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Bakgrund: Övervikt och fetma ökar exponentiellt i alla samhällsklasser i alla delar av världen idag. Det kan orsaka lidande och förtida död för de drabbade. Risken att drabbas av våra vanligaste vällevnadssjukdomar som hjärt- och kärlsjukdom, typ 2 diabetes och neurodegenerativa sjukdomar som Alzheimers sjukdom ökar vid övervikt och fetma. Det i särklass mest effektiva sättet att gå ned i vikt är genom att minska sitt kaloriintag. För att behålla en viktnedgång behövs beteendeförändringar, stöttning och en långsiktig plan. Syfte: Syftet med studien är att undersöka om intermittent kalorirestriktion (CR) är mer effektivt än kontinuerlig CR när det gäller viktreduktion och bibehållande av ny vikt. Metod: En litteraturstudie genomfördes där fyra olika parallellstudiers resultat sammanställs. Parallellstudierna jämför effektiviteten av intermittent och kontinuerlig CR på viktreduktion och bibehållande av ny vikt. Resultat: I tre av de fyra studier som undersökts kan inga skillnader i effektivitet uppvisas mellan intermittent och kontinuerlig CR när det gäller viktreduktion och bibehållande av ny vikt över tid. En av studierna fann att intermittent CR, i form av ”week on, week off” två veckor i taget är mer effektiv när det gäller viktreduktion efter 16 veckors interventionsfas samt 6 månader senare. Slutsats: Som alla metastudier jag läst och de flesta studier på ämnet kan ingen skillnad i effektivitet mellan intermittent och kontinuerlig CR uppvisas gällande viktreduktion. Inte heller verkar den ena vara överlägsen den andra när det gäller bibehållande av ny vikt. Fler studier över längre tidsspann med fler deltagare krävs för att kunna dra slutsatser om vilken typ av CR som är mest effektiv på lång sikt. / Background: Overweight and obesity are increasing exponentially in all social classes in all parts of the world today. It can cause suffering and premature death to those affected. The risk of suffering from our most common well-being diseases such as cardiovascular disease, type 2 diabetes and neurodegenerative diseases such as Alzheimer's disease increases with overweight and obesity. By far the most effective way to lose weight is by reducing your calorie intake. To maintain a weight loss, behavioural changes, support and a long-term plan are needed. Purpose: The purpose of the study was to investigate whether intermittent calorie restriction (CR) is more effective than continuous CR in terms of weight reduction and maintenance of new weight. Method: A literature study was conducted where the results of four parallel studies were put together. The parallel studies compare the effectiveness of intermittent or continuous CR on weight reduction and maintenance of new weight. Result: In three of the four studies examined, no differences in effectiveness can be demonstrated between intermittent and continuous CR in terms of weight reduction and maintenance of new weight over time. One of the studies found that intermittent CR, in the form of "week on, week off" two weeks at a time, is more effective in weight reduction after 16 weeks of intervention and 6 months later. Conclusion: Like all meta-studies and most studies on the subject, no difference in effectiveness between intermittent and continuous CR can be demonstrated in terms of weight reduction. Nor does one seem superior to the other when it comes to maintaining new weight. More studies over longer time spans with more participants are required to be able to draw conclusions about the type of CR that is most effective in the long term.

