Die Neue Rückenschule ist ein standardisiertes Rückenschulkonzept der Konföderation der deutschen Rückenschulen, dessen Hauptanliegen in der Förderung der Rückengesundheit und der Verhinderung der Chronifizierung von Rückenschmerzen besteht. Die Zielsetzungen und Inhalte der Neuen Rückenschule richten sich in erster Linie nach den aktuellen Europäischen Leitlinien zur Prävention von Rückenschmerzen und den für die Prävention formulierten Kernzielen für Gesundheitssport. Diese Festlegungen basieren auf dem biopsychosozialen Modell, dem Salutogenesemodell und der Internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF). Mit ihrem multimodalen Programm zielt die Neue Rückenschule darauf ab, dass Menschen ein eigenverantwortliches, gesundheitsorientiertes und Risikofaktoren vermeidendes Handeln aufbauen, ihr individuelles Gesundheitspotential fördern und damit das eigene Wohlbefinden und ihre Lebensqualität verbessern. Das Konzept integriert sowohl bewegungsbezogene praktische als auch informations- und verhaltensbezogene theoretische Anteile. Dennoch steht bis dato eine Wirksamkeitsprüfung der Neuen Rückenschule, insbesondere zur Vermittlungsstrategie der Neuen Rückenschule aus. So liegt das Erkenntnisinteresse der vorliegenden Dissertationsschrift in der Beantwortung der Frage, inwieweit die Intervention Neue Rückenschule im präventiven Kontext günstige Effekte bezüglich der Parameter gesundheitsbezogene Lebensqualität, Rückenschmerzen, körperliche Aktivität, (rücken-)gesundheitsbezogenes Wissen, Selbstwirksamkeit und Kontrollüberzeugung hervorruft. Eine Analyse, ob der nachhaltige Mehrwert der Neuen Rückenschule darin besteht, theoretische Wissensvermittlung und praktische Übungsanteile miteinander zu vernetzen, stellt ein weiteres zentrales Ziel der Arbeit dar. So lässt der momentane Stand der Evaluation noch offen, ob nicht bereits die kognitiv-theoretischen Module die Effekte der Neuen Rückenschule zu einem sehr hohen Anteil erklären. Zur Beantwortung dieser Fragen wurde eine Längsschnittstudie mit Versuchs-Kontrollgruppen-Design durchgeführt, die eine dreimonatige Intervention mit zwei unterschiedlichen Vermittlungsstrategien vorsah. Die empirischen Analysen konzentrierten sich auf die Beschreibung von unmittelbaren Effekten der Intervention sowie Nachhaltigkeits-Effekten sechs Monate nach Interventionsende. Zusammenfassend wird ersichtlich, dass insbesondere für eine Verhaltensänderung im Sinne der Implementierung von körperlicher Aktivität und einer langfristigen Bindung an diese, spezifisches Wissen allein offenbar nicht ausreicht, sondern Handlungserfahrungen und Körperwahrnehmungen in Verbindung mit erlebter Selbstkompetenz den Erfolg einer Intervention maßgeblich bedingen.

Type 1 diabetes (T1D) is an auto-immune disease characterized by insulin-deficiency. Insulin is a metabolic hormone that is involved in lowering blood glucose (BG) levels in order to control BG level to a tight range. In T1D this glycemic control is lost, causing chronic hyperglycemia (excess glucose in blood stream). Chronic hyperglycemia damages vital tissues. Therefore, glycemic control must be restored. A common therapy for restoring glycemic control is intensive insulin therapy, where the missing insulin is replaced with regular insulin injections. When dosing this compensatory insulin many factors that affect glucose metabolism must be considered. Linkura is a company that has developed tools for monitoring the most important factors, which are meals and exercise. In the Linkura meal and exercise tools, the nutrition content in meals and the calorie consumption during exercise are estimated. Another tool designed to aid control of BG is the bolus calculator. Bolus calculators use input of BG level, carbohydrate intake, and insulin history to estimate insulin need. The accuracy of these insulin bolus calculations suffer from two problems. First, errors occur when users inaccurately estimate the carbohydrate content in meals. Second, exercise is not included in bolus calculations. To reduce these problems, it was suggested that the Linkura web tools could be utilized in combination with a bolus calculator. For this purpose, a bolus calculator was developed. The bolus calculator was based on existing models that utilize clinical parameters to relate changes in BG levels to meals, insulin, and exercise stimulations. The bolus calculator was evaluated using data collected from Linkura's web tools. The collected data showed some inconsistencies which cannot be explained by any model.  The performance of the bolus calculator in predicting BG levels using general equations to derive the clinical parameters was inadequate. Performance was increased by adopting an update-algorithm where the clinical parameters were updated daily using previous data. Still, better model performance is prefered for use in a bolus calculator.   The results show potential in developing bolus calculator tools combined with the Linkura tools. For such bolus calculator, further evaluation on modeling long-term exercise and additional safety features minimizing risk of hypoglycemia are required.

