| 1. |
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| 2. |
- Molin, Carl Johan, et al.
(författare)
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Profile of upregulated inflammatory proteins in sera of Myasthenia Gravis patients.
- 2017
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- This study describes specific patterns of elevated inflammatory proteins in clinical subtypes of myasthenia gravis (MG) patients. MG is a chronic, autoimmune neuromuscular disease with antibodies most commonly targeting the acetylcholine receptors (AChRab), which causes fluctuating skeletal muscle fatigue. MG pathophysiology includes a strong component of inflammation, and a large proportion of patients with early onset MG additionally present thymus hyperplasia. Due to the fluctuating nature and heterogeneity of the disease, there is a great need for objective biomarkers as well as novel potential inflammatory targets. We examined the sera of 45 MG patients (40 AChRab seropositive and 5 AChRab seronegative), investigating 92 proteins associated with inflammation. Eleven of the analysed proteins were significantly elevated compared to healthy controls, out of which the three most significant were: matrix metalloproteinase 10 (MMP-10; p = 0.0004), transforming growth factor alpha (TGF-α; p = 0.0017) and extracellular newly identified receptor for advanced glycation end-products binding protein (EN-RAGE) (also known as protein S100-A12; p = 0.0054). Further, levels of MMP-10, C-X-C motif ligand 1 (CXCL1) and brain derived neurotrophic factor (BDNF) differed between early and late onset MG. These novel targets provide valuable additional insight into the systemic inflammatory response in MG.
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| 3. |
- O'Connor, Laura, et al.
(författare)
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Myasthenia Gravis and Physical Exercise : A Novel Paradigm
- 2020
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Ingår i: Frontiers in Neurology. - : Frontiers Media SA. - 1664-2295. ; 11
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Forskningsöversikt (refereegranskat)abstract
- The benefits of physical exercise for healthy individuals are well-established, particularly in relation to reducing the risks of chronic lifestyle related diseases. Furthermore, physical exercise has been seen to provide beneficial effects in many chronic diseases such as multiple sclerosis, rheumatoid arthritis, and chronic obstructive pulmonary disease and is therefore recommended as part of the treatment regimen. Myasthenia Gravis (MG) is a chronic autoimmune disease that causes neuromuscular transmission failure resulting in abnormal fatigable skeletal muscle weakness. In spite of this fluctuating skeletal muscle weakness, it is reasonable to assume that MG patients, like healthy individuals, could benefit from some of the positive effects of physical exercise. Yet exercise-related research in the field of MG is sparse and does not provide any guidelines on how MG patients should perform physical training in order to obtain exercise's favorable effects without risking disease deterioration or more pronounced muscle fatigue. A handful of recent studies report that MG patients with mild disease activity can adhere safely to general exercise recommendations, including resistance training and aerobic training regimens, without subjective or objective disease deterioration. These findings indicate that MG patients can indeed improve their functional muscle status as a result of aerobic and high-resistance strength training. This knowledge is important in order to establish collective as well as personalized guidelines on physical exercise for MG patients. This review discusses the present knowledge on physical exercise in MG.
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| 4. |
- O'Connor, Laura, et al.
(författare)
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Pattern of Habitual Physical Exercise in Myasthenia Gravis Patients
- 2019
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Ingår i: JOURNAL OF NEUROMUSCULAR DISEASES. - : IOS Press. - 2214-3599 .- 2214-3602. ; 6:1, s. 85-91
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Tidskriftsartikel (refereegranskat)abstract
- Background: Notwithstanding the amount of deliberate exercise, the daily patterns of active versus sedentary behavior have a major influence on health outcomes [1]. Patterns of habitual active and sedentary behavior in Myasthenia Gravis (MG) patients, as well as their possible relations to disease activity, are not known. Objective: To evaluate baseline patterns of physical and sedentary behavior in MG patients. Methods: Activity patterns of twenty-seven MG patients were assessed by a Dynaport Move Monitor (McRoberts) accelerometer, worn for seven consecutive days. The amount of time spent in moderate and vigorous intensity activities, physical activity level (PAL), number of steps/day and sedentary time were assessed and correlations to disease severity were analyzed. The results were compared to general recommendations and published data of healthy individuals and to data of patients with the chronic disorders chronic obstructive pulmonary disease (COPD) and mitochondrial myopathy. Results: MG patients had sedentary behavior during 78 +/- 7% of the day. There was neither a correlation between disease severity and number of steps/day (R = -0.15;p = 0.56) nor between disease severity and PAL (R = 0.33;p = 0.26). Nevertheless, the MG patients met the recommendations of daily deliberate exercise (181 +/- 158 MET min/day). PAL was lower in MG patients (1.5 f 0.138) than in healthy individuals (1.67 +/- 0.145, p < 0.00001). Conclusion: Although a majority of MG patients meet the recommendations of deliberate exercise, their baseline physical activity levels are dominated by sedentary behavior. In comparison with a healthy population, MG patients are less physically active, but the reason for this remains unclear with no correlations between disease severity and physical activity patterns.
