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  • 1.
    Berntsen, Sveinung
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Aaronson, Neil K
    Buffart, Laurien
    Börjeson, Sussanne
    Demmelmaier, Ingrid
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Hellbom, Maria
    Hojman, Pernille
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Johansson, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Experimentell och klinisk onkologi.
    Pingel, Ronnie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Raastad, Truls
    Velikova, Galina
    Åsenlöf, P.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Nordin, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    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 outcome2017Ingår i: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 17, nr 1, artikel-id 218Artikel i tidskrift (Refereegranskat)
    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.

  • 2.
    Berntsen, Sveinung
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Hetlelid, Ken J.
    Henriksson, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Nordin, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Phys-Can Feasibility Study: Objectively Recorded Physical Activity in Cancer Patients2014Konferensbidrag (Övrigt vetenskapligt)
  • 3.
    Ekström, Magnus
    et al.
    Lund Univ, Fac Med, Resp Med & Allergol, Dept Clin Sci, Lund, Sweden;Blekinge Hosp, Dept Med, Karlskrona, Sweden.
    Bornefalk, Hans
    Hans Bornefalk AB, Vallentuna, Sweden.
    Sköld, Magnus
    Karolinska Inst, Dept Med Solna, Resp Med Unit, Stockholm, Sweden;Karolinska Inst, Ctr Mol Med, Stockholm, Sweden.
    Jansson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Blomberg, Anders
    Umea Univ, Publ Hlth & Clin Med, Umea, Sweden.
    Sandberg, Jacob
    Jamjo Primary Hlth Care Cent, Karlskrona, Sweden;Lund Univ, Dept Clin Sci, Lund, Sweden.
    Bornefalk Hermansson, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Åsenlöf: Fysioterapi.
    Sundh, Josefin
    Orebro Univ, Sch Med Sci, Dept Resp Med, Orebro, Sweden.
    Validation of the Swedish Multidimensional Dyspnea Profile (MDP) in outpatients with cardiorespiratory disease2019Ingår i: BMJ OPEN RESPIRATORY RESEARCH, ISSN 2052-4439, Vol. 6, nr 1, artikel-id UNSP e000381Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction Breathlessness is a cardinal symptom in cardiorespiratory disease. An instrument for measuring different aspects of breathlessness was recently developed, the Multidimensional Dyspnea Profile (MDP). This study aimed to validate the MDP in terms of the underlying factor structure, internal consistency, test-retest reliability and concurrent validity in Swedish outpatients with cardiorespiratory disease. Methods Outpatients with stable cardiorespiratory disease and breathlessness in daily life were recruited. Factor structure of MDP was analysed using confirmatory factor analysis; internal consistency was analysed using Cronbach's alpha; and test-retest reliability was analysed using intraclass correlation coefficients (ICCs) for patients with unchanged breathlessness between assessments (baseline, after 30-90 min and 2 weeks). Concurrent validity was evaluated using correlations with validated scales of breathlessness, anxiety, depression and health-related quality of life. Results In total, 182 outpatients with cardiorespiratory disease and breathlessness in daily life were included; 53.3% were women; main diagnoses were chronic obstructive pulmonary disease (24.7%), asthma (21.4%), heart failure (19.2%) and idiopathic pulmonary fibrosis (18.7%). The MDP total, immediate perception and emotional response scores, and individual item scores showed expected factor structure and acceptable measurement properties: internal consistency (Cronbach's alpha, range 0.80-0.93); test-retest reliability at 30-90 min and 2 weeks (ICC, range 0.67-0.91); and concurrent validity. There was no evidence of a learning effect. Findings were similar between diagnoses. Discussion MDP is a valid instrument for multidimensional measurement of breathlessness in Swedish outpatients across cardiorespiratory diseases.

  • 4.
    Henriksson, Anna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Arving, Cecilia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Johansson, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk psykologi i hälso- och sjukvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Experimentell och klinisk onkologi.
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Nordin, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Perceived barriers to and facilitators of being physically active during adjuvant cancer treatment2016Ingår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 99, nr 7, s. 1220-1226Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The aim was to describe cancer patients' perceived barriers and facilitators of physical activity during adjuvant cancer treatment.

    METHODS: Semi-structured focus group interviews were conducted with patients with breast cancer (n=9) and colorectal cancer (n=1) and prostate cancer (n=8) undergoing adjuvant cancer treatment. To capture perceived barriers and facilitators before starting treatment, individual interviews with women with breast cancer (n=5) were also conducted. 23 patients in total, were interviewed, and the transcribed interviews were analysed with qualitative content analysis.

    RESULTS: Three categories emerged: "Physical and emotional barriers"-addresses experiences of side-effects, co-morbid conditions and emotional barriers, preventing physical activity (PA). "Perspective and attitudes"-how self-efficacy, self-image, preference, concerns, expectations, experience and new perspective regarding one's health influencing PA. "Support and practicalities"-addresses needs of support and information and how practicalities could be a barrier to PA.

    CONCLUSIONS: Several barriers were side effects of oncological treatment, which can be alleviated by PA. Another barrier was concerns regarding safety of PA during treatment. Communicating benefits and safety of PA to cancer patients early as possible after diagnosis might be beneficial.

