<p>The overall aims of the studies were to investigate the effects of different training modalities on exercise capacity and health-related quality of life (HRQoL) in patients with moderate or severe COPD and, further, to explore two of the physical tests used in pulmonary rehabilitation.</p><p>In <b>study I</b>, the 12-minute walking distance (12MWD) did not increase on retesting in patients with exercise-induced hypoxemia (EIH) whereas 12MWD increased significantly on retesting in the non-EIH patients. In <b>study II</b>, we found that the incremental shuttle walking test was as good a predictor of peak exercise capacity (W peak) as peak oxygen uptake (VO₂ peak) is. In <b>study III</b>, we investigated the effects of two different combination training programmes when training twice a week for eight weeks. One programme was mainly based on endurance training (group A) and the other on resistance training and callisthenics (group B). W peak and 12MWD increased in group A but not in group B. HRQoL, anxiety and depression were unchanged in both groups. Ratings of perceived exertion at rest were significantly lower in group A than in group B after training and during 12 months of follow-up. Twelve months post-training, 12MWD was back to baseline in group A, but significantly shorter than at baseline in group B. Thus, a short endurance training intervention delayed decline in 12MWD for at least one year. Patients with moderate and severe COPD responded to training in the same way. In <b>study IV</b>, both interval and continuous endurance training increased W peak, VO₂ peak, peak exhaled carbon dioxide (VCO₂ peak) and 12MWD. Likewise, HRQoL, dyspnoea during activities of daily life, anxiety and depression improved similarly in both groups. At a fixed, submaximal workload (isotime), the interval training reduced oxygen cost and ventilatory demand significantly more than the continuous training did.</p>

During extreme exercise, athletes experience increased inflammation that is similar to the acute phase response. Endurance athletes, distance runners in particular, are also more susceptible to compromised iron stores. This study evaluated inflammation, immune function and iron status in athletes completing a 50K ultramarathon. Twenty-two well-trained distance runners, 11 males and 11 females, were randomized in a double blind manner into--1) those who consumed 300 mg vitamin E and 1000 mg vitamin C (500 mg twice daily) or 2) placebos--for six weeks before and one week following a 50K ultramarathon race. Blood samples were obtained on 13 separate occasions throughout the study: before supplementation, during supplementation, the day before the race, pre-race, mid-race, immediately post-race, 2 hours following the race, and daily for six days following the race. Plasma levels of ascorbic acid and ��-tocopherol were measured by HPLC with electrochemical detection. Inflammatory cytokines, interleukin-6 (IL-6), tumor necrosis factor-�� (TNF-��), and interleukin-1�� (IL-1��) were measured using standard clinical assays. Each subject recorded immune function in an activity log and incidence of illness was tabulated as number of days ill. Ferritin was measured by enzyme immunoassay. Hemoglobin, hematocrit, and total-iron binding capacity (TIBC) and serum total iron were analyzed by standard procedures. Plasma concentrations of ascorbic acid and ��-tocopherol increased significantly in supplemented subjects (p<0.0001). Although the ultramarathon race elicited an inflammatory response, antioxidant supplementation did not alter the responses of IL-6 and TNF-��, which both increased from pre-race to mid-race, post- and post-2 h (Scheffe post-hoc analysis, p<0.0001) and returned to pre-race concentrations by 1 day after the race. Male supplemented subjects had lower IL-1�� concentrations compared to females consuming the supplement or to males consuming the placebo (ANCOVA, gender/time/treatment interaction; p<0.01) at mid-race (p<0.05 females, p<0.005 males), post 1 and 2 days (all p<0.002). Males had significantly higher ferritin levels than the female subjects (ANOVA, p<0.0001); supplementation resulted in lower ferritin concentrations at post-5 days (p<0.02, ANCOVA treatment time interaction, p<0.005). Supplementation did not reduce the days illness among those consuming antioxidants compared to those consuming the placebos. Ferritin not only increases during inflammation, it also is a measure of iron stores. Females had significantly lower levels of iron than the male subjects for each of the iron parameters measured (hemoglobin and hematocrit both p<0.0001, ferritin p<0.001, TIBC p<0.02) excluding serum total iron. The ferritin concentrations measured in the women were indicative of depleted iron stores (<12 ��g/l), and antioxidant supplementation increased hematocrit levels in the female subjects (p<0.05). This investigation indicates that female distance runners need to be aware of an increased susceptibility to iron depletion compared to their male counterparts. Antioxidant supplementation improved hematocrit levels (p<0.05) among female runners and may improve iron status among females with depleted stores. Although other investigations have suggested that antioxidant vitamins decrease exercise induced inflammation, no profound benefit of supplementation was found in this investigation though a response similar to the acute phase response was elicited by the ultramarathon race. Improvements in IL-i and ferritin in response to antioxidant supplementation may indicate that the supplementation was beneficial, but more research is needed to draw definitive conclusions. / Graduation date: 2003