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| 5. |
- Rostedt Punga, Anna, et al.
(författare)
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Implementation of tailored exercise programs for MG patients in a gym setting : a pragmatic feasibility case study
- 2023
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Ingår i: Neuromuscular Disorders. - : Elsevier. - 0960-8966 .- 1873-2364. ; 33:4, s. 334-338
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Tidskriftsartikel (refereegranskat)abstract
- Although supervised aerobic and resistance training in a hospital setting was proven safe and beneficial for well-controlled myasthenia gravis (MG) patients, implementation of similar programs in the community has not been studied. We conducted a pragmatic open-label study at a large gym in Uppsala, Sweden. Seven patients with generalized MG were recruited to participate in an individualized, tailored exercise program, based on individual baseline status and personal goals, with a personal trainer. All patients completed the entire training period. The individually tailored exercise program was implemented safely and effectively, with all patients improving in aerobic capacity, muscle strength, and balance. Our pragmatic open-label case study suggests that well-controlled patients with generalized MG can extend their physical exercise to personal training in the gym. This is an essential step towards reducing the barriers to implementing exercise procols and increasing the availability of these interventions to MG patients.
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| 6. |
- Sabre, Liis, et al.
(författare)
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Diversity in mental fatigue and social profile of patients with myasthenia gravis in two different Northern European countries
- 2017
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Ingår i: Brain and Behavior. - : WILEY. - 2162-3279 .- 2162-3279. ; 7:4
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Tidskriftsartikel (refereegranskat)abstract
- Tntroduction: Self-estimated health can be used for comparison of different diseases between countries. It is important to elaborate on whether disparities in self-estimated health are due to disease-specific parameters or socioeconomic differences. In this study, we aimed at evaluating clinical and social similarities and differences in myasthenia gravis (MG) patients between comparable regions in two Baltic Sea countries, Estonia and Sweden. Methods: This cross-sectional study included southern counties in Sweden and Estonia of comparable size. All patients with a confirmed MG diagnosis were asked to answer two questionnaires including demographic and disease-specific data, lifestyle issues, and mental fatigue (Fatigue Severity Scale [FSS]). Clinical fatigue was assessed objectively through the Quantitative Myasthenia Gravis Score (QMG). Results: Thirty-six of 92 identified patients in Estonia and 40 of 70 identified MG patients in Sweden chose to participate in the study. The demographic characteristics and symptoms reported by the patients were similar. QMG score did not differ; however, the Estonian patients scored their current subjective disease severity significantly higher (5.6 +/- 2.8) compared to the Swedish patients (3.4 +/- 2.3, p=.0005). Estonian patients also had significantly higher FSS scores (5.0 +/- 1.7) than Swedish patients (3.5 +/- 1.6; p=.001). Swedish patients were more active and performed physical activity more regularly (29.1% in Estonia and 74.2% in Sweden, p=.004). Conclusions: Although, the patients had comparable clinical fatigue, Estonian patients evaluated their health state as being more severe and reported more mental fatigue than Swedish patients. These data indicate large regional differences in disease perception of MG, which is important to consider in international studies.
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| 7. |
- Sandberg, Mats, et al.
(författare)
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Air flow pattern and pressure distribution within a street network in an urban area with a high building area density
- 2006
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Ingår i: The 6th International Conference on Urban Climate. - 9163190001 ; , s. 188-191
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- We report on the effect of the overall shape of a city on the flow within the street network. We start with a solid round block, aspect ratio, diameter/ height = 6. The block is subdivided into smaller blocks and step by step an increasing number of streets are introduced. In the wind tunnel visualization with helium filled soap bubbled was carried out for obtaining qualitative information about the flow pattern. The pressure distribution on the ground within the street network was recorded in 400 points. CFD predictions provided the overall flow balance; flow entering through the street portals, leaving through the exit street portals and the updraft.
