Fatigue is a distressing, complex, and multidimensional sensation, that is common in individuals with chronic obstructive pulmonary disease (COPD), and impacts negatively on their functioning and quality of life. Limited research has been conducted to examine how various factors may influence the different dimensions of subjective fatigue experienced in these individuals. Four dimensions of subjective fatigue including: emotional, behavioural, cognitive, and physical, were examined in a convenience sample of 42 participants with COPD who attended an outpatient pulmonary rehabilitation program. The primary purpose of this feasibility study was to determine the proportion of individuals experiencing the four dimensions of fatigue, and to examine the relationships between these dimensions of fatigue and various influencing factors (dyspnea, depression, anxiety, sleep quality, activity limitation, heart rate, and oxygen saturation). The secondary purpose was to compare the four dimensions of fatigue by sex, supplemental oxygen use, smoking status, and severity of dyspnea, and to examine the relationships between the four dimensions of fatigue and age, the number of co-morbidities, and the amount of pulmonary rehabilitation received. Self-report questionnaires were used to measure fatigue (Multidimensional Fatigue Inventory MFI), anxiety and depression (Hospital Anxiety and Depression Scale HADS), and sleep quality (Pittsburgh Sleep Quality Index PSQI). Pulmonary rehabilitation health records were accessed to collect data on the remaining variables. The majority of the participants (61.9% - 81.0%) experienced moderate levels of subjective fatigue in all four dimensions. Moderate to severe levels of physical fatigue were experienced in 95.3% of the participants. The only significant relationship was between anxiety and emotional fatigue; all other relationships were statistically insignificant. There were no significant differences between sex, supplemental oxygen use, smoking status, and severity of dyspnea on the four dimensions of subjective fatigue. Many of the participants had probable presence of clinical anxiety (42.9%), where the prevalence of anxiety was nearly twice as high as depression (21.4%). Findings from this study can be used by healthcare professionals to gain a better understanding of fatigue in individuals with COPD who attend pulmonary rehabilitation, and help in developing effective interventions for reducing the distressing effects of fatigue.

Fatigue is a distressing, complex, and multidimensional sensation, that is common in individuals with chronic obstructive pulmonary disease (COPD), and impacts negatively on their functioning and quality of life. Limited research has been conducted to examine how various factors may influence the different dimensions of subjective fatigue experienced in these individuals. Four dimensions of subjective fatigue including: emotional, behavioural, cognitive, and physical, were examined in a convenience sample of 42 participants with COPD who attended an outpatient pulmonary rehabilitation program. The primary purpose of this feasibility study was to determine the proportion of individuals experiencing the four dimensions of fatigue, and to examine the relationships between these dimensions of fatigue and various influencing factors (dyspnea, depression, anxiety, sleep quality, activity limitation, heart rate, and oxygen saturation). The secondary purpose was to compare the four dimensions of fatigue by sex, supplemental oxygen use, smoking status, and severity of dyspnea, and to examine the relationships between the four dimensions of fatigue and age, the number of co-morbidities, and the amount of pulmonary rehabilitation received. Self-report questionnaires were used to measure fatigue (Multidimensional Fatigue Inventory MFI), anxiety and depression (Hospital Anxiety and Depression Scale HADS), and sleep quality (Pittsburgh Sleep Quality Index PSQI). Pulmonary rehabilitation health records were accessed to collect data on the remaining variables. The majority of the participants (61.9% - 81.0%) experienced moderate levels of subjective fatigue in all four dimensions. Moderate to severe levels of physical fatigue were experienced in 95.3% of the participants. The only significant relationship was between anxiety and emotional fatigue; all other relationships were statistically insignificant. There were no significant differences between sex, supplemental oxygen use, smoking status, and severity of dyspnea on the four dimensions of subjective fatigue. Many of the participants had probable presence of clinical anxiety (42.9%), where the prevalence of anxiety was nearly twice as high as depression (21.4%). Findings from this study can be used by healthcare professionals to gain a better understanding of fatigue in individuals with COPD who attend pulmonary rehabilitation, and help in developing effective interventions for reducing the distressing effects of fatigue.