La finalitat d’aquest estudi és, des d’una perspectiva fisiològica, descriure i comparar la resposta aguda a dues sessions d’entrenament de càrrega global moderada però de diferent intensitat i distribució de l’esforç. Els participants, 9 homes i 1 dona amb bona condició física, varen realitzar dues sessions d’entrenament que varen consistir en 45 minuts de cursa contínua al 90% de la velocitat del llindar de lactat individual (vIAT), o 8 sèries de 4 minuts de cursa al 105% de la vIAT i pauses de 2’30” (sessió CI). Abans i durant la recuperació es va procedir a l’extracció de sang venosa per a l’anàlisi dels paràmetres estudiats. Els resultats indiquen que l’exercici físic aeròbic en intervals causa una resposta pro-inflamatòria i pro-oxidant superior a la de l’exercici físic continu, però aquesta és de poca magnitud i transitòria. També s’ha apreciat que les concentracions plasmàtiques de lactat, IL-8 i d’urat augmenten més si la intensitat de l’esforç és elevada; mentre que les de IL-6 i IL-10 s’eleven en major mesura després de l’exercici físic continuo. Per altra banda, l’anàlisi del metaboloma plasmàtic suggereix que els canvis estan dominats per alteracions de compostos lipídics. En general els canvis varen ser moderats i transitoris, i no sembla que l’exercici aeròbic en intervals de durada mitjana suposi un risc elevat per a persones habituades a realitzar exercici físic. / La finalidad del estudio es, desde una perspectiva fisiológica, describir y comparar la respuesta aguda a dos sesiones de entrenamiento de carga global moderada pero de diferente intensidad y distribución del esfuerzo. Los participantes, 9 varones y 1 mujer con buena condición física realizaron dos sesiones de entrenamiento que consistieron en 45 minutos de carrera continua al 90% de la velocidad del umbral de lactato individual (vIAT), o 8 series de 4 minutos de carrera al 105% de la vIAT y pausas de 2’30”. Antes y durante la recuperación se procedió a la extracción de sangre venosa para el análisis de los parámetros estudiados. Los resultados indican que el ejercicio físico aeróbico en intervalos causa una respuesta pro-inflamatoria y pro-oxidante superior a la del ejercicio físico continuo de intensidad moderada, pero de poca magnitud y transitoria. També se ha apreciado que las concentraciones plasmáticas de lactato, IL-8 y urato aumentan más si la intensidad del esfuerzo es elevada; mientras que las de IL-6 y IL-10 crecen más después del ejercicio físico continuo. Por otro lado, el análisis del metaboloma plasmático sugiere que los cambios inducidos por el ejercicio están dominados por alteraciones de compuestos lipídicos. En general las alteraciones fueron moderadas y transitorias y no parece que el ejercicio aeróbico en intervalos suponga un riesgo elevado para las personas acostumbradas a realizar ejercicio físico regular. / The aim of the study was, from a physiological perspective, to describe and to compare the acute response to two training sessions of moderate global load, but of different intensity and distribution of the exertion. Participants, 9 men and one woman with good physical condition, performed two training sessions that consisted in 45 minutes of continuous running at the 90% of individual anaerobic threshold speed, or 8 series of 5 minutes at the 105% of individual anaerobic threshold speed with rest pauses of 2’30” between them. Before and during the recovery period venous blood samples were drawn for the analysis of hematologic and biochemistry parameters. Results show that aerobic interval training causes more pro-inflammatory and pro-oxidant response compared to continuous running at moderate intensity, but changes are moderate and transient. In the same way, lactate, IL-8 and urate plasma concentrations were superior after high intensity exercise, meanwhile IL-6 and IL-10 plasma concentrations were more respondents to continuous running and to the greater duration of the physical work. On the other hand, the non-oriented metabolomic approach suggests that changes in plasma metabolome induced by the exercise are dominated by lipid molecular species. Altogether changes were moderate and transient, and it seems that aerobic interval training does not represent an important risk for trained individuals.