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| 8. |
- Smits, Anja, et al.
(författare)
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Adding 11C-methionine PET to the EORTC prognostic factors in grade 2 gliomas
- 2008
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Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer Science and Business Media LLC. - 1619-7070 .- 1619-7089. ; 35:1, s. 65-71
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:The management of adult patients with grade 2 gliomas remains a challenge for the clinical neuro-oncologist. Several clinical prognostic factors appear to be as important as treatment factors in determining outcome. From the European Organisation for Research and Treatment of Cancer (EORTC) trials 22844 and 22845, a prognostic scoring system has been proposed based on the presence of unfavourable prognostic factors. The aim of the present study was to assess the additional prognostic value of (11)C-methionine (MET) measured by positron emission tomography (PET) in the setting of the EORTC prognostic scoring system.METHODS:In this retrospective review, 129 patients with supratentorial grade 2 gliomas were subjected to a PET study as part of the pre-treatment tumour investigation. One hundred and three cases were classified as low-risk patients (0-2 unfavourable factors) and 26 cases as high-risk patients (3-5 unfavourable factors) according to the EORTC criteria. MET PET was evaluated as an extra prognostic factor in both groups.RESULTS:In the high-risk group, patients with high MET uptake had a worse outcome than patients with low MET uptake. A similar trend was found for the low-risk group in patients with oligodendrocytic tumours.CONCLUSIONS:Our findings further strengthen the role of MET PET as an important prognostic tool in the management of this group of patients.
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| 9. |
- Vergoossen, Dana L. E., et al.
(författare)
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Enrichment of serum IgG4 in MuSK myasthenia gravis patients
- 2022
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Ingår i: Journal of Neuroimmunology. - : Elsevier. - 0165-5728 .- 1872-8421. ; 373
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Tidskriftsartikel (refereegranskat)abstract
- Muscle-specific kinase (MuSK) myasthenia gravis (MG) is a neuromuscular autoimmune disease belonging to a growing group of IgG4 autoimmune diseases (IgG4-AIDs), in which the majority of pathogenic autoantibodies are of the IgG4 subclass. The more prevalent form of MG with acetylcholine receptor (AChR) antibodies is caused by IgG1-3 autoantibodies. A dominant role for IgG4 in autoimmune disease is intriguing due to its antiinflammatory characteristics. It is unclear why MuSK autoantibodies are predominantly IgG4. We hypothesized that MuSK MG patients have a general predisposition to generate IgG4 responses, therefore resulting in high levels of circulating IgG4. To investigate this, we quantified serum Ig isotypes and IgG subclasses using nephelometric and turbidimetric assays in MuSK MG and AChR MG patients not under influence of immunosuppressive treatment. Absolute serum IgG1 was increased in both MuSK and AChR MG patients compared to healthy donors. In addition, only MuSK MG patients on average had significantly increased and enriched serum IgG4. Although more MuSK MG patients had elevated serum IgG4, for most the IgG4 serum levels fell within the normal range. Correlation analyses suggest MuSK-specific antibodies do not solely explain the variation in IgG4 levels. In conclusion, although serum IgG4 levels are slightly increased, the levels do not support ubiquitous IgG4 responses in MuSK MG patients as the underlying cause of dominant IgG4 MuSK antibodies.
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| 10. |
- Verwijst, Johanna, et al.
(författare)
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Cancer in myasthenia gravis subtypes in relation to immunosuppressive treatment and acetylcholine receptor antibodies : A Swedish nationwide register study
- 2021
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Ingår i: European Journal of Neurology. - : John Wiley & Sons. - 1351-5101 .- 1468-1331. ; 28:5, s. 1706-1715
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose The potentially increased risk of extrathymic cancers in myasthenia gravis (MG) remains uncertain. We present the occurrence of extrathymic cancer diagnoses in different MG subgroups. Methods We conducted a nationwide Swedish register-based cohort study, including patients who had their first MG diagnosis or first prescription of acetylcholine esterase inhibitors between the years 2006 and 2018. Timing and subtypes of cancer diagnosis in relation to MG as well as corticosteroid-sparing immunosuppressants (CSISs) were identified from national patient, cancer and drug registers. Results In the study population of 2812 MG patients, 92 had juvenile MG (3%), 632 had early-onset MG (23%), 1968 had late-onset MG (LOMG; 70%) and 120 patients had thymoma-associated MG (TAMG; 4%). Extrathymic cancers were observed in 630 patients (22.4%). Skin cancer and cancer in the male genital organs were most common (N = 138, respectively), followed by cancers in the female genital organs (N = 103), digestive organs (N = 90) and breast (N = 80). Patients with TAMG (29.2%) and LOMG (28.4%) had the highest occurrence of extrathymic cancer. Cancer frequency was comparable between acetylcholine receptor antibody seropositive and seronegative patients. Two or more CSIS prescriptions significantly increased the frequency of cancer, especially cancers in the digestive organs (p = 0.0026), male genital organs (p = 0.0037) and skin (p < 0.0001). Conclusions Most extrathymic cancer types in MG were observed in TAMG and LOMG patients, and there was a clear correlation between CSIS exposure and cancer risk. This study sheds light on extrathymic cancers also in non-thymoma MG.
