Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate Professor Inger-Lise Aamodt Aksetøy, NTNU: Norwegian University of Science and Technology, Norway
- Second opponent: Professor Martin van der Esch, The Amsterdam University of Applied Sciences, Netherlands
- Third member and chair of the evaluation committee: Associate Professor Trygve Skonnord, University of Oslo
Chair of the Defence
Professor John Anker Zwart, University of Oslo
Principal Supervisor
Professor Anne Therese Tveter, Diakonhjemmet/OsloMet
Summary
Patients with inflammatory joint disease (IJD), including rheumatoid arthritis, spondyloarthritis, and psoriatic arthritis, face an elevated risk of cardiovascular disease. Cardiorespiratory fitness (VO2peak), often lower in IJD patients, is linked to this risk and can be enhanced through targeted exercise interventions.
The aim of this thesis was to deepen the understanding of cardiorespiratory fitness and its measurements in IJD patients and assess the impact of high-intensity interval training (HIIT) in physiotherapy primary care.
Paper one identified factors influencing VO2peak in IJD patients. Cardiorespiratory fitness was inversely related to age and fat mass percentage, and positively related to physical activity. Patients with normal VO2peak levels had better health profiles, including higher HDL cholesterol and exercise self-efficacy, and lower triglycerides, fat mass percentage, and resting heart rate.
Paper two assessed the validity and responsiveness of estimated cardiorespiratory fitness models in IJD patients. These models showed moderate criterion validity but tended to overestimate VO2peak and had weak responsiveness to change, although larger improvements in VO2peak were detected.
Paper three evaluated a HIIT intervention delivered in physiotherapy primary care. Findings showed significant improvements in VO2peak at 3 months (2.5 mL/kg/min), sustained at 6 months. The intervention was well-tolerated, with minimal adverse events and trends towards reduced disease activity.
Overall, factors influencing VO2peak in IJD patients are similar to those in the general population, though fitness levels are generally lower. While estimated cardiorespiratory fitness models may be useful at a group level, they are less suited for individual assessments. The thesis underscores the importance of cardiorespiratory fitness assessment and structured exercise, such as HIIT, in managing IJD, as it effectively improves VO2peak and is well-tolerated.