Aurimas Medonis Pasirinkto fizinių pratimų komplekso veiksmingumas Santrauka Tyrimo tikslas  įvertinti X klasės vaikinų pasirinktų fizinių pratimų kompleksų įvairialypį veiksmingumą. Nuo 2006 m. sausio 9d. iki 2006 m. gegužės 22 d. Vilniaus Žirmūnų gimnazijoje ir Vilniaus Šv. Kristoforo mokykloje buvo vykdytas ugdomasis pedagoginis eksperimentas. Jame dalyvavo 59 X klasių pagrindinės medicininės fizinio pajėgumo grupės vaikinai. Atsitiktiniu būdu buvo parinktos 3 eksperimentinės (E1  2a, 10c, 10d ─ 24 vaikinai) ir 4 kontrolinės (E2 ─ 2d, 2c, 10b, 10e ─ 35 vaikinai) klasės. Nepriklausomas kintamasis ─ sukurta fizinių ypatybių lavinimo per kūno kultūros pamokas bei laisvalaikiu metodika, kuri rėmėsi mokinio pasirinktu fizinių pratimų kompleksu. Ši metodika didino kūno kultūros pamokų žinias, įtvirtino savimoką. Eksperimentinėje (E1) grupėje vaikinams per 2 savaitines kūno kultūros pamokas buvo galima rinktis pratimus iš pateiktų variantų, taip pat sugalvoti savų pratimų. Be to pratimų kompleksą rekomenduota atlikti ir laisvalaikiu bent vieną kartą per savaitę. E2 grup��s vaikinai per kūno kultūros pamokas dirbo įprastai, į kūno kultūros pamokas įkomponuojant tradicines fizinių ypatybių lavinimosi priemones ir metodiką. Per eksperimentines kūno kultūros pamokas kryptingiau dirbta taikant bendradarbiavimo metodą: kūno kultūros ir socialiniai gebėjimai buvo plėtojami tiesiogiai mokiniams bendradarbiaujant dėl individualios atsakomybės ir teigiamos tarpusavio priklausomybės... [toliau žr. visą tekstą] / Aurimas Medonis Efficiency of individually chosen physical exercise complex Summary The purpose of the research is to evaluate individually chosen physical exercise complex method’s efficiency of the 10th grade schoolboys. Fifty-nine schoolboys, who belong to the main medical physical ability group and attend Vilniaus Žirmūnų gymnasium and Vilniaus Šv.Kristoforo secondary school, took part in the pedagogical experiment. The experiment was organized during the school year 2006, from January 9th to May 22d. Schoolboys were distributed into three experimental (E1  2a, 10c, 10d ─ 24 schoolboys) and four control (E2 ─ 2d, 2c, 10b, 10e ─ 35 schoolboys) classes. The experimental program was applied to group E1, while group E2 had the same physical education lessons as earlier. Independent variable ─ method of improving physical features was designed in order to increase individually chosen physical exercise complex. Research methods used in the Master‘s thesis are the following: analysis of literature, questionnaire, physical features testing and statistical analysis. Questionnaire investigated 10th grade schoolboys’ attitude towards sport, healthy life style as well as independent work out. Eurofit’s (2002) and J.Skernevičius’ (2004) physical tests as well as physical education standards were used in order to identify physical features of the pupils. Investigation results were evaluated with „Statistica“ and MS „Excel“ computer programmes. Results of the questionnaire show... [to full text]

Eine angemessene, regelmäßige sportliche Aktivität wirkt protektiv auf die Erhaltung und Wiederherstellung körperlicher und geistiger Gesundheit. Die Herzinsuffizienz ist nicht zuletzt durch ihre hohe Prävalenz ein internistisches Krankheitsbild von enormer Relevanz im klinischen Alltag. Im Rahmen einer bestehenden Herzinsuffizienz kann es zur pathophysiologischen Ausprägung einer gestörten Endothelfunktion kommen, welche sich in einer verringerten endothelialen Dilatationsfähigkeit ausdrücken kann. Das Ziel dieser Dissertation bestand in der Untersuchung der Auswirkungen eines körperlichen Trainings auf die Funktionsleistung der Endothelzellen von herzinsuffizienten Mäusen. Hierzu wurde in einem operativen Eingriff durch die Ligatur des Ramus interventricularis anterior bei jungen Mäusen ein herzinsuffizientes Tiermodell geschaffen und der sekundärpräventive Effekt eines anschließenden zehnwöchigen Laufbandtrainings eruiert. Als Funktionsmaß der Endothelzellen diente dabei ihre endothelabhängige Dilatationsfähigkeit, welche im Organbad erhoben wurde. Weiterhin lag der Fokus auf der Untersuchung des Einflusses der im Endothel exprimierten microRNA-21 und microRNA-126 im trainierten und untrainierten herzinsuffizienten Aortenendothel. Ihre Expression wurde in den verschiedenen Versuchsgruppen quantitativ mittels Real-Time PCR erfasst. In einem weiteren Ansatz bestand das Ziel, den Einfluss einer Angiotensin II- beziehungsweise Zytokinstimulation - als Modell eines mit der Herzinsuffizienz vergesellschafteten Inflammationsgeschehens - auf diese beiden endothelexprimierten microRNAs zu erforschen.