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| 11. |
- Westerberg, Elisabet, 1971-
(författare)
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Environmental Factors of Importance in Myasthenia Gravis : Emphasis on Physical Activity
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Myasthenia Gravis (MG) is an autoimmune disease caused by antibodies directed against proteins at the neuromuscular junction (NMJ). The disturbed neuromuscular transmission induces fatigable weakness in skeletal muscles. The severity of MG ranges from purely ocular symptoms to extensive weakness with, at worst, respiratory failure and need of intensive care. Due to different pathogenic antibodies, as well as varying phenotypes there is a classification into MG subgroups.As lifestyle disorders are common conditions they occur also in MG patients. It is unknown whether there are any lifestyle factors associated with MG or MG subgroups. However, medication side effects and disability due to disease could contribute to higher risks for lifestyle related diseases. General treatment guidelines are not suitable to MG patients, since various medications are known to affect the disease negatively and as the tolerance and effects of physical activity in MG is unknown.In this thesis the occurrence of lifestyle related environmental factors in MG patients were investigated. MG epidemiology, subgroup differences and the presence of lifestyle related risks in MG patients were evaluated in Jönköping county in Southern Sweden. The findings were compared to a similar evaluation in a region of Estonia. We found that MG patients in the late-onset disease subgroup had a more disadvantageous pattern of life-style related risk factors, with a higher rate of obesity, smoking and physical inactivity and a lower rate of fish consumption in comparison to matched population controls. Furthermore, we found that despite comparable clinical muscle fatigue status, Estonian MG patients subjectively scored fatigue and disease severity higher than Swedish MG patients. More Estonian patients were physically inactive. The tolerance and effects of physical exercise was further evaluated in two intervention studies, where MG patients with stable disease performed a 12-week-training-program according to general exercise recommendations to healthy adults. We found that physical exercise was well tolerated by the MG patients and that they had a beneficial skeletal muscle response to physical exercise.
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| 12. |
- Westerberg, Elisabet, et al.
(författare)
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Epidemiology of Myasthenia Gravis in Sweden 2006-2016
- 2020
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Ingår i: Brain and Behavior. - : Wiley. - 2162-3279 .- 2162-3279. ; 10:11
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionReported incidence and prevalence rates of Myasthenia Gravis (MG) vary widely and are assumed to have increased over the last few decades. We conducted a nationwide register‐based study on the current incidence and prevalence of MG and MG subgroups in Sweden.MethodsData were acquired from four Swedish Health Registers in order to identify patients with MG. Incidence and prevalence rates were calculated for the years 2006–2016, using population numbers provided by Statistics Sweden.ResultsIn 2016, the incidence of MG in Sweden was 2.9 per 100,000 inhabitants (95% CI: 2.5–3.2/100,000) and the crude prevalence was 36.1 per 100,000 inhabitants (95% CI: 34.9–37.3). There was a significant increase in Myasthenia Gravis prevalence from 2006 to 2016. Prevalence rates of all MG subgroups but thymoma‐associated MG increased over the same period of time.ConclusionsThe incidence and prevalence of Myasthenia Gravis have increased over time in Sweden, and the rates are high in comparison with other countries.
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| 13. |
- Westerberg, Elisabet, et al.