    PRACTICE IMPLICATIONS: Information about PA from health care staff should be given early after diagnosis and as a part of standard care.

  • 5.
    Henriksson, Anna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Arving, Cecilia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Johansson, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Nordin, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Phys-Can Feasibility Study: Perceived Barriers and Facilities to Exercise During Adjuvant Cancer Treatment2014Konferensbidrag (Övrigt vetenskapligt)
  • 6.
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Physical Activity and Eating Behaviour Changes in Patients with Obstructive Sleep Apnea Syndrome2013Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    This thesis aimed at developing and evaluating a tailored behavioural sleep medicine intervention for enhanced physical activity and healthy eating in patients with obstructive sleep apnea syndrome (OSAS) and overweight.

    Participants with moderate or severe OSAS (apnea-hypopnea index ≥15) and obesity (Studies I-II) or overweight (Studies III-IV), treated with continuous positive airway pressure (CPAP) (Studies I-II) or admitted to CPAP treatment (Studies III-IV), were recruited from the sleep clinic at Uppsala University Hospital, Sweden. Semi-structured individual interviews were analysed using qualitative content analysis (Study I). Data on moderate-to-vigorous physical activity (MVPA) and sedentary time were collected with three measurement methods and analysed regarding the level of measurement agreement (Study II). Potential disease-related and psychological correlates for the amount of MVPA, daily steps and sedentary time were explored using multiple linear regression (Study III). Physical activity and eating behaviour changes were examined after a six month behaviour change trial (Study IV). A tailored behavioural sleep medicine intervention targeting physical activity and healthy eating in combination with first- time CPAP treatment was compared with CPAP treatment and advice on the association between weight and OSAS.

    According to participants’ conceptions, a strong incentive is needed for a change in physical activity and bodily symptoms, external circumstances and thoughts and feelings influence physical activity engagement (Study I). Compared with accelerometry, the participants overestimated the level of MVPA and underestimated sedentary time when using self-reports (Study II). The participants spent 11 hours 45 minutes (71.6% of waking hours) while sedentary. Fear of movement contributed to the variation in steps and sedentary time. Body mass index was positively correlated to MVPA (Study III). The experimental group increased intake of fruit and fish and reduced more weight and waist circumference compared with controls. There were no changes in physical activity (Study IV).

    The novel tailored behavioural sleep medicine intervention combined with first-time CPAP facilitated eating behaviour change, with subsequent effects on anthropometrics, but it had no effects on physical activity and sedentary time. Fear of movement may be a salient determinant of sedentary time, which has to be further explored in this population. The results confirm sedentary being a construct necessary to separate from the lower end of a physical activity continuum and highlight the need of developing interventions targeting sedentary behaviours specifically.

    Delarbeten
    1. Physical activity in sleep apnea and obesity: personal incentives, challenges, and facilitators for success
    Öppna denna publikation i ny flik eller fönster >>Physical activity in sleep apnea and obesity: personal incentives, challenges, and facilitators for success
    Visa övriga...
    2012 (Engelska)Ingår i: Behavioural Sleep Medicine, ISSN 1540-2002, E-ISSN 1540-2010, Vol. 10, nr 2, s. 122-137Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background:

    Physical activity combined with changes in eating habits is recommended for weight reduction in obstructive sleep apnea (OSA). Studies of how to enhance such health behaviours in persons with OSA and obesity are scarce.

    Aim:

    To explore aspects associated with engagement in physical activity in individuals with OSA and obesity.

    Method:

    7 women and 8 men with moderate or severe OSA (apnea-hypopnea index >15) and obesity (mean BMI 38.2) were selected from the Sleep clinic at Uppsala University Hospital, Sweden. Using semi-structured interviews, following content areas were covered: 1) health perceptions and susceptibility, 2) outcome expectations, and 3) facilitating and hindering factors for physical activity. Transcribed data were analysed according to content analysis using researcher triangulation.

    Results:

    Two comprehensive themes evolved exploring influences on engagement: 1) Incentives strong enough, and 2) Facilitators for success and challenges to overcome. Five categories reflected the meaning of theme 1: Consequences of OSA and obesity, Reasons to devote oneself to physical activity, Perceived benefits, Perceived disadvantages, and Ambivalence. Three categories reflected theme 2: Cognitions, Context, and Disease and physical symptoms.

    Conclusion:

    What constitutes strong incentives to change seems crucial for the understanding of how physical activity is initiated and maintained. Identified challenges and facilitators concerned a broad spectrum of cognitions and contextual aspects and were not only related to disease and physical symptoms. Future interventions aiming at enhanced physical activity may benefit from integrating these aspects.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-153826 (URN)10.1080/15402002.2011.574763 (DOI)000304277100004 ()22468930 (PubMedID)
    Tillgänglig från: 2011-05-19 Skapad: 2011-05-19 Senast uppdaterad: 2017-12-11Bibliografiskt granskad
    2. Level of agreement between methods for measuring moderate-to-vigorous physical activity and sedentary time in people with obstructive sleep apnea and obesity
    Öppna denna publikation i ny flik eller fönster >>Level of agreement between methods for measuring moderate-to-vigorous physical activity and sedentary time in people with obstructive sleep apnea and obesity
    2013 (Engelska)Ingår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 93, nr 1, s. 50-59Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background

    There is ambiguity about what measures to use to best identify physical activity and sedentary behavior, and agreement between methods for measuring physical activity and sedentary behavior in people with obstructive sleep apnea syndrome (OSAS) and obesity has not been evaluated.