Human health is a complex and wide-ranging subject far beyond nutrition and physical exercise. Still, these factors have a huge impact on global health by their ability to prevent diseases and thus promote health. Thus, to identify health risks and benefits, it is necessary to reveal the underlying mechanisms of nutrition and exercise, which in many cases follows a complex chain of events. As a consequence, current health research is generating massive amounts of data from anthropometric parameters, genes, proteins, small molecules (metabolites) et cetera, with the intent to understand these mechanisms. For the study of health responses, especially related to physical exercise and nutrition, alterations in small molecules (metabolites) are in most cases immediate and located close to the phenotypic level and could therefore provide early signs of metabolic imbalances. Since there are roughly as many different responses to exercise and nutrients as there are humans, this quest is highly multifaceted and will benefit from an interpretation of treatment effects on a general as well as on an individual level. This thesis involves the application of chemometric methods to the study of global metabolic reactions, i.e. metabolomics, in a strategy coined predictive metabolomics. Via the application of predictive metabolomics an extensive hypothesis-free biological interpretation has been carried out of metabolite patterns in blood, acquired using gas chromatography-mass spectrometry (GC-MS), related to physical exercise, nutrition and diet, all in the context of human health. In addition, the chemometrics methodology have computational benefits concerning the extraction of relevant information from information-rich data as well as for interpreting general treatment effects and individual responses, as exemplified throughout this work. Health concerns all lifestages, thus this thesis presents a strategic framework in combination with comprehensive interpretations of metabolite patterns throughout life. This includes a broad range of human studies revealing metabolic patterns related to the impact of physical exercise, macronutrient modulation and different fitness status in young healthy males, short and long term dietary treatments in overweight post menopausal women as well as metabolic responses related to probiotics treatment and early development in infants. As a result, the studies included in the thesis have revealed metabolic patterns potentially indicative of an anti-catabolic response to macronutrients in the early recovery phase following exercise. Moreover, moderate differences in the metabolome associated with cardiorespiratory fitness level were detected, which could be linked to variation in the inflammatory and antioxidaive defense system. This work also highlighted mechanistic information that could be connected to dietary related weight loss in overweight and obese postmenopausal women in relation to short as well as long term dietary effects based on different macronutrient compositions. Finally, alterations were observed in metabolic profiles in relation to probiotics treatment in the second half of infancy, suggesting possible health benefits of probiotics supplementation at an early age. / Embargo until 2012-06-01

Conselho Nacional de Desenvolvimento Científico e Tecnológico / Traumatic brain injury (TBI) is a major cause of morbidity and mortality in industrialized countries leading to the motor and cognitive deficits. Evidence demonstrated that exercise is neuroprotective in traumatic brain injury. However, the effects of exercise before of the TBI at the cognitive function are unknown. Role of excitotoxicity and oxidative damage in secondary damage of TBI, however, until this moment, were not demonstrated if exists a relationship between early phase of damage and the late cognitive deficit. In the current study, we proposed that improvement cognitive response induced by exercise prior in rats after a TBI can be associated with the neuroprotection of early phase after injury. To demonstrate this hypotheses, adult rats practice swimming exercise during 6 weeks followed for TBI operation. We assessed the motor alterations of early phase, the glutamate uptake and antioxidant defense in twenty four hours (24 h) and 15 days after TBI. Acquisition of memory was assessed by recognition object task on days 15 post TBI. Moreover, we evaluated the brain-derived neurotrophic factor (BDNF) to assessement the synaptic plastic. In the present study, we showed that TBI induced by fluid percussion injury (FPI) in adult male Wistar rats induced early motor impairment 24 h, followed by learning retention deficit (2 weeks after neuronal injury). Previous swimming training improved the memory in object recognition task per se and protected against FPI-related disabilities. Although the FPI did not alter hippocampal