(författare)
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Lifestyle factors and disease-specific differences in subgroups of Swedish Myasthenia Gravis
- 2018
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 138:6, s. 557-565
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate disease-specific differences between Myasthenia Gravis (MG) subgroups and compare patterns of lifestyle between MG patients and population controls.METHODS: All MG patients (n=70) in Jönköping County, Sweden, were invited to answer a disease-specific questionnaire, containing questions about disease-specific data, lifestyle, co-morbidity and mental fatigue. The patients were clinically evaluated. Four hundred age- and gender matched population controls were invited to answer the non-disease-specific part of the questionnaire. Disease-specific issues were compared between MG subgroups. Lifestyle related factors and concomitant conditions were compared to the population controls.RESULTS: Forty MG patients and 188 population controls participated in the study. In the late onset MG (LOMG; N=18) subgroup, the male predominance was higher than previously reported. In the early onset MG (EOMG; N=17) subgroup, time to diagnosis was longer, fatigue was higher and bulbar weakness was the dominant symptom (65%). Compared to their matched population controls, LOMG patients were more obese (OR 13.7, p=0.015), ate less fish (OR 4.1, p=0.012), tended to smoke more (OR 4.1, p=0.086) and tended to be employed as manual laborers more often (OR 2.82, p=0.083). Mental health problems and sickness benefits were more common among MG patients than in controls and MG patients were less regularly doing focused physical activity.CONCLUSIONS: It is important to consider disease-specific differences when tailoring the management of individual MG patients. There is a need for improved knowledge on how to apply primary and secondary prevention measures to lifestyle disorders in MG patients without risk of deterioration.
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| 14. |
- Westerberg, Elisabet, 1971-, et al.
(författare)
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Lifestyle factors and gender-related differences in clinical subgroups of Myasthenia Gravis in southern Sweden
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Ingår i: BMC Neurology. - 1471-2377.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Based on the need for further regional and global epidemiological knowledge on Myasthenia Gravis (MG) and MG subgroups, we conducted a questionnaire-based epidemiological survey in a medium-sized health care region in southern Sweden. The primary aims were to investigate disease-specific items and lifestyle related factors between MG subgroups and matched population controls.Methods: All MG patients (n=70) in Jönköping County were invited to participate in a survey, using a standardized disease-specific questionnaire, previously developed by an expert group. This questionnaire contains three parts, including demographic and disease-specific data, lifestyle and health-related aspects as well as co-morbidity and mental fatigue. The patients were clinically evaluated. Four hundred age- and gender matched randomly selected population controls excluding MG were invited to answer the non-disease-specific part of the questionnaire. Statistical tests included student t-test (for parametric data) or Mann–Whitney U test (for nonparametric data) and Chi-square test and Fisher’s exact test for evaluations between MG subgroups. In the case-control analysis conditional logistic regression was used to estimate the adjusted Odds Ratios.Results: Forty of the 70 identified MG patients and 188 of the 400 age-and gender matched population controls participated in the study (response rate 57.1%). In the late onset MG (LOMG; N=18) subgroup, the male predominance was higher than previously reported. In the early onset MG (EOMG; N=17) group, time to diagnosis was longer and bulbar weakness was the dominant symptom (65%). EOMG patients had higher fatigue compared to LOMG. Compared to their matched population controls, LOMG patients were obese more often, ate ess fish, smoked more, had a lower educational level and were employed as manual laborers more often. Mental health problems and sickness benefits were more common among MG patients than in controls and MG patients were less regularly doing focused physical activity.Conclusions: These findings highlight lifestyle and gender related differences between the EOMG and LOMG subgroups and between MG patients and population controls. Importantly, these lifestyle issues such as cardiovascular risk factors and physical inactivity, as well as mental health problems should be addressed intensively in the clinical follow-up of MG patients.
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| 15. |
- Westerberg, Elisabet, et al.
(författare)
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Mortality rates and causes of death in Swedish Myasthenia Gravis patients
- 2020
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Ingår i: Neuromuscular Disorders. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0960-8966 .- 1873-2364. ; 30:10, s. 815-824
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Tidskriftsartikel (refereegranskat)abstract
- Myasthenia Gravis (MG) is an autoimmune disease with several comorbidities, however information on MG mortality remains sparse. We conducted a nationwide register-based study on mortality rates and causes of death among Swedish MG patients. Data was acquired from four Swedish National Board of Health and Welfare registers. A total of 4559 MG patients (2522 women, 55.3%) being alive entering the year 2006, were identified. 1121 patients (562 women, 50.1%) died during 2006-2016. Age- and gender-standardized mortality rate was 1.51 (95% CI 0.40) per 100 patients and did not differ from the Swedish general population. Time from MG diagnosis to death was 8.9 +/- 6.8 years. The most common ultimate cause of death was cancer (19.5%), followed by ischemic heart disease (13.3%) and MG (11.3%). When MG was stated as the ultimate cause of death, there was a strikingly higher likelihood of having influenza/pneumonia as a contributing cause of death (OR 2.5, p<0.0001). In conclusion, although we could not confirm a higher mortality rate in Swedish MG patients compared to the general population, and despite modern advancements in treatment, we observed that MG itself was stated as the third most common ultimate cause of death in Swedish MG patients.
