| 1. |
- Fernberg, Ulrika, 1979-
(författare)
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Arterial stiffness and risk factors for cardiovascular disease in young adults
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Atherosclerosis is a complex, chronic vessel wall disease that often leads to severe and acute cardiovascular diseases (CVD), such as myocardial infarction and stroke. CVD are the most common cause of death, both globally and in Sweden. Since most of the risk factors for atherosclerosis are preventable, it is of great importance to highlight the benefits of a healthy lifestyle to young adults who are about to create their own habits.A general concern about physical inactivity, low cardiorespiratory fitness (CRF), and high body mass are supported by reports of an increased incidence and prevalence of obesity worldwide. In addition to this, the proportion of Swedish adults with low CRF almost doubled the last 20 years and the decline in CRF is more pronounced in the youngest age group.The scientific work presented in this thesis was carried out to investigate the impact of different lifestyle related factors on vascular status, especially arterial stiffness, in young Swedish adults. In total 840 young adults in the age range 18-25 years were recruited to the cross-sectional Lifestyle, Biomarkers, and Atherosclerosis (LBA) study, to examine vascular status, biomarkers, and lifestyle related factors.In the LBA study population of young adults in Sweden, 12% were classified as being at risk of future CVD. A high CVD risk was associated with low CRF and less physical activity. In the total study population 24% had unhealthy food habits, and 24% did not spend the recommended 30 minutes per day at moderate or vigorous intensities of physical activity. Low CRF, less physical activity, and overweight and obesity, were associated with stiffer arteries.The results raises concerns about future CVD risk and highlights the health enhancing possibilities of high CRF and physical activity on vascular status in young Swedish adults.
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| 2. |
- Jonsson, Marcus, 1977-
(författare)
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Physiotherapy and physical activity in patients undergoing cardiac or lung cancer surgery
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cardiovascular diseases are the leading cause of death worldwide. Cardiac surgery is performed to improve prognosis, relieve symptoms and increase functional capacity in patients with cardiac disease. Postoperative pulmonary complications are common after cardiac surgery and a reduced lung function can persist a long time after surgery. A positive association between level of physical activity and lung function has been proposed in both healthy individuals and people with different disabilities. It is not clear if there is an association between level of physical activity and recovery of lung function after cardiac surgery. Lung cancer is one of the most frequently diagnosed forms of cancer worldwide, and a leading cause of cancer deaths. Surgical resection is the primary approach for curative treatment. Despite the fact that physical activity has many positive effects on health, patients undergoing lung cancer surgery often report a low level of physical activity. Measuring physical activity is not easy, self-reported physical activity remains the most clinically applicable type of measurement, and a simple and valid questionnaire for screening patients would be valuable. Patients undergoing lung cancer surgery are often routinely treated by physiotherapists, but this kind of treatment has not been thoroughly investigated. The purpose of this thesis was to investigate the effect of physiotherapy and physical activity in patients undergoing cardiac or lung cancer surgery. This thesis include one cohort study of physical activity and recovery of lung function in patients undergoing cardiac surgery, one validation study of two self-reported physical activity instruments in patients undergoing lung cancer surgery, and two randomized controlled trials investigating the effect of physiotherapy for patients undergoing lung cancer surgery. In study I, patients who remained active or increased their level of physical activity had better recovery of lung function, compared to patients who remained sedentary or reported a lower level of physical activity postoperatively. In study II, two self-reported physical activity instruments were validated against accelerometer data in patients three and twelve months after lung cancer surgery. Both instruments were found able to identify patients not meeting recommendations on physical activity. In study III, patients treated by physiotherapists were significantly more active during the first three days after lung cancer surgery, compared to an untreated control group. In study IV, no between-group differences three months after surgery were found between patients receiving in-hospital physiotherapy compared to an untreated control group. However, the patients in the treatment group reported an increase of physical activity three months after surgery compared to preoperatively, while the patients in the control group did not.
