| 1. |
- Ashman Kröönström, Linda, 1982, et al.
(författare)
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Muscle function in adults with congenital heart disease
- 2014
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 170:3, s. 358-363
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim was to assess muscle function in a sample of Swedish adult men and women with congenital heart disease (ACHD) and to compare the results with published reference values in healthy adults. METHODS AND RESULTS: From April 2009 to December 2010, 762 adult outpatients were assessed for their suitability and individual need for tests of physical fitness. The patients performed five muscle function tests, two isotonic tests and three isometric tests. Of the 762 patients, 315 (41.3%) patients performed the tests. Patients with ACHD had lower isotonic muscle function compared to healthy reference values. In the heel lift test, men with ACHD performed at 63% and women at 58% of the healthy reference values and in the shoulder flexion test the corresponding performance level was 60% for men with ACHD and 85% for the women. Multiple regression analyses showed that NYHA class II-IV was a significant predictor for a lower isotonic muscle function i.e. heel lift in women (p<0.001) and men (p=0.05) and in shoulder flexion (p<0.001) in women, as well as in isometric knee extension (p=0.04) and isometric shoulder abduction (p<0.001) in women. CONCLUSION: This is the first report of muscle function in a broad and unselected group of patients with ACHD. Our data shows that patients with ACHD have lower isotonic muscle function. The impacts of low muscle function in activities of daily living and the question of whether muscle function could be improved with exercise training need further investigation.
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| 2. |
- Borland, Maria, 1967, et al.
(författare)
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A group-based exercise program did not improve physical activity in patients with chronic heart failure and comorbidity: A randomized controlled trial
- 2014
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977. ; 46:5, s. 461-467
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate how group-based exercise affects the levels of physical activity, physical fitness and health-related quality of life (HRQoL) in patients with chronic heart failure and comorbidities. Patients: A total of 48 patients (10 women, 38 men), mean age 71 years (standard deviation 8 years), ejection fraction 27% (standard deviation 10%), and New York Heart Association functional class I-III. Methods: A bicycle test, 6-min walk test (6MWT) and muscle endurance tests were performed. Physical activity was assessed with a pedometer and the International Physical Activity Questionnaire (IPAQ), BRQoL was evaluated with the Short Form-36 (SF-36). Patients were randomized to control or intervention groups. Intervention consisted of an individually designed group-based exercise programme twice a week, for a period of 3 months. Subjects in the control group were asked to continue with their usual lives. Results: A total of 42 patients completed the study, and 6 dropped-out. Steps/day did not increase significantly after intervention (p=0.351), but IPAQ score did (p=0.008). Exercise tolerance (p=0.001), 6MWT (p=0.014), shoulder abduction (p=0.028), heel lift (p<0.0001) and BRQoL (p=0.018) improved significantly in the intervention group compared with the control group. Conclusion: Group-based exercise did not improve the level of physical activity in patients with chronic heart failure and comorbidity; however, physical fitness and HRQoL were significantly improved.
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| 3. |
- Bäck, Maria, 1978, et al.
(författare)
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Kinesiofobi (rörelserädsla) hos patienter med kranskärlssjukdom
- 2011
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Ingår i: Abstraktbok Sjukgymnastdagarna 14-16 sept 2011, Stockholm.
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Konferensbidrag (refereegranskat)abstract
- Bakgrund och syfte Att patienter med kranskärlssjukdom är rörelserädda är ett känt kliniskt fenomen, som dock inte finns vetenskapligt studerat. Studiens syfte var tvådelat: 1). Reliabilitets- och validitetstesta Tampaskalan för kinesiofobi – Heart (TSK-SV Heart). 2). Undersöka förekomsten av kinesiofobi bland patienter med kranskärlssjukdom. Metoder Studien bestod av 332 patienter (75 kvinnor) med kranskärlssjukdom som vårdats vid Sahlgrenska Universitetssjukhuset/Sahlgrenska mellan 2007-2009. Patienterna inkluderades 6 månader efter vårdtillfället. Kinesiofobi utvärderades med TSK-SV Heart, ett frågeformulär som subjektivt mäter patientens grad av kinesiofobi. Ett värde >37 poäng indikerar kinesiofobi. För test av reliabilitet av TSK-SV Heart mättes stabilitet över tid, inre konsistens samt homogenitet. Validitetstesterna inkluderade ytvaliditet, innehållsvaliditet samt begreppsvaliditet. Resultat Reliabilitetstesterna visade på en god stabilitet över tid (Intraclass Correlation Coefficient=0.84) och en god inre konsistens (Cronbach’s alpha=0.79). Validitetstesterna resulterade i en god yt- och innehållsvaliditet. Begreppsvaliditeten utvärderades genom en konfirmatorisk faktoranalys som visade på acceptabla modellanpassningmått för en fyra faktor modell. Tjugo procent av patienterna hade en förhöjd grad av kinesiofobi (>37 poäng på TSK-SV Heart). Konklusion Att med ett reliabelt och valitt instrument kunna identifiera de patienter med kranskärlssjukdom som har en hög grad av kinesiofobi kan vara ett första steg mot att utforma en behandling för att öka dessa patienters följsamhet till fysisk aktivitet och träning, som har väl vedertagna positiva effekter.