Title: The Effect of Exercise Intervention on Physical Fitness and Quality of Life in Patients after Bariatric Surgery Objectives: The aim of this thesis is to evaluate the effect of a three-month physical intervention on the physical fitness and quality of life in patients after bariatric surgery. Compare the measured values from six-minute walk test (6MWT) and the questionnaire survey of quality of life between the group undergoing exercise program and the group of non-exercise patients. Methods: The diploma thesis was constructed as a quasi-experiment. A six-minute walk test, a visual analogue pain scale, a Borg scale and a standardized IWQOL-Lite questionnaire were used to asses physical fitness and quality of life. The study involved 28 patients (8 undergoing an exercise program, 20 non-excercisers). The groups were measured before the planned bariatric surgery and about 3-4 months after the surgery. For the analysis of final values, the Microsoft Excel and its add-in Realstatistics was used. Results: In patients undergoing the exercise program, the VAS on average decreased of 2,04 cm, 6MWT improved on average of 42,75 m, and quality of life of 34 points. In non-exercise patients there was an average decrease in VAS of 0,08 cm, an increase in 6MWT of 41,45 m and an increase in quality of life...

Made available in DSpace on 2014-12-17T15:16:09Z (GMT). No. of bitstreams: 1 ThiagoJAL_DISSERT.pdf: 946704 bytes, checksum: e827cc09ae18a75d76980a58fe6e619b (MD5) Previous issue date: 2010-06-25 / Morbidly obese patients present an increase in heart rate, blood pressure and perceived exertion besides lower walking ability compared to normal weight people. However, little is known about how these variables are presented after bariatric surgery. Moreover, despite the distance walked during the six-minute walk (6MWT) improve after surgery is not well established if the level of physical activity influences this improvement. Objective: To evaluate cardiovascular performance, perceived effort, ability of walking and physical activity level of patients with morbid obesity before and after bariatric surgery. Methods: The cardiovascular performance, perception of effort, the ability to walk and level of physical activity were assessed in 22 patients before (BMI = 50.4 kg/m2) and after (BMI = 34.8 kg/m2) bariatric surgery through the 6MWT. The heart rate, blood pressure and perceived exertion were assessed at rest, at the end of the 6MWT and in the second minute post-test (HR recovery). The ability to walk was measured by total distance walked at the end of the test while the level of physical activity was estimated by applying the Baecke questionnaire, analyzing domains occupation, leisure and locomotion and leisure and physical activity. Results: The HR at rest and recovery decreased significantly (91.2 ? 15.8 bpm vs. 71.9 ? 9.8 bpm, 99.5 ? 15.3 bpm vs 82.5 ? 11.1 bpm, respectively), as well as all the arterial pressure and perceived exertion after surgery. The distance achieved by the patients increased by 58.4 m (p = 0.001) postoperatively. Time postoperatively had correlation with the percentage of excess weight lost (r = 0.48, p = 0.02), BMI (r =- 0.68, p = 0.001) and the Baecke (r = 0.52, p = 0.01) which did not happen with the distance walked (r = 0.37, p = 0.09). Despite weight loss, patients showed no difference in the level of physical activity in any of the areas before and after surgery. Conclusion: The cardiovascular performance, the perception of effort and ability to walk seem to improve after bariatric surgery. However, despite improvement in the ability to walk by the distance achieved in the 6MWT after weight loss, this is not reflected in an increase in physical activity level of obese patients after surgery / Obesos m?rbidos apresentam aumento da freq??ncia card?aca, da press?o arterial e da percep??o do esfor?o al?m de baixa capacidade de caminhar em rela??o a pessoas eutr?ficas. No entanto, pouco se sabe como essas vari?veis se apresentam ap?s a realiza??o da cirurgia bari?trica. Al?m disso, apesar da dist?ncia percorrida no teste de caminhada de seis minutos (TC6M) melhorar ap?s a cirurgia, ainda n?o est? bem estabelecido como o n?vel de atividade f?sica influencia nesta melhora. Objetivo: Avaliar o desempenho cardiovascular, a percep??o do esfor?o, a capacidade de caminhar e o n?vel de atividade f?sica de pacientes portadores de obesidade m?rbida antes e depois da cirurgia bari?trica. M?todos: O desempenho cardiovascular, a percep??o do esfor?o, a capacidade de caminhar e o n?vel de atividade f?sica foram avaliados em 22 pacientes antes (IMC=50,4kg/m2) e ap?s (IMC=34,8kg/m2) a cirurgia bari?trica atrav?s do TC6M. A FC, a press?o arterial e a percep??o do esfor?o foram avaliados no repouso, ao final do TC6M e no segundo minuto p?s-teste (FC recupera??o). J? a capacidade de caminhar foi aferida atrav?s da dist?ncia total caminhada ao final do TC6M enquanto o n?vel de atividade f?sica foi estimado pela aplica??o do Question?rio de Baecke, analisando os dom?nios ocupa??o, lazer e locomo??o e lazer e atividade