expression of glutamate transporters (EAAT1 / EAAT2) and brain-derived neurotrophic factor (BDNF), the alterations in the redox status, herein characterized by DCFH-DA oxidation and SOD activity inhibition, led to marked impairment of protein functionally (Na+, K+-ATPase activity inhibition) and glutamate uptake inhibition 24 h after neuronal injury in sedentary injured rats. Indeed, the early increase of nuclear factor erythroid 2-related factor (pNRF2/NRF2 ratio) followed by a repair mechanism (protein HSP70 expression), 24 h and 2 weeks after neuronal injury, suggests that FPI-induced signal transduction may exert compensatory effect on pathophysiological processes. In this report we showed that previous physical exercise induced the increase of immune content of glutamate transporters (EAAT1/ EAAT2), pNrf2/Nrf2 ratio, SOD enzyme and HSP70 per se besides preventing against FPI-induced Na+, K+ - ATPase activity, glutamate uptake inhibition DCFH-DA oxidation 24 h after neuronal injury. The enhancement of hippocampal pNrf2/Nrf2 and HSP70 immune content in trained injured when compared with sedentary rats suggest that protein expression modulation associated to antioxidant defense elicited by previous physical exercise prevent against toxicity induced by TBI. The significant increase of BDNF levels in trained injured rats 24 h and 2 weeks strongly reinforce the idea that physical activity alters neuronal functions and thus delays or prevents secondary cascades that leave the neurobehavioral disability after TBI. / O traumatismo cranioencefálico (TCE) é uma das maiores causas de morte e morbidade nos países industrializados podendo levar ao comprometimento motor e déficits cognitivos. Evidências demonstram que o exercício físico é neuroprotetor na recuperação após o TCE. Porém, os efeitos do exercício físico antes do TCE na função cognitiva não são totalmente conhecidos. Sabe-se da participação da excitotoxicidade e do estresse oxidativo na cascata do dano secundário após o TCE, entretanto até o momento não foi demonstrado qual a relação da fase inicial após o TCE com os déficits cognitivos tardios. Portanto, no presente estudo, nós propomos que a melhora cognitiva tardia induzida pelo exercício prévio em ratos após o TCE pode estar associada com a neuroproteção da fase inicial após o dano. Para demonstrar esta hipótese, ratos adultos praticaram treinamento de natação durante 6 semanas e posteriormente foram submetidos a cirurgia para o TCE. Nós avaliamos as alterações motoras iniciais, a captação de glutamato e a defesa antioxidante em 24 horas (24 h) e 15 dias após o TCE. Aquisição da memória foi avaliada pela tarefa de reconhecimento de objetos em 15 dias após o TCE. Além disso, nós avaliamos o fator neurotrófico derivado do encéfalo (BDNF) para avaliar a plasticidade sináptica. No presente estudo, nós mostramos que o TCE induzido pela lesão de percussão de fluido (LPF) em ratos Wistar machos adultos induziu déficit motor inicial 24 h, seguido por déficit de aprendizagem (15 dias após o dano neuronal). O treinamento de natação prévio melhorou a memória na tarefa de reconhecimento de objeto per se e protegeu contra desabilidades relacionadas ao LPF. Embora o LPF não tenha alterado a expressão dos transportadores de glutamato (EAAT1/EAAT2) e de BDNF, causou uma alteração no estado redox, caracterizado pela oxidação de DCFH-DA e inibição da atividade da SOD. O LPF também causou prejuízo acentuado da funcionalidade de proteínas (inibição da atividade da enzima Na+, K+-ATPase) e inibição da captação de glutamato 24 h após o dano neuronal em ratos sedentários lesionados. De fato, o aumento inicial do fator de transcrição Nrf2 (relação pNrf2/Nrf2), 24 h após o TCE, seguido por um mecanismo de reparo (expressão da proteína Hsp70), 24 h e 15 dias após o dano neuronal, sugerem que a transdução de sinal induzida pelo LPF pode exercer um efeito compensatório em processos patofisiológicos. Neste trabalho, nós mostramos que o exercício físico prévio induziu o aumento do imunoconteúdo dos transportadores de glutamato (EAAT1/EAAT2), relação pNrf2/Nrf2, enzima SOD e a proteína Hsp70 per se, além de prevenir contra inibição da atividade da Na+, K+-ATPase, inibição da captação de glutamato e oxidação de DCFH-DA induzida pelo LPF, 24 h após o dano neuronal. O aumento do imunoconteúdo hipocampal de pNrf2/Nrf2 e Hsp70 em ratos treinados e lesionados quando comparado com ratos sedentários, sugerem que a modulação da expressão das proteínas associadas às defesas antioxidantes induzidas pelo exercício físico prévio preveniu contra a excitotoxicidade induzida pelo TCE. O significante aumento nos níveis de BDNF em ratos treinados e lesionados 24 h e 15 dias, reforçam fortemente a ideia que a atividade física altera a função neuronal e assim retarda ou previne as cascatas do dano secundário que levam a desabilidade neuronal após o TCE.

