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Demmelmaier, Ingrid
Publications (10 of 27) Show all publications
Johnsson, A., Demmelmaier, I., Sjövall, K., Wagner, P., Olsson, H. & Tornberg, Å. B. (2019). A single exercise session improves side-effects of chemotherapy in women with breast cancer: an observational study. BMC Cancer, 19, Article ID 1073.
Open this publication in new window or tab >>A single exercise session improves side-effects of chemotherapy in women with breast cancer: an observational study
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2019 (English)In: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 19, article id 1073Article in journal (Refereed) Published
Abstract [en]

Background: To measure changes in four common chemotherapy related side-effects (low energy, stress, nausea and pain) immediately after a single exercise session within the first week after treatment.

Methods: Thirty-eight patients with chemotherapy-treated breast cancer, participating in a multi-centre randomised controlled study, the Physical Training and Cancer study (Phys-Can) were included in this sub-study. The Phys-Can intervention included endurance and resistance training. Before and after a single training session (endurance or resistance) within the first week of chemotherapy, energy and stress were measured with the Stress-Energy Questionnaire during Leisure Time, and nausea and pain were assessed using a Visual Analog Scale 0-10. Paired t-tests were performed to analyse the changes, and linear regression was used to analyse associations with potential predictors.

Results: Thirty-eight participants performed 26 endurance training sessions and 31 resistance training sessions in the first week after chemotherapy. Energy and nausea improved significantly after endurance training, and energy, stress and nausea improved significantly after resistance training. Energy increased (p = 0.03 and 0.001) and nausea decreased (p = 0.006 and 0.034) immediately after a single session of endurance or resistance training, and stress decreased (p = 0.014) after resistance exercise.

Conclusions: Both endurance and resistance training were followed by an immediate improvement of common chemotherapy-related side-effects in patients with breast cancer. Patients should be encouraged to exercise even if they suffer from fatigue or nausea during chemotherapy.

Place, publisher, year, edition, pages
BMC, 2019
Keywords
Acute exercise, Breast cancer, Chemotherapy, Side-effects
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-398019 (URN)10.1186/s12885-019-6310-0 (DOI)000495640000013 ()31703567 (PubMedID)
Funder
Swedish Cancer SocietyRegion Skåne
Available from: 2019-12-04 Created: 2019-12-04 Last updated: 2019-12-04Bibliographically approved
Mazzoni, A.-S., Carlsson, M., Berntsen, S., Nordin, K. & Demmelmaier, I. (2019). "Finding my own motivation" - A Mixed Methods Study of Exercise and Behaviour Change Support During Oncological Treatment. International Journal of Behavioral Medicine, 26(5), 499-511
Open this publication in new window or tab >>"Finding my own motivation" - A Mixed Methods Study of Exercise and Behaviour Change Support During Oncological Treatment
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2019 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 26, no 5, p. 499-511Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Exercising during oncological treatment is beneficial but challenging for persons with cancer and may require strategies to increase motivation. Behaviour change support, including specific behaviour change techniques (BCTs), have been used to facilitate exercise in persons undergoing oncological treatment, but more detailed knowledge from an individual perspective is needed to inform clinical practice. The aims were to explore the motivational experiences of exercise combined with behaviour change support, and to describe how specific BCTs were valued among persons exercising during oncological treatment. METHODS: A mixed-methods study was conducted using semi-structured interviews (n = 18) and a questionnaire (n = 229). Participants with breast, colorectal or prostate cancer who completed or dropped out of a six-month exercise programme during oncological treatment were included. The interviews were analysed with thematic analysis and the questionnaire with descriptive statistics (median and interquartile range). RESULTS: The participants underwent a motivational process through the exercise programme. By experiencing 'Health gains and mastery', 'Learning', 'Affinity', 'Commitment', and 'Managing challenges', they found incentives that fostered feelings of autonomy, competence and relatedness, leading to an increased motivation to exercise. Social support from coaches, structuring the physical environment with scheduled sessions, self-monitoring with resistance training log, and feedback based on heart rate monitor and fitness tests were the most valued BCTs. CONCLUSIONS: The results indicate the importance of finding incentives and creating an environment that fosters autonomy, competence and relatedness to motivate persons to exercise during oncological treatment. Some BCTs appear particularly useful and may be used by health professionals to increase patients' motivation to exercise.