    Objective

    The objective of this study was to examine the level of agreement between an accelerometer and a self-report questionnaire (International Physical Activity Questionnaire [IPAQ]) or a logbook for measuring time spent on moderate to vigorous physical activity and time spent sedentary in people with OSAS and obesity.

    Design

    This prospective study was a psychometric evaluation of agreement between measurement methods.

    Methods

    Thirty-nine people who were obese (mean body mass index 36.1 kg/m2, SD=4.35) and had moderate to severe OSAS (apnea-hypopnea index of ≥15) were consecutively recruited from a sleep clinic in Sweden. All were treated with continuous positive airway pressure and were waiting for a follow-up sleep evaluation.

    Results

    Agreement between the measurement methods was limited. For physical activity, the mean difference between the accelerometer and the IPAQ was 47 minutes, and the mean difference between the accelerometer and the logbook was 32 minutes. Agreement was limited for sedentary time as well; the mean difference between the accelerometer and the IPAQ was 114 minutes, and the mean difference between the accelerometer and the logbook was 86 minutes.

    Limitations

    The small sample size may affect the interpretation and generalizability of the results.

    Conclusions

    The results imply that the methods cannot be used interchangeably. A combination of an accelerometer and a daily logbook seems to provide a detailed description of physical activity and sedentary behavior.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-181011 (URN)10.2522/ptj.20120123 (DOI)000313320400006 ()
    Tillgänglig från: 2012-09-14 Skapad: 2012-09-14 Senast uppdaterad: 2017-12-07Bibliografiskt granskad
    3. Physical activity and sedentary time in persons with obstructive sleep apnea and overweight enrolled in a randomized controlled trial for enhanced physical activity and healthy eating
    Öppna denna publikation i ny flik eller fönster >>Physical activity and sedentary time in persons with obstructive sleep apnea and overweight enrolled in a randomized controlled trial for enhanced physical activity and healthy eating
    2013 (Engelska)Ingår i: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 17, nr 4, s. 1257-1266Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background

    The aim of the study was to describe the amount of physical activity and sedentary time in patients with obstructive sleep apnea syndrome (OSAS) and overweight, and to explore potential disease-related and psychological correlates.

    Methods

    A descriptive and correlational study was performed. Prospective data of physical activity and sedentary time were collected through accelerometry, and a one-point measurement of body mass index (BMI), daytime sleepiness, exercise self-efficacy, fear of movement, and depressive symptoms. Seventy-three participants with overweight (mean BMI 35kg/m2 SD 5) and moderate/severe OSAS (Apnea-Hypopnea Index >15) were consecutively recruited. Multivariate associations were determined through multiple linear regression analysis.

    Results

    The participants took a daily average of 7734 (SD 3528) steps, spent an average of 77 (SD 54) minutes in moderate-to-vigorous physical activity (MVPA), and spent 11h 45 min (SD 2h 8 min) sedentary. BMI, daytime sleepiness, exercise self-efficacy, fear of movement, and depressive symptoms did not explain variance in MVPA or steps, but explained 22.9% of variance in sedentary time. In backward selection analysis, BMI contributed to the explanatory degree of MVPA with 9% whereas, fear of movement explained 6.3% of the variance in steps and 14.3% of the variance in sedentary time.

    Conclusions

    An important implication for future physical activity interventions is that both physical activity and sedentary behaviors should be targeted, and fear of movement may be an important determinant for change in patients with OSAS and overweight.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Forskningsämne
    Medicinsk vetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-197191 (URN)10.1007/s11325-013-0831-6 (DOI)000326928000020 ()
    Tillgänglig från: 2013-03-18 Skapad: 2013-03-18 Senast uppdaterad: 2017-12-06Bibliografiskt granskad
    4. Tailored behavioral medicine intervention for enhanced physical activity and healthy eating in patients with obstructive sleep apnea syndrome and overweight
    Öppna denna publikation i ny flik eller fönster >>Tailored behavioral medicine intervention for enhanced physical activity and healthy eating in patients with obstructive sleep apnea syndrome and overweight
    2014 (Engelska)Ingår i: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 18, nr 3, s. 655-668Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    This study aims to evaluate the effects on physical activity (PA) and eating behavior (EB) of a tailored behavioral medicine intervention and first-time continuous positive airway pressure (CPAP) treatment compared with first-time CPAP treatment and advice in patients with obstructive sleep apnea syndrome (OSAS) and overweight. Seventy-three patients (mean +/- SD, 55 +/- 12 years) with overweight (body mass index (BMI), 34.5 +/- 4.8) and moderate or severe OSAS (Apnea-Hypopnea Index, 41.7 +/- 20.9) scheduled for CPAP prescription were randomized to a control group (CPAP and advice on the association between weight and OSAS) or an experimental group (CPAP and a 6-month behavioral medicine intervention targeting PA and EB). At baseline and after 6 months, eating behavior (food frequency screening and Dutch Eating Behavior Questionnaire), weight, BMI, and waist circumference were assessed at one point, while PA and sedentary time were measured with accelerometry during 4 days. The experimental group reduced 2.1 kg (+/- 4.6) in weight and 3 cm (+/- 4.9) in waist circumference, significantly more than the control group. At 6 months, the experimental group ate more fruit and fish/shellfish than the control group. Low and moderate to vigorous PA did not change over time either within or between groups. Regarding BMI, steps, and sedentary time, there were within-group differences but no differences between groups. The behavioral medicine intervention did not change physical activity but facilitated changes in EB in patients with OSAS and overweight. The amount of weight loss and reduction in waist circumference favored the participants receiving this treatment. Since the strategies for achieving behavioral changes were tailored according to the individual's goals and personal functional behavioral analyses and progressed slowly in a graded manner, it might require higher PA quotas or a period longer than 6 months to reveal a behavioral change of larger proportions.

