| 1. |
- Andersson, Alva, et al.
(författare)
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Functional muscle power in the lower extremity in adults with congenital heart disease
- 2023
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Ingår i: International Journal of Cardiology Congenital Heart Disease. - : Elsevier BV. - 2666-6685. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to investigate functional muscular power in the lower extremity in adults with congenital heart disease (ACHD) and compare results with those of healthy persons. Secondarily, we set out to assess muscle power in relation to age, sex, and complexity of ACHD.Methods: Between 2013 and 2019, 1126 patients attended the ACHD Unit of Sahlgrenska University Hospital/Ostra and performed a test battery to determine physical fitness. Of these patients, 559 who performed the Timed-Stands Test (TST)-which requires 10 stands from a chair at the maximal possible speed-were included in the study.Results: Patients with ACHD performed the TST slower than reference (14.6 s [12.0-18.0] vs. 11.7 s [9.8-14.3], p < 0.001). Men with ACHD performed the TST more rapidly or according to reference in 8% of patients aged 18-39 years, 21% of patients aged 40-65 years, and 55% of patients aged >65 years. Women with ACHD performed the TST more rapidly or according to reference in 21% of patients aged 18-39 years, 56% of patients aged 40-65 years, and 32% of patients aged >65 years. Men with ACHD performed the TST significantly faster than women with ACHD (p < 0.001).Conclusions: Decreased functional muscle power was observed in patients with ACHD and was most pronounced in patients aged 18-39 years. Decreased muscle power is important to detect and requires further assessment because it may contribute to an increased risk of falling and developing lifestyle related diseases.
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| 2. |
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| 3. |
- Ashman Kröönström, Linda, 1982, et al.
(författare)
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Exercise capacity, physical activity, and health-related quality of life in adults with CHD
- 2020
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Ingår i: Cardiology in the Young. - 1047-9511 .- 1467-1107. ; 30:5, s. 668-673
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to assess exercise capacity, physical activity, and health-related quality of life within a broad and unselected group of adults with CHD.Design: From April 2009 to February 2014, 1310 patients were assessed for suitability to participate in this single-centre cross-sectional study. Seven hundred and forty-seven (57%) patients were included, performed a submaximal bicycle test, and answered questionnaires regarding physical activity and health-related quality of life. Exercise capacity, physical activity, and health-related quality of life were compared with reference values and correlations were studied.Results: The exercise capacities of men and women with CHD were 58.7 and 66.3%, respectively, of reference values. Approximately, 20-25% of the patients did not achieve the recommended amount of physical activity. In addition, men scored significantly less points on 7 out of 10 scales of health-related quality of life and women in 6 out of 10 scales, compared with reference values. The strongest correlation was between exercise capacity and the Short Form-36 (physical function).Conclusions: Exercise capacity was impaired in all adults with CHD, including those with less complicated CHD. One-quarter of the patients did not achieve the recommended levels of physical activity. Exercise tests followed by individualised exercise prescriptions may be offered to all patients with CHD aiming to increase exercise capacity, levels of physical activity, improve health-related quality of life, and reduce the risk of acquired life-style diseases.
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| 5. |
- 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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| 6. |
- Ashman Kröönström, Linda, 1982, et al.
(författare)
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Post-operative musculoskeletal outcomes in patients with coarctation of the aorta following different surgical approaches.
- 2021
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Ingår i: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 327, s. 80-85
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine range of motion and muscle function in the upper extremity and spine in patients with coarctation of the aorta (CoA) comparing different surgical approaches.From October 2017 to February 2019, 150 patients were assessed for inclusion. A total of 99 patients (n=75 CoA, n=24 control), were included and assessed regarding muscle function, arm length and circumference, and spinal and thoracic mobility.There were significant differences between the right and left arm in patients with CoA, operated with the subclavian flap technique compared to controls in regards to shoulder flexion (p<0.001), elbow flexion (p=0.001), shoulder abduction (p=0.02), handgrip strength (p=0.01), length of upper arm (p<0.001), lower arm (p<0.001), and of whole arm (p<0.001), circumference regarding upper arm (p=0.001), lower arm (p<0.001), and wrist (p<0.001). Structural scoliosis was more frequent in patients who had undergone thoracotomy (25.4%) than patients who had not undergone a thoracotomy (5.9%, p=0.04), and were often located in the thoracic part of the spine.Patients with CoA operated on using the subclavian flap technique have impaired muscle function as well as reduced arm length and circumference. An increased rate of structural scoliosis was found in patients who underwent thoracotomy, in comparison with patients who had not undergone a thoracotomy. Further research is needed to determine whether muscle function impaired by surgical procedures can be improved with exercise.