Keywords
Behaviour change techniques, Cancer, Incentives, Physical activity, Qualitative research, Self-determination theory
National Category
Cancer and Oncology Physiotherapy
Identifiers
urn:nbn:se:uu:diva-392500 (URN)10.1007/s12529-019-09809-z (DOI)000489300800006 ()31441015 (PubMedID)
Funder
Swedish Cancer Society, 15 0841Swedish Research Council, 521-2013-2734
Available from: 2019-09-05 Created: 2019-09-05 Last updated: 2019-11-06Bibliographically approved
Emilson, C., Demmelmaier, I., Bergman, S., Pettersson, S. & Åsenlöf, P. (2018). Concurrent Validity and Stability of Subgroup Assignment to Three Levels of Pain Condition Severity in Patients With Musculoskeletal Pain. Paper presented at Congress of the European-League-Against-Rheumatism (EULAR), JUN 13-16, 2018, Amsterdam, NETHERLANDS. Annals of the Rheumatic Diseases, 77, 1835-1835
Open this publication in new window or tab >>Concurrent Validity and Stability of Subgroup Assignment to Three Levels of Pain Condition Severity in Patients With Musculoskeletal Pain
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2018 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, p. 1835-1835Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-368671 (URN)10.1136/annrheumdis-2018-eular.7207 (DOI)000444351005504 ()
Conference
Congress of the European-League-Against-Rheumatism (EULAR), JUN 13-16, 2018, Amsterdam, NETHERLANDS
Funder
Swedish Rheumatism Association
Available from: 2018-12-06 Created: 2018-12-06 Last updated: 2018-12-06Bibliographically approved
Demmelmaier, I. & Iversen, M. D. (2018). How Are Behavioral Theories Used in Interventions to Promote Physical Activity in Rheumatoid Arthritis?: A Systematic Review. Arthritis care & research, 70(2), 185-196
Open this publication in new window or tab >>How Are Behavioral Theories Used in Interventions to Promote Physical Activity in Rheumatoid Arthritis?: A Systematic Review
2018 (English)In: Arthritis care & research, ISSN 2151-464X, E-ISSN 2151-4658, Vol. 70, no 2, p. 185-196Article, review/survey (Refereed) Published
Abstract [en]

ObjectiveTo identify the use of behavioral theories in physical activity interventions in populations with rheumatoid arthritis (RA). MethodsThis review includes articles published in English between January 1, 1980 and November 8, 2015 in MEDLINE, Cochrane, and CINAHL, identified by a strategic literature search. Included studies were published in international peer-reviewed journals, mentioned theory, evaluated a physical activity intervention for adults with RA, and had 1 physical activity variable as the outcome. References and reviews were also checked. Two investigators independently selected articles and extracted data using a validated scale, the theory coding scheme. Additional extracted data included author, sample characteristics, study design, physical activity outcomes, intervention type and duration, and control group. ResultsA total of 245 articles were identified, 211 articles and references were screened, and 29 articles were reviewed. Of these, 18 were excluded, leaving 11 articles with 1,472 participants (75% women). Ten studies (91%) were randomized controlled trials, 8 (73%) assessed physical activity plus self-management, and 3 (27%) physical activity only. Program durations ranged from 5 weeks to 1 year. Eight studies (73%) used a single theory, 7 studies (64%) linked at least 1 intervention technique to theory, 2 studies (18%) analyzed mediating effects of theoretical constructs, and 5 studies (45%) discussed results in relation to theory. ConclusionFindings indicate that physical activity intervention studies claiming the use of behavioral theories use theory to a small extent. We suggest expanding theory use in design, evaluation, and interpretation of physical activity intervention results. Further, we recommend that future studies evaluate the most salient behavioral theories, interventions components, and delivery modes in RA populations.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-350108 (URN)10.1002/acr.23265 (DOI)000423517400003 ()28437600 (PubMedID)
Available from: 2018-05-07 Created: 2018-05-07 Last updated: 2018-05-07Bibliographically approved
Emilson, C., Demmelmaier, I., Bergman, S., Lindberg, P., Denison, E. & Åsenlöf, P. (2017). A 10-year follow-up of tailored behavioural medicine treatment and exercise-based physiotherapy in persistent musculoskeletal pain. Clinical Rehabilitation, 31(2), 186-196
Open this publication in new window or tab >>A 10-year follow-up of tailored behavioural medicine treatment and exercise-based physiotherapy in persistent musculoskeletal pain
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2017 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, no 2, p. 186-196Article in journal (Refereed) Published
Abstract [en]

Objective: To study the long-term outcomes of two interventions targeting patients with sub-acute and persistent pain in a primary care physiotherapy setting.