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| 4. |
- Bäck, Maria, 1978, et al.
(författare)
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Physical activity in relation to cardiac risk markers in secondary prevention for patients with coronary artery disease
- 2012
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Ingår i: European Society of Cardiology (ESC), Münich, Germany.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: The strong evidence of the benefits of exercise-based cardiac rehabilitation can not be questioned. However, the relationship between level of habitual physical activity and cardiac risk markers in secondary prevention for patients with coronary artery disease (CAD) has yet to be quantified. The aims of the study were to describe the level of physical activity in patients with CAD, and to investigate the association between physical activity and cardiac risk markers. Methods: In total, 332 patients, mean age 65±9.1 years, diagnosed with CAD at a university hospital were included in the study, six months after the cardiac event. Physical activity was measured with a pedometer (steps/day). Investigation of cardiac risk markers included serum lipids, oral glucose-tolerance test, twenty-four hour blood pressure and heart rate monitoring, smoking, body-mass index, waist-hip ratio, and muscle endurance. Correlations with cardiac risk indicators were assessed using Spearman's rank order correlation, where adjustments were made for characteristics univariately associated (p<0.05) with both pedometer steps/day and the variable in question. Results: The patients performed in median 7027 (inter-quartile range 4553-9356) steps/day. The significant adjusted correlations between pedometer steps/day and cardiac risk markers were in general small. Pedometer steps/day was positively correlated with high-density lipoprotein cholesterol (HDL) (0.19, p<0.001), muscle endurance tests (0.19-0.25, p<0.001) and inversely associated with triglycerides (-0.20, p<0.001), glucose-tolerance (-0.23, p<0.001), twenty-four hour heart rate recording during night (-0.17, p=0.004), and total heart rate over 24h (-0.13, p=0.02). Conclusions: There were small, but significant, associations between habitual physical activity and HDL, muscle endurance, triglycerides, glucose-tolerance, and 24-h heart rate, indicating the possibility of positive effects of physical activity on these parameters. However, before more confirmatory data are available, we recommend that patients with CAD are routinely referred to exercise-based cardiac rehabilitation, due to the principle of evidence-based medicine.
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| 5. |
- Bäck, Maria, 1978, et al.
(författare)
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Physical activity in relation to cardiac risk markers in secondary prevention of coronary artery disease.
- 2013
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Ingår i: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 168:1, s. 478-483
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The relationship between physical activity and cardiac risk markers in secondary prevention for patients with coronary artery disease (CAD) is uncertain. The aims of the study were therefore to examine the level of physical activity in patients with CAD, and to investigate the association between physical activity and cardiac risk markers. METHODS: In total, 332 patients, mean age, 65±9.1years, diagnosed with CAD at a university hospital were included in the study 6months after their cardiac event. Physical activity was measured with a pedometer (steps/day) and two questionnaires. Investigation of cardiac risk markers included serum lipids, oral glucose-tolerance test, twenty-four hour blood pressure and heart rate monitoring, smoking, body-mass index (BMI), waist-hip ratio, and muscle endurance. The study had a cross-sectional design. RESULTS: The patients performed a median of 7027steps/day. After adjustment for confounders, statistically significant correlations between steps/day and risk markers were found with regard to; high-density lipoprotein cholesterol (HDL-C) (r=0.19, p<0.001), muscle endurance measures (r ranging from 0.19 to 0.25, p=0.001 or less) triglycerides (r=-0.19, p<0.001), glucose-tolerance (r=-0.23, p<0.001), BMI (r=-0.21, p<0.001), 24-h heart rate recording during night (r=-0.17, p=0.004), and average 24-h heart rate (r=-0.13, p=0.02). CONCLUSIONS: A relatively high level of physical activity was found among patients with CAD. There was a weak, but significant, association between pedometer steps/day and HDL-C, muscle endurance, triglycerides, glucose-tolerance, BMI and 24-h heart rate, indicating potential positive effects of physical activity on these parameters. However, before clinical implications can be formed, more confirmatory data are needed.
