Thesis (M.S.)--Brigham Young University. Dept. of Exercise Sciences, 2004. / Includes bibliographical references.

Thesis (M.S.)--Brigham Young University. Dept. of Exercise Sciences, 2007. / Includes bibliographical references.

Thesis (Ph. D.)--University of Missouri-Columbia, 1996. / Typescript. Vita. Includes bibliographical references (leaves 81-90). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 1996. / Typescript. Vita. Includes bibliographical references (leaves 81-90). Also available on the Internet.

Thesis (Ph.D.) -- University of Texas Southwestern Medical Center at Dallas, 2005. / Embargoed. Vita. Bibliography: 149-156.

Thesis--University of Oklahoma. / Bibliography: leaves 59-65.

Thesis (M.S.)--Portland State University, 2005. / Includes bibliographical references (leaves 29-30). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (M.S.)--Portland State University, 2005. / Includes bibliographical references (leaves 29-30).

Background Adults with congenital heart disease (CHD) is a growing population and related to advances in surgical and medical treatment, they now outnumber the children with corresponding lesions. Since a congenital heart lesion often results in reduced exercise capacity, this population is a potential target for physiotherapy. To what extent this reduction in exercise capacity is caused by abnormal cardiovascular anatomy and physiology or to what degree insufficient physical activity contributes is not known. To support the advancements in paediatric cardiac care, increased knowledge regarding physical performance, physical activity level, body composition and the effects of exercise training among adults with CHD is required. Methods In a cross-sectional study skeletal- and respiratory muscle function, physical activity level and exercise self-efficacy was investigated among 85 adults with various forms of CHD and 42 control subjects. A second study was conducted to analyse height, weight and body mass index (BMI) in 538 adults with complex CHD and 1886 adults with simple CHD. Data were extracted from the Swedish registry on congenital heart disease (SWEDCON) and compared to data from a national population survey. In a third study, factors associated with self-reported quality of life (QoL) were analysed using SWEDCON data on 315 adults with congenital aortic valve disease. Finally, a randomised controlled trial was conducted to investigate the effects of interval exercise training among adults with complex CHD. Results Adults with complex CHD showed impaired muscle function compared to both patients with simple CHD and controls. In addition, patients with complex CHD had a lower exercise self-efficacy compared to controls. Patients with CHD were equally active at moderate-to-vigorous level as the controls. However, approximately 50% of both patients and controls failed to reach the recommended physical activity level. In general patients with CHD had the same height, weight and BMI, as the general population. However, compared to the general population, men with CHD were more commonly underweight and less commonly overweight/obese. Additionally, especially male patients with complex CHD were shorter compared to the general population. Among adults with congenital aortic valve disease, a higher physical activity level was associated with better QoL. Furthermore, interval training increased exercise capacity and endurance among adults with complex CHD. Conclusion A higher physical activity level was associated with better self-reported QoL in patients with congenital aortic valve disease which implies that QoL might be possible to improve, by adopting a physically active life-style. Adults with CHD were equally active as controls at a moderate-to-vigorous physical activity level. However, approximately half of both groups were insufficiently physically active based on current recommendations. This indicates that low physical activity, on group level, does not explain the lower exercise capacity commonly found among patients with CHD. In addition, this is consistent the finding that the majority of patients followed the same pattern regarding BMI as seen in the general population. However, impaired muscle function in combination with the shorter stature and higher prevalence of underweight found in men, especially with complex CHD, implies an altered body composition in this group. The findings of the present thesis suggests an indication for physiotherapy targeting increased physical activity level and individualized exercise training in this patient population. Moreover, regular evaluation of muscle function, exercise self-efficacy and QoL, in addition to exercise capacity, might be useful for monitoring disease development over time.

The purpose of the following study was to re-address the energy requirements of Canadian Armed Forces (CAF) during training in a cold winter environment. Twenty CAF personnel were recruited to participate in a 5-day winter training exercise at Canadian Forces Base Meaford in Ontario, Canada. Energy expenditure (n=10) and body composition (n=14) were measured via the doubly labelled water (DLW) method and the deuterium isotope dilution technique, respectively. Mean total daily energy expenditure (TDEE) was 4900±693 kcal·day-1 with no significant differences observed between sexes. Body mass and body composition of CAF personnel changed significantly (p < 0.05) across the 5-day exercise. This decrease was associated with a significant (p < 0.05) reduction in fat mass. Despite these losses, participants were able to maintain high physical activity level (PAL) values (2.6) and high TDEE levels throughout the study period. It is recommended to increase the caloric content of the rations via additional supplements that provide energy-dense foods in bar format that can be easily consumed at the convenience of the individual. / February 2016