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  • 1.
    Eriksson, Linda
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Schagatay, Filip
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Sjöström, Rita
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Soderstrom, Lars
    Hanstock, Helen
    Sandström, Thomas
    Department of Medicine, Respiratory & allergy unit, Umeå university hospital, Umeå, Sweden.
    Stenfors, Nikolai
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Symptoms of moderate exercise in subzero temperatures - An experimental exposure study2018Ingår i: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Humans react to cold with various symptoms. Previous studies enquiring about symptoms during cold exposure have for the most part been population based studies using questionnaries and have focused on a narrow spectrum of symptoms. The purpose of this study was to study the effect of cold air and physical exercise on a wide range of symptoms in healthy individuals.

    A total of 31 healthy subjects were experimentally exposed to +10 °C and -10 °C in an environmental chamber for one hour, on two separate occasions. During each exposure, subjects performed an intermittent moderate-intensity running protocol between 62-78% of maximal oxygen consumption (VO2 max). At five timepoints, before, during and after the exposures, subjects were asked about 18 symptoms and their intensity. The Borg CR10 scale was used to rate the intensity from 0 to 11, where 0 meant "none" and 11 meant "maximal". The sum of all five Borg CR10-scores were added together to form a single score for each exposure. Paired Wilcoxon signed-rank test was used for analysis. Data are presented as medians.

    Symptoms of cough, eye irritation, physical discomfort, and cold extremities were present only at -10 °C. Compared to exercise in +10 °C, exercise in -10 °C induced significantly higher summed symptom scores for eye irritation 2.0 vs 0.5 (p=0.011), rhinitis 12.0 vs 8.0 (p=0.000), nasal irritation 3.5 vs 0.5 (p=0.001), cold face 7.0 vs 1.0 (p=0.000), physical discomfort 6.5 vs 0.0 (p=0.000), and cold extremities 10.0 vs 0.5 (p=0.000).

    In healthy subjects, moderate-intensity exercise in -10 °C can induce and enhance the intensity of a wide range of symptoms. Symptoms of the lower airways were infrequent and mild.

  • 2. Essner, Ann
    et al.
    Zetterberg, Lena
    Hellström, Karin
    Gustås, Pia
    Högberg, Hans
    Sjöström, Rita
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Psychometric evaluation of the canine brief pain inventory in a Swedish sample of dogs with pain related to osteoarthritis2017Ingår i: Acta Veterinaria Scandinavica, ISSN 1751-0147, E-ISSN 1751-0147, Vol. 59, artikel-id 44Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: To evaluate intervention, implement evidence-based practice and enhance the welfare of dogs with naturally occurring osteoarthritis (OA), access to valid, reliable and clinically relevant outcome measures is crucial for researchers, veterinarians and rehabilitation practitioners. The objectives of the present study were to translate and evaluate psychometric properties, in terms of internal consistency and construct validity, of the owner-reported measure canine brief pain inventory (CBPI) in a Swedish sample of dogs with pain related to OA. Results: Twenty-one owners of clinically sound dogs and 58 owners of dogs with pain related to OA were included in this observational and cross-sectional study. After being translated according to the guidelines for patient-reported outcome measures, the CBPI was completed by the canine owners. Construct validity was assessed by confirmatory factor analysis, by repeating the principal component analysis and by assessing for differences between clinically sound dogs and dogs with pain related to OA. Internal consistency was estimated by Cronbach's a. Confirmatory factor analysis was not able to confirm the factor-structure models tested in our sample. Principal component analysis showed a two-component structure, pain severity and pain interference of function. Two components accounted for 76.8% of the total variance, suggesting an acceptable fit of a two-component structure. The ratings from the clinically sound dogs differed from OA dogs and showed significantly lower CBPI total sum. Cronbach's a was 0.94 for the total CBPI, 0.91 for the pain severity and 0.91 for the pain interference of function. Conclusions: The results indicate that the translated version of the CBPI is valid for use in the Swedish language. The findings suggest satisfying psychometric properties in terms of high internal consistencies and ability to discriminate clinically sound dogs from OA dogs. However, based on the confirmatory factor analysis, the original factor structure in the CBPI is not ideally suited to measure pain related to OA in our sample and the hypothesis of the presented two-factor structure was rejected. Further research needs to be conducted to determine whether the original psychometric results from CBPI can be replicated across different target groups and particularly with larger sample size.

  • 3.
    Sjöström, Rita
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering. Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden.
    Söderström, Lars
    Klockmo, Carolina
    Patrician, Alexander
    Sandström, Thomas
    Björklund, Glenn
    Hanstock, Helen
    Stenfors, Nikolai
    Qualitative identification and characterisation of self-reported symptoms arising in humans during experimental exposure to cold air2019Ingår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 78, nr 1, artikel-id 1583528Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Exposure to cold air is associated with increased morbidity and mortality in the general population. It is difficult to study the effects of whole-body exposure to cold air under controlled conditions in real life. Objectives: The aim of this study was to (1) explore and describe the experience of symptoms in humans during experimental and controlled exposures to cold air, by using controlled environmental chamber exposures and qualitative methodology, and to (2) categorise the symptoms. Method: The study used a randomised, double blind design, in which 34 subjects undertook rest and moderate-intensity exercise in an environmental chamber set to two or three different temperatures (0, -10, and -17 degrees C) on separate occasions. During the chamber exposures, subjects were interviewed. Qualitative content analysis was selected as the method of analysis. Findings: Subjects reported 50 distinct symptoms during the exposures. The symptoms were grouped into ten sub-categories and two major categories; airway versus whole-body symptoms. Conclusion: We have identified a broad range of symptoms in humans undertaking rest and moderate-intensity exercise at sub-zero temperatures. The symptoms and their categories may well be used to more extensively and quantitatively map cold-induced morbidity.

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