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| 6. |
- Bäck, Maria, 1978, et al.
(författare)
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The impact on kinesiophobia (fear of movement) by clinical variables for patients with coronary artery disease
- 2013
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Ingår i: International Journal of Cardiology. - : Elsevier Ireland Ltd. - 0167-5273 .- 1874-1754. ; 167:2, s. 391-397
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Tidskriftsartikel (refereegranskat)abstract
- Background: The impact on kinesiophobia (fear of movement) for patients with coronary artery disease (CAD) is not known. The aims were to describe the occurrence of kinesiophobia in patients with CAD, and to investigate the influence on kinesiophobia by clinical variables. Material and methods: In total, 332 patients, mean age, 65±9.1 years diagnosed with CAD at a university hospital were included in the study. The Tampa Scale for Kinesiophobia Heart (TSK-SV Heart) was used to assess kinesiophobia. Comparisons between high versus low levels of kinesiophobia were measured for each variable. Binary logistic regression analyses were performed with a high level of kinesiophobia (TSK-SV Heart >37) as dependent variable, and with the observed variables as independent. The study had an exploratory, cross-sectional design. Results: A high level of kinesiophobia was found in 20% of the patients. The following variables decreased the odds ratio (OR) for a high level of kinesiophobia: Attending cardiac rehabilitation (yes vs no; -56.7%), level of physical activity (medium vs high; -80.2%), Short Form-36: general health (-4,3%), physical functioning (-1.8%). Two variables increased the OR for a high level of kinesiophobia: heart failure as complication at hospital (yes vs no; 418.7%), anxiety (19.2%). Previous heart failure (yes vs no) was unexpectedly found to reduce kinesiophobia (-88.3%) due to suppression. Conclusions: Several important clinical findings with impact on rehabilitation and prognosis for patients with CAD were found to be associated with a high level of kinesiophobia. Therefore, kinesiophobia needs to be considered in secondary prevention for patients with CAD.
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| 7. |
- Bäck, Maria, 1978, et al.
(författare)
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Validation of a queationnaire to detect kinesiophobia (fear of movement) in patients with coronary artery disease
- 2011
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Ingår i: World Physical Therapy 16th International WCPT Congress 20-23 June 2011, Amsterdam.
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Konferensbidrag (refereegranskat)abstract
- Purpose The aim of the study was twofold; firstly to examine the reliability and validity of the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), and secondly to investigate the occurrence of kinesiophobia among patients with coronary artery disease (CAD). Relevance Kinesiophobia, i.e. debilitating fear of movement, in relation to cardiac disease is a well-known clinical phenomenon. So far, however, there is not known which role kinesiophobia, plays for the level of physical activity in patients with CAD. Participants The study consisted of 331 patients (75 women), age 65±9.1 years, with CAD who attended the medical department at Sahlgrenska University Hospital between year 2007–2009. Exclusion criteria were death during the hospital period, serious diseases interfering participation in the study and inability to understand the Swedish language. Methods The patients were asked to fill in the TSK-SV Heart, which comprises of 17 items that assess the patient’s subjective rating of kinesiophobia. An operational definition of kinesiophobia was defined as TSK-SV Heart >37 points. The reliability test included stability over time, internal consistency and homogeneity. The test of validity comprised face validity, content validity and construct validity. Results In terms of reliability the TSK-SV Heart was found to be stable over time (Intraclass Correlation Coefficient 0.84) and internal consistency measured with Cronbach’s alpha was 0.84. The TSK-SV Heart was considered to have face, content and construct validity. Twenty percentage of the patients had kinesiophobia (TSK-SV Heart >37 points). Conclusion: TSK-SV Heart seems to be a reliable and valid and could be used to detect kinesiophobia in patients with CAD. Impact: One third of a sample of patients with CAD suffered from kinesiophobia, which might negatively impact the patients’ future level of physical activity.
