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- Bendrik, Regina, et al.
(author)
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Follow-up of individualised physical activity on prescription and individualised advice in patients with hip or knee osteoarthritis : A randomised controlled trial.
- 2024
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In: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 38:6, s. 770-782
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Compare the long-term effects of two different individualised physical activity interventions in hip or knee osteoarthritis patients.DESIGN: Randomised, assessor-blinded, controlled trial.SETTING: Primary care.SUBJECTS: Patients with clinically verified hip or knee osteoarthritis, <150 min/week with moderate or vigorous physical activity, aged 40-74.INTERVENTION: The advice group (n = 69) received a 1-h information and goalsetting session for individualised physical activity. The prescription group (n = 72) received information, goalsetting, individualised written prescription, self-monitoring, and four follow-ups.MAIN MEASURES: Physical activity, physical function, pain and quality of life at baseline, 6, 12 and 24 months.RESULTS: There were only minor differences in outcomes between the two groups. For self-reported physical activity, the advice group had improved from a mean of 102 (95% CI 74-130) minutes/week at baseline to 214 (95% CI 183-245) minutes/week at 24 months, while the prescription group had improved from 130 (95% CI 103-157) to 176 (95% CI 145-207) minutes/week (p = 0.01 between groups). Number of steps/day decreased by -514 (95% CI -567-462) steps from baseline to 24 months in the advice group, and the decrease in the prescription group was -852 (95% CI -900-804) steps (p = 0.415 between groups). Pain (HOOS/KOOS) in the advice group had improved by 7.9 points (95% CI 7.5-8.2) and in the prescription group by 14.7 points (95% CI 14.3-15.1) from baseline to 24 months (p = 0.024 between groups).CONCLUSIONS: There is no evidence that individualised physical activity on prescription differs from individualised advice in improving long-term effects in patients with hip or knee osteoarthritis.
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| 3. |
- Bendrik, Regina, et al.
(author)
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One leg testing in hip and knee osteoarthritis : A comparison with a two-leg oriented functional outcome measure and self-reported functional measures.
- 2024
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In: Osteoarthritis and Cartilage. - : Elsevier. - 1063-4584 .- 1522-9653. ; 32:7, s. 937-942
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To compare the responsiveness of two unilateral lower-limb performance-based tests, the one-leg rise test and the maximal step-up test, with the bilateral 30-second chair-stand test and the self-reported measure of physical function (HOOS/KOOS). Specific aims were to evaluate responsiveness, floor/ceiling effect and association between the instruments.METHOD: Data was included from 111 participants, mean age 61.3 years (8.3), with clinically verified hip or knee osteoarthritis, who reported less than 150 minutes/week of moderate or vigorous intensity physical activity. Responsiveness, how well the instruments captured improvements, was measured as Cohen's standardised mean difference for effect size, and was assessed from baseline to 12 months following a physical activity intervention. Other assessments were floor and ceiling effects, and correlations between tests.RESULTS: The maximal step-up test had an effect size of 0.57 (95% CI 0.37, 0.77), the 30-second chair-stand 0.48 (95% CI 0.29, 0.68) and the one-leg rise test 0.12 (95% CI 0.60, 0.31). The one-leg rise test had a floor effect as 72% of the participants scored zero at baseline and 63% at 12 months. The correlation between performance-based tests and questionnaires was considered to be minor (r = 0.188 to 0.226) (p = 0.018 to 0.048).CONCLUSION: The unilateral maximal step-up test seems more responsive to change in physical function compared to the bilateral 30-second chair-stand test, although the tests did not differ statistically in effect size. The maximal step-up test provides specific information about each leg for the individual and allows for comparison between the legs.
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| 5. |
- Gustavsson, Catharina, et al.