f?sica. Resultados: A FC de repouso e recupera??o diminu?ram significativamente (91,2?15,8 bpm vs 71,9?9,8 bpm; 99,5?15,3 bpm vs 82,5?11,1 bpm, respectivamente), assim como todos os valores de press?o arterial e percep??o de esfor?o ap?s a cirurgia. J? a dist?ncia atingida pelos pacientes aumentou em 58,4 m (p=0,001) no p?soperat?rio. O tempo de p?s-operat?rio obteve correla??o com o percentual de excesso de peso perdido (r=0,48;p=0,02), com o IMC (r=-0,68;p=0,001) e com o Baecke (r=0,52;p=0,01), no entanto n?o teve rela??o com a dist?ncia caminhada (r=0,37;p=0,09). Outrossim, a despeito da perda ponderal, os pacientes n?o apresentaram diferen?a no n?vel de atividade f?sica em nenhum dos dom?nios antes e depois da cirurgia. Conclus?o: O desempenho cardiovascular, a percep??o do esfor?o e a capacidade de caminhar parecem melhorar ap?s a realiza??o da cirurgia bari?trica. No entanto, apesar da xii melhora na capacidade de caminhar pela dist?ncia alcan?ada no TC6M ap?s a perda de peso, isso n?o repercutiu em aumento no n?vel de atividade f?sica dos obesos depois da cirurgia

Bakgrund: Fysisk aktivitet är en viktig del av behandlingen hos personer med kroniskt obstruktiv lungsjukdom (KOL), då det kan förbättra personens self-efficacy. Fysisk aktivitet kan även förbättra den fysiska kapaciteten och upplevda livskvalitén. Efterfrågan på tillgänglighet, delaktighet och självständighet i egenvård har ökat vilket medfört en snabb utveckling av digitala lösningar. Kunskapsluckor föreligger fortfarande i hur effektivt en aktiv e-hälsointervention påverkar personer med KOL. Syfte: Genom denna strukturerade litteraturstudie undersöka om nyttjandet av aktiva e-hälsointerventioner har effekt på fysisk kapacitet, self-efficacy samt upplevd livskvalité hos personer med KOL.Metod: Datainsamling genomfördes i databaserna Pubmed, Cinahl, Web of science. En sållning utifrån titel och abstrakt följdes av en relevans och kvalitetsbedömning på potentiellt relevanta artiklar. Etiska aspekter beaktades i granskningen. Data extraherades och sammanställdes samt analyserades kvalitativt. Resultat: Totalt inkluderades sju studier: sex stycken randomiserade kontrollerade studier och en experimentell crossover studie. Kvalitetsbedömningen för systematiska bias var låg till medelhög. Fysisk kapacitet och livskvalité förbättrades signifikant i samtliga studier med nämnda utfallsmått. Däremot visade endast en av studierna på signifikant förbättring jämfört med kontrollgrupp för fysisk kapacitet och två studier för livskvalité. Self-efficacy förbättrades signifikant inom två av fyra studier varav det i en av dessa uppvisades en signifikant förbättring jämfört med kontrollgrupp. Slutsats: Denna strukturerade litteraturstudie indikerar att aktiva e-hälsointerventioner leder till förbättringar av fysisk kapacitet och upplevd livskvalité hos personer med KOL och kan användas som ett alternativ till sedvanlig behandling. Det går inte att dra någon slutsats gällande effekten av en aktiv e-hälsointerventionen på self-efficacy. / Background: Physical activity is an important part of the treatment of people with chronic obstructive pulmonary disease (COPD), as it can increase the person's self-efficacy. Physical activity may also increase the physical capacity and perceived quality of life. The demand for accessibility, participation and independence in self-care has increased as a result and rapid development of digital solutions. Knowledge gaps are still built in how effectively an active e-health intervention affects people with COPD.Aim: Through this structured literature study, to investigate whether the use of active e-health interventions has an effect on physical capacity, self-efficacy and perceived quality of life in people with COPD.Method: Data collection was performed in the databases Pubmed, Cinahl, Web of science. A screening based on title and abstract was followed by a relevance and quality assessment of potentially relevant articles. Ethical aspects were considered in the review. Data were extracted and compiled and analyzed qualitatively.Results: A total of seven studies were included: six randomized controlled trials and one experimental crossover study. The quality assessment for systematic bias was low to medium. Physical capacity and quality of life improved significantly in all studies physical capacity and quality of life improved significantly in all studies with the mentioned outcome measures. However, only one of the studies showed significant improvement compared with the control group for physical capacity and two studies for quality of life. Self-efficacy improved significantly in two of four studies, one of which showed a significant improvement compared with the control group. Conclusion: This structured literature study indicates that active e-health interventions lead to improvements in physical capacity and perceived quality of life in people with COPD and it can be used as an alternative to conventional treatment. It is not possible to draw any conclusions about the effect of an active e-health intervention on self-efficacy.