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| 8. |
- Bäck, Maria, 1978, et al.
(författare)
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Validation of a questionnaire to detect kinesiophobia (fear of movement) in patients with coronary artery disease
- 2012
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 44:4, s. 363-369
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the validity and reliability of the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), which is a brief questionnaire to detect kinesiophobia (fear of movement), in patients with coronary artery disease (CAD). Design: Methodological research (cross-sectional study). Subjects: A total of 332 patients, mean age, 65±9.1 years diagnosed with CAD at a university hospital were included in the study. Methods: The psychometric properties of the TSK-SV Heart were tested. The tests of validity comprised face validity, content validity, and construct validity. The reliability tests included composite reliability, internal consistency and stability over time. Results: In terms of reliability, the TSK-SV Heart was found to be stable over time (Intra Class Correlation coefficient = 0.83), and internally consistent (Cronbach’s alpha = 0.78). A confirmatory factor analysis provided acceptable fit for a hypothesized four-factor model with inclusion of a method factor. Conclusions: These results provide support showing the TSK-SV Heart to be reliable and the questionnaire seems to be valid for use in patients with CAD. However, some items need further investigation due to low influence on some sub-dimensions of the test. The sub-dimensions of kinesiophobia require future studies concerning their implications for the target group.
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| 9. |
- Bäck, Maria, 1978, et al.
(författare)
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What variables predict participation in exercise-based cardiac rehabilitation in patients with coronary artery disease?
- 2014
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Ingår i: European Heart Journal. European Society of Cardiology, 30 August - 3 September 2014, Barcelona. ; 35:Suppl 1
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose Despite the well-established positive effects of exercise-based cardiac rehabilitation (CR) participation has been shown to be sub-optimal. A significant association between kinesiophobia (fear of movement) and participation in CR has previously been found. Therefore, the aim of this study was to identify predictors of participation in CR in patients with coronary artery disease (CAD), with a special reference to kinesiophobia. Methods In all, 332 patients (75 women; mean age 65±9.1 years) with a diagnosis of CAD were recruited between 2007 and 2009 at Sahlgrenska University Hospital/Sahlgrenska. The patients were tested regarding muscle endurance, level of physical activity, health related quality of life, anxiety, depression and kinesiophobia. A path model with direct and indirect effects via kinesiophobia was used to predict participation in CR. An explorative selection of significant predictors was performed. Results Kinesiophobia (p=.012), waist circumference (p=.023), and a previous history of PCI (p=.037) had direct negative effects on participation in CR, while current incidence of CABG (p<.001), PCI (p=.005) and BMI (p=.008) had positive effects. Compared to patients diagnosed with unstable angina, a diagnosis of myocardial infarction (p=.004) had a positive effect on participation in CR. The following indirect effects on participation in CR were found. Anxiety (p=.001) and previous PCI (p=.025) increased kinesiophobia, while muscle endurance (p=.003), perceptions of general health (p<.001) and physical functioning (p=.009) decreased kinesiophobia. Moreover, men had higher kinesiophobia compared to women (p=.031) and smoking was found to reduce kinesiophobia (p=.004). Conclusions Several important variables with an influence on participation in CR were identified and should be further analysed in relation to clinical practice. A reduction of kinesiophobia can be an efficient way to increase participation in CR and should therefore be given priority in future research.
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| 10. |
- Cider, Åsa, 1960, et al.
