| 1. |
- Borland, Maria, 1967, et al.
(author)
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Träning vid kronisk hjärtsvikt för att förbättra livskvaliteten
- 2015
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In: Läkartidningen. - 0023-7205. ; 112
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Journal article (peer-reviewed)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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| 2. |
- Borland, Maria, 1967, et al.
(author)
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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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In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977. ; 46:5, s. 461-467
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Journal article (peer-reviewed)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. |
- Borland, Maria, 1967, et al.
(author)
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Effects of 3months of detraining following cardiac rehabilitation in patients with atrial fibrillation.
- 2022
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In: 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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Journal article (peer-reviewed)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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| 4. |
- Borland, Maria, 1967, et al.
(author)
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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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In: Translational Sports Medicine. - : Hindawi Limited. - 2573-8488. ; 3:5, s. 415-425
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Journal article (peer-reviewed)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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| 5. |
- Borland, Maria, 1967
(author)
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Exercise-based cardiac rehabilitation, physical fitness, and physical activity in cardiac disease
- 2018
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Doctoral thesis (other academic/artistic)abstract
- Background: Evidence suggests that individualised exercise-based cardiac rehabilitation should be offered to patients with ischemic heart disease and chronic heart failure (HF) because it improves physical fitness and health-related quality of life (HR-QoL), and reduces cardiac mortality and hospital admissions. If physiotherapist-led exercise-based cardiac rehabilitation (PT-X) can similarly improve physical fitness in patients with atrial fibrillation (AF), and improve physical activity levels in patients with chronic HF or permanent AF, has been sparsely studied. In addition, whether increased physical activity in patients with chronic HF or permanent AF can improve physical fitness in the same way as exercise has not been evaluated. Aim: The general aim for this thesis was to investigate the effect of individually prescribed PT-X in elderly patients with chronic HF or permanent AF especially in regards to exercise modality, physical fitness, level of physical activity, HR-QoL, and metabolic risk factors. Method and Main Findings: Study I. A randomised controlled trial (RCT) in patients with chronic HF and comorbidity investigating the effect of PT-X regarding the level of physical activity, physical fitness (i.e., exercise capacity and muscle function), and HR-QoL. Physical activity did not increase significantly after PT-X, though self-reported physically activity levels were higher. Physical fitness and HR-QoL improved significantly in the PT-X group compared to the control group. Study II. A RCT multicentre trial comparing PT-X and physical activity on prescription (PAP) with regard to physical fitness, level of physical activity, HR-QoL and metabolic risk markers in patients with permanent AF. Physical fitness improved significantly in PT-X compared to PAP. PAP increased energy expenditure but not physical fitness. No significant difference was found in HR-QoL or metabolic risk markers. Study III. A 3-month follow-up of study II investigating the effect of 3 months detraining with respect to physical fitness, level of physical activity, and HR-QoL in patients with permanent AF. The improvements achieved in physical fitness in the PT-X group decreased significantly with detraining, and HR-QoL was markedly reduced. Conclusion: PT-X is well tolerated and safe and, therefore, should be used to improve physical fitness in patients with chronic HF or permanent AF. Neither PT-X nor PAP increases the physical activity level. PT-X improves HR-QoL in patients with chronic HF but not in patients with permanent AF. In patients with permanent AF, it is important to continue exercising because detraining reverses the gains in physical fitness obtained from PT-X and markedly decreases HR-QoL.
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| 6. |
- Stenmarker, Margaretha, et al.
(author)
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Morbidity and mortality among children, adolescents, and young adults with cancer over six decades : a Swedish population-based cohort study (the Rebuc study)
- 2024
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In: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 42
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Journal article (peer-reviewed)abstract
- Background Despite progress in managing cancer in children, adolescents, and young adults (CAYAs), persistent complications may impact their quality of life. This study covers the morbidity and mortality, among CAYAs, with the aim to investigate the influence of socioeconomic factors on outcomes. Methods This retrospective matched cohort study included the entire Swedish population of individuals under 25 with cancer 1958 - 2021. The population was identified from the Cancer Register, and controls were paired 1:5 based on age, sex, and residence. Multiple registers provided data on morbidity, mortality, and demographics. Findings This survey covering 63 years, identified 65,173 CAYAs and matched controls, a total of 378,108 individuals (74% females). CAYAs exhibited a 3.04 -times higher risk for subsequent cancer (Odds ratio (OR) 95% confidence interval (CI) 2.92 - 3.17, p < 0.0001), a 1.23 -times higher risk for cardiovascular disease (OR 95% CI 1.20 - 1.26, p < 0.0001), and a 1.41 -times higher risk for external affliction (OR 95% CI 1.34 - 1.49, p < 0.0001). CAYAs had a higher mortality hazard, and after adjusting for socioeconomic factors, males, individuals born outside Europe, and those with greater sick -leave had a higher association with mortality, while education and marriage showed a beneficial association. Interpretation The Rebuc study, showed an increased risk for serious complications among young cancer patients in Sweden. Patient -specific variables, demographics, and socioeconomic factors influenced mortality. These results underscore the impact of cancer on the health and lifespan of young individuals and the necessity for further research to address socioeconomic disparities in cancer care.
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