<p>Syftet med uppsatsen var att studera hur Försvarsmakten bör organisera, utbilda och träna ett skyttekompani i framtiden inom några områden. Den skall med hjälp av några av de grundläggande förmågorna ge svar på hur vi organiserar, utbildar och tränar idag samt analysera om några förändringar bör ske för att skapa ett bättre förband.</p><p>Den teoretiska grunden för uppsatsen har varit de grundläggande förmågorna; ledning, rörlighet och uthållighet. Uppsatsen har tagit sin utgångspunkt i bland annat Arméns utvecklingsplan och studien Verkan Mot Markmål. Litteraturstudier har även genomförts av andra studier och dokument. Även två stycken intervjuer har genomförts för att belysa dagsläget respektive framtiden för ett skyttekompani. Resultaten visar på att det finns en bra grund för ledning av ett skyttekompani men även en avsaknad av tillfredsställande sjukvård. De slutsatser som uppsatsen finner är behovet av utveckling och träning av metoder för att ledning. Förmågan att leda utländska enheter och ledas på exempelvis engelska bör finnas ner på plutonsnivå. Vidare konstateras att en fungerande sjukvårdskedja från enskildsoldat och uppåt måste skapas.</p> / <p>The objective of this essay was to examine how we should organize, educate and train a mechanised infantry company in the future. The essay will use the fundamental capabilities to give an answer how we organize, educate and train today. It will also analyse if there should be any changes made in order to create better units.</p><p>Based on studies<strong> </strong>in literature such as the <em>development plan for the army</em>, the study <em>effect towards ground target</em> and interview. I have tried to show the current situation and how the future looks like for a mechanised infantry company.  I have chosen to study three fundamental capabilities; command and control, mobility, endurance. The results indicate that there is a good base to command and control a mechanised infantry company but also that the medical capacity is not satisfying. Some of the conclusions from the essay are that we need development and training in methods to command and control. The capability to command and control foreign units should be found down to platoon level. Regarding medical treatment we must create a work line of medical treatment, from soldier to field hospitals.</p>

Syftet med uppsatsen var att studera hur Försvarsmakten bör organisera, utbilda och träna ett skyttekompani i framtiden inom några områden. Den skall med hjälp av några av de grundläggande förmågorna ge svar på hur vi organiserar, utbildar och tränar idag samt analysera om några förändringar bör ske för att skapa ett bättre förband. Den teoretiska grunden för uppsatsen har varit de grundläggande förmågorna; ledning, rörlighet och uthållighet. Uppsatsen har tagit sin utgångspunkt i bland annat Arméns utvecklingsplan och studien Verkan Mot Markmål. Litteraturstudier har även genomförts av andra studier och dokument. Även två stycken intervjuer har genomförts för att belysa dagsläget respektive framtiden för ett skyttekompani. Resultaten visar på att det finns en bra grund för ledning av ett skyttekompani men även en avsaknad av tillfredsställande sjukvård. De slutsatser som uppsatsen finner är behovet av utveckling och träning av metoder för att ledning. Förmågan att leda utländska enheter och ledas på exempelvis engelska bör finnas ner på plutonsnivå. Vidare konstateras att en fungerande sjukvårdskedja från enskildsoldat och uppåt måste skapas. / The objective of this essay was to examine how we should organize, educate and train a mechanised infantry company in the future. The essay will use the fundamental capabilities to give an answer how we organize, educate and train today. It will also analyse if there should be any changes made in order to create better units. Based on studies in literature such as the development plan for the army, the study effect towards ground target and interview. I have tried to show the current situation and how the future looks like for a mechanised infantry company.  I have chosen to study three fundamental capabilities; command and control, mobility, endurance. The results indicate that there is a good base to command and control a mechanised infantry company but also that the medical capacity is not satisfying. Some of the conclusions from the essay are that we need development and training in methods to command and control. The capability to command and control foreign units should be found down to platoon level. Regarding medical treatment we must create a work line of medical treatment, from soldier to field hospitals.

