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Abstract Coronary artery disease (CAD) and type 2 diabetes (T2D) are associated with cardiovascular autonomic dysfunction, which is widely used as a predictor of mortality in cardiovascular diseases. The determinants of autonomic dysfunction in CAD patients with or without T2D are not well known. The aim of this thesis was to examine the determinants of cardiovascular autonomic function in healthy subjects and CAD patients with and without T2D. A second aim was to study the prognostic value of autonomic function in the patient population. A third aim was to study the effects of exercise prescriptions on physical activity and exercise capacity in the patient groups. The association between heart rate (HR) variability and physical activity was examined by means of 24-hour recordings in 45 healthy adults. The determinants and prognostic value of autonomic function, measured by HR recovery, HR variability, and HR turbulence, were assessed in 1060 CAD patients (50% were patients with T2D). Physical activity was measured before and after a six-month exercise prescription in 44 CAD patients without T2D and 39 CAD patients with T2D. In healthy patients, short-term HR variability indexes and the complexity properties of HR were influenced by physical activity, whereas long-term HR variability indexes remained relatively stable at various activity levels, making them robust indexes for assessment of autonomic function during ambulatory conditions. In CAD patients, exercise capacity was the most important determinant of autonomic function in addition to physical activity, age, presence of T2D, and left ventricular systolic function. During a 2-year follow-up, autonomic dysfunction predicted cardiovascular events only in CAD patients with T2D, but did not provide independent prognostic information after multivariate adjustment when high-sensitivity C-reactive protein, a marker of inflammation, remained as an independent predictor. CAD patients with T2D were physically less active than patients without T2D. Exercise prescription promoted a more active lifestyle and improved exercise capacity in both patient groups. In conclusion, cardiovascular autonomic dysfunction in CAD patients with and without T2D is closely related to low exercise capacity and physical activity, which both can be increased by exercise prescriptions. Autonomic dysfunction predicts short-term cardiovascular events only in CAD patients with T2D, but is not as strong an independent predictor as low-grade inflammation. / Tiivistelmä Autonomisen hermoston toiminnan häiriö on yleinen komplikaatio sepelvaltimotaudissa ja tyypin 2 diabeteksessa (T2D), ja sen tiedetään olevan itsenäinen kuolleisuutta ennustava tekijä. Autonomista säätelyä selittäviä tekijöitä ei kuitenkaan tunneta hyvin. Tässä tutkimuksessa selvitettiin autonomisen hermoston toimintaa selittäviä tekijöitä kolmessa ryhmässä: osa tutkittavista oli terveitä, osalla oli sepelvaltimotauti ja T2D, ja osalla pelkästään sepelvaltimotauti. Lisäksi tutkittiin, miten autonominen säätely vaikuttaa sepelvaltimotautipotilaiden ennusteeseen sekä miten liikuntaohjelma vaikuttaa heidän fyysiseen aktiivisuuteensa ja suorituskykyynsä. Sykevaihtelun ja fyysisen aktiivisuuden välistä yhteyttä selvittävään tutkimukseen osallistui 45 tervettä henkilöä. Autonomisen hermoston toimintaa selittäviä tekijöitä ja sen ennustearvoa tutkittiin 1060 sepelvaltimotautipotilaalta, joista puolet sairasti T2D:ta. Näistä potilaista valittiin satunnaisotannalla kuuden kuukauden liikuntaohjelmaan ja fyysisen aktiivisuuden mittauksiin 44 sepelvaltimotautipotilasta, joilla ei ollut T2D:ta, ja 39 potilasta, jotka sairastivat T2D:ta. Terveillä henkilöillä lyhyen aikavälin sykevaihtelumuuttujat olivat yhteydessä fyysiseen aktiivisuuteen, mutta pitkän aikavälin sykevaihtelumuuttujissa tätä yhteyttä ei havaittu. Sepelvaltimotautipotilailla vahvimmiksi autonomista säätelyä selittäviksi tekijöiksi osoittautuivat maksimaalinen suorituskyky, fyysinen aktiivisuus, ikä, T2D ja vasemman kammion ejektiofraktio. Poikkeava autonominen säätely ennusti sydän- ja verisuonitautitapahtumia kahden vuoden seurannan aikana vain T2D:ta sairastavilla sepelvaltimotautipotilailla, mutta sillä ei ollut itsenäistä ennustearvoa, kun vakioitiin muilla riskitekijöillä. Lopulta ainoa huonon ennusteen merkki oli tulehdustilaa kuvaava herkkä CRP. T2D:ta sairastavat sepelvaltimotautipotilaat olivat fyysisesti passiivisempia kuin pelkästään sepelvaltimotautia sairastavat. Yksilöllinen liikuntaohjelma lisäsi korkean intensiteetin fyysistä aktiivisuutta ja paransi suorituskykyä molemmissa potilasryhmissä. Tämän tutkimuksen tulokset osoittavat, että sepelvaltimotautipotilailla autonomisen hermoston toiminnan häiriö on yhteydessä vähäiseen fyysiseen aktiivisuuteen ja heikkoon fyysiseen kuntoon. Molempiin tekijöihin voidaan vaikuttaa positiivisesti liikuntaohjelmalla. Poikkeava autonominen säätely ennustaa lyhyen aikavälin sydän- ja verisuonitautitapahtumia vain T2D:ta sairastavilla sepelvaltimotautipotilailla. Se ei kuitenkaan ole yhtä vahva itsenäinen ennustaja kuin tulehdusta kuvaava herkkä CRP.

