| 1. |
- Andersson, Sofia E M, 1979, et al.
(författare)
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Moderate- to high intensity aerobic and resistance exercise reduces peripheral blood regulatory cell populations in older adults with rheumatoid arthritis
- 2020
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Ingår i: Immunity & Ageing. - : Springer Science and Business Media LLC. - 1742-4933. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective Exercise can improve immune health and is beneficial for physical function in patients with rheumatoid arthritis (RA), but the immunological mechanisms are largely unknown. We evaluated the effect of moderate- to high intensity exercise with person-centred guidance on cells of the immune system, with focus on regulatory cell populations, in older adults with RA. Methods Older adults (>= 65 years) with RA were randomized to either 20-weeks of moderate - to high intensity aerobic and resistance exercise (n = 24) or to an active control group performing home-based exercise of light intensity (n = 25). Aerobic capacity, muscle strength, DAS28 and CRP were evaluated. Blood samples were collected at baseline and after 20 weeks. The frequency of immune cells defined as adaptive regulatory populations, CD4 + Foxp3 + CD25 + CD127- T regulatory cells (Tregs) and CD19 + CD24hiCD38hi B regulatory cells (Bregs) as well as HLA-DR-/lowCD33 + CD11b + myeloid derived suppressor cells (MDSCs), were assessed using flow cytometry. Results After 20 weeks of moderate- to high intensity exercise, aerobic capacity and muscle strength were significantly improved but there were no significant changes in Disease Activity Score 28 (DAS28) or CRP. The frequency of Tregs and Bregs decreased significantly in the intervention group, but not in the active control group. The exercise intervention had no effect on MDSCs. The reduction in regulatory T cells in the intervention group was most pronounced in the female patients. Conclusion Moderate- to high intensity exercise in older adults with RA led to a decreased proportion of Tregs and Bregs, but that was not associated with increased disease activity or increased inflammation.
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| 2. |
- Bilberg, Annelie, 1965, et al.
(författare)
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How Do Patients With Axial Spondyloarthritis Experience High-Intensity Exercise?
- 2020
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Ingår i: ACR open rheumatology. - : Wiley. - 2578-5745. ; 2:4, s. 207-213
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Tidskriftsartikel (refereegranskat)abstract
- In a few studies, high-intensity exercise has displayed beneficial effects on cardiovascular health among patients with rheumatic diseases, yet the high-intensity exercise mode is still not fully accepted among health care professionals. The aim of this study was to investigate experiences of high-intensity exercise among patients with axial spondyloarthritis.Fourteen respondents who had participated in a high-intensity exercise program for 12 weeks were included in this qualitative study with individual semistructured, in-depth interviews. The respondents' median age was 53, ranging from 23 to 63 years old, and both men and women of different ethnicities were represented. Interviews were analyzed by qualitative content analysis, including both manifest content and interpretations of underlying latent meaning.The analysis resulted in five categories describing the respondents' experiences with high-intensity exercise: 1) high-intensity exercise as a challenge for both body and mind, 2) increased faith in one's own body, 3) changed attitude toward exercise, 4) taking charge of one's own health by challenging the disease, and 5) exercise in a social context.Supervised high-intensity interval exercise was perceived as challenging for both body and mind but was also described as a positive experience, with rapid bodily effects that strengthened respondents' faith in their own bodies. The new experience seemed to have changed the respondents' attitude and motivation for exercise and made them start taking charge of their health by challenging the disease. Exercise in a social context, under professional leadership, enhanced exercise self-efficacy and helped the respondents to adhere to the exercise program.
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| 3. |
- Danielsbacka, Jenny S, et al.