(author)
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What is required to facilitate implementation of Swedish physical activity on prescription? - interview study with primary healthcare staff and management
- 2018
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In: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 18:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: The method, Swedish Physical Activity on Prescription (SPAP), has been launched in Swedish healthcare to promote physical activity for prevention and treatment of lifestyle related health disorders. Despite scientific support for the method, and education campaigns, it is used to a limited extent by health professionals. The aim of the study was to describe the views of health professionals on perceived facilitators, barriers and requirements for successful implementation of SPAP in primary healthcare.METHODS: Eighteen semi-structured interviews with stakeholders in SPAP, i.e. ten people working in local or central management and eight primary healthcare professionals in two regional healthcare organisations, were analysed using qualitative content analysis.RESULTS: We identified an overarching theme regarding requirements for successful implementation of SPAP: Need for knowledge and organisational support, comprising four main categories: Need for increased knowledge and affirmative attitude among health professionals; Need for clear and supportive management; Need for central supporting structures; Need for local supporting structures. Knowledge of the SPAP method content and core components was limited. Confidence in the method varied among health professionals. There was a discrepancy between the central organisation policy documents declaring that disease preventive methods were prioritised and a mandatory assignment, while the health professionals asked for increased interest, support and resources from management, primarily time and supporting structures. There were somewhat conflicting views between primary healthcare professionals and managers concerning perceived barriers and requirements. In contrast to some of the management's beliefs, all primary healthcare professionals undisputedly acknowledged the importance of promoting physical activity, but they lacked time, written routines and in some cases competence for SPAP counselling.CONCLUSION: The study provides knowledge regarding requirements to facilitate the implementation of SPAP in healthcare. There was limited knowledge among health professionals regarding core components of SPAP and how to practise the method, which speaks for in-depth training in the SPAP method. The findings highlight the importance of forming policies and guidelines and establishing organisational supporting structures, and ensuring that these are well known and approved in all parts of the healthcare organisation.
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| 9. |
- Kallings, Lena V, 1969-
(author)
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FaR® -Individanpassad skriftlig ordination av fysisk aktivitet.
- 2011
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Book (other academic/artistic)abstract
- Fysisk aktivitet på recept (FaR) är en metod för att främja fysisk aktivitet som utgår från hälso- och sjukvården. Detta är den första läroboken i ämnet och bokens syfte är att ge en samlad bild av FaR. Den samlade kunskapen syftar även till att stödja och underlätta implementering av metoden FaR. Läroboken har en bred målgrupp; studenter på hälso- och sjukvårdsutbildningar, utbildningar inom folkhälsovetenskap, hälsopedagogik, idrottslärare med flera. Boken vänder sig också till yrkesverksamma såsom hälso- och sjukvårdspersonal som förskriver FaR eller arbetar med implementering av metoden, aktivitetsarrangörer som stöttar individen till fysisk aktivitet och folkhälsoplanerare som arbetar med strukturerna för att implementera FaR. Givetvis vänder sig boken även till kursansvariga och lärare på relevanta utbildningar och kurser.
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| 11. |
- Kallings, Lena V, 1969-
(author)
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Fysisk aktivitet på recept – en underutnyttjad resurs
- 2012
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 109:51-52, s. 2348-50
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Journal article (peer-reviewed)abstract
- Fysik aktivitet på recept (FaR) är en effektiv metod för att främja fysisk aktivitet. FaR inkluderar rådgivande samtal, skriftlig ordination och uppföljning, vilket rekommenderas i Socialstyrelsens nya riktlinjer för sjukdomsförebyggande metoder.Drygt 49 000 FaR skrevs ut i Sverige under 2010 – en tredubbling sedan 2007.I genomsnitt förskrevs ca 5 FaR per 1 000 invånare, med en variation på 2–15 FaR per 1 000 invånare i olika landsting och regioner.Det förskrevs 0,8 (0,5–2) FaR per 1 000 besök inom hälso- och sjukvården, eller motsvarande 1,2 (0,5–3) FaR per 1 000 besök inom primärvården.Variationerna är stora mellan olika landsting/regioner, och FaR är en underutnyttjad resurs som behöver implementeras bättre.
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| 14. |
- Kallings, Lena V, 1969-, et al.
(author)
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Physical activity on prescription reduces sedentary behaviour for 6 months, without long term effect
- 2014
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Conference paper (peer-reviewed)abstract
- ObjectivesThere is a lack of knowledge regarding methods to reduce sedentary behaviour. The aim of this study was to evaluate the efficacy of physical activity on prescription (PAP) in patients with overweight and abdominal obesity. PAP decrease sitting time at 6-months follow-up in this population, and data is now further analysed to study the longterm effect.MethodsSix month randomised controlled study in 101 women and men (57% female, 67-68 year). All participants received a minimal intervention with brief general information on physical activity and measurement of PAL. The intervention group received in addition an individualized PAP that consisted of a patient centred counselling and a written agreement. Focus of the intervention was to reduce sedentary behaviour as well as to promote an increased PAL. Sedentary behaviour was assessed by questionnaire, the sitting item from IPAQ.ResultsBoth groups reduced sitting time from baseline to 6-months follow-up, intervention group by 114 min/day and control group by 86 min/day. However, the changes disappeared at the long term follow-ups (Figure). There were no significant differences between the groups at either time point.ConclusionsIt is possible to reduce sitting time in overweight individuals. An individualized prescription of physical activity reduces sedentary behaviour for 6 months, but had no long term effects. There was no significant better effect of PAP compared to a minimal intervention. Studies with more subjects and objective methods are needed.