Abstract The dihydropyridine receptor (DHPR) in the skeletal muscle plasma membrane functions as a voltage sensor for excitation-contraction coupling. In the present work the expression and special features of DHPR were studied under various conditions. In order to localize and visualize the DHPRs, a method using fluorophore-conjugated dihydropyridine molecules as a probe was developed. In addition, different laboratory assays and electrophysiological measurements were used to study the expression of the myofibrillar proteins, force production of the muscle and conduction velocity of the plasma membrane. During the postnatal development of mouse skeletal muscle the density of DHPR increased. By the time of DHPR appearance, the expression of sodium channels had started and the typical assembly of basic structural components and membrane compartments was clearly detectable. According to the histochemical analysis, the DHPR was selectively expressed in type IIA muscle fibres of mouse. In addition to the fibre type specificity, the uneven distribution of DHPRs was also seen at the muscle level. The attenuation of the contraction force after addition of DHPR blocker was largest in muscles with a high percentage of type IIA fibres. In fish muscles, the distribution of DHPR was homogenous and the density between different fibre types was quite similar. In gastrocnemius muscle of mouse, the density and mRNA expression of DHPR increased significantly by 21.5 and 66.8%, respectively, after a 15-week aerobic exercise programme. The increase correlated significantly with the raise in % myosin heavy chain IIa isoform. In thigh and heart muscles, no significant changes were observed. In fish, the environmental change following hatchery release and downstream migration of 46.5 km induced an increase in the DHPR density in swimming muscles. Furthermore, a transition of phenotypic profile from fast-to-slow fibres was observed. Taken together, the present data provide evidence for the fact that the expression of DHPR increases during postnatal development. Moreover, the expression correlates with a specific fibre-type metabolism, thus having an impact on the overall contractile properties of the muscle. This is further manifested as an increase in the DHPR density after endurance training in mammalian as well as in fish muscle. In addition, a strong correlation exists between the level of muscle activity and the density of DHPR. / Tiivistelmä Poikkijuovaisen lihaksen solukalvolla esiintyvä dihydropyridiini (DHP) reseptori toimii jännitesensorina lihaksen ärsytys-supistus kytkennässä. Tässä työssä tutkittiin DHP reseptorin erityispiirteitä sekä erilaisten fysiologisten tekijöiden vaikutusta reseptorin ilmenemiseen. DHP reseptorien visualisointiin kehitettiin histologinen värjäysmenetelmä, jossa merkkiaineena toimi fluorofori-konjugoitu DHP molekyyli. Lisäksi työssä tutkittiin lihaksen proteiinien ekspressiota, lihaksen voimantuottoa sekä solukalvon johtonopeutta erilaisten määritysmenetelmien ja elektrofysiologisten mittausmenetelmien avulla. Tulokset osoittivat, että yksilönkehityksen aikana DHP reseptorien tiheys kasvoi hiiren poikkijuovaisessa lihaksessa. DHP reseptorien ekspression alkaessa natriumkanavat olivat jo ilmaantuneet solukalvolle ja lihassolun rakenne oli pitkälle erilaistunut. Histokemiallisten määritysten perusteella DHP reseptorin ekspressio oli selektiivistä. Reseptoreita esiintyi runsaimmin tyypin IIA soluissa. Reseptoriproteiinin solutyyppispesifisyys oli huomattavissa myös lihastasolla. Tulosten mukaan proteiinin salpaaja alensi lihaksen supistumisvoimaa erityisesti niissä hiiren lihaksissa, joiden solutyyppikoostumuksessa tyypillä IIA on suuri prosentuaalinen osuus. Kalan lihaksissa DHP reseptorit olivat homogeenisesti jakautuneet. Lisäksi reseptoritiheys oli samankaltainen eri solutyyppien välillä. 