(författare)
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Aquatic Exercise Is Effective in Improving Exercise Performance in Patients with Heart Failure and Type 2 Diabetes Mellitus
- 2012
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Ingår i: Evidence-Based Complementary and Alternative Medicine. - : Hindawi Limited. - 1741-427X .- 1741-4288. ; 2012
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Tidskriftsartikel (refereegranskat)abstract
- Background. Peak oxygen uptake (VO2peak) and muscle function are more decreased in patients with a combination of chronic heart failure (CHF) and type 2 diabetes mellitus (2DM) compared to patients with only one of the conditions. Further, patients with 2DM have peripheral complications that hamper many types of conventional exercises. Aim. To evaluate the efficacy and applicability of eight-week aquatic exercise in patients with the combination of CHF and 2DM. Methods. Twenty patients (four women) with both CHF and 2DM (age 67.4 +/- 7.1, NYHA II-III) were randomly assigned to either aquatic exercise or a control group. The patients exercised for 45 minutes 3 times/week in 33-34 degrees C, swimming pool. Results. The training programme was well tolerated. Work rate (+11.7 +/- 6.6 versus -6.4 +/- 8.1watt, P < 0.001) and VO2peak (+2.1 +/- 0.8 versus -0.9 +/- 1.4 mL.kg(-1) . min(-1), P < 0.001) and walking capacity (P = 0.01) increased significantly in the training group. Muscle function was also significantly improved and Hba1c decreased significantly (P < 0.01) during training, while fasting glucose, insulin, c-peptide, and lipids were unchanged. Training also increased vitality measured by SF-36 significantly (P = 0.05). Conclusion. Aquatic exercise could be used to improve exercise capacity and muscle function in patients with the combination of CHF and 2DM.
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| 11. |
- DuttaRoy, Smita, 1971, et al.
(författare)
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The effects of age on circulating vascular markers and cardiac prognostic markers, before and after 2 months home-based high-frequency exercise training in patients with stable coronary artery disease
- 2014
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Ingår i: European Heart Journal. European Society of Cardiology, 30 August - 3 September 2014, Barcelona. - 0195-668X .- 1522-9645. ; 35:Supplement: 1
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: Vascular endothelial growth factor (VEGF) and stromal derived factor (SDF-1) play an important role in angiogenesis. Relaxin-2 (Rlx-2) has both angiogenic and vasodilatory properties, while endothelin-1 (ET-1) is a potent vasocontrictor.VEGF, SDF-1 and Rlx-2-levels have shown to be positively modulated by exercise training, while the effect of exercise on (Rlx-2) is not known. Age is a known risk factor for morbidity and mortality in coronary artery disease (CAD). We wanted to investigate how age affects levels of these vascular factors and known prognostic cardiac markers before and after high frequency exercise training (HFE), in patients with CAD. Methods: Patients with stable CAD (age 48-80 years) were randomized to HFE (aerobic exercise 70% of max, 30 minutes, 5 times/week and resistance exercise 3 times/week), performed at home for 8 weeks, or usual lifestyle (ctrl). Serum and plasma was collected from 21 controls and 24 HFE-patients and analyzed at baseline and after 8 weeks. VEGF, SDF-1, Rlx-2 and ET-1were analyzed with enzymelinked immunoadsorbent assay (ELISA). TnT and NT-pro-BNP were analyzed on Cobas e602 (Roche). Correlation was calculated using the statistical software Graph Pad Prism 6. Pearson’s r was calculated to determine correlation between the factors prior to exercise, while Spearman’s r was used for the analysis on the exercise induced effects of the HFE-group. The exercise-induced effect on cardiac biomarkers was determined by comparing % change (from baseline to 8 weeks) between HFE and Ctrl using Mann-Whitney U-test. Results: At baseline, there was a significant positive correlation between age and TnT (r=0.38, p<0.05) and a non-significant positive correlation between age and NT-proBNP (r=0.36, p=0.06), while no correlation was found between age and levels of vascular markers (VEGF r=-0,14, SDF-1 r=-0,13, ET-1 r=0,08, Rlx-2 r=0,06, p=ns for all). As we have previously shown, home-based HFE decreased VEGF (2,6+29% (ctrl) and -3,9 +13% (HFE), p<0,05), but the other studied factors were not significantly affected. We found no correlation between age and changes in cardiac markers after exercise. Conclusions: Elderly patients with stable CAD have higher levels of TnT and NT-proBNP, indicating a higher degree of underlying CAD. This may also reflect their higher mortality in CAD. HFE-training may lower VEGF in patients with stable CAD. Interestingly, there seems to be no difference in the respone response to exercise in cardiac biomarkers, between younger and older CAD patients
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| 12. |
- Grüner Sveälv, Bente, 1956, et al.
(författare)
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Is hydrotherapy an appropriate form of exercise for elderly patients with biventricular systolic heart failure?