    Nationell ämneskategori
    Lungmedicin och allergi Neurologi
    Forskningsämne
    Medicinsk vetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-197593 (URN)10.1007/s11325-013-0929-x (DOI)000341820300026 ()
    Anmärkning

    Correction in: Sleep and Breathing, May 2015, Volume 19, Issue 2, p 753

    DOI: 10.1007/s11325-015-1147-5

    Tillgänglig från: 2013-03-29 Skapad: 2013-03-29 Senast uppdaterad: 2017-12-06Bibliografiskt granskad
  • 7.
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Physical Activity and Sedentary Time in Sleep Apnea and Obesity2014Ingår i: Modulation of sleep by obesity, diabetes, age, and diet / [ed] Ronald Watson, Waltham, Massachusetts: Academic Press, 2014, s. 297-301Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [en]

    This chapter comprises a review of physical activity and sedentary time among persons with obstructive sleep apnea syndrome (OSAS) and/or obesity. Different correlates of these behaviors are described and a discussion is offered regarding behavior change techniques for enhanced physical activity. Through increased energy expenditure, physical activity has a vital role in weight reduction. Additionally, regardless of weight change, physical activity reduces the risk of life-threatening diseases and there are promising results pointing to positive effects of physical activity on OSAS severity. Thus, physical activity and sedentary time are highly relevant to be addressed in the treatment of OSAS and obesity. Attending to an individual's prerequisites and strengthening self-efficacy, self-management, and self-regulation might encourage a behavior change in physical activity and sedentary time.

  • 8.
    Igelström, Helena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Berntsen, Sveinung
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom. Univ Agder, Dept Publ Hlth Sport & Nutr, Kristiansand, Norway.
    Demmelmaier, Ingrid
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Johansson, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Experimentell och klinisk onkologi.
    Nordin, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom. Univ Agder, Dept Publ Hlth Sport & Nutr, Kristiansand, Norway.
    Exercise during and after curative oncological treatment: a mapping review2017Ingår i: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 22, nr 3/4, s. 103-115Artikel i tidskrift (Refereegranskat)
    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.

  • 9.
    Igelström, Helena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Berntsen, Sveinung
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Hetlelid, Ken
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Demmelmaier, Ingrid
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Henriksson, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Arving, Cecilia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Johansson, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för onkologi.
    Nordin, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Phys-Can feasibility Study: Preparing for Physical Training and Behavioral Medicine Strategies2014Konferensbidrag (Övrigt vetenskapligt)
  • 10.
    Igelström, Helena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Emtner, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Lindberg, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Level of agreement between methods for measuring moderate-to-vigorous physical activity and sedentary time in people with obstructive sleep apnea and obesity2013Ingår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 93, nr 1, s. 50-59Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    There is ambiguity about what measures to use to best identify physical activity and sedentary behavior, and agreement between methods for measuring physical activity and sedentary behavior in people with obstructive sleep apnea syndrome (OSAS) and obesity has not been evaluated.

    Objective

    The objective of this study was to examine the level of agreement between an accelerometer and a self-report questionnaire (International Physical Activity Questionnaire [IPAQ]) or a logbook for measuring time spent on moderate to vigorous physical activity and time spent sedentary in people with OSAS and obesity.

    Design

    This prospective study was a psychometric evaluation of agreement between measurement methods.

    Methods

    Thirty-nine people who were obese (mean body mass index 36.1 kg/m2, SD=4.35) and had moderate to severe OSAS (apnea-hypopnea index of ≥15) were consecutively recruited from a sleep clinic in Sweden. All were treated with continuous positive airway pressure and were waiting for a follow-up sleep evaluation.

    Results

    Agreement between the measurement methods was limited. For physical activity, the mean difference between the accelerometer and the IPAQ was 47 minutes, and the mean difference between the accelerometer and the logbook was 32 minutes. Agreement was limited for sedentary time as well; the mean difference between the accelerometer and the IPAQ was 114 minutes, and the mean difference between the accelerometer and the logbook was 86 minutes.

    Limitations

    The small sample size may affect the interpretation and generalizability of the results.

    Conclusions

    The results imply that the methods cannot be used interchangeably. A combination of an accelerometer and a daily logbook seems to provide a detailed description of physical activity and sedentary behavior.

