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  • Hagströmer, Maria, et al. (författare)
  • Bedöma och utvärdera fysisk aktivitet
  • 2016. - 3
  • Ingår i: FYSS 2017 : Fysisk aktivitet i sjukdomsprevention och sjukdomsbehandling - Fysisk aktivitet i sjukdomsprevention och sjukdomsbehandling. - : Läkartidningen Förlag AB. - 9789198171129 ; , s. 250-266
  • Bokkapitel (refereegranskat)
  • Larisch, Lisa-Marie, et al. (författare)
  • Associations between 24 h Movement Behavior and Mental Health in Office Workers.
  • 2020
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:17
  • Tidskriftsartikel (refereegranskat)abstract
    • The associations between 24 h movement behavior, i.e., the way people distribute their time in different movement-related behaviors, on mental health are not well understood. This study applied a compositional data analysis approach to explore cross-sectional associations between device-measured moderate to vigorous physical activity (MVPA), light intensity physical activity (LIPA), sedentary behavior (SED), self-reported time in bed and mental health outcomes, i.e., depression or anxiety symptoms, burnout, mental wellbeing and stress, in office workers. ActiGraph accelerometers were worn for 24 h for at least 4 days to assess MVPA, LIPA, and SED. Sleep diaries were used in addition to identify time in bed. Analytic sample sizes for the different outcomes ranged from N = 345-370 participants. In this population of office workers with high levels of MVPA, the entire movement behavior composition was not associated to any of the mental health outcomes, but MVPA relative to all other behaviors was positively associated with mental wellbeing. This confirms the importance of MVPA for health relative to other movement-related behaviors.
  • Bergman, Patrick, et al. (författare)
  • No one accelerometer-based physical activity data collection protocol can fit all research questions.
  • 2020
  • Ingår i: BMC Medical Research Methodology. - : BioMed Central. - 1471-2288 .- 1471-2288. ; 20:1, s. 1-8
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Measuring physical activity and sedentary behavior accurately remains a challenge. When describing the uncertainty of mean values or when making group comparisons, minimising Standard Error of the Mean (SEM) is important. The sample size and the number of repeated observations within each subject influence the size of the SEM. In this study we have investigated how different combinations of sample sizes and repeated observations influence the magnitude of the SEM.METHODS: A convenience sample were asked to wear an accelerometer for 28 consecutive days. Based on the within and between subject variances the SEM for the different combinations of sample sizes and number of monitored days was calculated.RESULTS: Fifty subjects (67% women, mean ± SD age 41 ± 19 years) were included. The analyses showed, independent of which intensity level of physical activity or how measurement protocol was designed, that the largest reductions in SEM was seen as the sample size were increased. The same magnitude in reductions to SEM was not seen for increasing the number of repeated measurement days within each subject.CONCLUSION: The most effective way of reducing the SEM is to have a large sample size rather than a long observation period within each individual. Even though the importance of reducing the SEM to increase the power of detecting differences between groups is well-known it is seldom considered when developing appropriate protocols for accelerometer based research. Therefore the results presented herein serves to highlight this fact and have the potential to stimulate debate and challenge current best practice recommendations of accelerometer based physical activity research.
  • Bergqvist-Norén, Linnea, et al. (författare)
  • Patterns and correlates of objectively measured physical activity in 3-year-old children
  • 2020
  • Ingår i: BMC Pediatrics. - 1471-2431 .- 1471-2431. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: To increase the knowledge about physical activity (PA) patterns and correlates among children under the age of 4, there is a need for study's using objective measurements. The aim of this study was therefore to investigate if objectively measured PA among 3-year-old children differed between day of week and time of day and whether it correlated to child weight status and sex as well as parental weight status and education.METHODS: Totally 61 children (51% girls) aged 3, participating in Early Stockholm Obesity Prevention Project were included. PA was measured with a tri-axial accelerometer (ActiGraph GT3X+) worn on the non-dominant wrist for one week. The main outcome was average PA expressed as counts per minute from the vector magnitude. PA and demographics/family-related factors were collected at baseline and at age 3. To analyze the results simple linear regression, ANOVA and paired t-tests were performed.RESULTS: The mean number of valid days was 6.7 per child. The children were more active on weekdays than weekends (p < 0.01) and the hourly pattern differed over the day with children being most active midmorning and midafternoon (p = 0.0001). Children to parents with low education were more active (p = 0.01) than those with highly educated parents. No differences in PA by child weight status, sex nor parental weight status were found.CONCLUSIONS: PA in 3-year-old children was lower during weekends than weekdays and varied over the day. Boys and girls had similar PA patterns, these patterns were independent of child or parental weight status. Children to parents with low education were more active than their counterparts. The fact that PA differed between weekdays and weekends indicates that PA might be affectable in 3-year-old children.