(författare)
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Health care professionals' conceptions of respiratory symptoms and physical activity in patients with acute pulmonary embolism. A phenomenographic interview study
- 2022
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Ingår i: Thrombosis Research. - : Elsevier BV. - 0049-3848. ; 212, s. 22-29
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Acute pulmonary embolism (PE) often presents with respiratory symptoms, such as dyspnea and respiratory pain, and patients are affected both physically and mentally by the consequences of PE for a long time after the event. This study aimed to explore health care professionals (HCPs) conceptions of respiratory symptoms, physical activity, and information given to patients during in-hospital care. Materials and methods: Qualitative individual interviews were conducted with twenty-one HCPs (physicians, nurses, physiotherapist) working with patients with PE, and analyzed with a phenomenographic approach. Results: The findings resulted in an overall theme: “Health care professionals' knowledge of PE, and an individualized patient approach, are cornerstones for adequate management of respiratory symptoms in PE”. Three major categories described conceptions of a heterogenous patient group physically and mentally affected by their respiratory symptoms, of accurate information given at right time being crucial, and of giving appropriate information about respiratory symptoms and physical activity being complex due to many prerequisites needing to be fulfilled. Conclusions: This study provides new knowledge about the complexity of management of patients with PE and respiratory symptoms. The patient group was conceived as heterogenous with different needs for information given at the appropriate time. Structural prerequisites, such as time and staff rotation in the hospital setting, and personal issues, for example levels of knowledge of PE among HCPs affected the ability of HCPs to give correct information. Further research is needed to ensure optimal design of in-hospital care for patients with PE. © 2022
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| 4. |
- Danielsbacka, Jenny S, et al.
(författare)
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Physical activity and respiratory symptoms after pulmonary embolism. A longitudinal observational study
- 2020
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Ingår i: Thrombosis Research. - : Elsevier BV. - 0049-3848. ; 189, s. 55-60
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Acute pulmonary embolism (PE) is a major cause of hospitalization and morbidity. Common symptoms are dyspnea and respiratory pain. Physical activity (PA) and respiratory symptoms during the first year after PE are not previously studied. The aim of the study was to describe PA and respiratory symptoms, to have as base for recommendations on PA after PE. Materials and methods: Sixty-four consecutive patients with first time PE were investigated during hospitalization and at 3, 6 and 12 months after discharge. The investigations included spirometry, six-minute walk test as well as ratings of PA, dyspnea and respiratory pain. Results: Median PA per week increased from 4 (0-27) hours to 7 (0-29) hours, while ratings of dyspnea and respiratory pain decreased during the year. Lung function, measured as forced expiratory volume in one second, increased between discharge and 3 months. Functional capacity, measured as six-minute walk distance, increased during the whole year. Reasons for change in amount of physical activity after pulmonary embolism were identified. To keep healthy and avoid recurrence of PE were two of the reasons to increase PA, and fear of respiratory pain, dyspnea at exertion and fear of recurrence of PE, among the reasons to decrease it. Conclusions: Median PA increased during the year. Respiratory symptoms and lung function improved during the first 3 months, whereas functional capacity improved during the whole year after. These results indicate that PA after PE is safe and can be recommended to patients, at least if no severe cardiovascular co-morbidity is present.
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| 5. |
- Danielsbacka, Jenny S, et al.
(författare)
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"Whole life changed"-Experiences of how symptoms derived from acute pulmonary embolism affects life. A qualitative interview study
- 2021
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Ingår i: Thrombosis Research. - : Elsevier BV. - 0049-3848. ; 205, s. 56-62
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Acute pulmonary embolism (PE) presents itself with a wide range of hemodynamic consequences. Respiratory symptoms as dyspnea and respiratory pain are common. The aim of this study was to explore patients' experiences of how symptoms affected their physical and social activities following the PE. Materials and methods: Qualitative interviews were conducted with 14 patients, with median time of 7 months (range 3-34 months) since the PE and analysed with qualitative content analysis according to Graneheim and Lundman. Results: The findings indicated that respiratory symptoms affected many aspects of life, illustrated by an overall theme: "Whole life changed". Two major categories, on changes of psychological/social nature, and changes of perception towards physical activity, described how the participants experienced changes in themselves and their relations, and that the psychological affection resulted in an existential crisis. All participants experienced changes in their physical activity and that remaining respiratory symptoms hindered them from being active. Fear inhibited physical activity and created a feeling of low self-efficacy concerning activity in general. Conclusions: To the best of our knowledge, this is the first study to present results on experiences of how the symptoms deriving from PE affected the physical and social activities of the participants during recovery phase. The results indicate that patients with PE need support from the health care system to manage both psychological and physical symptoms in the aftermath of their illness. Further research is needed to find out how optimal rehabilitation for these patients should be designed.