15 viikon aerobinen harjoittelu lisäsi sekä DHP reseptorin proteiini- että mRNA- ekspressiota tilastollisesti merkitsevästi (21,5 ja 66,8 %) hiiren kantalihaksessa. Ekspression kasvu korreloi merkitsevästi samanaikaisesti tapahtuneen myosiini isomuoto IIa määrän kasvun kanssa. Reisi- ja sydänlihaksessa merkittäviä muutoksia ei havaittu. Kalan uintilihaksissa DHP reseptorien tiheys kasvoi vapauttamisen jälkeisen ympäristön muutoksen ja 46,5 km pituisen vaelluksen jälkeen. Lisäksi lihasten solutyyppikoostumuksessa tapahtui muutos kohti hitaasti supistuvia solutyyppejä. Yhteenvetona voidaan todeta, että saatujen tulosten perusteella DHP reseptorien ekspressio kasvaa syntymän jälkeen hiiren poikkijuovaisessa lihaksessa. Solujen erilaistuessa ekspressio korreloi solutyyppimetabolian kanssa vaikuttaen edelleen lihaksen supistumisominaisuuksiin. Tästä johtuen myös kestävyysharjoittelun seurauksena DHP reseptorien määrä kasvaa sekä nisäkkään että kalan lihaksissa. Erityisesti lihaksen aktiivisuudella on merkitystä DHP reseptorin ekspressioon.

The present study aimed to examine how physical exertion influences cognitive performance.Orienteers (n = 23) competing at primarily a national to international level were recruited toparticipate. A randomised control trial using a cross-over research design required participantsto complete two trials measuring performance over a duration of 35 minutes. Specifically, inone trial participants undertook a cognitive testing protocol divided into five blocks comprisedof three separate cognitive tests that each lasted approximately one minute, between each testparticipants rested for one minute (i.e., one minute testing, followed by one minute resting fora duration of 35 minutes). The other trial required participants to complete the same cognitivetesting protocol whilst simultaneous completing a cycling time trial (i.e., aiming to cycle amaximum distance within the time of 35 minutes). Analyses revealed participants performedsignificantly worse on the cognitive tests whilst simultaneously completing the cycling timetrial. Upon closer scrutiny of the individual tests, designed to measure the cognitive functionsof decision-making, working memory, and updating, a similar trend in performance wasobserved although it was not found to be statistically significant. The findings of the presentstudy highlights implications for athletes, coaches, and sports psychologists in attempts tooptimise sport performance and minimize cognitive impairments during physical exertion. Thestudy supports the need for greater ecological validity in the investigation of cognitiveperformance in sport science research. The findings of the present study indicate that appliedsport psychology research may be enhanced by the use of research designs comprised ofcognitive tests that more closely replicate the cognitive demands of competition settings. / Denna studie syftade till att undersöka hur fysisk ansträngning påverkar kognitivprestation. Urvalet bestod av orienterare tävlandes på huvudsakligen nationell tillinternationell nivå (n = 23). Studien var en randomiserad korsstudie där deltagarna genomfördekognitiva tester vid två försökstillfällen på 35 minuter vardera. Under det ena försökstillfälletgenomförde deltagarna ett kognitivt testprotokoll, indelat i fem block innehållande tre testervardera, där varje test varade i ungefär en minut, följt av en minuts vila mellan testerna (dvs.en minuts testning, följt av en minuts vila med en varaktighet på 35 minuter). Det andraförsökstillfället bestod av att deltagarna genomförde samma kognitiva testprotokoll samtidigtsom de cyklade, med målet att komma så lågt som möjligt i distans under 35 minuter.Resultaten visade på signifikant lägre kognitiv prestation när deltagarna cyklade samtidigt.Genom närmare analys av varje enskilt test (som ämnade mäta de kognitiva funktionernabeslutsfattande, arbetsminne och uppdatering) hittades samma trend, men utan signifikans.Fynden kan vara av vikt för idrottare, tränare och idrottspsykologer i deras arbete för attoptimera prestation och minimera kognitiv försämring under fysisk ansträngning. De stödjeräven behovet av ekologisk validitet i studier ämnade att undersöka kognitiv prestation inomidrott. Vidare indikerar fynden att tillämpad idrottspsykologisk forskning kan förbättras genomatt använda en forskningsdesign innehållande kognitiva test som är mer jämförbara med dekognitiva utmaningar idrottare ställs inför under tävlingssammanhang.

