ≥102 cm (men) or ≥88 cm (women), who were randomized to an intervention group or a control group. The 36-item Short Form Health Survey (SF-36) was used to assess HRQoL.

    Results: The multiple choice answer mode of the two PA -questions was found to have the strongest validity, compared with the two other (an open mode, and one where PA minutes is specified per weekday). The validity is in line with many other established PA-questionnaires, but the open mode has limitations. The assessment of PA pattern showed that 61% of motion sensor wear time represented sitting, 35% LIPA, and 4% MVPA. Only 7% of the sample met the PA recommendations. The odds for describing perceived health as good was found to increase by 5% per each increment of 1 ml/kg/min in VO2max. This was stable across genders and all three LIV-samples (i.e. over time). Waist circumference, chronic disease, sleep problems, and level of satisfaction with one’s life, were also important correlates. The Swedish PAP group improved significantly more, and more participants displayed clinically relevant improvements (OR 2.43), in mental aspects of HRQoL, compared to the controls. Physical aspects of HRQoL improved in the PAP group, but not in the control group.

    Conclusions: The multiple choice answer mode has the strongest validity and Open mode the weakest. The PA -questions may be used in populations, or in individuals to determine appropriateness for treatment. The questions’ advantages and limitations must be considered and further reliability and validity studies are needed. The results regarding sitting, LIPA, MVPA and fulfillment of PA recommendations, are of high clinical relevance. A great challenge remains to further implement methods to increase the level of PA in the Swedish population. Physical fitness is related to self-perceived health independently of changes in society and lifestyle over time, and simple questions may be useful for the clinical assessment of physical fitness. Swedish PAP has a positive effect on mental aspects of HRQoL, measured by the SF-36. This finding supports the clinical use of the Swedish PAP model.

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  • 23.
    Qvarfordt, Anna
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences. University of Gävle.
    Anti-doping – a legitimate effort?: Elite athletes' perspectives on policy and practice2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The global anti-doping enterprise in sport is a comprehensive system in which the athlete is at the centre of regulation, scrutiny and control. There is limited knowledge about the implications of this extensive control system for athletes and about how athletes perceive the system; little is known about possible consequences of these implications and perceptions for the legitimacy of the system. The overall aim of this thesis is to analyse the legitimacy of global anti-doping policy and practice from the perspectives of international elite athletes.

    Four articles are included in this compilation thesis. The first illustrates, based on a discourse analytical approach, how claims for legitimacy of the anti-doping system are produced in policy documents aimed at athletes. The second explores the perceptions and legitimacy of anti-doping policy and practice through a survey aimed at elite athletes in different sports and from different regions of the world. The third article examines, through an interview study, how athletes in different contexts experience the practice of anti-doping and what consequences this may have for the system's legitimacy. The interview study was also the basis for the fourth article, focusing on the athletes' experiences and perceptions of their opportunities for compliance and how this is related to their view of the system's legitimacy. Using the four articles as a basis, the analysis of legitimacy within the anti-doping system is expanded in the thesis through an overarching analytical framework inspired by David Beetham.

    The results show that the legitimacy of the policy documents is based on essentially authoritative, but also rational, arguments for justifying the anti-doping enterprise. Elite athletes are generally in favour of anti-doping policy and the principle that doping should be prohibited. However, when the rules are implemented into practice, problems to do with lack of procedural justice arise which may have an impact on the system's legitimacy. Procedures in the system are perceived as having a negative effect on sportspersons' private life, and as ineffective and unequally implemented across the world; also, athletes have little influence over decision-making processes. Anti-doping practice is moreover perceived to cause structural inequalities due to inequality in access to technology, education and knowledge as well as supportive systems. Most athletes wish to comply with the rules, but many struggle with lack of control and have limited scope for taking responsibility regarding compliance with the doping rules. Even when athletes are dutiful and perform acts that confer legitimacy to the rules and the authorities, some experiences and perceptions could endanger the legitimacy of antidoping, as seen in the overall legitimacy analysis of the thesis. Athletes' perceptions of inequality, ineffectiveness and lack of leeway can be interpreted as a lack of rule conformity to the anti-doping authority. There also appears to be a lack of shared normative beliefs between sportspersons and the anti-doping authorities, as many athletes feel that their opinions are not taken into account. Decision-making processes that do not pay attention to the perceptions of those involved can result in a discrepancy between the rules and the norms.