6 Abstract Title: Monitoring the effect of selected physical activities considering the risk of falling down in the elderly. Objectives: The aim of this work is to compare the effect of two physical activities used in the prevention of falling down in the elderly, on the traveled distance using the 6MWT (Six Minute Walk Test).The two chosen physical activities are "Nordic walking" and "Sensomotoric stimulation". Methods:Initially, a literature research was conducted in the key area of prevention of falling down in the elderly, the possibilities of physical treatment in this risky group of people, and then were the "Nordic walking" and "Sensomotoric stimulation" activities chosen, as methods used in the prevention of falling down. Two groups were created: "The Nordic Walking Activity Group" and the "Sensomotoric Stimulation Physical Activity Group". The length and intensity of workouts: weeklyfor3-month period, min. 60 minutes and max. 3 hours. Each group counts from 9 to 10 clients, with their age range being between 60 and 69 years. A standardized 6MWT (Six Minute Walk Test) is used to obtain the data to be processed. The results were statistically evaluated using Microsoft Office Excel XP Professional. Three times took place the measurement of each client, at the beginning of physical activity, in the 2nd...

Made available in DSpace on 2014-12-17T15:16:06Z (GMT). No. of bitstreams: 1 SheylaTSL.pdf: 1123530 bytes, checksum: 9d193a5e8ae6cbd93482dabd85a41d69 (MD5) Previous issue date: 2009-07-30 / Introduction: The ability to walk is impaired in obese by anthropometric factors (BMI and height), musculoskeletal pain and level of inactivity. Little is known about the influence of body adiposity and the acute response of the cardiovascular system during whole the 6-minute walk test (6mWT). Objective: To evaluate the effect of anthropometric measures (BMI and WHR waist-to-hip ratio), the effort heart and inactivity in ability to walk the morbidly obese. Materials and Methods: a total 36 morbidly obese (36.23 + 11.82 years old, BMI 49.16 kg/m2) were recruited from outpatient department of treatment of obesity and bariatric surgery in University Hospital Onofre Lopes and anthropometric measurements of obesity (BMI and WHR), pulmonary function, pattern habitual physical activity (Baecke Questionnaire) and walking capacity (6mWT). The patient was checking to measure: heart rate (HR), breathing frequency (BF), peripheral oxygen saturation, level of perceived exertion, systemic arterial pressure and duplo-produto (DP), moreover the average speed development and total distance walking. The data were analysed between gender and pattern of body adiposity, measuring the behavior minute by minute of walking. The Pearson and Spearmam correlation coefficients were calculated, and stepwise multiple Regression examined the predictors of walking capacity. All analyses were performed en software Statistic 6.0. Results: 20 obese patients had abdominal adiposity (WHR = 1.01), waist circumference was 135.8 cm in women (25) and 139.8 cm in men (10). Walked to the end of 6mWT 412.43 m, with no differences between gender and adiposity. The total distance walked by obesity alone was explained by BMI (45%), HR in the sixth minute (43%), the Baecke (24%) and fatigue (-23%). 88.6% of obese (31) performed the test above 60% of maximal HR, while the peak HR achieved at 5-minute of 6mWT. Systemic arterial pressure and DP rised after walking, but with no differences between gender and adiposity. Conclusion: The walk of obese didn?t suffers influence of gender or the pattern of body adiposity. The final distance walked is attributed to excess body weight, stress heart, the feeling of effort required by physical activity and level of sedentary to obese. With a minute of walking, the obeses achieved a range of intensity cardiovascular trainning / Introdu??o: A capacidade de caminhar dos obesos ? prejudicada pelo ?ndice de Massa Corporal (IMC), dores osteomioarticulares e n?vel de sedentarismo. Pouco se sabe sobre a influ?ncia do perfil da adiposidade corporal, do g?nero e da resposta aguda do sistema cardiovascular sobre a capacidade de caminhada do obeso. Objetivo: Avaliar o efeito de medidas antropom?tricas (IMC e WHR, waist-to-hip ratio), esfor?o card?aco e sedentarismo sobre a capacidade de caminhada de portadores de obesidade m?rbida. Materiais