- 2012
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Ingår i: Journal of Geriatric Cardiology. - : Tsinghua University Press. - 1671-5411. ; 9:4, s. 408-410
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Tidskriftsartikel (refereegranskat)abstract
- Hydrotherapy (exercise in warm water) is considered to be a safe and beneficial method to use in the rehabilitation of stable heart failure patients, but there is little information on the effect of the increased venous return and enhanced preload in elderly patients with biventricular heart failure. We present a case of an elderly man who was recruited to participate in a hydrotherapy study. We compared echocardiographic data during warm water immersion with land measurements, and observed increases in stroke volume from 32 mL (land) to 42 mL (water), left ventricular ejection fraction from 22% to 24%, left ventricular systolic velocity from 4.8 cm/s to 5.0 cm/s and left atrioventricular plane displacement from 2.1 mm to 2.2 mm. By contrast, right ventricular systolic velocity decreased from 11.2 cm/s to 8.4 cm/s and right atrioventricular plane displacement from 8.1 mm to 4.7 mm. The tricuspid pressure gradient rose from 18 mmHg on land to 50 mmHg during warm water immersion. Thus, although left ventricular systolic function was relatively unaffected during warm water immersion, we observed a decrease in right ventricular function with an augmented right ventricular pressure. We recommend further investigations to observe the cardiac effect of warm water immersion on patients with biventricular systolic heart failure and at risk of elevated right ventricular pressure.
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| 13. |
- Hambraeus, Kristina, et al.
(författare)
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SWEDEHEART annual report 2012
- 2014
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa Healthcare. - 1401-7431 .- 1651-2006. ; 48:SUPPL. 63, s. 1-333
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Tidskriftsartikel (refereegranskat)abstract
- The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) supports continuous monitoring and improvement of care for coronary artery disease, catheter-based and surgical coronary interventions, secondary prevention as well as catheter based and surgical valve intervention, by providing extensive data on base-line, diagnostic, procedural and outcome variables. Design. This national quality registry collects information from all Swedish hospitals treating patients with acute coronary artery disease and all patients undergoing coronary angiography, catheter-based interventions or heart surgery. Combination with other national mandatory official registries enables complete follow-up of all individuals regarding myocardial infarction, new interventional procedures, death and all-cause hospitalizations. The registry is governed by an independent steering committee and funded by the Swedish National Health care provider. The software is developed by Uppsala Clinical Research Center. Results. The SWEDEHEART Quality Index reflects overall quality of care for coronary artery disease including secondary prevention. In comparison with 2011, an improvement of the index occurred in 2012 overall. There was however, still a wide range in performance between individual centers, emphasizing the need for continuous monitoring of quality of care at a national as well as on a center level. © 2014 Informa Healthcare.
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| 14. |
- Mannerkorpi, Kaisa, 1955, et al.
(författare)
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Does moderate-to-high intensity Nordic walking improve functional capacity and pain in fibromyalgia? A prospective randomized controlled trial
- 2010
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Ingår i: Arthritis Research & Therapy. - : Springer Science and Business Media LLC. - 1478-6354 .- 1478-6362. ; 12:5
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The objective of this study was to investigate the effects of moderate-to-high intensity Nordic walking (NW) on functional capacity and pain in fibromyalgia (FM). METHODS: A total of 67 women with FM were recruited to the study and randomized either to moderate-to-high intensity Nordic Walking (n = 34, age 48 ± 7.8 years) or to a control group engaging in supervised low-intensity walking (LIW, n = 33, age 50 ± 7.6 years). Primary outcomes were the six-minute walk test (6MWT) and the Fibromyalgia Impact Questionnaire Pain scale (FIQ Pain). Secondary outcomes were: exercise heart rate in a submaximal ergometer bicycle test, the FIQ Physical (activity limitations) and the FIQ total score. RESULTS: A total of 58 patients completed the post-test. Significantly greater improvement in the 6MWT was found in the NW group (P = 0.009), as compared with the LIW group. No between-group difference was found for the FIQ Pain (P = 0.626). A significantly larger decrease in exercise heart rate (P = 0.020) and significantly improved scores on the FIQ Physical (P = 0.027) were found in the NW group as compared with the LIW group. No between-group difference was found for the change in the FIQ total. The effect sizes were moderate for the above mentioned outcomes. CONCLUSIONS: Moderate-to-high intensity aerobic exercise by means of Nordic walking twice a week for 15 weeks was found to be a feasible mode of exercise, resulting in improved functional capacity and a decreased level of activity limitations. Pain severity did not change over time during the exercise period. TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT00643006.