    The international anti-doping system is a major international enterprise with comprehensive rules that need to be applied equally around the world, and that also need to be legitimated in different countries where athletes have different conditions to comply with the regulations. In this thesis, I have shown that these different conditions have consequences for the ability to comply with the rules and also for the application of the regulations. The far-reaching rules mean that procedures within the system are experienced as causing a number of negative consequences. I have shown that this poses a risk to the legitimacy of the system if these problems are not addressed.

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  • 24.
    Roe, Daniel
    Swedish School of Sport and Health Sciences, GIH, Department of Movement, Culture and Society.
    Sport in youth detention: A “pedagogical” practice?2021Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Sport can be an important part of life inside youth detention, often believed to contribute to the rehabilitation of youth. However, there has been little ethnographic research examining this phenomenon. How is sport arranged, delivered, and experienced in these closed settings? This thesis examines pedagogies of sport in youth detention, based on ethnography at Capeview and Summerholm – two all-male youth detention homes in Sweden. By framing youth detention as pedagogical practice, and through a life-world methodology, the thesis provides close descriptions of sport in which the lived experiences of youth are situated in the particular functions and practices of these institutions.

    The findings of the thesis are compiled into three independent but interrelated articles. The first article explores a pedagogical approach at Capeview – one of the sites –that a select group of students experienced as initiating and guiding a developmental process. The findings elaborate four aspects of the program – building a pedagogical platform, “seeing” and meeting students, creating a supportive environment, and thinking beyond the institution – that characterized this “rings on the water” (i.e., “ripple effect”) approach. The second article examines the dominant pedagogies of sport at both institutions: withholding sport, busying with sport, and sport as developmental community. Findings illustrate how competing functions of youth justice – punishment, containment, and development – are accomplished, and experienced, through sport pedagogical practice. The third article examines sport in these male-dominated institutions from a masculinities perspective. It shows how pedagogical endeavors must address the impact of divergent notions of masculinity in order to integrate, and avoid further marginalizing, these young men through sport.

    The principal contribution of the thesis is to show how different sport pedagogies function in order to educate or support and, conversely, contain or punish placed youth– illustrating how desirable benefits of sport in youth detention are contingent upon pedagogical practice. Bringing pedagogical and gender-critical perspectives to bear, it identifies challenges and shortcomings as well as opportunities and promising practices. Endeavors for doing sport for the benefit of detained youth and a safe, just society must consider issues of pedagogy, gender, and philosophical dilemmas such as conflicting missions of education and corrections. Ultimately, efforts to improve outcomes for detained youth through sport calls for tactful pedagogical action, sensitive to the needs, interests, and life-worlds of youth.

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  • 25.
    Rosén, Johanna
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Performance determinants and classification in paracanoe2021Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Valid classification systems are vital for Paralympic sports in order to minimise the impact of impairment on sports performance. To achieve valid classification, each Paralympic sport must develop evidence-based classification systems by examining the impact of impairment on key performance determinants. The aim of this thesis was to examine the impact of impairment on key performance determinants in para va’a and para kayak. Additional aims were to examine the reliability of the para va’a classification system and the validity of the para kayak classification system.

    In studies I and III, three-dimensional (3D) kinematic data from the arms, trunk and legs as well as force from the paddle was collected. Ten non-impaired va’a and 44 para va’a athletes participated in study I and 10 non-impaired kayak and 41 para kayak athletes participated in study III. In study II, three international classifier teams, each comprised of a medical and technical classifier, classified 12 para va’a athletes using the new trunk, leg and on-water classification test batteries and class allocation for para va’a. In study IV, 3D kinematics of the trunk, legs and paddle as well as forces at the footrest, seat and paddle were measured in 17 para kayak athletes with above knee (AK) (n=11) or below knee (BK) (n=6) amputation.