This ethnographic observation exercise is a first recognition of Abancay Avenueas an urban space of practices and social communication. It seeks to understandthe relationship that subjects build among themselves and with their  environment. It starts out wondering who are the pedestrians of Abancay Avenue today? What social practices do those pedestrians set up today in there? What forms of communication do these pedestrians establish with each other? Positioning itself from the perspective of the territory as vital space, the author is placed like idle observer that wanders by the avenue. The results point to it as a practiced place that communicates from the combined action of its actors and the  social practices that they develop in it. Abancay Avenue is a cultural space where social life is articulated dialectically and daily, fostering horizontal dialogue, where modernity coexists with tradition, allowing it to be individualized, recognized and therefore continue to exist. / Este ejercicio de observación etnográfica es un primer reconocimiento de la avenida Abancay como espacio urbano de prácticas y comunicación social y busca comprender la relación que los sujetos construyen entre ellos y su entorno. Parte de preguntarse ¿quiénes son hoy los peatones de la avenida Abancay? ¿Qué prácticas sociales realizan esos peatones en ella? ¿Qué formas de comunicación establecen entre sí esos peatones? Desde la perspectiva del territorio como espacio vital, la autora se sitúa como observadora ociosa que deambula por la avenida. Los resultados señalan dicha avenida como un lugar practicado que comunica desde la acción combinada de sus actores y las prácticas sociales que estos desarrollan en ella. La avenida Abancay es un espacio cultural donde la vida social se articula dialéctica y cotidianamente, propiciando el diálogo horizontal, donde convive la  modernidad y la tradición, y le permite a esta individualizarse, reconocerse y, por ende, seguir existiendo.

El presente trabajo de investigación desarrolla el análisis de la viabilidad del proyecto Centro de Bienestar R.I.E., una empresa dedicada a brindar los servicios de clases virtuales de ejercicios y de relajación, dirigido exclusivamente para personas mayores de 60 años. Este proyecto pretende atender la necesidad del cuidado de la salud física y emocional del adulto mayor en nuestro país; quienes debido al contexto actual de la crisis sanitaria, generado por la pandemia del COVID-19, ha sido identificado como parte de la población vulnerable frente a este virus. Es así que, esta idea de negocio le brindará la opción a este segmento de contratar los servicios de clases virtuales, a través de membresías, para que desde la comodidad de su hogar puedan mantener una rutina física que los ayude a mantener un buen estado físico. En principio, el proyecto está dirigido al NSE A y B del segmento y que residen en Lima Metropolitana; sin embargo, se proyecta una expansión gradual a nivel nacional para el segundo año y tercer año de operaciones. De acuerdo con la investigación del mercado, la viabilidad del proyecto, según el análisis respectivo, presenta resultados favorables para los tres años de horizonte planteados, con una tasa de porcentaje de retorno de inversión, lo cual demuestra que el proyecto tiene grandes probabilidades de éxito. / This research work develops the analysis of the viability of the R.I.E. Wellness Center Project, a company dedicated to providing virtual exercise and relaxation lessons services, aimed exclusively for people over 60 years old. This project aims to meet the need for physical and emotional health care of the elderly in our country; who, due to the current context of the health crisis, generated by the COVID-19 pandemic, has been identified as part of the population vulnerable to this virus. Thus, this business idea will give this segment the option of hiring the services of virtual classes, through memberships, so that from the comfort of their home they can maintain a physical routine that helps them maintain a good physical condition. At the beginning of the project, the socioeconomic level is aimed at A and B of the segment who reside in Metropolitan Lima; however, a gradual expansion at the national level is projected for the second and third years of operations. According to market research, the viability of the project, according to the respective analysis, presents favorable results for the three-year horizon proposed, with a% rate of return on investment, which shows that the project has a high probability of success. / Trabajo de investigación