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| 15. |
- Pihl, Emma, et al.
(författare)
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Exercise in elderly patients with chronic heart failure in primary care : Effects on physical capacity and health-related quality of life
- 2011
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Ingår i: European Journal of Cardiovascular Nursing. - London : Sage Publications. - 1474-5151 .- 1873-1953. ; 10:3, s. 150-158
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Chronic heart failure (CHF) limits exercise capacity which influences physical fitness and health-related quality of life (HRQoL). AIM: The aim was to determine the effects on physical capacity and HRQoL of an exercise programme in elderly patients with CHF in primary care.METHODS: An exercise intervention was conducted as a prospective, longitudinal and controlled clinical study in primary care in elderly patients with CHF. Endurance exercise and resistance training were conducted as group-training at the primary care centre and as home training. Follow-up on physical capacity and HRQoL was done at 3, 6 and 12 months.RESULTS: Exercise significantly improved muscle endurance in the intervention group (n=29, mean age 76.2years) compared to the control group (n=31, mean age 74.4years) at all follow-ups except for shoulder flexion right at 12months (shoulder abduction p=0.006, p=0.048, p=0.029; shoulder flexion right p=0.002, p=0.032, p=0.585; shoulder flexion left p=0.000, p=0.046, p=0.004). Six minute walk test improved in the intervention group at 3months (p=0.013) compared to the control group. HRQoL measured by EQ5D-VAS significantly improved in the intervention group at 3 and 12months (p=0.016 and p=0.034) and SF-36, general health (p=0.048) and physical component scale (p=0.026) significantly improved at 3months compared to the control group. CONCLUSION: This study shows that exercise conducted in groups in primary care and in the patients' homes could be used in elderly patients with CHF. The combination of endurance exercise and resistance training has positive effects on physical capacity. However, the minor effects in HRQoL need further verification in a study with a larger study population. ©Sage Publications
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| 16. |
- Thelandersson, Annelie, et al.
(författare)
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Blood flow velocity and vascular resistance during passive leg exercise in the critically ill patient
- 2012
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Ingår i: Clinical Physiology and Functional Imaging. - 1475-0961. ; 32:5, s. 338-342
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Tidskriftsartikel (refereegranskat)abstract
- Passive range of motion exercise is a very common physical therapy treatment for patients admitted to an intensive care unit. However is the knowledge scarce regarding its impact on blood circulation in the extremities. The objective of this study was therefore to investigate the effect of passive range of motion on arterial peripheral leg blood flow velocity (BFV) and vascular resistance. A cross-sectional consecutive study of twelve patients admitted to an intensive care unit and twelve healthy age- and gender-matched controls was conducted. Passive range of motion was performed in one leg by a physical therapist. Blood flow velocities and resistance index in the common femoral artery (CFA), blood pressure and heart rate were measured before, directly after and at rest after passive range of motion. No changes were seen in BFV or resistance index in the patient group or the control group. No changes were found in blood pressure or heart rate in the patient group. In the control group, changes were found in systolic and mean blood pressure, with a higher pressure before passive range of motion. The controls had lower BFV and higher resistance index than the patients when comparing the groups. The conclusion of this study including twelve patients is that passive range of motion does not alter BFV or resistance index in the CFA in comatose and/or sedated critically ill patients.
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| 17. |
- Varkey, Emma, et al.
(författare)
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Exercise as migraine prophylaxis: a randomized study using relaxation and topiramate as controls.