    The main findings were:

    • If para va'a athletes have full trunk function, the level of leg impairment does not affect the performance in terms of paddling force (Study I).
    • The inter-rater reliability of the evidence-based classification system for para va’a was excellent with no discrepancies between the classifier teams in class allocation and minor discrepancies in individual tests (Study II).
    • The differences between the three para kayak classes were in line with the definition of the classes in the new evidence-based classification system for para kayak. In addition, no significant correlations were seen between power output and joint variables in trunk or legs for two of the three classes indicating that these classes are valid (Study III).
    • Differences between athletes with AK and BK amputation were seen for variables concerning the hip joint. No differences were however seen between the groups in paddle performance variables (Study IV).

    In conclusion, this thesis has described how athletes with different impairment differ in key performance determinants for para va’a and para kayak. The results of the thesis also gave indications that the new evidence-based classification system for para va’a is reliable and that the new evidence-based classification system for para kayak is valid in regard to two of the three classes.  

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  • 26.
    Salier Eriksson, Jane
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, The Research Unit for Movement, Health and Environment.
    The heart rate method for estimating oxygen uptake in walking and cycle commuting: Evaluations based on reproducibility and validity studies of the heart rate method and a portable metabolic system2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Walking and cycling to work can contribute to population health, but more objective knowledge concerning exercise intensities, oxygen uptake and the metabolic demands of this physical activity is needed for this and other evaluations. To attain this, valid and reliable instruments are a requirement. The focus of this thesis was to evaluate whether the heart rate method can be used for this purpose. It involves establishing the relation between heart rate and oxygen uptake during ergometer cycling in laboratory conditions, and thereafter checking if the same relation exists during cycle or walking commuting in a metropolitan area.

    To accomplish this, a portable metabolic system was tested for validity and reliability in laboratory and field conditions and the reproducibility of the heart rate and oxygen uptake relation in the laboratory was evaluated. Furthermore, the heart rate and oxygen uptake relations during cycle and walking commuting was compared with those attained in the laboratory.

    The first two studies showed that a portable metabolic system is valid during laboratory and sustained field conditions. Studies 3 and 4 showed that the heart rate method with respect to the heart rate-oxygen uptake relationship is reliable on the group level for both walking and cycling commuters during repeated measures in the laboratory. The last two studies showed that applying the heart rate method during cycle commuting leads to valid levels of oxygen uptake on the group level for both males and females. Contrary to that, the measured levels of oxygen uptake in the field during walking commuting were on average 17% higher for males, and 13% higher for females than the values obtained with the heart rate method. For both walking and cycling commuters, the individual spread around the mean values was rather high, creating somewhat wide confidence intervals for the mean values.

    In summary, the heart rate method can be used for cycle commuters during their normal commuting conditions, while for pedestrians it is necessary to take into account that oxygen uptake per heart rate is higher while walking than that estimated from ergometer cycling in the laboratory.

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  • 27.
    Sandamas, Paul Nicolas
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Athletic Sprint Start Biomechanics: Investigations into the relationships between three dimensional starting technique, first step width and performance2021Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The block and early acceleration phase plays a very important role in the overall outcome of athletic sprint events. During this part of the race it is commonly observed that sprinters use a lower-body technique that involves the swing leg crossing medially in front of the athlete followed by wide steps. These wide initial steps give the impression that the legs are flailing out to the side. Some coaches believe that this action could be inefficient and thus should be curtailed. However, there is limited knowledge about this movement pattern and its relation to performance.

    Therefore, the overall aim of this thesis was to help elucidate from a biomechanical perspective a) the fundamental underlying kinematic and mechanical basis to this technique and b) how both performance and muscular contributions to propulsion would be affected when step width was restricted.

    A cross sectional study design was used to examine specific kinematic and kinetic variables from 11 competitive sprinters (9 male, 2 female) performing maximum effort 15 m sprint starts. Three-dimensional kinematics, ground reaction force and electromyographical data were recorded from the block phase to the end of the 1st stance phase. Each athlete performed five trials with their natural technique and five trials inside a 0.3 m wide lane. A 15-segment, full-body model and a 37 degrees of freedom full-body musculoskeletal model were created and used to calculate relevant variables/parameters. Normalised average horizontal external power was used as the performance measure.

    A combination of pelvis list and rotation (but not hip adduction) was found to be coupled with the thigh of the swing leg moving medially during the single push phase. In the unrestricted width trials, pelvic list range of motion and medial impulses correlated positively with step width but step width was not found to be related to performance. When step width was restricted, a more forward pointing normalised average ground reaction force vector was seen but lower body muscular contributions to acceleration were reduced and no immediate improvement to performance was found.