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| 6. |
- Feldthusen, Caroline, 1977, et al.
(författare)
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Experience of co-creation of a health plan and support for sustainable physical activity among people with chronic widespread pain: a qualitative interview study in Sweden.
- 2022
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to gain deeper knowledge about how people with chronic widespread pain (CWP) experience the co-creation of a health plan for sustainable physical activity, working in partnership with a physiotherapist, supported by a digital platform.Qualitative semistructured in-depth individual interviews were analysed with qualitative content analysis.Five primary healthcare centres in western Sweden.The interviewees comprised 19 individuals with CWP who had previously participated in a person-centred intervention involving co-creation of a health plan and support via a digital platform. The interviews were carried out from late 2019 to spring 2020, 1-6 months after the respondents' final follow-up.The analysis resulted in an overarching theme; hope for physical activity that actually works, illustrating the experience of taking part in co-creating a reasonable health plan, based on the respondents' own goals and interests with the potential to actually work. This theme was based on two categories: a plan tailored for me and a frame for participation and accessibility to help fulfil the plan. The digital platform provided a way to participate and an assurance that there was someone there for them if necessary.The co-creation of a health plan nurtured hope of having developed a manageable plan for physical activity that could lead to improved future health and well-being. Digital support may serve as a valuable complement in order to sustain and adjust the planned physical activity.ClinicalTrials.gov Identifier: NCT03434899.
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| 7. |
- Ghafouri, Bijar, et al.
(författare)
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The Vastus Lateralis Muscle Interstitium Proteome Changes after an Acute Nociception in Patients with Fibromyalgia Compared to Healthy Subjects-A Microdialysis Study
- 2023
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Ingår i: Biomedicines. - : MDPI AG. - 2227-9059. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Fibromyalgia (FM) is a complex disorder and a clinical challenge to diagnose and treat. Microdialysis is a valuable tool that has been used to investigate the interstitial proteins and metabolites of muscle in patients with fibromyalgia. The implantation of the catheter in the muscle causes acute tissue trauma and nociception. The aim of this study was to investigate acute proteome changes in the vastus lateralis muscle in women fibromyalgia patients (FM) and healthy subjects (CON). A further aim was to study if a 15-week resistance exercise program in FM had any influence on how chronic painful muscle responds to acute nociception. Twenty-six women patients with FM and twenty-eight CON were included in this study. A microdialysis catheter (100 kilo Dalton cut off, membrane 30 mm) was inserted in the vastus lateralis muscle, and samples were collected every 20 min. Subjects rated pain before catheter insertion, directly after, and every 20 min of sample collection. Dialysate samples from time points 0-120 were pooled and considered trauma samples due to the catheter insertion. The samples were analyzed with nano-liquid chromatography-tandem mass spectrometry (nLC-MS/MS). Advanced multivariate data analysis was used to investigate protein profile changes between the groups. Multivariate data analysis showed significant (CV-ANOVA p = 0.036) discrimination between FM and CON based on changes in 26 proteins. After the 15-week exercise intervention, the expression levels of the 15 proteins involved in muscle contraction, response to stimulus, stress, and immune system were increased to the same expression levels as in CON. In conclusion, this study shows that microdialysis, in combination with proteomics, can provide new insights into the interstitial proteome in the muscle of FM. In response to acute nociception, exercise may alter the innate reactivity in FM. Exercise may also modulate peripheral muscle proteins related to muscle contraction, stress, and immune response in patients with FM.
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| 8. |
- Goksör, Clara, et al.
(författare)
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Experiences with an educational program for patients with chronic widespread pain: a qualitative interview study.