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| 16. |
- Westerberg, Elisabet, et al.
(författare)
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Physical exercise in Myasthenia Gravis is safe and improves neuromuscular parameters and physical performance-based measures : A pilot study
- 2017
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Ingår i: Muscle and Nerve. - : Wiley. - 0148-639X .- 1097-4598. ; 56:2, s. 207-214
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Due to the shortage of exercise-related research in Myasthenia Gravis (MG), there are no consensus guidelines on physical exercise for MG patients.METHODS: In this prospective pilot study, 10 MG patients with mild disease performed supervised aerobic and resistance training twice weekly for 12 weeks. The Myasthenia Gravis Composite (MGC) score, compound motor action potential (CMAP), repetitive nerve stimulation, muscle force, physical performance-based measures, serum levels of interleukin-6, muscle enzymes as well as immuno-microRNAs miR-150-5p and miR-21-5p were assessed before and after the training period.RESULTS: Physical exercise was well tolerated, and the MGC score was unchanged. Muscle resistance weights and CMAP amplitudes increased for biceps brachii and rectus femoris muscles, and physical performance-based measures improved. Muscle enzymes remained normal, whereas disease-specific microRNAs miR-150-5p and miR-21-5p were reduced after the training period.CONCLUSIONS: We propose that general recommendations regarding physical exercise safely can be applied to well-regulated MG patients.
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| 17. |
- Westerberg, Elisabet, 1971-, et al.
(författare)
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The impact of physical exercise on neuromuscular function in Myasthenia gravis patients : A single-subject design study
- 2018
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Ingår i: Medicine. - : Lippincott Williams & Wilkins. - 0025-7974 .- 1536-5964. ; 97:31
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Tidskriftsartikel (refereegranskat)abstract
- There is a need for tailored exercise recommendations to patients with Myasthenia Gravis (MG). A few pilot studies have recently shown that physical exercise in accordance with general recommendations to healthy adults can be applied safely to patients with mild MG symptoms. How physical exercise affects muscle parameters and risk factors for life-style diseases in patients with MG is, however, only poorly known. We evaluated functional skeletal muscle parameters in 11 MG patients, before and after conducting a 12-week supervised physical therapy regimen of aerobic and high-resistance strength training. After the training program, parameters of the proximal leg muscle rectus femoris improved: compound motor action potential (from 4.5 ± 2.6 to 5.3 ± 2.8 mV, p=0.016), isometric muscle force (from 25.2 ± 4.4 to 30.2 ± 3.8 kg; p=0.014) and ultrasound muscle thickness (from 19.6 ± 5.6 to 23.0 ± 3.9 mm, p=0.0098) all increased. Further, physical performance-based measures improved, including the 30-Second Chair Stand Test (median change +2, p=0.0039) as well as the clinical MG composite score (from 3[2-5] to 2 [0-4], p=0.043). These findings indicate that MG patients can improve their functional muscle status as a result of aerobic and high-resistance strength training, especially in proximal leg muscles. This is important knowledge when physical therapy is considered for this patient group, for whom no guidelines on physical exercise currently exist.
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| 18. |
- Westerberg, Ulla, et al.
(författare)
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Perceived windiness in urban spaces.
- 2006
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Ingår i: The 6th International Conference on Urban Climate - Preprints. - 9163190001 ; , s. 209-212
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The paper discusses the perception of windiness in the urban environment and especially its visual aspects. Various urban spaces in two cities, both with a reputation of being windy, have been chosen for field studies. Perceived windiness of the spaces has been investigated through questionnaire surveys and on-site interviews simultaneous to climate measurements. Result: Windy has a negative connotation that interacts with other environmental aspects such as beauty and comfort. Also naturalness and mental images of what constitutes sheltered and windy places seem to influence the survey as well as the on-site assessments of windiness.
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