  • Franzén, Erika, et al. (författare)
  • Depressive symptoms associated with concerns about falling in Parkinson's disease
  • Ingår i: Brain and Behavior. - : John Wiley and Sons Inc.. - 2162-3279. ; 6:10
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Concerns about falling, a construct related to fear of falling, is increased in people with Parkinson's disease (PD) and is recognized as a barrier for exercise, negatively affecting health-related quality of life and participation. Aim: To investigate modifiable factors associated with concerns about falling in elderly with mild-to-moderate PD. Methods: Eighty-nine elderly (39 females, mean age 73 years) with mild-to-moderate PD were recruited. Concerns about falling were assessed with the Falls Efficacy Scale-international, that is, the dependent variable in multiple linear regression analysis. Independent variables included both motor (e.g., objective measures of physical activity and gait) and nonmotor aspects such as depressive symptoms. Results: A model with three significant independent variables explained 33% of the variance in concerns about falling. According to the standardized regression coefficients (β), the strongest contributing factor was depressive symptoms (0.40), followed by balance performance (−0.25), and use of mobility devices (0.24). Conclusions: The findings imply that factors associated with concerns about falling are a multifactorial phenomenon. For its management in elderly with mild-to-moderate PD, one should consider depressive symptoms, balance deficits, and mobility devices.
  • Franzén, Erika, et al. (författare)
  • The EXPANd trial : effects of exercise and exploring neuroplastic changes in people with Parkinson's disease
  • 2019
  • Ingår i: BMC Neurology. - 1471-2377 .- 1471-2377. ; 19:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Parkinson's disease (PD) affects many physiological systems essential for balance control. Recent studies suggest that intensive and cognitively demanding physical exercise programs are capable of inducing plastic brain changes in PD. We have developed a highly challenging balance training (the HiBalance) program that emphasizes critical aspects of balance control through progressively introducing more challenging exercises which incorporates dual-tasking. Earlier studies have shown it to be effective in improving balance, gait and dual-tasking. The study design has thereafter been adjusted to link intervention-induced behavioral changes to brain morphology and function. Specifically, in this randomized controlled trial, we will determine the effects of the HiBalance program on balance, gait and cognition and relate this to task-evoked functional MRI (fMRI), as well as brain-derived neurotrophic factor (BDNF) in participants with mild-moderate PD.METHODS: One hundred participants with idiopathic PD, Hoehn & Yahr stage 2 or 3, ≥ 60 years of age, ≥ 21 on Montreal Cognitive Assessment will be recruited in successive waves and randomized into either the HiBalance program or to an active control group (the HiCommunication program, targeting speech and communication). Both interventions will be performed in small groups, twice a week with 1 h sessions for 10 weeks. In addition, a 1 h, once a week, home exercise program will also be performed. A double-blinded design will be used. At the pre- and post-assessments, participants will be assessed on balance (main outcome), gait, cognitive functions, physical activity, voice/speech function, BDNF in serum and fMRI (3 T Philips) during performance of motor-cognitive tasks.DISCUSSION: Since there is currently no cure for PD, findings of neuroplastic brain changes in response to exercise would revolutionize the way we treat PD, and, in turn, provide new hope to patients for a life with better health, greater independence and improved quality of life.TRIAL REGISTRATION: ClincalTrials.gov: NCT03213873, first posted July 11, 2017.
  • Johansson, Hanna, et al. (författare)
  • Controlling the uncontrollable : Perceptions of balance in people with parkinson disease
  • 2019
  • Ingår i: Physical Therapy. - 0031-9023 .- 1538-6724. ; 99:11, s. 1501-1510
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Exercise improves balance in Parkinson disease (PD), yet the majority of people with the diagnosis are physically inactive. Insights gained from understanding how people with PD (PwPD) make sense of their symptoms and their ability to control them may inform the communication strategies and motivational approaches adopted by physical therapists. No previous study has qualitatively explored how PwPD perceive the concept of balance and the beliefs they hold concerning their ability to affect balance.OBJECTIVE: This study aimed to explore the meaning of balance for PwPD and the beliefs they hold regarding their ability to influence their balance in everyday life.DESIGN: The design is a qualitative study with an inductive approach.METHODS: In-depth interviews were conducted with 18 participants with PD (age range 46 to 83 years, Hoehn and Yahr range 1 to 4), and transcripts were analyzed using qualitative content analysis.RESULTS: Five main themes emerged from the analysis: remaining in control over the body; adapting behavior to deal with uncertainty; directing focus to stay one step ahead; resilience as a defense, and exercise beliefs and reservations. Interpretation of the underlying patterns in the main themes yielded the overarching theme of focus and determination to regain control over shifting balance.CONCLUSIONS: The concept of balance was perceived as both bodily equilibrium and mind-body interplay and was described in the context of remaining in control over one's body and everyday life. Cognitive resources were utilized in order to direct focus and attention during balance-challenging situations in a process involving internal dialogue. Even participants who did not express beliefs in their ability to affect balance through exercise used psychological resilience to counter the challenges of impaired balance.