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| 3. |
- Pettersson-Pablo, Paul, 1986-
(författare)
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Biomarkers of vascular function and structure in young healthy adults
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Atherosclerosis is a disease affecting the blood vessels in the body. Its pathophysiologic mechanisms involve infiltration of the vessel walls by fatty matter and immune cells. This process is slow, starting in childhood but typically not manifesting as symptomatic disease until late adulthood (after 60 years of age). The identification of younger individuals with a high risk for early intervention has a higher potential of preventing morbidity and mortality.In this thesis, part of the Lifestyle, Biomarkers and Atherosclerosis study (LBA), the earliest stages of vascular dysfunction have been examined in a population of young, healthy, non-smoking subjects. Vascularfunction and structure measurements predict a future risk of cardiovascular disease (CVD). The measurements were analyzed in relation to clinical chemistry analyses of various biomarkers in serum and plasma that have been associated with inflammation or cardiovascular risk. A secondary aim was to examine estrogen containing contraceptive use and its relation to the CVD biomarkers.In Paper I and Paper II of the thesis, the association between inflammatory biomarkers, body fat percentage and vascular function and structure measurements was examined in multivariable linear regression models. A higher body fat percentage predicted an increased serum concentration of C-reactive protein (CRP) and orosomucoid. In Paper II, a higher body fat percentage and a higher CRP were associated with a more unfavorable vascular function and structure.In Paper III and Paper IV, we employed two multiplex proteomics panels to analyze inflammatory proteins and proteins previously implicated in CVD. In multivariable linear regression models, proteins implicated in hemostasis, inflammatory signaling and chemoattraction correlated with different vascular function and structure measurements. InPaper IV, insulin-like growth factor-binding protein 1 (IGFBP1) and IGFBP2 were independently predictive of an increased vascular stiffness.In conclusion, even in young, healthy individuals, altered concentrations of serum biomarkers can be detected in subjects with increased body fat and unfavorable vascular function and structure.
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| 4. |
- Ekelund, Ulf, 1960-, et al.
(författare)
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Heart rate as an indicator of the intensity of physical activity in human adolescents
- 2001
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Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 85:3-4, s. 244-249
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this study were, in a group of adolescents, firstly to identify the absolute heart rates (HR) and the percentages of maximal heart rates (HRmax) corresponding to 40%, 60% and 80% of peak oxygen uptake (PVO2), secondly to identify absolute and relative (%PVO2) oxygen uptakes (VO2) corresponding to HR of 120, 140 and 160 beats.min-1, and thirdly to examine a possible effect of fatness and fitness on the relationship between HR and VO2. The subjects were 127 (60 boys, 67 girls) adolescents with a mean age of 14.8 (SD 0.3) years. The HR and VO2 were measured by means of an incremental exercise test to exhaustion. Linear regressions were performed for the HR-VO2 and VO2-HR relationships using absolute and relative (%HRmax, %PVO2) data for each individual. From these regressions, target HR and VO2 were computed. Average target HR corresponding to 40%, 60% and 80% of PVO2 were: 119 (SD 9), 145 (SD 9), 171 (SD 8), and 120 (SD 10), 146 (SD 8), 172 (SD 8) beats.min-1 for boys and girls, respectively. Average VO2 corresponding to HR of 120, 140 and 160 beats.min-1 were: 22 (SD 5), 30 (SD 5), 38 (SD 6) and 18 (SD 4), 24 (SD 4), 31 (SD 4) mlO2.kg-1.min-1 for boys and girls, respectively. An analysis of covariance showed a significant fitness effect (P < 0.001) for predicted VO2 at all HR studied. The results suggest that the use of absolute HR to define exercise intensity levels when assessing young people's physical activity using HR monitoring detracts from the validity of the interpretation of the data.
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| 5. |
- Hurtig-Wennlöf, Anita, 1958-, et al.
(författare)
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Serum lipids, glucose and insulin levels in healthy schoolchildren aged 9 and 15 years from Central Sweden : reference values in relation to biological, social and lifestyle factors
- 2005
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Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation. - : Informa UK Limited. - 0036-5513 .- 1502-7686. ; 65:1, s. 65-76
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:There is a shortage of reference values for cardiovascular risk factors such as serum lipids, glucose and insulin related to biological, social and lifestyle factors for Swedish children and adolescents. Such values are needed for planning and evaluation of public health activities, and for clinical use.DESIGN AND METHODS:Data for this cross-sectional, school-based study were collected during a school year (September to May). A random sample of 1137 girls and boys aged 9 and 15 years from two locations in central Sweden participated in the study, and blood samples were taken from 969 of them.METHODS:Fasting serum blood samples were analysed for triglycerides, total cholesterol, high-density lipoprotein cholesterol, glucose and insulin. Physical examination included measurement of height, weight and pubertal status. Questionnaires provided family background data. Total physical activity was measured by accelerometer registration.RESULTS:Serum levels differed significantly between age and gender groups and were correlated to pubertal status. Neither genetic nor socio-economic background nor smoking status influenced the serum levels. Insulin levels were elevated in subjects with a body mass index in the highest decentile, compared with the levels in the rest of the subjects. The insulin levels were inversely associated with total physical activity, and physical activity varied with season.CONCLUSIONS:Pubertal status (biological age) should to be considered in the interpretation of serum values in schoolchildren rather than chronological age. The interpretation of insulin values should include both body mass index and physical activity level, and perhaps also season. Previously described regional differences in serum lipid levels in Swedish adults seem to be present also in children.
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| 6. |
- Jonsson, Marcus, 1977-, et al.