[ES] Las infusiones exógenas de insulina son vitales para las personas con diabetes tipo 1 para suplir parcialmente la incapacidad del páncreas de secretar insulina. Sin embargo, las terapias intensivas actuales pueden restringir la calidad de vida de los pacientes. Los pacientes con esta enfermedad tienen que tomar decisiones constantemente sobre las dosis de insulina que lleva a la glucosa a niveles seguros. Si no lo consiguen, pueden sufrir las complicaciones crónicas y agudas derivadas de los niveles anormalmente altos o bajos de glucosa. La regulación automática de glucosa con sistemas de páncreas artificial prometía reducir la carga del autocontrol de la enfermedad al mismo tiempo que se mejoraba el tiempo en normoglucemia y se reducía la variabilidad. Sin embargo, estas promesas sólo se han cumplido parcialmente. Aunque esta tecnología mejora el control glucémico que logran las terapias tradicionales, la ingesta de alimentos y la práctica de ejercicio limitan la eficiencia de los sistemas de páncreas artificial durante el día. De hecho, los sistemas comerciales sólo pueden hacerles frente con la ayuda de los pacientes. Para compensar las ingestas, los pacientes deben anunciar el contenido de carbohidratos al sistema. Para el ejercicio, deben anunciar el inicio de la actividad o tomar medidas preventivas como modificar la referencia de glucosa o reducir la basal con mucha antelación. Estas exigencias no sólo no ayudan a reducir la carga del paciente, sino que pueden comprometer la eficiencia del sistema cuando el paciente se equivoca al estimar los carbohidratos, omite el anuncio de la comida o no puede planificar el ejercicio. Así pues, esta tesis propone nuevos métodos para eliminar el anuncio de ingestas y ejercicio lo que ayudaría a reducir la intervención del paciente en los sistemas de páncreas artificial, y, en consecuencia, mejorar la calidad de vida. Desde un punto de vista de control, las ingestas y el ejercicio pueden considerarse perturbaciones. Esta tesis explota métodos de la literatura de rechazo de perturbaciones y acomodación de fallos para lograr el objetivo de la tesis. En concreto, hay que destacar tres aplicaciones: 1) se ha desarrollado un observador super-twisting para detectar comidas no anunciadas como primer paso para su compensación; 2) se ha diseñado un observador de modos deslizantes de primer orden para la estimación de la ratio de aparición de glucosa, la cual ha sido integrada en un generador de bolos para compensar las comidas; 3) se ha empleado el principio de diseño por modelo interno para mitigar el efecto de las ingestas de alimentos y ejercicio, añadiendo sugerencias de carbohidratos de rescate a la insulina. Como resultado, las contribuciones de esta tesis allanan el camino para el desarrollo de sistemas de páncreas artificial sin anuncios, que liberen al paciente de la carga de la gestión de la diabetes. / [CA] Les infusions exògenes d'insulina són vitals per a les persones amb diabetis tipus 1 per a suplir parcialment l'incapacitat del pàncrees de secretar insulina. No obstant, les teràpies intensives actuals poden restringir la qualitat de vida dels pacients. Les persones amb aquesta malaltia han de prendre decisions contínuament sobre la dosi d'insulina que fa que la glucosa estiga en valors segurs. Si no ho aconsegueixen, poden sofrir les complicacions cròniques i agudes derivades dels nivells anormalment alts o baixos de glucosa. La regulació automàtica de glucosa amb sistemes de pàncrees artificials prometia reduir la càrrega d'autocontrol de la malaltia al mateix temps que es millorava el temps en normoglucèmia i es reduïa la variabilitat. No obstant, aquestes promeses s'han complit només parcialment. Encara que aquesta tecnologia millora el control de la glucosa, la ingesta d'aliments i la pràctica d'exercici limiten l'eficiència dels sistemes de pàncrees artificials durant el dia. De fet, els sistemes comercials només poden fer-les front amb la ajuda dels pacients. Per a compensar les ingestes, el pacients han d'anunciar al sistema la quantitat de carbohidrats. Per al exercici, han d'anunciar l'inici de l'activitat o prendre mesures preventives com modificar la referència de glucosa o reduir la infusió basal d'insulina. Aquestes exigències no només no ajuden a reduir la càrrega al pacient, sinó que poden comprometre l'eficiència del sistema quan el pacient confon la estimació dels carbohidrats, omet l'anunciament de la ingesta o no pot planificar l'exercici. Així doncs, aquesta tesi proposa nous mètodes per a eliminar l'anunciament d'ingestes i exercici permetent reduir així la intervenció del pacient, i, en conseqüència, millorar la qualitat de vida. Des del punt de vista de control, les ingestes i el exercici poden considerar-se pertorbacions. Aquesta tesi explota mètodes de la literatura de rebuig de pertorbacions i acomodament de fallades. En particular, es destaquen tres aplicacions: 1) s'ha desenvolupat un observador super-twisting per a detectar ingestes no anunciades com a primer pas per a la seua compensació; 2) se ha dissenyat un observador de modes lliscants per a estimar el rati