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| 7. |
- 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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| 8. |
- Borland, Maria, 1967, et al.
(författare)
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Effects of 3months of detraining following cardiac rehabilitation in patients with atrial fibrillation.
- 2022
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Ingår i: European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity. - : Springer Science and Business Media LLC. - 1813-7253. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Atrial fibrillation negatively impacts physical fitness and health-related quality of life. We recently showed that 3months of physiotherapist-led exercise-based cardiac rehabilitation improves physical fitness and muscle function in elderly patients with permanent atrial fibrillation and concomitant diseases. Little is, however, known about the consequences for physical fitness, physical activity level, and health-related quality of life after ending the rehabilitation period.Prospective 3months follow-up study of 38 patients out of 40 eligible (10 women) who, as part of a randomized controlled trial, had completed a 3months physiotherapist-led cardiac rehabilitation resulting in improved physical fitness,. In the current study, the participants were instructed to refrain from exercise for 3months after completion of the rehabilitation period. Primary outcome measure was physical fitness measured as highest achieved workload using an exercise tolerance test. Secondary outcome measures were muscle function (muscle endurance tests), physical activity level (questionnaire and accelerometer), and health-related quality of life, (Short Form-36), as in the preceding intervention study. We used the Wilcoxon Signed Rank test to analyse differences between the end of rehabilitation and at follow-up. The effect size was determined using Cohen's d .Exercise capacity and exercise time significantly decresead between end of rehabilitation and at follow-up (p<.0001 for both). A significant reduction in shoulder flexion repetitions (p=.006) was observed as well as reduced health-related quality of life in the Short Form-36 dimensions Physical Function (p=.042), Mental Health (p=.030), and Mental Component Score (p=.035). There were, however, no changes regarding objective and subjective physical activity measurements.In older patients with permanent atrial fibrillation, previously achieved improvements from physiotherapist-led exercise-based cardiac rehabilitation in physical fitness and muscle function were lost, and health-related quality of life was impaired after ending the rehabilitation period. A strategy for conserving improvements after a rehabilitation period is essential.
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| 9. |
- Borland, Maria, 1967, et al.
(författare)
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Exercise-based cardiac rehabilitation improves physical fitness in patients with permanent atrial fibrillation - A randomized controlled study
- 2020
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Ingår i: Translational Sports Medicine. - : Hindawi Limited. - 2573-8488. ; 3:5, s. 415-425
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this multicenter randomized controlled trial was to compare physiotherapist-led exercise-based cardiac rehabilitation (PT-X) with physical activity on prescription (PAP) with regard to physical fitness, physical activity, health-related quality of life (HR-QoL), and metabolic risk markers in patients with permanent atrial fibrillation. Ninety six patients (28 women), age 74 (5) years, and ejection fraction >= 45% were randomized. An exercise tolerance test (primary outcome measure), muscle endurance tests, HR-QoL, physical activity assessments (questionnaire and accelerometer), and blood sampling were performed. The PT-X consisted of 60-minute group sessions and home-based exercise, both twice a week. The PAP consisted of 40 minutes of active walking, 4 times a week. Eighty seven patients completed the study. Exercise tolerance (maximum exercise capacity) improved significantly after PT-X (n = 40) but not after PAP (n = 47) (16 vs -3 W; P < .0001). Muscle endurance also improved after PT-X: shoulder flexion left arm (7 vs -1 repetition; P < .001), heel-lift right leg (4 vs 1 repetition; P < .05), left leg (4 vs -1 repetition; P < .001), and shoulder abduction (17 vs -4 s; P < .010). PAP significantly increased energy expenditure. Health-related quality of life and lab-tests did not differ. PT-X improved physical fitness in patients with permanent atrial fibrillation.
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| 10. |
- Borland, Maria, 1967, et al.
(författare)
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Träning vid kronisk hjärtsvikt för att förbättra livskvaliteten
- 2015
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Ingår i: Läkartidningen. - 0023-7205. ; 112
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Tidskriftsartikel (refereegranskat)abstract
- Persons with chronic heart failure should be recommended aerobic and resistance exercise to be able to increase maximal oxygen uptake (VO2 max), walking distance, and health related quality of life (moderately strong scientific evidence - quality of evidence +++), and to reduce mortality and hospital admissions and increase muscle strength and endurance (low scientific evidence - quality of evidence ++). Prescription of exercise in chronic heart failure should always be preceded of assessments of aerobic and muscular fitness. The aerobic exercise could be conducted as continuous or interval exercise. In connection with ongoing exercise special attention is needed regarding heart rate, diverging blood pressure reactions, contingent occurrence of arrhythmias and the advent of symptoms such as dizziness and severe dyspnea.
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