(författare)
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In-Hospital Physiotherapy and Physical Recovery 3 Months After Lung Cancer Surgery : A Randomized Controlled Trial
- 2019
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Ingår i: Integrative Cancer Therapies. - : Sage Publications. - 1534-7354 .- 1552-695X. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Lung cancer is the most frequently diagnosed cancer and one of the leading causes of cancer deaths. Surgery is the primary approach for curative treatment. Postoperative complications are common, and physiotherapy is often routinely provided for their prevention and treatment, even though the evidence is limited. The aim of this study was to examine the effect of in-hospital physiotherapy on postoperative physical capacity, physical activity, and lung function among patients undergoing lung cancer surgery.Methods: A total of 107 patients undergoing elective thoracic surgery were included in a single-blinded randomized controlled trial, and randomized to a study group, receiving in-hospital physiotherapy treatment, or a control group, not receiving in-hospital physiotherapy treatment. The patients were assessed preoperatively and 3 months after surgery. The in-hospital physiotherapy treatment consisted of early mobilization, ambulation, breathing exercises, and thoracic range of motion exercises. Physical capacity was assessed with the 6-minute walk test. Level of physical activity was objectively assessed with an accelerometer and subjectively assessed with the International Physical Activity Questionnaire Modified for the Elderly.Results: Physical capacity for the whole sample was significantly decreased 3 months postoperatively compared with preoperative values (P = .047). There were no statistically significant differences between the groups regarding physical capacity, physical activity, spirometric values, or dyspnea. However, patients in the study group increased their level of self-reported physical activity from preoperatively to 3 months postoperatively, while the patients in the control group did not.Conclusions: No difference in physical capacity, physical activity, or lung function was found 3 months postoperatively in lung cancer surgery patients receiving in-hospital physiotherapy compared with control patients.
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| 7. |
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| 8. |
- Jonsson, Marcus, 1977-, et al.
(författare)
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In-hospital physiotherapy improves physical activity level after lung cancer surgery : a randomized controlled trial
- 2019
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Ingår i: Physiotherapy. - : Elsevier. - 0031-9406 .- 1873-1465. ; 105:4, s. 434-441
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Patients undergoing lung cancer surgery are routinely offered physiotherapy. Despite its routine use, effects on postoperative physical recovery have yet not been demonstrated. The aim of this study was to investigate whether physiotherapy could improve postoperative in-hospital physical activity level and physical capacity.DESIGN: Single-blind randomized controlled trial.SETTING: Thoracic surgery department at a University Hospital.PARTICIPANTS: Patients undergoing elective thoracic surgery (n=94) for confirmed or suspected lung cancer were assessed during hospital stay.INTERVENTION: Daily physiotherapy, consisting of mobilization, ambulation, shoulder exercises and breathing exercises. The control group received no physiotherapy treatment.OUTCOMES: In-hospital physical activity assessed with the Actigraph GT3X+ accelerometer, six-minute walk test, spirometry and dyspnea scores.RESULTS: The treatment group reached significantly more accelerometer counts (2010 (1508) vs 1629 (1146), mean difference 495 [95% CI 44 to 1109]), and steps per hour (49 (47) vs 37 (34), mean difference 14 [95% CI 3 to 30]), compared to the control group, during the first three postoperative days. No significant differences in six-minute walk test (percent of preoperative 71% vs 79%, P=0.13), spirometry (FEV1 percent of preoperative 69% vs 69%, P=0.83) or dyspnoea (M-MRC 2 vs 2, P=0.74) between the groups were found.CONCLUSIONS: Patients receiving in-hospital physiotherapy showed increased level of physical activity during the first days after lung cancer surgery, compared to an untreated control group. However, no effects on the six-minute walk test or spirometric values were found. The clinical importance of an increased physical activity level during the early postoperative period needs to be further evaluated.CLINICAL TRIAL REGISTRATION NUMBER: NCT01961700.
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| 9. |
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| 10. |
- Jonsson, Marcus, 1977-, et al.
(författare)
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Physical activity level during the first three days after lung cancer surgery improves with physiotherapy : a randomized controlled trial
- 2018
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Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52:Suppl. 62
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: Physical inactivity is common after lung cancer surgery. Patients undergoing lung cancer surgery are routinely offered physiotherapy. Despite its routine use, any effect on postoperative physical activity has not yet been demonstrated. The aim of this study was to investigate whether physiotherapy could improve physical activity during the first days after surgery.Methods: A total of 94 patients undergoing elective surgery for confirmed or suspected lung cancer were consecutevily included and randomized to treatment group (n=50) or control group (n=44). The treatment group received daily physiotherapy, consisting of mobilization and ambulation, shoulder exercises and breathing exercises. The control group received no physiotherapy. Physical activity was assessed with the Actigraph GT3X+ accelerometer.Results: The patients in the treatment group reached significantly more counts (1692 vs 1197, p=0.029) and steps per hour (39 vs 25, p=0.013), during the first three days, compared to the control group.Conclusions: Physical activity during the first three days is increased by physiotherapy treament. The long term effect of in-hospital physiotherapy needs to be further evaluated.
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