  • Kuster, Roman P, et al. (författare)
  • Detecting Prolonged Sitting Bouts with the ActiGraph GT3X.
  • 2020
  • Ingår i: Mätning av det dagliga aktivitetsmönstret. - : Wiley-Blackwell. ; 30:3, s. 572-582
  • Tidskriftsartikel (refereegranskat)abstract
    • The ActiGraph has a high ability to measure physical activity, however, it lacks an accurate posture classification to measure sedentary behaviour. The aim of the present study was to develop an ActiGraph (waist-worn, 30Hz) posture classification to detect prolonged sitting bouts, and to compare the classification to proprietary ActiGraph data. The activPAL, a highly valid posture classification device, served as reference criterion.1 Both sensors were worn by 38 office workers over a median duration of 9 days. An automated feature selection extracted the relevant signal information for a minute based posture classification. The machine-learning algorithm with optimal feature number to predict the time in prolonged sitting bouts (≥5 and ≥10 minutes) was searched and compared to the activPAL using Bland-Altman statistics. The comparison included optimised and frequently used cut-points (100 and 150 counts-per-minute (cpm), with and without low-frequency-extension (LFE) filtering). The new algorithm predicted the time in prolonged sitting bouts most accurate (bias ≤7 minutes/day). Of all proprietary ActiGraph methods, only 150 cpm without LFE predicted the time in prolonged sitting bouts non-significantly different from the activPAL (bias ≤18 minutes/day). However, the frequently used 100 cpm with LFE accurately predicted total sitting time (bias ≤7 minutes/day). To study the health effects of ActiGraph measured prolonged sitting, we recommend using the new algorithm. In case a cut-point is used, we recommend 150 cpm without LFE to measure prolonged sitting, and 100 cpm with LFE to measure total sitting time. However, both cpm cut-points are not recommended for a detailed bout analysis.
  • Leavy, Breiffni, et al. (författare)
  • Outcome evaluation of highly challenging balance training for people with Parkinson disease : a multicenter effectiveness-implementation study
  • 2020
  • Ingår i: Journal of Neurologic Physical Therapy. - 1557-0576 .- 1557-0584. ; 44:1, s. 15-22
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND AND PURPOSE: In order for people with Parkinson disease (PwPD) to benefit from neurorehabilitation research, interventions tested in research settings require assessment in real-world clinical practice. There is little evidence for whether efficacious exercise interventions for PwPD remain effective when transferred to standard clinical settings. The aim of this study was to assess the clinical effectiveness of the adapted HiBalance program on balance control and gait among PwPD.METHODS: Participants (n = 117) with mild-moderate Parkinson disease were consecutively included into either the 10-week HiBalance group training (n = 61) or the control (n = 56) group. The main outcome was balance performance (Mini-BESTest). Secondary outcomes were comfortable gait speed (10-m Walk Test); functional mobility (Timed Up and Go [TUG] test) and dual-task interference (cognitive TUG test); physical activity level (steps per day); perceived balance confidence (Activities-specific Balance Confidence scale) and perceived walking difficulty (Walk-12G) and self-rated health (EQ-5D visual analog scale).RESULTS: In total, 98 people completed the trial. Compared with controls, the training group showed significant improvement in balance performance (P < 0.001), gait speed (P = 0.001), and dual-task interference (P = 0.04) following the intervention. No group differences were observed for physical activity level or any patient-reported measures.DISCUSSION AND CONCLUSIONS: Highly challenging balance training is effective at improving balance, gait, and dual-task performance when delivered at a clinically feasible dose, in a range of rehabilitation settings, without direct involvement of the research group.Video Abstract available for more insights from the authors (see the Video, Supplementary Digital Content 1, available at: http://links.lww.com/JNPT/A299).
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