  • 11.
    Igelström, Helena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Emtner, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Lindberg, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Physical activity and sedentary time in persons with obstructive sleep apnea and overweight enrolled in a randomized controlled trial for enhanced physical activity and healthy eating2013Ingår i: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 17, nr 4, s. 1257-1266Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The aim of the study was to describe the amount of physical activity and sedentary time in patients with obstructive sleep apnea syndrome (OSAS) and overweight, and to explore potential disease-related and psychological correlates.

    Methods

    A descriptive and correlational study was performed. Prospective data of physical activity and sedentary time were collected through accelerometry, and a one-point measurement of body mass index (BMI), daytime sleepiness, exercise self-efficacy, fear of movement, and depressive symptoms. Seventy-three participants with overweight (mean BMI 35kg/m2 SD 5) and moderate/severe OSAS (Apnea-Hypopnea Index >15) were consecutively recruited. Multivariate associations were determined through multiple linear regression analysis.

    Results

    The participants took a daily average of 7734 (SD 3528) steps, spent an average of 77 (SD 54) minutes in moderate-to-vigorous physical activity (MVPA), and spent 11h 45 min (SD 2h 8 min) sedentary. BMI, daytime sleepiness, exercise self-efficacy, fear of movement, and depressive symptoms did not explain variance in MVPA or steps, but explained 22.9% of variance in sedentary time. In backward selection analysis, BMI contributed to the explanatory degree of MVPA with 9% whereas, fear of movement explained 6.3% of the variance in steps and 14.3% of the variance in sedentary time.

    Conclusions

    An important implication for future physical activity interventions is that both physical activity and sedentary behaviors should be targeted, and fear of movement may be an important determinant for change in patients with OSAS and overweight.

  • 12.
    Igelström, Helena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Emtner, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Lindberg, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Tailored behavioral medicine intervention for enhanced physical activity and healthy eating in patients with obstructive sleep apnea syndrome and overweight2014Ingår i: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 18, nr 3, s. 655-668Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aims to evaluate the effects on physical activity (PA) and eating behavior (EB) of a tailored behavioral medicine intervention and first-time continuous positive airway pressure (CPAP) treatment compared with first-time CPAP treatment and advice in patients with obstructive sleep apnea syndrome (OSAS) and overweight. Seventy-three patients (mean +/- SD, 55 +/- 12 years) with overweight (body mass index (BMI), 34.5 +/- 4.8) and moderate or severe OSAS (Apnea-Hypopnea Index, 41.7 +/- 20.9) scheduled for CPAP prescription were randomized to a control group (CPAP and advice on the association between weight and OSAS) or an experimental group (CPAP and a 6-month behavioral medicine intervention targeting PA and EB). At baseline and after 6 months, eating behavior (food frequency screening and Dutch Eating Behavior Questionnaire), weight, BMI, and waist circumference were assessed at one point, while PA and sedentary time were measured with accelerometry during 4 days. The experimental group reduced 2.1 kg (+/- 4.6) in weight and 3 cm (+/- 4.9) in waist circumference, significantly more than the control group. At 6 months, the experimental group ate more fruit and fish/shellfish than the control group. Low and moderate to vigorous PA did not change over time either within or between groups. Regarding BMI, steps, and sedentary time, there were within-group differences but no differences between groups. The behavioral medicine intervention did not change physical activity but facilitated changes in EB in patients with OSAS and overweight. The amount of weight loss and reduction in waist circumference favored the participants receiving this treatment. Since the strategies for achieving behavioral changes were tailored according to the individual's goals and personal functional behavioral analyses and progressed slowly in a graded manner, it might require higher PA quotas or a period longer than 6 months to reveal a behavioral change of larger proportions.

  • 13.
    Igelström, Helena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Martin, Cathrin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik. Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Fakulteten för utbildningsvetenskaper, Institutionen för pedagogik, didaktik och utbildningsstudier.
    Emtner, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Lindberg, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Physical activity in sleep apnea and obesity: personal incentives, challenges, and facilitators for success2012Ingår i: Behavioural Sleep Medicine, ISSN 1540-2002, E-ISSN 1540-2010, Vol. 10, nr 2, s. 122-137Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Physical activity combined with changes in eating habits is recommended for weight reduction in obstructive sleep apnea (OSA). Studies of how to enhance such health behaviours in persons with OSA and obesity are scarce.

    Aim:

    To explore aspects associated with engagement in physical activity in individuals with OSA and obesity.

    Method:

    7 women and 8 men with moderate or severe OSA (apnea-hypopnea index >15) and obesity (mean BMI 38.2) were selected from the Sleep clinic at Uppsala University Hospital, Sweden. Using semi-structured interviews, following content areas were covered: 1) health perceptions and susceptibility, 2) outcome expectations, and 3) facilitating and hindering factors for physical activity. Transcribed data were analysed according to content analysis using researcher triangulation.

    Results:

    Two comprehensive themes evolved exploring influences on engagement: 1) Incentives strong enough, and 2) Facilitators for success and challenges to overcome. Five categories reflected the meaning of theme 1: Consequences of OSA and obesity, Reasons to devote oneself to physical activity, Perceived benefits, Perceived disadvantages, and Ambivalence. Three categories reflected theme 2: Cognitions, Context, and Disease and physical symptoms.