d'aparició de glucosa de la ingesta, el qual s'ha integrat en un generador de bols d'insulina per compensar les ingestes; 3) se ha empleat el principi de disseny per model intern per a mitigar l'efecte de les ingestes i exercici, incorporant recomanacions de carbohidrats a la insulina. Com a resultat, les contribucions d'aquesta tesi obren el camí per a desenvolupar sistemes de pàncrees artificial sense anunciaments, que alliberen al pacient de la càrrega de la gestió de la diabetis. / [EN] Exogenous insulin infusions are vital for people with type 1 diabetes to partially make up for the inability of the pancreas to secrete insulin. However, current intensive therapies may restrict patients' quality of life. People with this disease have to constantly make decisions about insulin doses to bring glucose levels to a safe range. If unsuccessful, they may suffer from chronic and acute complications related to abnormally high and low glucose values. The automatic regulation of glucose with artificial pancreas systems promised to reduce patients' self-control burdens while improving time in normoglycemia and decreasing variability. However, these promises are fulfilled only partially. Although this technology outperforms the glycemic outcomes achieved by conventional therapies, meal intake and physical activity limit its daytime performance. Indeed, commercially available systems only can handle them with the support of the patients. For meals, patients must announce the carbohydrate content to the system. For exercise, they must notify the activity or take preventive actions like changing glucose setpoint or decreasing basal well ahead before exercise. These demands do not help reduce the patient's burden. They even can compromise the system performance when the patient misestimates the carbohydrate content, omits the meal announcement, or cannot plan the exercise event. Hence, this thesis proposes new methods to eliminate the need for meal and exercise announcements, thus reducing patient intervention in artificial pancreas systems for a better quality of life. From a control perspective, meals and exercise can be regarded as disturbances; therefore, this thesis exploits methods from the disturbance rejection and fault accommodation literature to achieve the thesis goal. Specifically, the following three applications must be highlighted: 1) a super-twisting-based residual generator has been developed to detect unannounced meals as the first step to their compensations; 2) a sliding-mode disturbance observer has been designed to estimate the glucose meal appearance, which is fed into a bolusing algorithm to compensate the meals; 3) the internal model principle is employed to mitigate the effects of meal intakes and exercise, supplementing insulin infusions with carbohydrate recommendations. As a result, the contributions of this thesis pave the way for the development of announcement-free artificial pancreas systems, releasing patients from the burden of diabetes management. / This work was partially supported by: grant DPI2016-78831-C2-1-R funded by MCIN/AEI/10.13039/501100011033 and by “ERDF A way of making Europe”; grant PID2019-107722RB-C21 funded by MCIN/AEI/10.13039/501100011033; and grant ACIF/2017/021 funded by the Generalitat Valenciana through European Social Funds (FSE). Also, the grant BEFPI/2019/077, funded by the Generalitat Valenciana through FSE funds, supported a 7-month research stay at Physiological da University (Óbudai Egyetem, Óbuda, Budapest, Hungary) / Sala Mira, I. (2023). New Contributions Towards Meal and Exercise Announcement-Free Artificial Pancreas Systems [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/192684

The purpose of this study was to investigate the prevalence of exercise dependence, as well as conducting a re-evaluation of the Exercise Dependence Scale-Revised (EDS-R) through a confirmatory factor analysis. The study was based on three Swedish data collections (N = 1101), collected through online questionnaires answered by physically active adults. The study found a prevalence of exercise dependence between 3.6-9%, primary exercise dependence between 1.7-2.2%, and a prevalence of primary exercise dependence with anxiety management as motivation of 1.8% across the three data-collections. The confirmatory factor analysis revealed that the hypothesized 21-item 7-factor structure of the EDS-R contributed to a tolerable fit of data with good psychometric properties, although a poor factor loading of item 19 in the factor ‘Reduction in other activities’ was found. This study concludes that the EDS-R is a valid measurement of exercise dependence, but further research is needed to evaluate the relation between primary exercise dependence and anxiety management, as well as the construct validity of the individual items. / Syftet med denna studie var att