- 2022
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Ingår i: Scandinavian journal of pain. - : Walter de Gruyter GmbH. - 1877-8879 .- 1877-8860. ; 22:2, s. 279-287
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Tidskriftsartikel (refereegranskat)abstract
- Chronic widespread pain (CWP) is a common problem in primary health care, with a prevalence of 10-15%. An educational program called Pain School has been developed for use in primary health care, comprising four educational group sessions and 10 weeks of physical activity. The purpose of this study was to explore patients' experiences with participating in an educational program that aims to increase their understanding of pain, self-efficacy, tools in daily life, and physical activity.Twelve women (age 25-72 years) with CWP were included in this qualitative interview study set in primary health care. Semi-structured individual interviews were held 10 weeks after the completion of the four educational group sessions. Data was analyzed through the established method of content analysis, and the results are presented as a theme with categories and subcategories.An overarching theme that described the participants' experiences with the educational program was evolvement of skills and perspectives to master pain. This theme covered four categories: understanding one's body and mind, experiencing the value of participation, applying strategies and ways of thinking, and evaluating and adding to one's personal framework. Participation contributed to an increased understanding of one's body and mind and to experiencing the individual and social value of participation. The participants applied new strategies and ways of thinking related to pain and physical activity. An evaluation of the relevance for the individual and the value of being in the group could reinforce or add to the participants' personal framework.The educational program Pain School that was used in this study appears to give knowledge and support for women with CWP in primary health care and provide them with applicable skills and perspectives to manage pain.
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| 9. |
- Gyllensten, Hanna, 1979, et al.
(författare)
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Physical activity with person-centered guidance supported by a digital platform or with telephone follow-up for persons with chronic widespread pain: Health economic considerations along a randomized controlled trial.
- 2024
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Ingår i: Scandinavian Journal of Pain. - 1877-8860 .- 1877-8879. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate the resource use and costs associated with the co-creation of a physical activity plan for persons with chronic widespread pain (CWP) followed by support through a digital platform, compared to telephone follow-up.In this 12-month cost comparison study following up results after a randomized controlled trial, individuals with CWP, aged 20-65 years, were recruited at primary healthcare units in Western Sweden. All participants developed a person-centered health-enhancing physical activity plan together with a physiotherapist. Participants were then randomized to either an intervention group (n = 69) who had a follow-up visit after 2 weeks and was thereafter supported through a digital platform, or an active control group (n = 70) that was followed up through one phone call after a month. Costs to the health system were salary costs for the time recorded by physiotherapists when delivering the interventions.The reported time per person (2.8h during the 12 months) corresponded to costs of SEK 958 (range: 746-1,517) for the initial visits and follow-up (both study groups), and an additional 2.5h (corresponding to a mean SEK 833; range: 636-1,257) for the time spent in the digital platform to support the intervention group.After co-creation of a physical activity plan, it was more costly to support persons through a digital platform, compared to telephone follow-up.
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| 10. |
- Juhlin, Sofia, et al.
(författare)
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Factors promoting improvements in symptoms and health in women with fibromyalgia and chronic widespread pain: a qualitative interview study
- 2023
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Ingår i: Disability and Rehabilitation. - 0963-8288.
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo describe experiences of improvement among women with chronic widespread pain (CWP).Materials and methodsRecruitment was made from a cohort of women with CWP who participated in a 10- to 12-year follow-up study in 2016. The inclusion criterion was an improvement of at least 30% on a visual analog scale of pain intensity between baseline and follow-up. Seventeen women participated in semi-structured interviews. Data were analysed using qualitative content analysis.ResultsThe analysis resulted in three categories with eight subcategories: Experience of improvement included feeling better despite persisting symptoms and to be capable of more activity. Developing strategies for better health included choosing to act to improve health, developing a constructive mental approach to the illness, and changing one's view of oneself and one's life. Contextual factors supporting improvement included support from healthcare, social support from one's environment, and reduced load in daily life.ConclusionsExperiences of health improvement involved active changes as well as contextual factors. Clinical implications of this study are that increased knowledge regarding pain management, increased physical activity, and reduced stress could contribute to symptom improvement in persons with CWP.
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