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Aims Exergaming is a new tool to increase physical activity. This study aimed to determine the effects of access to a home‐based exergame (Nintendo Wii) in patients with heart failure (HF) on exercise capacity, self‐reported physical activity and patient‐reported outcome measures. Methods and results We enrolled 605 HF patients in New York Heart Association functional class I–IV, independent of ejection fraction, in an international multicentre randomized controlled trial. Patients were randomized to exergame (intervention) or motivational support (control). The primary endpoint was change in submaximal aerobic exercise capacity as measured by the distance walked in 6 min (6MWT) between baseline and 3 months. Secondary endpoints included long‐term submaximal aerobic exercise capacity, muscle function, self‐reported physical activity, exercise motivation, exercise self‐efficacy at 3, 6 and 12 months. At baseline, patients on average walked 403 ± 142 m on the 6MWT. Patients in the exergame group walked further compared to controls at 3 months (454 ± 123 vs. 420 ± 127 m, P = 0.005), at 6 months (452 ± 123 vs. 426 ± 133 m, P = 0.015) and 12 months (456 ± 122 vs. 420 ± 135 m, P = 0.004). However, correcting for baseline 6MWT values by means of a linear mixed‐effects model revealed no main effect for the intervention on 6MWT. Small significant effects on muscle function were found. Statistically significant treatment effects were found for muscle function but after correction for baseline and confounders, only the treatment effect for the heel‐rise left at 6 months was significant (P < 0.05). No treatment effect was found for exercise motivation, exercise self‐efficacy, or self‐reported physical activity. Conclusion Exergaming was safe and feasible in patients with HF with different profiles in different health care systems, cultures and climates. However, it was not effective in improving outcomes on submaximal aerobic exercise capacity. Subgroup analysis did not iden

Introduction: Heart failure (HF) in combination with multiple chronic conditions is increasing rapidly, mainly in the elderly. Self-care is presumed to be one of the best practices for chronic illness including HF. Most of HF-related costs are attributed to hospitalizations with poor HF selfcare as an important cause. The complexity of self-care leads to poor adherence to self-care. Mobile health (mHealth) and the use of technology has the possibility to support persons with HF and families to engage in self-care. Other strategies for improving self-care can be physical activities, known to improve cardiorespiratory and muscular fitness/strength, functional health, maintained cognitive function, reduction of anxiety and depression together with improved self-esteem. Self-care with yoga may be an alternative to exercise training and increase quality of life. Aim: The overall aim of this thesis was to describe experiences and evaluate the effects of innovative self-care approaches such as the mHealth system and yoga among persons with heart failure. Methods: The thesis is based on four studies using both quantitative and qualitative methods. Study I and II used an RCT design with follow-up assessment after three and six months including 82 persons with heart failure. The control group received care as usual. Data was collected using questionnaires before and after tree and six months to determine the long-term effects on selfcare, HRQoL, knowledge and hospitalization (I, II). To evaluate the experiences from the mHealth system a qualitative study with interviews where performed including 17 persons in study III. Study IV was conducted as a RCT study with 40 persons with HF, receiving either hydrotherapy or yoga. Evaluation before and after three months included HRQoL, six-minute walk test, sit-to-stand test, clinical variables, anxiety and depression. Results: The mHealth intervention resulted in improved self-care, HRQoL and reduction in hospitalization days after bo

Klättring som utförs på överhängande ytor blir allt vanligare och kräver mer avancerad användning av underkroppen. Då tidigare forskning i synnerhet undersökt överkroppsstyrka saknas en muskulär profilering av underkroppen hos klättrare vilket således var syftet med denna studie. Frågeställningarna eftersträvade att undersöka om skillnader i styrka och power i nedre extremiteter kan relateras till prestation hos manliga klättrare. Deltagarna var 10 manliga amatörklättrare som delades in i 2 grupper baserat på idrottsspecifik prestationsnivå. Grupp 1 (n=6) kategoriserades som avancerade klättrare och grupp 2 (n=4) som moderata. Ett isokinetiskt styrketest och två olika hopptester genomfördes av samtliga studiedeltagare. Efter statistisk analys framgick det att det inte fanns några signifikanta skillnader (p= 0,05) mellan grupperna gällande relativ styrka i quadriceps, relativ styrka i hamstrings, H/Q-kvot, hopphöjd vid SJ eller hopphöjd vid CMJ. Gruppen med mer avancerade klättrare presterade signifikant högre vid CMJ kontra SJ (p=0,013). Slutsatserna av denna studie är att klättrare har förhållandevis låga resultat både vid mätning av H/Q-kvot vid 90°/s (grupp 1: 51% vs. grupp 2: 53,9%), 210°/s (59,4% vs. 57,9%) och vid vertikala hopptester (SJ: 32,1cm vs. 31,7cm; CMJ: 35,8 cm vs. 33,9 cm) samt att hoppteknik verkar kunna vara en bidragande faktor för prestation inom klättring., Rock climbing performed on overhanging surfaces is becoming more common and requires more advanced use of the lower body. Since previous research has mostly examined upper body strength there is a need for a muscular profiling of the lower body of climbers, which was the purpose of this study. The study sought to investigate whether differences in strength and power in the lower extremities can be related to climbing performance in male climbers. The participants were 10 male amateur climbers divided into two groups based on athletes-specific performance level. Group 1 (n=6) where categorized as advanced climbers and group 2 (n=4) as moderate. An isokinetic strength test and two different jump tests were performed by all study participants. After statistical analysis, there were no significant differences (p= 0,05) between the groups in relative strength in the quadriceps, relative strength in hamstrings, H/Q-ratio, jump height at SJ or jump height at CMJ. The group with more advanced climbers performed significantly higher at CMJ versus SJ (p = 0.013). The conclusions of this study are that climbers have relatively low results when measuring H/Q-ratio at 90°/s (group 1: 51% vs. group 2: 53,9%), 210°/s (59,4% vs. 57,9%) and height at vertical jump tests (SJ: 32,1cm vs. 31,7cm; CMJ: 35,8 cm vs. 33,9 cm) and that jump technique seems to be a contributing factor in climbing performance.