Design: A 10-year follow-up of a two-armed randomised controlled trial, initially including 97 participants.

Interventions: Tailored behavioural medicine treatment, applied in a physiotherapy context (experimental condition), and exercise-based physiotherapy (control condition). Main measures: Pain-related disability was the primary outcome. The maximum pain intensity, pain control, fear of movement, sickness-related absence (register data) and perceived benefit and confidence in coping with future pain problems were the secondary outcomes.

Results: Forty-three (44%) participants responded to the follow-up survey, 20 in the tailored behavioural medicine treatment group and 23 in the exercise-based physiotherapy group. The groups did not differ in terms of the change in the scores for the primary outcome (p=0.17) of pain-related disability between the experimental group (median: 2.5, Q1-Q3: -2.5-14.25), and the control group (median: 0, Q1-Q3: -5-6). Further, there were also no significant differences found for the secondary outcomes except for sickness-related absence, where the exercise-based physiotherapy group had more days of sickness-related absence three months before treatment (p= 0.02), and at the 10-year follow-up (p=0.03).

Discussion: The beneficial effects favouring tailored behavioural medicine treatment that observed post-treatment and at the two-year follow-up were not maintained 10 years after treatment.

Keywords
Chronic pain, behavioural medicine, primary care, physical exercise, long-term compliance
National Category
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-281461 (URN)10.1177/0269215516639356 (DOI)000394758500005 ()27009057 (PubMedID)
Funder
Swedish Rheumatism Association
Available from: 2016-03-24 Created: 2016-03-24 Last updated: 2017-08-22Bibliographically approved
Mazzoni, A.-S., Nordin, K., Berntsen, S., Demmelmaier, I. & Igelström, H. (2017). Comparison between logbook-reported and objectively-assessed physical activity and sedentary time in breast cancer patients: an agreement study. BMC sports science, medicine and rehabilitation, 9, Article ID 8.
Open this publication in new window or tab >>Comparison between logbook-reported and objectively-assessed physical activity and sedentary time in breast cancer patients: an agreement study
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2017 (English)In: BMC sports science, medicine and rehabilitation, ISSN 2052-1847, Vol. 9, article id 8Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Increasing physical activity (PA) and decreasing sedentary time (ST) have important health effects among breast cancer patients, a growing population group. PA and sedentary behaviors are complex multi-dimensional behaviors and are challenging to monitor accurately. To date few studies have compared self-reports and objective measurement in assessing PA and ST in women undergoing breast cancer treatments. The aim of the present study was to compare self-reports and objective measures for assessing daily time spent in moderate-intensity physical activity (MPA), vigorous-intensity physical activity (VPA) and ST in women undergoing breast cancer treatments.

METHODS: Baseline data from 65 women with breast cancer scheduled to undergo adjuvant treatment was included. Daily time spent in MPA, VPA and ST was assessed by a study-specific logbook and the SenseWear Armband mini (SWA). The level of agreement between the two measurement methods was then determined by performing Bland-Altman plots with limits of agreements, and calculating Spearman's rank correlation coefficients.

RESULTS: The mean difference between the logbook and SWA with limits of agreement was 14 (±102) minutes for MPA, 1 (±21) minute for VPA and -196 (±408) minutes for ST, respectively. The logbook reported an average of 34 and 50% higher values than the SWA for MPA and VPA, as well as an average of 27% lower values for ST (P < 0.05). The Spearman's rank correlation coefficients showed that the differences between the methods increased as the average amount of time spent in PA and ST increased (P < 0.01).

CONCLUSIONS: The results imply that the two measurement methods have limited agreement and cannot be used interchangeably.

