| 1. |
- Nilsson, Hanna, et al.
(författare)
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Is preoperative physical activity related to post-surgery recovery? : A cohort study of patients with breast cancer
- 2016
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of our study is to assess the association between preoperative level of activity and recovery after breast cancer surgery measured as hospital stay, length of sick leave and self-assessed physical and mental recovery. Design: A prospective cohort study. Setting: Patients included were those scheduled to undergo breast cancer surgery, between February and November 2013, at two participating hospitals in the Western Region of Sweden. Participants: Patients planned for breast cancer surgery filled out a questionnaire before, as well as at 3 and 6 weeks after the operation. The preoperative level of activity was self-assessed and categorised into four categories by the participants using the 4-level SaltinGrimby Physical Activity Level Scale (SGPALS). Main outcome measure: Our main outcome was postoperative recovery measured as length of sick leave, in-hospital stay and self-assessed physical and mental recovery. Results: 220 patients were included. Preoperatively, 14% (31/220) of participants assessed themselves to be physically inactive, 61% (135/220) to exert some light physical activity (PA) and 20% (43/220) to be more active (level 3+4). Patients operated with mastectomy versus partial mastectomy and axillary lymph node dissection versus sentinel node biopsy were less likely to have a short hospital stay, relative risk (RR) 0.88 (0.78 to 1.00) and 0.82 (0.70 to 0.96). More active participants (level 3 or 4) had an 85% increased chance of feeling physically recovered at 3 weeks after the operation, RR 1.85 (1.20 to 2.85). No difference was seen after 6 weeks. Conclusions: The above study shows that a higher preoperative level of PA is associated with a faster physical recovery as reported by the patients 3 weeks post breast cancer surgery. After 6 weeks, most patients felt physically recovered, diminishing the association above. No difference was seen in length of sick leave or self-assessed mental recovery between inactive or more active patients.
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| 2. |
- Fernström, Maria, 1960-, et al.
(författare)
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Improved Muscle Mitochondrial Capacity Following Gastric Bypass Surgery in Obese Subjects
- 2016
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Ingår i: Obesity Surgery. - New York, USA : Springer. - 0960-8923 .- 1708-0428. ; 26:7, s. 1391-1397
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Tidskriftsartikel (refereegranskat)abstract
- Background: Weight loss resulting from low-calorie diets is often less than expected. We hypothesized that energy restriction would influence proton leakage and improve mitochondrial efficiency, leading to reduced energy expenditure, partly explaining the difficulties in weight loss maintenance.Methods: Eleven women with a median BMI of 38.5 kg/m(2) (q-range 37-40), and referred to gastric bypass surgery participated. Before surgery, and at 6 months of follow-up, muscle biopsies were collected from the vastus lateralis muscle. Mitochondria were isolated and analyzed for coupled (state 3) and uncoupled (state 4) respiration and mitochondrial capacity (P/O ratio).Results: At follow-up, the participants had a median BMI of 29.6 kg/m(2) (28.3-32.0). State 3 increased from 20.6 (17.9-28.9) to 34.9 nmol O2/min/U citrate synthase (CS) (27.0-49.0), p = 0.01, while state 4 increased from 2.8 (1.8-4.2) to 4.2 nmol O2/min/U CS (3.1-6.1), although not statistically significant. The P/O ratio increased from 2.7 (2.5-2.8) to 3.2 (3.0-3.4), p = 0.02, indicating improved mitochondrial efficiency.Conclusions: Six months after gastric bypass surgery, the mitochondrial capacity for coupled, i.e., ATP-generating, respiration increased, and the P/O ratio improved. Uncoupled respiration was not enhanced to the same extent. This could partly explain the decreased basal metabolism and the reduced inclination for weight loss during energy restriction.
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| 3. |
- Askling, Carl, et al.
(författare)
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A new hamstring test to complement the common clinical examination before return to sport after injury
- 2010
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer-Verlag. - 0942-2056 .- 1433-7347. ; 18:12, s. 1788-1803
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim was to introduce and evaluate the reliability and validity of an active hamstring flexibility test as a complement to common clinical examination when determining safe return to sport after hamstring injury. METHODS: Eleven healthy subjects (28 years) were tested on repeated occasions, and 11 athletes (21 years) with MRI-verified acute hamstring strain were tested when common clinical examination revealed no signs of remaining injury, i.e. there was no differences between the legs in palpation pain, manual strength tests, and passive straight leg raise. Flexibility, i.e. highest range of motion of three consecutive trials, was calculated from electrogoniometer data during active ballistic hip flexions and conventional passive slow hip-flexions in a supine position. A VAS-scale (0-100) was used to estimate experience of insecurity during active tests. RESULTS: No significant test-retest differences were observed. Intra-class correlation coefficients ranged 0.94-0.99 and coefficients of variation 1.52-4.53%. Active flexibility was greater (23%) than passive flexibility. In the athletes, the injured leg showed smaller (8%) active, but not passive, flexibility than the uninjured leg. Average insecurity estimation was 52 (range 28-98) for the injured and 0 for the uninjured leg, respectively. CONCLUSION: The new test showed high reliability and construct validity; furthermore, it seems to be sensitive enough to detect differences both in active flexibility and in insecurity after acute hamstring strains at a point in time when the commonly used clinical examination fails to reveal injury signs. Thus, the test could be a complement to the common clinical examination before the final decision to return to sport is made.
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| 4. |
- Dreber, Helena, et al.
(författare)
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Health-Related Quality of Life 5 Years After Roux-en-Y Gastric Bypass in Young (18-25 Years) Versus Older (≥ 26 Years) Adults : a Scandinavian Obesity Surgery Registry Study.