    Conclusion:

    What constitutes strong incentives to change seems crucial for the understanding of how physical activity is initiated and maintained. Identified challenges and facilitators concerned a broad spectrum of cognitions and contextual aspects and were not only related to disease and physical symptoms. Future interventions aiming at enhanced physical activity may benefit from integrating these aspects.

  • 14.
    Igelström, Helena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Emtner, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Lindberg, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Improvement in obstructive sleep apnea after a tailored behavioural sleep medicine intervention targeting healthy eating and physical activity: a randomised controlled trial2018Ingår i: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 22, nr 3, s. 653-661Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: The aim of the present single-centre randomised controlled trial was to assess the effect of a behavioural sleep medicine (BSM) intervention on obstructive sleep apnea (OSA) severity in patients who have been referred for new treatment with continuous positive airway pressure (CPAP).

    METHODS: After baseline assessment including ventilatory and anthropometric parameters, and physical activity monitoring, 86 patients who were overweight (BMI ≥ 25) and had moderate-severe OSA with apnea-hypopnea index (AHI) ≥ 15 were randomised into a control group (CG; CPAP and advice about weight loss) or an experimental group (ExpG; CPAP and BSM intervention targeting physical activity and eating behaviour). The BSM intervention comprised 10 individual sessions with a dietician and a physiotherapist and included behaviour change techniques such as goal setting and self-monitoring. After 6 months, a new recording of ventilatory parameters was performed without CPAP.

    RESULTS: In ExpG, 40% (n = 14) had improved from severe to moderate or mild OSA or from moderate to mild OSA compared to 16.7% in CG (n = 6, p = 0.02). Further, a lower AHI and amount body fat at baseline were correlated with improvement in severity class. Being in ExpG implied a mean improvement in AHI by 9.7 and an odds ratio of 4.5 for improving in severity classification.

    CONCLUSIONS: The results highlight the clinical importance of lifestyle modifications in conjunction with CPAP treatment in patients with OSA.

  • 15.
    Mazzoni, Anne-Sophie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Nordin, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom. Univ Agder, Fac Hlth & Sport Sci, Dept Publ Hlth Sport & Nutr, Box 422, NO-4604 Kristiansand, Norway..
    Berntsen, Sveinung
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom. Univ Agder, Fac Hlth & Sport Sci, Dept Publ Hlth Sport & Nutr, Box 422, NO-4604 Kristiansand, Norway..
    Demmelmaier, Ingrid
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Comparison between logbook-reported and objectively-assessed physical activity and sedentary time in breast cancer patients: an agreement study2017Ingår i: BMC sports science, medicine and rehabilitation, ISSN 2052-1847, Vol. 9, artikel-id 8Artikel i tidskrift (Refereegranskat)
    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.

  • 16.
    Paivandy, Aida
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi.
    Sandelin, Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Landelius, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Thoraxkirurgi.
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Melo, Fabio R.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi.
    Pejler, Gunnar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden.
    Induction of Human Lung Mast Cell Apoptosis by Granule Permeabilization: A Novel Approach for Targeting Mast Cells2017Ingår i: Frontiers in Immunology, ISSN 1664-3224, E-ISSN 1664-3224, Vol. 8, artikel-id 1645Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Mast cells are implicated as detrimental players in inflammatory lung diseases, particularly asthma. Mast cells respond to activating stimuli by releasing a wide panel of pro-inflammatory compounds that can contribute profoundly to the pathology, and there is currently an unmet need for strategies that efficiently ameliorate harmful effects of mast cells under such conditions. Here, we sought to evaluate a novel concept for targeting human lung mast cells, by assessing the possibility of selectively depleting the lung mast cells by induction of apoptosis. For this purpose, we used lysosomotropic agents, i.e., compounds that are known to permeabilize the secretory granules of mast cells, thereby releasing the contents of the granules into the cytosol. Either intact human lung tissue, purified human lung mast cells or mixed populations of human lung cells were incubated with the lysosomotropic agents mefloquine or siramesine, followed by measurement of apoptosis, reactive oxygen species (ROS) production, and release of cytokines. We show that human lung mast cells were highly susceptible to apoptosis induced by this strategy, whereas other cell populations of the lung were largely refractory. Moreover, we demonstrate that apoptosis induced by this mode is dependent on the production of ROS and that the treatment of lung tissue with lysosomotropic agents causes a decrease in the release of pathogenic cytokines. We conclude that selective apoptosis of human lung mast cells can be accomplished by administration of lysosomotropic agents, thus introducing the possibility of using such drugs as novel therapeutics in the treatment of inflammatory lung disorders such as asthma.