The overall aims of the studies were to investigate the effects of different training modalities on exercise capacity and health-related quality of life (HRQoL) in patients with moderate or severe COPD and, further, to explore two of the physical tests used in pulmonary rehabilitation. In study I, the 12-minute walking distance (12MWD) did not increase on retesting in patients with exercise-induced hypoxemia (EIH) whereas 12MWD increased significantly on retesting in the non-EIH patients. In study II, we found that the incremental shuttle walking test was as good a predictor of peak exercise capacity (W peak) as peak oxygen uptake (VO2 peak) is. In study III, we investigated the effects of two different combination training programmes when training twice a week for eight weeks. One programme was mainly based on endurance training (group A) and the other on resistance training and callisthenics (group B). W peak and 12MWD increased in group A but not in group B. HRQoL, anxiety and depression were unchanged in both groups. Ratings of perceived exertion at rest were significantly lower in group A than in group B after training and during 12 months of follow-up. Twelve months post-training, 12MWD was back to baseline in group A, but significantly shorter than at baseline in group B. Thus, a short endurance training intervention delayed decline in 12MWD for at least one year. Patients with moderate and severe COPD responded to training in the same way. In study IV, both interval and continuous endurance training increased W peak, VO2 peak, peak exhaled carbon dioxide (VCO2 peak) and 12MWD. Likewise, HRQoL, dyspnoea during activities of daily life, anxiety and depression improved similarly in both groups. At a fixed, submaximal workload (isotime), the interval training reduced oxygen cost and ventilatory demand significantly more than the continuous training did.

Das maximale Laktat-steady-state (MLSS) gilt als ein physiologischer Parameter der Ausdauerleistungsfähigkeit. Bereits in den 1980er Jahren entwickelte Mader (1984) auf Basis der Michaelis-Menten-Kinetik eine Berechnungsmethode zur Bestimmung der Leistung im MLSS. Diese Methode setzt die Kenntnis der maximalen Reaktionsgeschwindigkeiten von Glykolyse und Atmung voraus. Die Goldstandard-Methode zur Ermittlung der Leistung im MLSS sind mehrere 30-minütige konstante Dauerbelastungen. Das hauptsächliche Ziel der vorliegenden Arbeit bestand in dem Vergleich der berechneten mit der empirisch ermittelten Leistung im MLSS. 57 männliche Probanden unterzogen sich zunächst in randomisierter Reihenfolge einem Test zur Bestimmung der maximalen Laktatbildungsrate sowie der maximalen Sauerstoffaufnahme. Im Anschluss absolvierten die Testpersonen mehrere 30 minütige Dauertests zur empirischen Ermittlung der Leistung im MLSS. Die ermittelten Ergebnisse zeigen, dass zwischen beiden Testmethoden eine hochsignifikante Korrelation (r = 0,89; p< 0,001) sowie eine mittlere Differenz von -13 Watt vorliegt. Ausgehend von den ermittelten Ergebnissen kann der Schluss gezogen werden, dass die Leistung im MLSS, ermittelt unter Verwendung der Methode nach Mader (1984) im Mittel mit der empirisch ermittelten Leistung im MLSS sehr gut übereinstimmt. Neben der angeführten Hauptstudie, wurde in der vorliegenden Arbeit weiterhin die Reliabilität und Tag-zu-Tag-Variabilität der Leistung im MLSS, der Einfluss der Testdauer auf die Laktatbildungsrate sowie die Praktikabilität der berechneten Leistung im MLSS in einem Einzelzeitfahren näher untersucht.