Bakgrund: Claudicatio Intermittens är vanligt förekommande hos äldre personer och ger upphov till fysiska och psykiska besvär såsom försämrad gångförmåga och sämre livskvalite. Fysisk aktivitet är en viktig fysioterapeutisk behandlingsmetod som har visat goda resultat för patientgruppen. Därför är det viktigt att sammanställa aktuell evidens för att öka och tillgängliggöra ny kunskap. Syfte: Att undersöka det vetenskapliga underlaget för fysisk aktivitet som behandling och dess effekt på gångförmåga och livskvalitet hos patienter med claudicatio intermittens. Metod: Studiens design var litteraturstudie. En litteratursökning efter randomiserade kontrollerade studier genomfördes i databasen PubMed. De utvalda studiernas kvalitet granskades enligt PEDro-skalan och tillförlitligheten av resultatet bedömdes utifrån ”Bedömning av den sammanvägda tillförlitligheten i systematiska översikter”. Resultat: Sex studier inkluderades i litteraturstudien. Bäst resultat gällande gångförmåga och livskvalitet fick grupperna som genomgick endovaskulär revaskularisering i kombination med en intervention som innehöll fysisk aktivitet. Samtliga studier fick hög kvalitet från granskningen enligt PEDro. Tillförlitligheten av det sammanvägda resultatet bedömdes enligt ”Bedömning av den sammanvägda tillförlitligheten i systematiska översikter” vara låg. Konklusion: Kombinationen av endovaskulär revaskularisering och fysisk aktivitet hade positiv effekt på utfallsmåttet gångförmåga och livskvalitét hos patienter med claudicatio intermittens, men ingen skillnad mellan olika sorters fysisk aktivitet framgick. Fler studier av hög kvalitet som jämför liknande interventioner behövs för att med hög tillförlitlighet kunna avgöra vilken behandling som ger bäst effekt. / Background: Intermittent claudication is common in the elderly population and causes physical and psychological problems such as impaired walking ability and poorer quality of life. Physical activity is an important physiotherapeutic method that has shown promising results for this population. Therefore, it is important to summarize current evidence in order to increase new knowledge and make it available. Purpose: The aim of this literature study was to examine the scientific evidence for physical activity as a treatment, and its effect on walking capacity and quality of life in patients with intermittent claudication  Method: The design of the study was literature study. A literature search for randomized controlled trials was conducted in the PubMed database. The quality of the included studies was examined by the PEDro scale, and the reliability of the results was assessed with ”Bedömning av den sammanvägda tillförlitligheten i systematiska översikter”. Result:  Six studies were included in the literature study. The best results regarding walking ability and quality of life were obtained by the groups that underwent endovascular revascularization in combination with an intervention that included physical activity. All studies received high quality according to PEDro. According to with ”Bedömning av den sammanvägda tillförlitligheten i systematiska översikter”, the reliability of the combined results was considered low. Conclusion: The combination of endovascular revascularization and physical activity had a positive effect on the outcome measures walking ability and quality of life in patients with intermittent claudication. No difference between different types of physical activity could be seen. More studies of high quality comparing similar interventions are needed to be able to determine, with high reliability, which treatment produces the best effect.

Localized muscular loads have in many cases replaced whole body loads in the current mechanized industry. In highly automated automobile industries, the prevalence of upper extremity musculoskeletal disorders is a matter of continuing concern. Overhead work has especially been noted for its association with shoulder related musculoskeletal disorders. Research aimed at determining causal relationships between overhead work and risk of injury has increasingly used localized muscle fatigue as an indirect or surrogate measure. In this study, localized muscle fatigue was used as a primary measure for studying the effects of workload level while performing overhead work. Subjective (ratings of perceived discomfort) measures of fatigue were collected and their predictive potential was investigated. Effect of personality type was also examined to account for any inter-individual differences in fatigue perception. While researchers have studied specific task conditions in controlled environments, the specific relationship between various risk factors and underlying injury mechanisms is largely unknown. Two main problems faced by researchers are limited resources and the large scope of potential ergonomic analyses. This study attempted to circumvent some of these limitations by examining the time-course of fatigue and the predictive potential of subjective measures. The feasibility of using shorter experimental durations to make deductions for a 2-hour work period was explored. Reductions in experimental duration means decreased experimental time, expenses and resources. Thus, in turn, the researcher can utilize available resources to study more factors and a more general scenario. Specifically, subjective measures of shoulder fatigue were used to determine the possibility of reducing experimental duration for an intermittent overhead task. A laboratory-simulated intermittent overhead task was designed based on observations made at an automotive assembly unit. For this study, two treatment conditions were tested consisting of different combinations of two tool masses and two duty cycles. The choice of the treatment conditions was made to simulate different task difficulty levels of occupational tasks and their effects on shoulder fatigue. Each experiment was conducted for 2 hours (a common duration in industries with job rotation) for these selected treatment conditions. Subjective measures of fatigue were collected to assess shoulder fatigue and relative acceptability of the overhead work. Any observed trends in the subjective fatigue measure were determined and tested using statistical and mathematical models to determine how best to represent their salient characteristics. Derived qualitative and quantitative measures were also used to estimate the maximal acceptable task durations using certain formalized assessment techniques. Results of this research suggest possible reductions in the experimental duration. Short (8 to 26 minute) trials were found to be sufficient to predict performance measures for 2 hours. Results also indicated a strong influence of task difficulty level on the predictive performance of subjective measures though personality type did not show very consistent trends. Various unique analysis techniques used to look at the psychophysical data may prove useful for further investigation into predictive verification. A generalized mathematical model, a type of approach, was also developed to represent changes in the psychophysical measures over time. This research can find both industrial and research applications where resources are constrained and using psychophysical measures is feasible. In the following report, details on this work are presented, including a description of the factors that inspired this study, an outline of the relevant literature, methodology, results and their implications. / Master of Science