  • 17.
    Palm, Andreas
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Berne, Christian
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk diabetologi och metabolism.
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Lindberg, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    The Impact of Continuous Positive Airway Pressure on Circulating IGF-1 in Patients With Obstructive Sleep Apnea2018Ingår i: Journal of Clinical Sleep Medicine (JCSM), ISSN 1550-9389, E-ISSN 1550-9397, s. 385-391Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study Objectives: Obstructive sleep apnea (OSA) is a disease with metabolic and cardiovascular consequences and is associated with decreased serum concentrations of insulin-like growth factor-1 (IGF-1). The aim of this study was to investigate whether continuous positive airway pressure (CPAP) will increase serum IGF-1 concentration in patients with OSA. Methods: Patients with moderate to severe OSA were recruited from a sleep clinic and serum IGF-1 was measured before initiation of CPAP and at follow-up after 4.8 +/- 2.5 months. Patients adherent to CPAP treatment (usage >= 4 h/night) were compared with those considered to be nonadherent (usage < 4 h/night). Results: Complete data were obtained from 69 patients (86% male, age 56 +/- 12 years, respiratory event index 43 +/- 21 events/h, Epworth Sleepiness Scale score 12 +/- 5). In those adherent to CPAP (n = 42), there was an increase in serum IGF-1 concentration with 21.1 (95% confidence interval [CI]: 13.1 to 29.2) mu g/L compared to 4.7 (95% CI: -4.1 to 13.5) mu g/L in the nonadherent group (n = 27) (P =.0083). In a linear multivariate model adjusting for sex, age, body mass index, respiratory event index, and mean oxygen saturation during the night recording, the change in serum IGF-1 concentration was significantly associated with adherence to CPAP treatment (adjusted beta coefficient: 21.8, 95% CI: 10.2 to 33.4) and inversely associated with change in body mass index (adjusted beta coefficient: -7.1, 95% CI: -11.3 to -3.0) and change in hemoglobin A1c (adjusted beta coefficient: -1.8, 95% CI: - 33 to -0.3). Conclusions: CPAP usage >= 4 h/night is associated with increased serum IGF-1 concentration in male patients with OSA.

  • 18.
    Spörndly-Nees, Sören
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Theorell-Haglöw, Jenny
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Svensson, Malin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Lindberg, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Leisure-time physical activity predicts complaints of snoring in women: a prospective cohort study over 10 years2014Ingår i: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 15, nr 4, s. 415-421Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    We aimed to assess the impact of self-reported physical activity on incidence and remission of snoring complaints in women.

    Methods

    A population-based sample of 4851 women aged >20 years responded to questionnaires in years 2000 and 2010. Based on the responses, the women were categorized into low, medium, or high level of physical activity at baseline and at follow-up.

    Results

    The prevalence of habitual snoring complaints increased from 7.6% at baseline to 9.2% in 2010 (P<.0001). After adjusting for age, body mass index (BMI), waist and neck circumference, weight gain, smoking status, alcohol dependence, and snoring status at baseline, reported physical activity level at baseline had a protective effect on habitual snoring complaints at follow-up. The adjusted odds ratio (OR) (95% confidence intervals]) for complaints of habitual snoring was 0.7 (0.5–0.9) for the reported medium physical activity level and 0.5 (0.4–0.8) for the high activity level. When subdividing the population by changes in reported physical activity level over the follow-up period, an increase in physical activity was followed by a decrease in the complaint of snoring. Similarly a high level of reported physical activity only had a protective effect on snoring in participants who remained at a high or medium level.

    Conclusions

    A low level of self-reported physical activity is a risk factor for future habitual snoring complaints in women, independent of weight, weight gain, alcohol dependence, and smoking. Increased physical activity can modify the risk.

  • 19.
    Spörndly-Nees, Søren
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Lindberg, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Martin, Cathrin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Facilitators and barriers for eating behaviour changes in obstructive sleep apnoea and obesity: a qualitative content analysis2013Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 1, s. 74-81Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose:

    Obesity is a major risk factor for obstructive sleep apnoea syndrome, a condition known causing lack of sleep continuity and daytime sleepiness. Weight loss interventions are recommended, however knowledge on what facilitate and impede eating behaviour change is lacking for this particular population. The aim of this study was to identify personal conceptions of prerequisites for eating behaviour change.

    Method:

    A qualitative study on 15 patients with obstructive sleep apnoea syndrome (OSAS; apnoea-hypopnoea index >15) and obesity (Mean body mass index 38.2). Semi-structured interviews were conducted and data were transcribed and analysed using qualitative content analysis with researcher triangulation for trustworthiness.

    Results:

    Data were organised according to barriers and facilitators for changing eating behaviour. Identified barriers were desire and reward, cravings and emotional control, low self-confidence, insufficient support, taxing behaviours, cost, lack of knowledge about healthy eating strategies, perceived helplessness and low susceptibility. Identified facilitators were positive expectations, fear of negative consequences, experience of success, support and follow-up, accessibility, applied skills for healthy eating, personal involvement and challenged self-image.

    Conclusion:

    This study adds knowledge on important barriers and facilitators of eating behaviour change according to individuals with obesity and OSAS. Information used to inform a tailored behavioural medicine intervention targeting eating behaviours. Implications for Rehabilitation Patients with obstructive sleep apnoea syndrome (OSAS) benefit from weight loss and eating behaviour changes are recommended. Patients' views on prerequisites for eating behaviour change are important to plan, conduct and tailor behaviour change interventions. These aspects have hitherto not been elaborated in patients with OSAS. Considerations on patient's self-image and perceived susceptibility along with providing strategies for controlling the desire and rewarding feeling associated with eating are emphasised.