Keywords
Activity monitor, Breast neoplasms, Exercise, Measurement accuracy, Sedentary lifestyle
National Category
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-319631 (URN)10.1186/s13102-017-0072-2 (DOI)000397925300001 ()28373907 (PubMedID)
Funder
Swedish Cancer Society, 15 0841Swedish Research Council, 521-2013-2734
Available from: 2017-04-06 Created: 2017-04-06 Last updated: 2017-04-13Bibliographically approved
Berntsen, S., Aaronson, N. K., Buffart, L., Börjeson, S., Demmelmaier, I., Hellbom, M., . . . Nordin, K. (2017). Design of a randomized controlled trial of physical training and cancer (Phys-Can) - the impact of exercise intensity on cancer related fatigue, quality of life and disease outcome. BMC Cancer, 17(1), Article ID 218.
Open this publication in new window or tab >>Design of a randomized controlled trial of physical training and cancer (Phys-Can) - the impact of exercise intensity on cancer related fatigue, quality of life and disease outcome
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2017 (English)In: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 17, no 1, article id 218Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cancer-related fatigue is a common problem in persons with cancer, influencing health-related quality of life and causing a considerable challenge to society. Current evidence supports the beneficial effects of physical exercise in reducing fatigue, but the results across studies are not consistent, especially in terms of exercise intensity. It is also unclear whether use of behaviour change techniques can further increase exercise adherence and maintain physical activity behaviour. This study will investigate whether exercise intensity affects fatigue and health related quality of life in persons undergoing adjuvant cancer treatment. In addition, to examine effects of exercise intensity on mood disturbance, adherence to oncological treatment, adverse effects from treatment, activities of daily living after treatment completion and return to work, and behaviour change techniques effect on exercise adherence. We will also investigate whether exercise intensity influences inflammatory markers and cytokines, and whether gene expressions following training serve as mediators for the effects of exercise on fatigue and health related quality of life.

METHODS/DESIGN: Six hundred newly diagnosed persons with breast, colorectal or prostate cancer undergoing adjuvant therapy will be randomized in a 2 × 2 factorial design to following conditions; A) individually tailored low-to-moderate intensity exercise with or without behaviour change techniques or B) individually tailored high intensity exercise with or without behaviour change techniques. The training consists of both resistance and endurance exercise sessions under the guidance of trained coaches. The primary outcomes, fatigue and health related quality of life, are measured by self-reports. Secondary outcomes include fitness, mood disturbance, adherence to the cancer treatment, adverse effects, return to activities of daily living after completed treatment, return to work as well as inflammatory markers, cytokines and gene expression.

DISCUSSION: The study will contribute to our understanding of the value of exercise and exercise intensity in reducing fatigue and improving health related quality of life and, potentially, clinical outcomes. The value of behaviour change techniques in terms of adherence to and maintenance of physical exercise behaviour in persons with cancer will be evaluated.

TRIAL REGISTRATION: NCT02473003 , October, 2014.

Keywords
Behaviour change techniques, Biological mechanism, Cancer, Fatigue, Physical exercise, Quality of life, Randomized controlled trial
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-319059 (URN)10.1186/s12885-017-3197-5 (DOI)000397448100002 ()28347291 (PubMedID)
Funder
Swedish Cancer Society, CAN 2012/621 CAN 2012/631 CAN 2015/414Swedish Research Council, K2014-99X
Available from: 2017-03-31 Created: 2017-03-31 Last updated: 2017-11-29Bibliographically approved
Igelström, H., Berntsen, S., Demmelmaier, I., Johansson, B. & Nordin, K. (2017). Exercise during and after curative oncological treatment: a mapping review. Physical Therapy Reviews, 22(3/4), 103-115
Open this publication in new window or tab >>Exercise during and after curative oncological treatment: a mapping review
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2017 (English)In: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 22, no 3/4, p. 103-115Article in journal (Refereed) Published
Abstract [en]

Background: By mapping the existing literature on exercise oncology, gaps in knowledge can be identified, and future directions for research can be pointed out.

Objectives: This review aimed to map diagnoses and outcome measures targeted in reviews and describe the effects on those outcomes. Further, the aim was to map exercise intervention characteristics being reviewed and the effects depending on these characteristics, and to discuss implications for future research.

Methods: A systematic search was performed in PubMed, Cinahl, PSYCHInfo, and Cochrane Library. Reviews including physical activity and exercise intervention trials in adult patients during or after curative oncological treatment were included. Reference lists were scanned in order to find additional relevant papers.