- 2011
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Ingår i: Cephalalgia. - : SAGE Publications. - 0333-1024 .- 1468-2982. ; 31:14, s. 1428-38
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Scientific evidence regarding exercise in migraine prophylaxis is required. Therefore this study aimed to evaluate the effects of exercise in migraine prevention. METHODS: In a randomized, controlled trial of adults with migraine, exercising for 40 minutes three times a week was compared to relaxation according to a recorded programme or daily topiramate use, which was slowly increased to the individual's highest tolerable dose (maximum 200 mg/day). The treatment period lasted for 3 months, and migraine status, quality of life, level of physical activity, and oxygen uptake were evaluated. The primary efficacy variable was the mean reduction of the frequency of migraine attacks during the final month of treatment compared with the baseline. RESULTS: Ninety-one patients were randomized and included in the intention-to-treat analysis. The primary efficacy variable showed a mean reduction of 0.93 (95% confidence interval (CI) 0.31-1.54) attacks in the exercise group, 0.83 (95% CI 0.22-1.45) attacks in the relaxation group, and 0.97 (95% CI 0.36-1.58) attacks in the topiramate group. No significant difference was observed between the groups (p = 0.95). CONCLUSION: Exercise may be an option for the prophylactic treatment of migraine in patients who do not benefit from or do not want to take daily medication.
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| 18. |
- Wiklund, Malin, 1972, et al.
(författare)
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Accuracy of a pedometer and an accelerometer in women with obesity.
- 2012
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Ingår i: Open obesity journal. - : Bentham Science Publishers Ltd.. - 1876-8237. ; 4, s. 11-17
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The main purpose of this study was to examine the accuracy of a specific pedometer (Silva model Pedometer Plus 56013-3) and accelerometer (Silva model Ex3 plus 56026) in women suffering from obesity. The second aim was to study the impact of BMI, waist and hip circumference and waist-hip ratio on different pedometer and accelerometer positions on the body. Methods: Forty women with a BMI > 30 kg/m 2 wore two pedometers and two accelerometers during a standardized 6 minute walk test. Accelerometer 1 (A1) was placed around the neck. Accelerometer 2 (A2) was attached to the waistband of the woman's trousers in line with left hip, Pedometer 1 (P1) in line with right hip and pedometer 2 (P2) behind back in line with the spine. During the test an assistant manually counted number of steps, using a hand counter as reference for step accuracy. Results: Steps registered with the pedometer were significantly different from actual steps counted. The intra class correlations for the actual steps counted compared with the steps registered were P1 = 0.13, P2 = 0.20, A1= 0.99 and A2 = 0.41. All correlations between the tested pedometer and accelerometer at the different locations and BMI, waist circumference, hip circumference and hip-to waist ratio were little (if any) or low. Conclusions: The accelerometer is more accurate than the pedometer in measuring steps in women suffering from obesity. The location, which gave the most accurate results, was found to be around the neck. © Wiklund et al.
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| 19. |
- Wiklund, Malin, 1972, et al.
(författare)
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Physical Fitness and Physical Activity in Swedish Women before and onePhysical Fitness and Physical Activity in Swedish Women before and one Year after Roux-en-Y Gastric Bypass Surgery
- 2014
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Ingår i: The Open Obesity Journal. - : Bentham Science Publishers Ltd.. - 1876-8237. ; 6, s. 38-43
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate physical fitness, physical activity level and time spent sitting in Swedish women before and one year after laparoscopic Roux-en-Y Gastric Bypass surgery (LRYGB). Method: Thirty-seven women (age: 41.2±9.6 years and Body Mass Index (BMI): 42±6.5 kg/m2) were tested before and one year after LRYGB. (BMI: 30.5±5.8 kg/m2). Physical fitness was assessed using the six minute walk test (6MWT), and three muscular endurance and one handgrip test. Physical activity level and sitting time were assessed using the short form of the International Physical Activity Questionnaire (IPAQ). Results: One year after surgery the mean distance walked during 6MWT increased from 532 m to 599 m (p=<0.001) and the muscular endurance was significantly improved (p0.016), while no statistical significant difference was found in grip force compared to pre-operatively. After surgery, the women walked significantly more minutes/week (p=0.018) and increased their level of moderate (p=0.039) and vigorous (p=0.033) physical activity, but there were no significant differences in sitting time (p=0.206) compared to preoperatively. Conclusions: The physical activity level as well as physical fitness increased while grip strength remained same in Swedish women one year after LRYGB, compared to before surgery. The improved physical fitness and the considerable weight loss are important factors in reducing the risk of developing lifestyle associated diseases and risk of premature death in this group of women. But even if both physical activity and physical fitness increased at group level one year after LRYGB, some individuals still needed to be more physically active and to enhance the physical fitness level. These patients might benefit from physiotherapy to be able to be more physically active.
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