undersöka prevalensen av träningsberoende, samt utföra en omvärdering av träningsberoendeskalan-reviderad (EDS-R) genom en konfirmatorisk faktoranalys. Studien baserades på tre svenska datakollektioner (N = 1101), insamlade genom online-enkäter besvarade av fysiskt aktiva vuxna. Studien fann en prevalens av träningsberoende mellan 3.6-9%, primärt träningsberoende mellan 1.7-2.2%, och en prevalens av primärt träningsberoende med ångesthantering som motivation på 1.8% över de tre datakollektionerna. Den konfirmatoriska faktoranalysen avslöjade att den hypotiserade 21-objekt 7-faktor strukturen av EDS-R bidrog till en tolerabel passform av data med goda psykometriska egenskaper, även om en dålig faktorladdning av objekt 19 i faktorn 'Reduktion i andra aktiviteter' hittades. Denna studie drar slutsatsen att EDS-R är ett giltigt mått på träningsberoende, men ytterligare forskning behövs för att utvärdera relationen mellan primärt träningsberoende och ångesthantering, samt konstruktionsvaliditeten för de enskilda objekten.

Träning och fysisk aktivitet har kommit att bli alltmer av en lärdom i en nutid och framtid som präglas av en allt mindre aktiv livsstil. Opinionen i rapporterade undersökningar och statistik visarpå en tydlig och permanent övergång till en mer flexibel och digital arbetsplats med mindre avsatt kontorstid i veckan. En lösning till problemet är användningen av en multifunktionell träningsmaskin för hemmabruk med möjlighet till träning som kan motsvara ett fulländat helkroppspass. En tydlig majoritet av studier och branschexperter hävdar att marknaden för hemmagym och träningsredskap för hemmabruk kommer att växa. Samtidigt är utbudet av träningsmaskiner påmarknaden för hemmabruk som möjliggör basövningar knapphändig. Projektets mål är att utveckla och konstruera en träningsmaskin som möjliggör effektiv belastande helkroppsträning. Produktutvecklingsprocessen utgörs av ett antal aktiviteter som utförs för att förstå, konstruera och marknadsföra produkter. Den tillämpade produktutvecklingsmetoden utgår från en hybrid av den allmänna produktutvecklingsprocessen enligt Ulrich och Eppinger samt projektmodellen somanvänds vid KTH Södertälje. Träningsmaskinen konstrueras med utgångspunkt i en kombination av ett så kallat power rack, en kubisk ram av stålbalkar som används vid skivstångsövningar, och en kabelmaskin tillämpad för att genomföra de sex vanligaste basövningarna för att uppnå en fullständig helkroppsträning. Ett antal befintliga lösningar på marknaden i kombination med en nyskapande talja implementeras föratt optimera och effektivisera såväl träningen som hemmabruk. Träningsmaskinen lämpar sig som såväl ett substitut som komplement till fria vikter samtidigt som stabiliteten och användarvänligheten förekommande hos kommersiella träningsmaskiner tas tillvara. Slutligen presenteras träningsmaskinen som en prototyp vars avsikt är att påvisa genomförbarheten med denna typ av utformning av träningsmaskin. / Exercise and physical activity have become more of an achieved knowledge in a present and future that is characterized by an increasingly less active lifestyle. The reported trend in surveys shows adistinct and permanent transition to a more flexible and digital workplace with less weekly office hours. One solution to the problem is the use of a multifunctional exercise machine for home use with the possibility of exercise that correspond to a full body workout. A clear majority of studies and experts claim that the market for home gyms and equipment will continue to grow. At the same time, the availability of multifunctional exercise machines on the market for home usage that utilizes compound exercises is scarce. The goal of the project is to develop and design an exercise machine that enables effective whole bodytraining. The product development process consists of several activities that are performed to understand, design and market products. The applied product development method is based on a hybrid of the general product development process according to Ulrich and Eppinger and the project course model used at KTH Södertälje. The exercise machine is designed based on a combination of a power rack, a cubical cage made of steel beams that is used for barbell exercises, and cable machine applied to perform the six most common basic exercises to achieve a complete full body workout. Several existing solutions onthe market in combination with an innovative hoist are implemented to optimize and streamline both training and home use. The exercise machine is suitable as both a substitute and a complement to free weights, while at the same time taking advantage of the stability and user-friendliness of commercial exercise machines. Finally, the exercise machine is presented as a prototype whose intention is to demonstrate the feasibility of this type of exercise machine design.