Abstract Physical activity with regular physical exercise (PE) has long been advocated because it lowers morbidity and mortality. However, there have been concerns about a transiently increased risk of adverse cardiac events such as sudden cardiac death (SCD) during PE. Our aim was to identify risk factors related to SCD during PE and clarify the effect of PE on cardiovascular well-being in the general population. In study I we found out that male gender as well as coronary artery disease (CAD), cardiac hypertrophy and myocardial scarring as autopsy-findings were clearly more common among exercise-related SCD. Typical northern activities in skiing and snow shoveling were among the three most common types of PE alongside cycling. In study II we analyzed the previously recorded electrocardiograms (ECG) of victims of SCD. Fragmented QRS complex (fQRS) in anterior leads was a common finding among subjects who died during exercise, especially among subjects with a prior diagnosis of CAD. In study III, we collected retrospectively out-of-hospital sudden cardiac arrest (SCA) data in Northern Ostrobothnia between the years 2007 and 2012. The subjects who suffered SCA in relation to PE were younger and previously healthier, and they had more often a shockable rhythm as the initial rhythm. There was a markedly better prognosis for hospital discharge when SCA occurred during PE. In study IV, we noticed a decrease in cardiac mortality in subjects who were physically active or became active during follow-up in a population of 1,746 stable CAD patients. A similar effect could be seen affecting SCD mortality. No increase in cardiac mortality could be seen among those with the highest levels of habitual PE. In conclusion, ischemic heart disease and male gender, especially when fQRS is present in anterior leads, are characteristics related to exercise-related SCD. On the other hand, when SCA takes place during PE, the prognosis is markedly better compared to SCA occurring at rest. An active lifestyle is also linked to decreased cardiac mortality. / Tiivistelmä Säännöllinen aktiivinen elämäntapa on yhteydessä pienempään fyysisten ja psyykkisten sairauksien riskiin. Tutkimuksissa on kuitenkin havaittu raskaampaan liikuntaan liittyvä väliaikaisesti lisääntynyt akuutin sydäntapahtuman, kuten äkkikuoleman, riski. Väitöskirjatutkimuksessa tutkitaan rasitukseen liittyvän sydänperäisen äkkikuoleman erityispiirteitä ja fyysisen aktiivisuuden merkitystä hyvinvoinnille. Ensimmäisessä osajulkaisussa havaittiin, että rasitukseen liittyvissä kuolemissa oli ruumiinavauslöydöksenä merkittävästi enemmän sepelvaltimotautia, sydänlihaksen arpeutumista ja sydänlihaksen liikakasvua verrattuna äkkikuolemiin levossa. Miessukupuoli oli selkeästi yliedustettuna rasituspopulaatiossa, sillä peräti 94 % oli miehiä. Yleisimmät rasitusmuodot olivat hiihto, pyöräily ja lumenluonti. Toisessa osatutkimuksessa tutkittiin edeltävien EKG-muutosten yhteyttä rasitusperäisiin äkkikuolemiin. Havaitsimme, että QRS-kompleksin pirstoutuminen etuseinäkytkennöissä oli selkeästi yleisempi löydös rasitusryhmässä. Tämä löydös oli erityisen merkittävä sepelvaltimotautipotilailla. Kolmas julkaisu sisältää tiedot sairaalan ulkopuolisista sydänpysähdyksistä Pohjois-Pohjanmaalla vuosina 2007–2012. Tässä aineistossa havaitsimme, että rasitukseen liittyvän sydänpysähdyksen alkurytmi oli useammin defibrilloitava, potilaat olivat nuorempia ja terveempiä, ja maallikkoelvytys aloitettiin useammin. Rasituksessa elottomaksi menneillä oli suhteellisen hyvä selviämisennuste. Neljännessä tutkimuksessa havaitsimme selkeästi paremman ennusteen niillä stabiilia sepelvaltimotautia sairastaneilla, jotka olivat liikunnallisesti aktiivisia. Sydänperäinen kuolleisuus oli pienempi myös niillä potilailla, jotka onnistuivat lisäämään liikunnallista aktiivisuuttaan. Samankaltainen tulos todettiin sydänperäisten äkkikuolemien osalta. Sepelvaltimotauti ja miessukupuoli ovat hyvin yleisiä löydöksiä, kun sydänperäinen äkkikuolema tapahtuu rasituksessa. Myös QRS-kompleksin pirstoutuminen etuseinäkytkennöissä liittyi rasitusperäisiin kuolemiin. Toisaalta potilaan ennuste selvitä on selkeästi parempi sydänpysähdyksen tapahtuessa rasituksessa. Osoitimme myös, että liikunnallinen aktiivisuus ja sen pienikin lisäys parantavat sepelvaltimotautipotilaiden ennustetta.