- 2019
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Ingår i: Obesity Surgery. - : Springer. - 0960-8923 .- 1708-0428. ; 29:2, s. 434-443
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To compare changes in health-related quality of life (HRQoL) in young (18-25 years) versus older (≥ 26 years) adults up to 5 years after Roux-en-Y gastric bypass (RYGB).METHODS: Data on Short Form-36 (SF-36) and obesity-related problems scale (OP) at baseline and 1, 2, and 5 years after RYGB were extracted from the Scandinavian Obesity Surgery Registry. Within-group changes and the effect of age group on 5-year changes in SF-36 and OP were analyzed. Effects sizes (ESs) were calculated.RESULTS: A total of 2542 young and 12,425 older adults were included at baseline, and 138 young (20.7% of those eligible) and 1021 older (31.8%) adults were followed-up 5 years post-RYGB. At this time, average to large improvements (ES ≥ 0.5) were observed in physical functioning, physical component score and OP in young adults, and in physical functioning, role physical, general health, physical component score, and OP in older adults (all, p ≤ 0.001). Both age groups displayed negligible to weak (ES < 0.5) or no improvements in mental HRQoL (all, p < 0.55). Older adults displayed greater 5-year improvements than their young counterparts in role physical, general health, vitality, social functioning, physical component score, and obesity-related problems scale (all, p < 0.05).CONCLUSIONS: Both young and older adults displayed improvements in OP and physical HRQoL 5 years post-RYGB compared to baseline, while mental HRQoL did not improve to the same extent. Greater HRQoL-improvements could be expected in older patients why future research on HRQoL post-RYGB should stratify data on age groups.
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| 5. |
- Dreber, H., et al.
(författare)
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Weight loss, adverse events, and loss to follow-up after gastric bypass in young versus older adults: A Scandinavian Obesity Surgery Registry study
- 2018
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Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier BV. - 1550-7289 .- 1878-7533. ; 14:9, s. 1319-1326
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Tidskriftsartikel (refereegranskat)abstract
- Background: Young adults display particularly poor weight loss in behavioral obesity treatment; nonetheless, they have seldom been included in bariatric research. Objectives: To compare weight loss, adverse events, and loss to follow-up in young (18-25 yr) versus older (>= 26 yr) adults up to 5 years after Roux-en-Y gastric bypass. Methods: Prospective registry data (Scandinavian Obesity Surgery Register) were analyzed in young (22.2 yr [standard deviation (SD): 2.1], 81.6% women, mean body mass index 43.7 kg/m(2) [SD: 5.4]) and older (42.6 years [SD: 9.6], 82.0% women, mean body mass index 43.4 kg/m(2) [SD: 5.0]) adults undergoing Roux-en-Y gastric bypass. Groups were matched for body mass index, sex, and year of surgery. Regression analyses and mixed models were used to compare outcomes between groups. Results: A total of 369 young (37.0% of eligible) and 2210 older (46.1%) adults attended the 5-year follow-up. At this time, weight loss was 31.8% in young and 28.2% in older adults (P < .001), with a serious adverse event (Clavien-Dindo >= 3b) being reported in 52 (14.1%) young and 153 (6.9%) older adults (odds ratio = 2.06, 95% confidence interval: 1.45-2.92, P < .001). Loss to follow-up was higher in young versus older adults throughout the study period (range of relative risk = 1.16-1.89, P < .001). Conclusions: While young adults displayed at least equal weight loss as older adults, rates of adverse events were approximately doubled, and loss to follow-up rates were higher. Future studies on the significance of and the etiology behind the higher incidence of serious adverse events are needed. Intensified clinical contact post Roux-en-Y gastric bypass should have the potential to further improve outcomes in young adults. (C) 2018 American Society for Bariatric Surgery.
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| 6. |
- Onerup, Aron, 1983, et al.
(författare)
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The preoperative level of physical activity is associated to the postoperative recovery after elective cholecystectomy : A cohort study
- 2015
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Ingår i: International Journal of Surgery. - : Ovid Technologies (Wolters Kluwer Health). - 1743-9191 .- 1743-9159. ; 19:July, s. 35-41
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Tidskriftsartikel (refereegranskat)abstract
- Introduction There is an increasing interest in the role of preoperative physical activity for postoperative recovery. The effect of preoperative physical activity and recovery after cholecystectomy is unknown. The aim of this study was to evaluate the association of self-reported leisure-time preoperative physical activity with postoperative recovery and complications after elective cholecystectomy due to gallstone disease. Methods Prospective observational cohort study with 200 patients scheduled to undergo elective cholecystectomy. Level of self-assessed leisure-time physical activity was compared with recovery. Results Regular physical activity was associated with a higher degree of return to work within three weeks post-operatively (relative chance (RC) 1.26, p = 0.040); with a higher chance of leaving hospital within one day post-op (RC 1.23, p = 0.001), as well as with better mental recovery (RC 1.18, p = 0.049), compared to physically inactive. No statistically significant association was seen with return to work within one week or with self-assessed physical recovery. Discussion In clinical practice, evaluating the patients’ level of physical activity is feasible, and may potentially be used to identify patients being more suitable for same-day surgery. Given the study design, the results from this study cannot prove causality. Conclusion The present study shows that the preoperative leisure-time physical activity-level, is positively associated with less sick leave, a shorter hospital stay and with better mental recovery, three weeks post-elective cholecystectomy. We recommend assessing the physical activity-level preoperatively for prognostic reasons. If preoperative/postoperative physical training will increase recovery remains to be shown in a randomized controlled study.
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| 7. |
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| 8. |
- Ekblom, Björn
(författare)
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Hade artrosen kunnat förebyggas?
- 2004
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 101:40, s. 3098-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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