  • 20.
    Sundh, Josefin
    et al.
    Orebro Univ, Sch Med Sci, Fac Med & Hlth, Dept Resp Med, Orebro, Sweden.
    Bornefalk, Hans
    Hans Bornefalk AB, Vallentuna, Sweden.
    Skold, Carl Magnus
    Karolinska Inst, Dept Med Solna, Resp Med Unit, Stockholm, Sweden;Karolinska Inst, Ctr Mol Med, Stockholm, Sweden.
    Jansson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Blomberg, Anders
    Umea Univ, Unit Med, Dept Publ Hlth & Clin Med, Umea, Sweden.
    Sandberg, Jacob
    Lund Univ, Fac Med, Dept Clin Sci, Resp Med & Allergol, Lund, Sweden;Lund Univ, Dept Clin Sci, Lund, Sweden.
    Bornefalk Hermansson, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Åsenlöf: Fysioterapi.
    Ekstrom, Magnus
    Lund Univ, Fac Med, Dept Clin Sci, Resp Med & Allergol, Lund, Sweden.
    Clinical validation of the Swedish version of Dyspnoea-12 instrument in outpatients with cardiorespiratory disease2019Ingår i: BMJ OPEN RESPIRATORY RESEARCH, ISSN 2052-4439, Vol. 6, nr 1, artikel-id UNSP e000418Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction Breathlessness is the cardinal symptom in both cardiac and respiratory diseases, and includes multiple dimensions. The multidimensional instrument Dyspnoea-12 has been developed to assess both physical and affective components of breathlessness. This study aimed to perform a clinical validation of the Swedish version of Dyspnoea-12 in outpatients with cardiorespiratory disease. Methods Stable outpatients with cardiorespiratory disease and self-reported breathlessness in daily life were recruited from five Swedish centres. Assessments of Dyspnoea-12 were performed at baseline, after 30-90 min and after 2 weeks. Factor structure was tested using confirmatory factor analysis and internal consistency using Cronbach's alpha. Test-retest reliability was analysed using intraclass correlation coefficients (ICCs). Concurrent validity at baseline was evaluated by examining correlations with lung function and several instruments for the assessment of symptoms and health status. Results In total, 182 patients were included: with the mean age of 69 years and 53% women. The main causes of breathlessness were chronic obstructive pulmonary disease (COPD; 25%), asthma (21%), heart failure (19%) and idiopathic pulmonary fibrosis (19%). Factor analysis confirmed the expected underlying two-component structure with two subdomains. The Dyspnoea-12 total score, physical subdomain score and affective subdomain scores showed high internal consistency (Cronbach's alpha 0.94, 0.84 and 0.80, respectively) and acceptable reliability after 2 weeks (ICC total scores 0.81, 0.79 and 0.73). Dyspnoea-12 showed concurrent validity with the instruments modified Medical Research Council scale, COPD Assessment Test, European Quality of Life-Five Dimensions-Five levels, the Functional Assessment of Chronic Illness Therapy-Fatigue, the Hospital Anxiety and Depression Scale, and with forced expiratory volume in 1 s in percentage of predicted value. The results were consistent across different cardiorespiratory conditions. Conclusion The Dyspnoea-12 is a valid instrument for multidimensional assessment of breathlessness in Swedish patients with cardiorespiratory diseases.

  • 21.
    Willman, Maria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Martin, Cathrin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Experiencens with CPAP treatment in patients with obstructive sleep apnea syndrome and obesity2012Ingår i: European Journal of Physiotherapy, ISSN 2167-9169, Vol. 14, nr 4, s. 166-174Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective:

    Continuous positive airway pressure (CPAP) is the fi rst treatment of choice for obstructive sleep apnea syndrome (OSAS). However, adherence rates are low with no clear consensus on causes. Behavioral support strategies are needed, which is an evolving arena for physiotherapists within sleep medicine. The purpose of this study was to describe patients ’ experiences of CPAP treatment in obese individuals with moderate to severe OSAS.

    Methods:

    A qualitative content analysis was employed. Fifteen participants were consecutively selected. Data were collected by semi-structured interviews.

    Results:

    Experiences were described and structured according to three themes: (1) coming to terms with wearing CPAP; (2) getting a new life; and (3) being restricted in everyday life.

    Conclusion:

    A focus on incentives for regular CPAP use is important when supporting the use of a device that has almost as many disadvantages as advantages. Positive and negative reinforcers may receive greater attention when tailoring behavioral support for initiation and maintenance of CPAP. The potential of involving spouses and signifi cant others to reinforce self-management behaviors needs further studies.

  • 22.
    Åsenlöf, Pernilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi. Uppsala Univ, Uppsala, Sweden.
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi. Uppsala Univ, Uppsala, Sweden.
    Sandborgh, Maria
    Malardalen Univ, Vasteras, Sweden.
    Fritz, Johanna
    Malardalen Univ, Vasteras, Sweden.
    Integration of Physiotherapy in Behavioral Medicine Intervention Research2018Ingår i: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 25, s. S3-S3Artikel i tidskrift (Övrigt vetenskapligt)
1 - 22 av 22
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