Le comportement envers une activité physique (AP) peut être compris sur un continuum où les individus inactifs et les individus qui pratiquent de façon excessive représentent les deux extrémités. Au milieu de ce continuum se trouvent les individus qui pratiquent de façon modérée et régulière. Ce sont ces derniers qui semblent bénéficier le plus de la pratique d’une AP (Canning et al., 2014; Kern et al., 2013; Warburton et al., 2006; Spirduso, 1995) (Spirduso, 1995). Cette thèse a pour but de comprendre les comportements dites ‘à risque pour la santé’ par rapport à la pratique d’AP, notamment l’inactivité physique et la pratique problématique d’exercice physique (PPEP). Cette thèse s’articule donc en deux parties. La première partie ‘‘Perspectives théoriques’’ a pour but la présentation d’une recherche adaptée afin de fournir une compréhension complète des comportements vis à vis la pratique d’AP et plus particulièrement l’inactivité physique et la PPEP. Cette partie vise également à faire un état de lieu de leurs méthodes d’évaluation, leurs causes et conséquences, ainsi que leurs préventions et traitements. La deuxième partie ‘‘Perspectives empiriques’’ qui sera elle même divisée en deux sous sections, sera consacrée aux différents articles (publiés ou en cours) englobant l’inactivité physique chez les étudiants universitaires et la PPEP: le but de cette dissertation est donc double et s’articule autour de sept articles. 1/Pour comprendre le problème d’inactivité physique à travers: (a) Une revue systématique de la prévalence globale de l’inactivité physique au sein des étudiants universitaires; (b) Une étude croisée effectuée au sein des communautés estudiantines françaises et indiennes; (c) Une étude exploratoire afin de tracer le profil des étudiants inactifs en Inde. 2/ Afin de mieux cerner le phénomène de la PPEP grâce à:(a) La validation d’un modèle hiérarchique définissant la PPEP; (b) L’étude du cas clinique d’un homme de cinquante ans mettant en lumière le développement et les motivations vis à vis la PPEP;(c) Une etude exploratoire sur les liens entre la PPEP et les traits d’impulsivité; (d) Cette étude vise à reproduire le modèle de Cook & Hausenblas (2008) qui postule que la PPEP joue un rôle de médiateur entre l’exercice physique et les troubles du comportements alimentaires (TCA). / Behavior towards physical activity (PA) can be investigated on a continuum with physical inactivity on one end and excessive exercise leading to the dangers of doping and/or problematic practice of physical exercise (PPPE), on the other. The aim of the current dissertation is to further clarify the concepts of physical inactivity as well as PPPE, in order to promote the adoption of regular and moderate PA while taking into account the negative consequences of excessive exercising. This dissertation is divided into two parts. The purpose of Part I – ‘Theoretical Perspectives’ is to present pertinent research and provide a general understanding of physical inactivity and PPPE. Part II – ‘Empirical Perspectives’, consists of the various research papers encompassing the two phenomena. Thus, the aim of this dissertation is twofold and is achieved through seven papers: 1/To understand the epidemic of physical inactivity through (a) a systematic review of prevalence of physical inactivity in college students globally on studies done between 2002 and 2015, (b) a cross sectional study done on a cohort of French and Indian university students and (c) an analysis of the psychological correlates of physical inactivity amongst Indian university students. 2/ To understand the phenomenon of PPPE through (a) the validation of an hierarchical model explaining PPPE, (b) a clinical case study of a 50 year old man throwing light upon the development and motivations towards PPPE, and (c) the possible links between traits of impulsivity and PPPE. This section also presents a fourth working article which (d) aims to replicate the mediation model of exercise, PPPE and eating pathology validated by Cook & Hausenblas (2008) along with the motivation to control weight.