    The primary kinematic reason behind the lower body posture the sprinters adopt during the block phase whereby the swing leg moves medially in front of the body is caused by a combination of three dimensional pelvis rotations rather than simply hip internal rotation/or adduction of the swing leg. Trying to reduce pelvic range of motion or minimising the flailing leg motion is unlikely to lead to an improvement in performance. Therefore, the notion that this technique is inefficient, was not supported by this study.

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  • 28.
    Svennberg, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences. University of Gävle.
    Grading in physical education2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In the thesis the aim is to investigate different aspects of what teachers value when grading in Swedish physical education (PE) and to analyses how sociological background factors impact students’ grades. Grades in PE have included aspects other than those prescribed in the grading criteria, for instance motivation and effort. Teachers sometimes find their value-setting difficult to articulate and refer to a “gut feeling”. In order to explore both explicit and implicit forms of value-setting, the Repertory Grid interview technique is employed.

    The thesis includes four sub-studies, three interview studies with Swedish PE teachers and a fourth study based on registry data from the Swedish National Agency for Education. The data of all students leaving nine-year compulsory school in 2014 (n=95317) is analysed to explore how sociological background factors, such as migration background, parents’ education, school provider and gender, affect PE grades.

    The results reveal aspects of grading that are not detectable in the official description of the grading assignment and highlight problems that teachers need to address when grading. Four themes are discerned in the teachers’ grading practices: motivation, knowledge, confidence and social skills. The implementation of a new national curriculum with specified knowledge requirements seems to improve the alignment with the national criteria, but there is still a gap between policy and practice. The knowledge requirements for movement are often interpreted as performances in competitive sports, even if the teachers try to find other interpretations. The odds ratio for getting a higher grade in PE is greater for the variables migration background and parents’ education than for the other investigated variables. The concepts formulated by Bernstein are applied to explore the relations between teachers’ grading practices and cultural and political influences and to discuss how the tensions between different interests could affect teachers’ grading.

    The conclusion is that the gap between policy and practice confirmed in this study is related to tensions between the interests and purposes of different agents, all of whom strive to influence steering documents and practice. Cultural and political influences need to be considered and facilitate discussions about how to understand which knowledge is valued in PE and who has better possibilities to assimilate it.

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  • 29.
    Thedin Jakobsson, Britta
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Forskningsgruppen för pedagogik, idrott och fritidskultur.
    Vilka stannar kvar och varför?: En studie om ungas föreningsidrottande under uppväxtåren2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The main aim of this thesis is to increase knowledge of what characterizes club sport participation during childhood and youth, and what distinguishes young participators who continue club sport in their late teens and to understand why they continue.

    An important premise for this thesis is that sport is one of the most widespread leisure activities among youth. Many young people in Sweden stop participating in club sport during their teens, but some continue. Rather than concentrating on those who drop out of club sports the focus of this thesis is on the ones who continue with club sports during teenager years. Aaron Antonovsky’s salutogenic theory and sense of coherence model (SOC) has inspired the analysis of what it is that seems to be comprehensible, manageable and meaningful when participating in club sport. Furthermore, Pierre Bourdieu's key concept habitus and capital have been used as research tools when analyzing the relationship between sports participation and social position among teenagers.

    This thesis is based on four studies and, empirically, it is partly longitudinal where the same 585 pupils born 1991 have answered a questionnaire at 10, 13, 16 and 19 years of age. The study is also based on 18 in-depth interviews with teenagers 15 to 19 years of age.

    The results of this thesis show that club sports are successful in getting large numbers of children to attend and participate, but there seem to be many who just participate for a short time and only about one third stay on in their late teens. Very few start after the age of 13. Teenagers who are active participants appear to have started early, have taken part in different sports and do not mind taking part in competitions. Furthermore, they seem to possess specific dispositions (and certain assets) in terms of a habitus with a taste for sport and a specific cultural capital in terms of academic success. Moreover, it looks as if doing club sport is a social space where the teenagers can experience meaningfulness based on learning, developing physical ability, experiencing a feeling of belonging, and being challenged but few had elite ambitions.