Forskning om människans fysiologi och hur den fungerar uppdateras dagligen. Inom idrottens värld testas nya som gamla, naturliga som onaturliga preparat och träningsmetoder kontinuerligt, allt för att optimera en idrottares prestation. Ett ämne som det forskas mycket om idag är kvävemonoxid och dess påverkan i kroppen. Från att ha tolkats som ett skadligt ämne i kroppen har det gått till att möjligen kunna hjälpa hjärtsjuka patienter och även optimera idrottsutövande. Kvävemonoxid bildas i kroppen naturligt med hjälp av syre, men det kan även bildas utan syre genom intag av nitrat som hittas i många grönsaker. Studier om nitrat inom idrottsområdet har koncentrerats till dess påverkan vid uthållighetsidrott och effekten har visat på ökad verkningsgrad och blodflöde till muskulaturen. Senare fann forskarna även hur dietärt nitrat sänkte ens syreupptagningsförmåga (Vo2max) tillsammans med en ökad uthållighet. Detta är en intressant upptäckt då sänkt Vo2max ofta leder till en försämrad arbetsprestation. Dessa studier ger en bild av hur nitrat fungerar vid aerobt arbete, det vill säga med syre. Det som forskningen inte tagit upp ännu är hur nitrat påverkar anaerobt arbete och maximala prestationer som förekommer vid styrketräning. Syftet med denna studie var därför att undersöka hur nitrat påverkar muskelfunktion och uthållighet vid styrketräning.  I en randomiserad, dubbelblind, korsande studie, konsumerade åtta män (ålder 19-26, 23 (±2, 3)) nitrat eller placebo (0,1 mmol/kg kroppsvikt/dag) under tre dagar. Under fjärde dagen testades männens prestation i fyra olika styrketest. Laktat och glukosvärden mättes för att se hur den laktacida systemet påverkades. Studien gav inget stöd till att dietärt nitrat påverkar styrketräning. Resultaten från tillfället med nitrat respektive placebo förblev i stort sett oförändrade. Slutsatsen blev att ett intag av nitrat inte har någon större betydelse för denna modell av styrketräning. Den främsta förklaringen till detta kan tänkas vara att nitratet ger störst inverkan vid långvariga arbetsdurationer och främst under aerobt arbete. I detta fall används mestadels lagrad energi i kroppen, och energisystemen där syre krävdes är troligen inte av större betydelse. / Research on human physiology and how it is working is updated daily. In the world of sports they are testing new as old, natural as unnatural preparations and different training methods continuously in order to optimize athletic performance. A substance that´s been research on, up till today is nitric oxide and its influence in the body. From being interpreted as a harmful substance in the body, it went to possibly help heart disease patients, and also optimize the physic in sport performance. Nitric oxide is formed in the body naturally by oxygen, but it can also be formed without oxygen through the ingestion of nitrates found in many vegetables. Studies on nitrate in the sport field have concentrated on the effect on endurance sports and the effect has been shown to increase the efficiency and the blood flow to the muscles. Later on they also found that nitrate supplementation seems to give a lower Vo2max together with an increased time to exhaustion. These findings are really interesting because normally a reduction in Vo2max leads us to a decrease in workability. All these studies give an idea on how nitrate works aerobic, that is with oxygen. The research has not yet an explanation on how nitrate affect anaerobic work and maximum performance that occurs in weight training. The purpose of this study was to investigate how nitrate affects muscle function and endurance in strength training. In a randomized, double-blind, crossover trial, eight men (age 19-26, 23 (±2, 3)) consumed nitrate or a placebo (0.1 mmol/kg bodyweight/day) for three days. During the fourth day the test persons were tested in four different strength tests to see how they performed. Lactate and glucose concentrations were measured to see how the laktacid system was influenced. The study gave no support that dietary nitrate affects weight training. The results from the occasion with nitrate respectively placebo remained essentially unchanged. It was concluded that an intake of nitrate not will give any significant effects on the model of strength training. The main reason for this may be that nitrate provides the greatest impact on long-term work-duration and mainly during aerobic work. In this case the main use is mostly stored energy in the body, and the energy systems in which oxygen is required will probably not be of major importance. / Pilotstudie i samarbete med Åstrands laboratoriet och Karolinska Institutet

The aim of this work was to find a correlation between the electrical, optical and microstructural properties of thin SiO2 layers containing group IV nanostructures produced by ion beam synthesis. The investigations were focused on two main topics: The electrical properties of Ge- and Si-rich oxide layers were studied in order to check their suitability for non-volatile memory applications. Secondly, photo- and electroluminescence (PL and EL) results of Ge-, Si/C- and Sn-rich SiO2 layers were compared to electrical properties to get a better understanding of the luminescence mechanism.