O objetivo geral deste estudo foi verificar os efeitos terapêuticos do enriquecimento ambiental e do exercício físico forçado sobre as conseqüências funcionais e cognitivas da Hipoperfusão Encefálica Crônica (HEC) em ratos Wistar. Além disso, padronizamos protocolo alternativo de HEC, a fim de aumentar a taxa de sobrevivência característica deste modelo, juntamente com a análise comportamental e imunohistoquímica do sétimo ao sexto mês após a cirugia, analisando o comportamento de neurônios e astrócitos no hipocampo. Os resultados mostraram que o protocolo modificado, ou seja, com a oclusão das carótidas realizadas com uma semana de intervalo, apresentam resultados comportamentais e morfológicos similares aos do protocolo padrão; todavia, a taxa de sobrevida dos animais no protocolo modificado é significativamente maior quando comparados ao padrão. Além disso, em ambos os protocolos, os animais hipoperfundidos apresentam um déficit cognitivo no Teste Water Maze três meses após a cirurgia, mas os grupos isquêmicos não apresentaram diferenças morfológicas quando comparados ao seus controles em relação a volume total Hipocampal e área Estriatal. Ao analisar o tempo pós- lesão do déficit cognitivo, verificamos que a HEC causa danos comportamentais a longo prazo, chegando a seis meses após o evento isquêmico. Enquanto a cognição é afetada na fase crônica, as células neuronais e astrogliais são acometidas nas fases mais agudas deste modelo, começando a aparecer morte neuronal (através da quantificação de NeuN) e astrogliose reativa (através da quantificação do imunoconteúdo de GFAP) já nos primeiros dias, permanecendo até aproximadamente 3 meses após a lesão. Após o dano estabelecido, testamos estratégias terapêuticas com o objetivo de amenizar principalmente o dano cognitivo apresentado pelos animais a partir dos três meses após cirurgia. Inicialmente foi analisado o efeito pré e pós - isquemia do exercício físico forçado através de uma esteira para ratos na memória espacial e de trabalho, através do Water Maze e bioquimicamente no estado oxidativo cerebral. Posteriormente, os mesmos parâmetros foram testados, só que com a intervenção do enriquecimnto ambiental tanto pré quanto pós-isquemia também. O modelo de hipoperfusão cerebral crônica causa como citado anteriormente, um déficit bastante importante na memória e no apredizado. Somado a isso, em relação ao estresse oxidativo, a quantidade de radicais livres e o estado de lipoperoxidação celular encontra-se bastante aumentados no hipocampo de animais submetidos a isquemia, assim como as enzimas antioxidantes. O protocolo de atividade física regular forçada (3 vezes por semana, durante 20 minutos num período de 3 meses), sobretudo nos grupos pré e pré+pós-isquemia, preveniu os efeitos cognitivos e bioquímicos da HEC. Tal reversão também ocorreu com o uso do enriquecimento ambiental realizado 3 vezes por semana, 1 hora durante 3 meses em todos os grupos estimulados. / The aim of this study was to verify the experimental therapeutic effects of environmental enrichment and forced physical exercise on the consequences of cognitive and functional chronic cerebral hypoperfusion (CCH) in Wistar rats. To do that, a CCH alternative protocol was standardized, in order to increase the survival rate of this model, together with the behavioral and immunohistochemistry analysis done up to the sixth month after the surgery, analyzing hippocampus neurons and astrocytes. Results showed that the modified protocol, with occlusion of both carotid arteries performed with a one-week interval, presents morphological and behavioral results similar to the standard protocol; however, the rate of survival after the modified protocol was significantly greater when compared to the standard one. In addition, both protocols produced ischemic animals with cognitive deficits in the Water Maze Task, three months after the surgery, however with no gross morphological lesion, as assessed by hippocampal volume and estriatal area. The cognitive deficit in CCH rats is long lasting, reaching six months after the ischemic event. While the cognition is affected in the chronic phase of hypoperfusion, the neuronal and astrogliais cells are affected in acute phases of this model; neuronal death (through quantification of NeuN) and reactive astrogliosis (through quantification of imunocontent of GFAP) are already present in the first days and remain until approximately 3 months after the lesion. We tested therapeutic strategies with the aim of alleviating mainly the cognitive damage presented by animals, as from three months after surgery. Initially, the effects of preand post-ischemia forced physical exercise in spatial and working memory, through the Water Maze Tak and oxidative stress parameters were analyzed. Subsequently, we tested the effects of environmental enrichment, both pre- and post-ischemia. The model of chronic cerebral hypoperfusion as previously mentioned, causes an important deficit in spatial learning and memory; the free radicals content and cellullar lipid peroxidation is also substantially increased in the hippocampus of animals submitted to hypoperfusion, as well as the antioxidant enzymes. Forced regular physical activity protocol (20-min, 3 times per week during 12 weeks – moderate), especially in groups pre and pre+post-ischemia, warned cognitive and biochemical preventive effects in CCH rats; the same occurred with the use of enrichment environmental performed 1- hr, 3 times per week during 12 weeks in all groups stimulated.