    The conclusion is that sports clubs should try to organize activities emphasizing development with numerous opportunities and challenges for motor and social learning with less focus on competitions as the only focal point. By asking questions about and taking into account what teens need to understand, cope with, and what they perceive as meaningful in sports, it is possible that more young people want to participate longer.

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  • 30.
    Tidén, Anna
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Forskningsgruppen för pedagogisk idrottsforskning.
    Bedömningar av ungas rörelseförmåga: En idrottsvetenskaplig problematisering och validering2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall purpose of this thesis is to investigate, discuss and problematise different aspects of movement ability. The four sub-studies of the thesis deal with various issues concerning assessment of movement ability. First, the focus is on how the concept of physical literacy has influenced the steering document of the subject physical education and health (PEH) in Sweden. The question is: What kind of tensions and conflicts arise when different approaches and interpretations of movement ability are used in an educational context? Second, a structural validation is conducted of the NyTid test, an assessment tool developed to assess basic and complex movement skills at the ages of 12-16 years. The question is: Which categories of movement skills are identified through the validation of the NyTid test? Third, the study examines how ‘ability’ is conceptualised, configured and produced in movement tests and movement assessment tools. Finally, an investigation of how or whether an assessed low or high movement ability at the age of 15 matters for developing an interest in, or taste for, sport and physical activities nine years later, in young adulthood.

    Movement ability is studied from different perspectives, including a multidisciplinary sport science approach using mixed methods. The theoretical standpoint in the sociocultural analyses is inspired by Bourdieu’s theories and concepts of habitus, capital, field and doxa, which are used as analytical tools. Different theories relating to the evaluation of movement abilities as product- or process oriented assessment are also made use of.

    Movement abilities tests and assessment tools are also found to construct a specific and narrow form of physical capital strongly related to traditional sports. Accordingly, the social construction of movement ability through assessment tools is far from neutral and could affect how children see themselves and their sense of ‘ability’. Furthermore, the assumption that an acquired high level of movement ability plays a central role for being physically active is challenged in the thesis. Even though pupils at the age of 15 had a low level of assessed movement ability, it did not prevent them from acquiring a taste for sport and physical activity later in life. However, more studies on movement ability and the underlining mechanisms and factors for engaging in physical activities are necessary.

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  • 31.
    Väisänen, Daniel
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Cardiorespiratory fitness, physical workload, and lifestyle-related factors in occupational groups: associations with sickness absence and cardiovascular disease2023Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The main aim of this thesis was to study cardiorespiratory fitness, physical workload, and lifestyle-related factors, with a special emphasis on cardiorespiratory fitness in an occupational context and the associations with cardiovascular disease and sickness absence across a wide range of occupations. A secondary aim was to study trends in cardiorespiratory fitness in different occupational groups over the last decades.

    The thesis is based on data from health profile assessments performed in the Swedish working population over the last decades and consists of four studies. Paper I examines health risk factors across a diverse range of occupational groups and finds that high-skilled occupations have a more favorable health risk profile than low-skilled occupations, with some sub-major categories displaying a more unfavorable health risk profile than others. Paper III demonstrates that individuals in low-skilled and blue-collar occupations have a significantly higher risk of incident cardiovascular disease than high-skilled white-collar workers. Cardiorespiratory fitness, smoking, and body mass index partially explain this association. Paper IV shows that occupational physical workload is associated with sickness absence, where a higher physical workload is related with a higher risk of total sickness absence due to musculoskeletal and cardiorespiratory causes but a lower risk of sickness absence due to psychiatric causes. Higher cardiorespiratory fitness is associated with reduced predicted days of sickness absence, mainly for cardiorespiratory diagnoses and musculoskeletal diagnoses, with some variations between occupational groups. Paper II finds a consistent decline in cardiorespiratory fitness from 2001 to 2020. This decline is more pronounced in low-skilled occupations, regardless of their classification as white-collar or blue-collar. Forecast analyses revealed a continuing downward trend in cardiorespiratory fitness, particularly in low-skilled occupations.

    In conclusion, promoting smoking cessation, reduced obesity, and physical activities to improve cardiorespiratory fitness may reduce the disparity in cardiovascular disease incidence observed across occupational groups. The decline in cardiorespiratory fitness, particularly in low-skilled occupations, is concerning and calls for targeted interventions that can reach out to those who need it most. This could be achieved through structural and individual-level changes at the workplace and in society at large.