e M?todos: Entre setembro de 2007 e setembro de 2008, 36 obesos m?rbidos (idade 36,23 + 11,82; IMC 49,16 kg/m2) foram recrutados no ambulat?rio de tratamento da obesidade e cirurgia bari?trica do Hospital Universit?rio Onofre Lopes e avaliados quanto marcadores antropom?tricos de obesidade, fun??o pulmonar, n?vel de atividade f?sica habitual (Question?rio de Baecke) e capacidade de caminhar (TC6M). O paciente era monitorado para verificar: freq??ncia card?aca (FC) e respirat?ria (FR), satura??o perif?rica de oxig?nio, n?vel de esfor?o percebido, press?o arterial sist?mica (PA) e duplo-produto (DP). Durante a caminhada, ainda mensurava-se a velocidade m?dia desenvolvida e dist?ncia total percorrida pelos portadores de obesidade m?rbida. Os dados foram analisados entre os g?neros e o tipo de distribui??o de gordura corporal, avaliando o comportamento das vari?veis a cada minuto caminhado. As correla??es de Pearson e Spearmam foram analisadas. A Regress?o M?ltipla buscou preditores da capacidade de caminhada. Foi utilizado o software Statistic 6.0 para an?lise estat?stica. Resultados: 20 obesos tinham adiposidade abdominal (WHR = 1,01), circunfer?ncia da cintura de 135,8 cm nas mulheres (25) e de 139,8 cm nos homens (10). Durante TC6M, foi caminhada uma dist?ncia de 412,43 m, sem diferen?as entre g?nero ou adiposidade. Essa dist?ncia total percorrida foi explicada isoladamente pelo IMC (45%), FC no sexto minuto (43%), Baecke (24%) e fadiga (-23%). 88,6% dos obesos (31) realizaram o teste acima de 60% da FCM?xima, sendo o pico de FC atingido aos 5 minutos de caminhada. PA e DP aumentaram significativamente com a caminhada, mas sem diferen?as entre g?nero ou adiposidade. Conclus?o: A acaminhada dos obesos m?rbidos n?o sofre influ?ncia do g?nero ou do perfil de adiposidade corporal. A dist?ncia final percorrida ? atribu?da ao excesso de peso corporal, estress card?aco, sensa??o de esfor?o imposta pela caminhada e ao n?vel de sedentarismo pr?vio do obeso. Dentro de 1 minuto de caminhada, os obesos atingem uma zona de treinamento cardiovascular

Syfte och frågeställningar Syftet med den här studien har varit att undersöka och jämföra kvinnor och män i åldersgrupperna 30-39 år respektive 40-49 år avseende antropometriska mått samt prestation på GIH:s hälsotester. En vidare målsättning var att undersöka om det förekom några skillnader mellan två separata testtillfällen. Frågeställningarna har varit om resultaten på hälsotesterna skiljer sig mellan könen, åldersgrupperna samt mellan två separata testtillfällen. Metod Totalt fullföljde 41 deltagare GIH:s hälsotester, av dem var 20 kvinnor och 21 män mellan 30-49 år. Det enda som krävdes för att delta var att man uppfattade sig själv som frisk. Personer som tidigare haft stroke, hjärtinfarkt eller opererats på grund av hjärtproblem har inte inkluderats, ej heller gravida och personer med ledbesvär. Testerna utfördes på LTIV (Laboratoriet för tillämpad idrottsvetenskap) mellan februari och mars 2016. Resultat Signifikanta skillnader mellan de två separata testtillfällena noterades för några av styrketesterna framför allt hos männen: axelpressar, handgrip och stolresningar. Mellan könen sågs signifikanta skillnader i de antropometriska måtten, samt i flera konditions- och styrketester. Bland dessa kunde signifikant högre värden ses för kvinnorna än för männen i ryggstyrketestet.  Signifikanta skillnader mellan åldersgrupperna 30-39 år och 40-49 år sågs näst intill endast för kvinnor. De yngre jämfört med de äldre kvinnorna presterade bättre i flera av testerna, de vägde mindre och hade mindre kroppsmått. Slutsats Det framkom vanligtvis inte några signifikanta skillnader mellan det första och andra testtillfället, med enstaka undantag. När så är fallet behövs bara ett test utföras initialt inför en period med exempelvis fysisk aktivitet som senare kanske ska följas upp med ett återtest. Skillnader mellan könen och olika åldersgrupper framkom i vissa tester men inte i alla. Resultaten i denna studie beror bland annat på urvalet av individer. Eftersom att syftet med den här studien har varit att endast utföra de tester som ingår i GIH:s hälsotester har inga tester lagts till eller exkluderats. I arbetet diskuteras bland annat hur optimala testerna är som ett mått på hälsa. För att effektivisera hälsotestundersökningar framöver behöver nödvändigtvis inte alla tester utföras.