Results: Twenty-three reviews were included in the present study. The majority included mixed forms of cancers. Significant improvements were reported on physical fitness, cancer-related fatigue (CRF), health-related quality of life, physical function, psychological outcomes, lymphedema-related symptoms, biological markers, and physical activity level. Four reviews targeted time point for implementation of exercise intervention. There were slightly greater effects on CRF, physical fitness, and walking distance from implementation after completed treatment. Two reviews comparing exercise types reported superior effects from combinations of aerobic exercise and resistance training compared to aerobic or resistance training alone. One review targeted exercise intensity, and the results indicated a greater effect from moderately intense exercise compared to high intense exercise. One review assessed behaviour change techniques in exercise trials and suggested the use of programme goal-setting, self-monitoring, and generalization of behaviour to promote adoption and maintenance of exercise behaviour.

Conclusion: Exercise seems to be beneficial during and after curative oncological treatment in several types of cancer. A higher reporting of exercise intervention details is essential in future exercise intervention trials and there is still a need for large, randomized trials, especially in forms of cancer other than breast cancer.

National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:uu:diva-315747 (URN)10.1080/10833196.2016.1262109 (DOI)000414044200002 ()
Available from: 2017-02-20 Created: 2017-02-20 Last updated: 2018-03-22Bibliographically approved
Emilson, C., Åsenlöf, P., Pettersson, S., Bergman, S., Sandborgh, M., Martin, C. & Demmelmaier, I. (2016). Physical therapists' assessments, analyses and use of behavior change techniques in initial consultations on musculoskeletal pain: direct observations in primary health care. BMC Musculoskeletal Disorders, 17, Article ID 316.
Open this publication in new window or tab >>Physical therapists' assessments, analyses and use of behavior change techniques in initial consultations on musculoskeletal pain: direct observations in primary health care
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2016 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 17, article id 316Article in journal (Refereed) Published
Abstract [en]

Background: Behavioral medicine (BM) treatment is recommended to be implemented for pain management in physical therapy. Its implementation requires physical therapists (PTs), who are skilled at performing functional behavioral analyses based on physical, psychological and behavioral assessments. The purpose of the current study was to explore and describe PTs' assessments, analyses and their use of behavioral change techniques (BCTs) in initial consultations with patients who seek primary health care due to musculoskeletal pain. Methods: A descriptive and explorative research design was applied, using data from video recordings of 12 primary health care PTs. A deductive analysis was performed, based on a specific protocol with definitions of PTs' assessment of physical and psychological prognostic factors (red and yellow flags, respectively), analysis of the clinical problem, and use of BCTs. An additional inductive analysis was performed to identify and describe the variation in the PTs' clinical practice. Results: Red and yellow flags were assessed in a majority of the cases. Analyses were mainly based on biomedical assessments and none of the PTs performed functional behavioral analyses. All of the PTs used BCTs, mainly instruction and information, to facilitate physical activity and improved posture. The four most clinically relevant cases were selected to illustrate the variation in the PTs' clinical practice. The results are based on 12 experienced primary health care PTs in Sweden, limiting the generalizability to similar populations and settings. Conclusion: Red and yellow flags were assessed by PTs in the current study, but their interpretation and integration of the findings in analyses and treatment were incomplete, indicating a need of further strategies to implement behavioral medicine in Swedish primary health care physical therapy.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2016
National Category
Orthopaedics Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-319411 (URN)10.1186/s12891-016-1173-x (DOI)000395014000001 ()27464877 (PubMedID)
Funder
Swedish Rheumatism Association
Available from: 2017-04-04 Created: 2017-04-04 Last updated: 2018-01-13Bibliographically approved
Emilson, C., Åsenlöf, P., Pettersson, S., Bergman, S., Sandborgh, M., Martin, C. & Demmelmaier, I. (2016). Physical Therapists' Assessments, Analyses And Use Of Behavioral Change Techniques In Initial Consultations On Musculoskeletal Pain: Direct Observations In Primary Health Care. International Journal of Behavioral Medicine, 23, S187-S187
Open this publication in new window or tab >>Physical Therapists' Assessments, Analyses And Use Of Behavioral Change Techniques In Initial Consultations On Musculoskeletal Pain: Direct Observations In Primary Health Care
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2016 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, p. S187-S187Article in journal, Meeting abstract (Refereed) Published
National Category
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-313852 (URN)000388943400587 ()
Available from: 2017-01-26 Created: 2017-01-25 Last updated: 2017-11-29Bibliographically approved
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