Background - Regular exercise reduces the risk of cardiovascular disease and subsequent sudden cardiac death (SCD). However, a small, but notable proportion of athletes die suddenly due to inherited or congenital disorders of the heart that predispose to malignant ventricular arrhythmias. Such tragedies are highly publicised, particularly when high-profile athletes are involved. To date, limited evidence for the efficacy of cardiovascular pre-participation screening exists outside of the Italian experience. Furthermore, limited data exists examining the impact of ethnicity on cardiac adaptations to physical training. Whilst the cardiovascular benefits of exercise are well known, the impact of life-long endurance exercise is less well understood. Long term high-intensity endurance exercise is associated with changes in cardiac morphology together with electrocardiographic alterations that are believed to be physiologic in nature. Recent data however, has suggested a number of deleterious adaptive changes in cardiac structure, function and electrical activity in response to life-long endurance activity. Aims and Objectives - The aims of this PhD were; 1) To find an effective preparticipation screening method that would successfully identify pre-existing cardiovascular abnormalities, 2) To identify the prevalence of hypertrophic cardiomyopathy and Long QT syndrome in elite UK athletes; 3) To examine the impact and significance of ethnicity upon left ventricular remodelling in elite athletes, and 4) To examine the acute and chronic impact of ultra-endurance exercise across the life-span in male endurance athletes. Major Results and Conclusions – 1) Study 2 sought to confirm the efficacy of resting 12-Lead ECG ‘alongside’ personal/family history questionnaires and physical examinations as collective tools to identify diseases that have the potential of causing sudden death within a cohort of elite junior athletes (n=1074) and physically active school children (n=1646). Nine participants were identified with a positive diagnosis of a disease associated with SCD. None of those diagnosed with a disease associated with SCD were symptomatic or had a family history of note. Thus, personal symptoms and family history questionnaires alone are inadequate in the identification of individuals with diseases associated with SCD. In conclusion, resting 12-Lead ECG is paramount when screening for diseases that have the potential of causing sudden death in the young. 2) Study 3 examined 3,500 asymptomatic elite athletes (75% male) with a mean age of 20.5 ± 5.8 years with 12-lead ECG and 2-dimensional echocardiography. None had a known family history of HCM. Of the 3,500 athletes, 53 (1.5%) had LVH (mean 13.6 ± 0.9mm, range 13 to 16mm), and of these 50 had a dilated LV cavity with normal diastolic function to indicate physiological left ventricular hypertrophy. Three (0.08%) athletes with LVH had a non-dilated LV cavity and associated deep T-wave inversion that could have been consistent with HCM. However, none of the 3 athletes had any other phenotypic features of HCM on further non-invasive testing and none had first-degree relatives with features of HCM. In conclusion, the prevalence of HCM in elite athletes is significantly less than in the general population; with the demands of strenuous exercise on the cardiovascular system selecting out most individuals with HCM. Study 4 examined 2000 elite athletes in order to identify the prevalence of Long QT syndrome. Three athletes had a QTc value of >500 ms and all exhibited one of: paradoxical prolongation of QTc during exercise, a confirmatory genetic mutation, or prolonged QTc in a first-degree relative. In contrast, none of the athletes with a QTc value of <500 ms had any other features to indicate LQTS. Accordingly, the prevalence of a prolonged QTc interval in elite British athletes is 0.4%. 3) Study 6 examined 300 nationally ranked UK black male athletes (mean age 20.5 years) in comparison to 150 black and white sedentary individuals and 300 highly-trained white male athletes. Black athletes exhibited greater LV wall thickness and cavity size compared with sedentary black and white individuals. Black athletes had greater LV wall thickness compared with white athletes. A minority of black athlete’s exhibit LVH ≥15 mm; proposing that in the absence of cardiac symptoms or a family history of HCM, an LV wall thickness ≥15 mm in black athletes may represent physiologic LVH when the LV cavity is enlarged and diastolic indexes are normal. 