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| 17. |
- Kallings, Lena V, 1969-
(author)
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The Swedish approach on physical activity on prescription
- 2016
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In: Clinical Health Promotion - research and best practice for patients, staff and community. - Bispebjerg : Clinical Health Promotion Centre. - 2226-5864. ; 6:Suppl 2, s. 31-33
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Journal article (other academic/artistic)
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| 20. |
- Olsson, Sven Johan Gustav, et al.
(author)
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Association of perceived physical health and physical fitness in two Swedish national samples from 1990 and 2015.
- 2018
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In: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 28:2, s. 717-724
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Journal article (peer-reviewed)abstract
- BACKGROUND: Perceived health and physical fitness have been shown to correlate, and low levels of either variable increase the risk for future illness and mortality. However, risk factors and their interrelationship may vary between societies and over time. In this study, the associations of physical fitness and perceived health were therefore assessed in two Swedish national samples 25 years apart.METHODS: Perceived physical health, dichotomized as "good" or "bad", maximal oxygen uptake (VO2 max), counter movement jump (CMJ), balance (one-legged 60 second stance), and self-reported demographics and lifestyle were recorded in two cross-sectional samples (sample size, number of eligible participants) of Swedish adults, aged 20 - 65 years, in 1990 - 1991 (2203, 1365), and 2013 - 2015 (3357, 422).RESULTS: The odds for good perceived physical health increased by 5% per mL · kg(-1) · min(-1) of VO2 max, 3% per cm CMJ height, and decreased by 4% per 1 time of overbalancing, in both samples. Mutually adjusted regression models showed that perceived physical health was best predicted by VO2 max and chronic illness in 1990 and by age, BMI, and educational level in 2015.CONCLUSION: Perceived physical health was related to physical fitness in two samples of Swedish adults from 1990 and 2015. However, multivariate, and mutually adjusted models, indicate that the most important covariates of perceived physical health may have changed from VO2 max and chronic illness in 1990, to age, BMI, and educational level in 2015. This article is protected by copyright. All rights reserved.
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| 21. |
- Sjögren, Per, et al.
(author)
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Functional changes in adipose tissue in a randomised controlled trial of physical activity
- 2012
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In: Lipids in Health and Disease. - 1476-511X. ; 11, s. 80-
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Journal article (peer-reviewed)abstract
- Background: A sedentary lifestyle predisposes to cardiometabolic diseases. Lifestyle changes such as increased physical activity improve a range of cardiometabolic risk factors. The objective of this study was to examine whether functional changes in adipose tissue were related to these improvements. Methods: Seventy-three sedentary, overweight (mean BMI 29.9 +/- 3.2 kg/m(2)) and abdominally obese, but otherwise healthy men and women (67.6 +/- 0.5 years) from a randomised controlled trial of physical activity on prescription over a 6-month period were included (control n = 43, intervention n = 30). Detailed examinations were carried out at baseline and at follow-up, including fasting blood samples, a comprehensive questionnaire and subcutaneous adipose tissue biopsies for fatty acid composition analysis (n = 73) and quantification of mRNA expression levels of 13 candidate genes (n = 51), including adiponectin, leptin and inflammatory cytokines. Results: At follow-up, the intervention group had a greater increase in exercise time (+ 137 min/week) and a greater decrease in body fat mass (-1.5 kg) compared to the control subjects (changes of 0 min/week and -0.5 kg respectively). Circulating concentrations of adiponectin were unchanged, but those of leptin decreased significantly more in the intervention group (-1.8 vs - 1.1 ng/mL for intervention vs control, P < 0.05). The w6-polyunsaturated fatty acid content, in particular linoleic acid (18:2w6), of adipose tissue increased significantly more in the intervention group, but the magnitude of the change was small (+ 0.17 vs + 0.02 percentage points for intervention vs control, P < 0.05). Surprisingly leptin mRNA levels in adipose tissue increased in the intervention group (+ 107% intervention vs -20% control, P < 0.05), but changes in expression of the remaining genes did not differ between the groups. Conclusions: After a 6-month period of increased physical activity in overweight elderly individuals, circulating leptin concentrations decreased despite increased levels of leptin mRNA in adipose tissue. Otherwise, only minor changes occurred in adipose tissue, although several improvements in metabolic parameters accompanied the modest increase in physical activity.
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