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  • 32.
    Åkesdotter, Cecilia
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Psychiatric disorders in Swedish elite athletes: Prevalence, comorbidity and life stories2023Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis is to explore psychiatric disorders in Swedish elite athletes.

    The first study investigates a) the prevalence of symptoms of psychiatric disorders, b) the prevalence of mental health problems, defined by psychological suffering and impairment>2 weeks, c) the usefulness of sport-specific instruments in indicating clinical levels of psychiatric symptoms, and d) the life history of psychiatric disorders.

    The second study describes psychiatric disorders and comorbidities in a clinical cohort of treatment-seeking elite athletes and high-performance coaches at two publicly funded outpatient psychiatric clinics in Stockholm and Malmö, Sweden.

    The third study uses a narrative approach to understand the reasons why elite athletes with established psychiatric disorders choose to seek support and treatment outside – rather than within – their own sport environment.

    The fourth study presents a poetic representation of one female elite athlete’s experiences of living with, and seeking treatment for, an eating disorder.

    In sum, 19.5% of Swedish elite athletes had symptoms of anxiety and/or depression, and 8.1% had previously received a psychiatric diagnosis. The lifetime prevalence of mental health problems was 51.7%, with 50% of onsets between ages 17 and 21. Sport-specific instruments generally reported fair diagnostic accuracy, but without sufficient sensitivity or specificity for practical use. Among elite athletes in psychiatric treatment, anxiety disorders were the most common (69%), followed by affective disorders (51%) and eating disorders (26%). Comorbidity was generally common between disorders.

    Regarding help-seeking, the performance narrative – defined as a single-minded focus on performance that justifies, and even demands, the exclusion of any form of psychological weakness – forced elite athletes to adopt various impression management strategies to hide their psychological suffering. In closing, being invited to witness the em-bodied experiences of a female elite athlete struggling with and seeking treatment for an eating disorder reminds us that behind every prevalence number there is a person.

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  • 33.
    Åman, Malin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Acute sports injuries in Sweden and their possible prevention: an epidemiological study using insurance data2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Physical activity is an essential component of a healthy life, e.g. to prevent obesity, cardiovascular disease and premature death, of which sports can be an important part. Unfortunately, sports activities increase the risk of both overuse and acute injuries. Severe acute injuries may also lead to a permanent medical impairment (PMI), which may influence the ability to be physically active throughout life. However, sports injuries may be prevented, but a profound understanding of the injuries and how to prevent them is needed.

    This doctoral thesis examine acute sports injuries reported by licensed athletes of all ages and level of sports nationwide in Sweden, by using national insurance data. Approximately 80% of all the Sports Federations (SF) had their mandatory accident insurance in the insurance company Folksam, and since there is no national sports injury surveillance system in Sweden, this is a unique database, able to be used in epidemiological studies on acute injuries occurring in organized sports in Sweden. The main aim of this thesis was to identify high-risk sports for acute injuries, the most common and the most severe injuries, especially in large sports with numerous licensed athletes, many injuries and injuries resulting in PMI. Based on the results, there will be recommendations regarding sports and body locations where injury prevention efforts should be focused to gain the greatest prevention effect at a national level in Sweden. Another aim was to evaluate the effectiveness of a neuromuscular knee control training program (KCP) that has been implemented nationwide to reduce knee and cruciate ligament injuries, among football players in Sweden.

    After evaluating the validity and reliability of the information within the database based on international guidelines, acute injury data were examined and the results presented in four papers. These results showed that there is a need of injury prevention especially in motorcycle sports, team ball sports, and ice hockey. Particularly, knee injuries need to be prevented since they were both the most common injuries and leading to PMI. The severe head- and upper limb injuries also need attention. Sixty-nine percent of the PMI injured athletes, were younger than 25 years. The injury prevention training program, KCP can be considered partially implemented nationwide, since 21 out of 24 district SFs provided KCP educations. The incidence of knee and cruciate ligament injuries has decreased among football players in Sweden. A concerning aspect is that there is no national official policy regarding sports injury and injury prevention in Sweden, nor an official authority that has the explicit responsibility for these issues.

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    Doktorsavhandling Malin Åman (rättad efter disp)
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