7 black athletes (12%) with LVH displaying deep T-wave inversions in leads V1 to V4. In conclusion, in the absence of obvious pathology, these electrical anomalies in black athletes likely represent a normal spectrum of ECG changes in response to physical training. 4) Study 8 examined 17 male participants (age 33.5 ± 6.5 years, 26–40 years) using cardiac magnetic resonance (CMR) and echocardiography before and after a marathon to investigate the relationship between systolic function and diastolic function against biomarkers of cardiac damage. Results demonstrates biomarkers of myocardial cell damage following an acute bout of prolonged exercise are not associated with either systolic or diastolic functional measures, and do not seem to be associated with any detectable myocardial inflammation, oedema, or scarring using either gold standard techniques of gadolinium enhanced CMR or echocardiography respectively. The impact of multiple episodes of prolonged exercise, as experienced by highly trained veteran endurance athlete is not fully understood. 5) Study 10 examined the cardiac structure and function of 12 life-long, competitive endurance veteran athletes (> 50 yrs, mean ± SD marathons 178 ± 209 (range 20 – 650)) against 17 young male endurance athletes (<40 yrs) using echocardiography and CMR with late gadolinium enhancement (LGE) to assess myocardial fibrosis. Lifelong veteran athletes had smaller LV and RV end-diastolic and end-systolic volumes (p<0.05) but maintained LV and RV systolic function compared with young athletes. In 6 (50%) of the veteran athletes LGE of CMR indicated the presence of myocardial fibrosis; no LGE in the young athletes. The prevalence of LGE in veteran athletes was not associated with the number of competitive marathons or ultra-endurance marathons (>50 miles) completed, age, LV and RV end-diastolic volumes or LV mass (p>0.05). In conclusion, there is limited evidence at present demonstrating that cardiovascular re-modelling following lifelong endurance exercise leads to long-term disease progression, cardiovascular disability or SCD.

Recent research suggests that adding protein (PRO) to a carbohydrate (CHO) supplement can have substantial benefits for endurance exercise performance and recovery beyond that of CHO alone. CHO+PRO supplements are often commercially available formulations consisting of carbohydrates (dextrose, maltodextrin) and whey protein. The effects of a supplement containing moderate protein and a low-CHO mixture on endurance performance has not been investigated. Also, the effects of CHO+PRO supplementation in the form of a natural food, flavored milk, on measures of recovery from acute endurance exercise, as well as on chronic aerobic exercise training adaptations, have not been characterized. Therefore, in this series of four studies, the effects of CHO+PRO supplementation on the following areas of endurance exercise performance, recovery, and adaptation are investigated: acute endurance exercise performance, inflammatory and muscle damage markers, muscle glycogen resynthesis, activation of signaling proteins involved in the initiation of protein synthesis and degradation, subsequent endurance exercise performance, and chronic aerobic training adaptations (maximal oxygen consumption, oxidative enzyme activity, body composition, immune cell levels, and inflammatory markers). Study 1 demonstrated that a supplement containing a low-CHO mixture plus moderate protein significantly improved aerobic endurance when cycling at or below the ventilatory threshold, despite containing 50% less CHO and 30% fewer calories relative to a higher CHO beverage. Study 2 demonstrated that CHO+PRO supplementation in the form of chocolate milk (CM) is an effective post-exercise supplement that can improve subsequent performance and provide a greater intracellular signaling stimulus for protein synthesis compared to CHO and placebo. Study 3 found that post-exercise CM supplementation during 4.5 wks of aerobic exercise training improves the magnitude of cardiovascular adaptations more effectively than isocaloric CHO or placebo, while the fourth study demonstrated that post-exercise CM supplementation during 4.5 wks of aerobic training improves body composition more effectively than isocaloric CHO or placebo. The fourth study also demonstrated that 4.5 wks of training does not appear to perturb resting immune cell concentrations or markers of inflammation and muscle damage. Taken together, the results of this research series suggest that CHO+PRO supplementation extends endurance performance, improves recovery, and increases training adaptations more effectively than CHO or placebo. / text