Il primo studio ha verificato l'affidabilità del software Polimedicus e gli effetti indotti d'allenamento arobico all’intensità del FatMax. 16 soggetti sovrappeso, di circa 40-55anni, sono stati arruolati e sottoposti a un test incrementale fino a raggiungere un RER di 0,95, e da quel momento il carico è stato aumentato di 1 km/ h ogni minuto fino a esaurimento. Successivamente, è stato verificato se i valori estrapolati dal programma erano quelli che si possono verificare durante a un test a carico costante di 1ora. I soggetti dopo 8 settimane di allenamento hanno fatto un altro test incrementale. Il dati hanno mostrato che Polimedicus non è molto affidabile, soprattutto l'HR. Nel secondo studio è stato sviluppato un nuovo programma, Inca, ed i risultati sono stati confrontati con i dati ottenuti dal primo studio con Polimedicus. I risultati finali hanno mostrato che Inca è più affidabile. Nel terzo studio, abbiamo voluto verificare l'esattezza del calcolo del FatMax con Inca e il test FATmaxwork. 25 soggetti in sovrappeso, tra 40-55 anni, sono stati arruolati e sottoposti al FATmaxwork test. Successivamente, è stato verificato se i valori estrapolati da INCA erano quelli che possono verificarsi durante un carico di prova costante di un'ora. L'analisi ha mostrato una precisione del calcolo della FatMax durante il carico di lavoro. Conclusione: E’ emersa una certa difficoltà nel determinare questo parametro, sia per la variabilità inter-individuale che intra-individuale. In futuro bisognerà migliorare INCA per ottenere protocolli di allenamento ancora più validi. / The most important treatment to prevent conditions such as being overweight and obesity, is regular exercise which increases daily energy expenditure and consumption of lipids. Numerous studies have described the relationship between exercise intensity and fat oxidation, the most recent in particular focused on FATmax. The first study verified the reliability of the software Polimedicus and the effects of aerobic training to FATmax. 16 overweight subjects were enrolled, about 40-55yrs old, and underwent incremental test until they reached an RER of 0.95, and from that moment the load increased of 1km/h every minute until exhaustion. Subsequently, it was checked if the values extrapolated from the program were those that may occur during a constant test of an hour. The subjects after 8 weeks did another incremental test. The final data has shown Polimedicus is not very reliable, especially the HR. In the second study new program was developed, Inca, and the results were compared to the data obtained from the first studies by Polimedicus. The final date have shows Inca is more reliable than Polimedicus. In the third study, we wanted to verify the accuracy of the calculation of the FATmax with Inca with the FATmaxwork test. 25 overweight subjects, between 40-55 yrs old, were enrolled and submitted to a FATmaxwork test. Subsequently, it was checked if the values extrapolated from INCA were those that may occur during a constant test load of an hour. The analysis showed accuracy of the calculation of FATmax during the workload. Conclusion: The difficulty of determining this parameter was highlighted, due both to the large inter-individual and intra-individual variability. In the future we need to improve INCA to allow us to obtain even more valid training protocols.