Mathias Forsberg Brobakken

• Brobakken, Mathias Forsberg; Nygård, Mona; Vedul-Kjelsås, Einar; Harvey, Philip D. & Wang, Eivind (2024). Everyday function in schizophrenia: The impact of aerobic endurance and skeletal muscle strength. Schizophrenia Research. ISSN 0920-9964. 270(August), p. 144–151. doi: 10.1016/j.schres.2024.06.027. Show summary

  Background: Patients with schizophrenia suffer from physical health conditions, culminating in reduced physical functioning with enormous costs for patients and society. Although aerobic endurance and skeletal muscle strength, typically reduced in this population, relate to cognition and function, no study has explored their respective contributions to performance of functional skills and everyday tasks. Methods: In a cross-sectional study, 48 outpatients (28/20 men/women; 35 ± 11(SD) years) with schizophrenia spectrum disorders (ICD-10; F20–25) were administered the UCSD Performance-based Skills Assessment-Brief (UPSA-B; functional skills), Specific Level of Functioning (SLOF; functional performance) and the Positive and Negative Syndrome (PANSS) scale. Peak oxygen uptake (V̇O2peak) was assessed along with leg press maximal muscle strength (1RM) and mechanical power. Results: UPSA-B performance was associated with V̇O2peak (r = 0.28,p < 0.05), accounting for 8 % (p < 0.05) of shared variance, but was unrelated to 1RM and mechanical power. The SLOF physical functioning domain was associated with V̇O2peak (r = 0.30,p < 0.05) and 1RM (r = 0.24,p < 0.05), while SLOF personal care (r = 0.27,p < 0.05) and activities (r = 0.30,p < 0.05) were related only to V̇O2peak. Hierarchical regression analyses revealed that while V̇O2peak and age combined to account for 20 % (p < 0.05) of the variance in physical functioning, the contribution of 1RM was eliminated after adjusting for age. V̇O2peak and negative symptoms combined predicted 24 % and 35 % of the variance in personal care and activities, respectively. UPSA-B scores did not add to the prediction of SLOF scores. Conclusions: Although V̇O2peak and 1RM both relate to functional outcomes, the combination of V̇O2peak, age, and negative symptoms exert the greatest detrimental influence on functional performance beyond skills deficits.

• Brobakken, Mathias Forsberg; Krogsæter, Iben; Helgerud, Jan; Wang, Eivind & Hoff, Jan (2023). Abdominal aerobic endurance exercise reveals spot reduction exists : a randomized controlled trial. Physiological Reports. ISSN 2051-817X. 11(22). doi: 10.14814/phy2.15853. Full text in Research Archive Show summary

  The existence of spot reduction, exercise-induced local body fat reduction, has been debated for half a century. Although the evidence is equivocal, no study has applied aerobic endurance training closely matching interventions for energy expenditure. Sixteen overweight (BMI: 29.8 ± 3.3(SD) kg m−2) males (43 ± 9 years) were randomized to: (1) abdominal endurance exercise (AG), combining treadmill running at 70% HRmax (27 min) with 4 × 4 min (30%–40% maximal strength, 1RM) of torso rotation and abdominal crunches (57 min), 4 days⋅week−1 for 10 weeks; or (2) control group (CG) performing only treadmill running (45 min) at 70% HRmax. Local fat mass was measured by dual-energy x-ray absorptiometry (DEXA), along with 1RM, and pulmonary oxygen uptake (to control energy expenditure during training). Trunk fat mass decreased more (697 g, 3%, p < 0.05) in AG (1170 ± 1093 g, 7%; p < 0.05) than in CG (no change). Total fat mass (AG: 1705 ± 1179 g, 6%; CG: 1134 ± 731 g, 5%; both p < 0.01) and body weight (AG: 1.2 ± 1.2 kg, 1%, p < 0.05; CG: 2.3 ± 0.9 kg, 3%, p < 0.01) decreased similarly in AG/CG. Torso rotation (AG: 32 ± 16 kg, 39%, p < 0.01; CG: no change) and abdominal crunch 1RM (AG: 35 ± 16 kg, 36%, p < 0.01; CG: 13 ± 12 kg, 17%, p < 0.05) increased more (p < 0.05/0.01) in AG than CG. Abdominal endurance exercise utilized more local fat than treadmill running, indicating that spot reduction exists in adult males.

• Tøien, Tiril; Lindberg Nielsen, Jakob; Berg, Ole Kristian Brones; Brobakken, Mathias Forsberg; Nyberg, Stian Kwak & Espedal, Lars [Show all 10 contributors for this article] (2023). The impact of life-long strength versus endurance training on muscle fiber morphology and phenotype composition in older men. Journal of applied physiology. ISSN 8750-7587. 135(6), p. 1360–1371. doi: 10.1152/japplphysiol.00208.2023.
• Nygård, Mona; Brobakken, Mathias Forsberg; Lydersen, Stian; Güzey, Ismail Cüneyt; Morken, Gunnar & Heggelund, Jørn [Show all 7 contributors for this article] (2023). Strength training integrated in long term collaborative care of patients with schizophrenia. Schizophrenia Research. ISSN 0920-9964. 260(October), p. 67–75. doi: 10.1016/j.schres.2023.08.017.
• Brobakken, Mathias Forsberg; Nygård, Mona & Wang, Eivind (2022). Physical Health Impairment and Exercise as Medicine in Severe Mental Disorders: A Narrative Review. Sports Medicine - Open. ISSN 2198-9761. 8(1), p. 1–19. doi: 10.1186/s40798-022-00490-3. Full text in Research Archive Show summary

  Background: Individuals with severe mental disorders (SMDs; schizophrenia spectrum disorders, bipolar disorder, and major depressive disorder) are not only suffering from their mental conditions; they also have an attenuated physical health, augmenting their overall critical condition. Objectives: We review and critically appraise the evidence based on (1) key physiological factors relating to aerobic endurance and skeletal muscle strength; (2) implications for physical function and health; and (3) effects of training interventions with different intensities evaluated in individuals with SMDs. Findings: Reductions in aerobic endurance factors, peak oxygen uptake (VO2peak) and walking work efficiency, are paralleled by reductions in maximal skeletal muscle strength and power. In turn, the poor aerobic endurance and muscle strength lead to impaired physical function, increased risk of lifestyle-related diseases, and ultimately early death. Exercise has the potential to counteract the attenuated physical health in people with SMDs. While aerobic endurance training is shown to increase VO2peak due to plasticity of the oxygen transport system, strength training is documented to improve maximal muscle strength, power, and walking work efficiency as a result of adaptations in neuromuscular force developing factors. Conclusions: In conclusion, improvements in these key determinants for physical health appear to be achievable in people with SMDs despite many being challenged by motivational difficulties with attending regular exercise and have beneficial implications for physical function during activities of daily living, lifestyle-related diseases, and early death.

• Melby, Katrine; Nygård, Mona; Brobakken, Mathias Forsberg; Gråwe, Rolf W.; Guzey, Ismail Cuneyt & Reitan, Solveig Merete Klæbo [Show all 9 contributors for this article] (2021). Test-retest reliability of the patient activation measure-13 in adults with substance use disorders and schizophrenia spectrum disorders. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 18>1185(3), p. 1–8. doi: 10.3390/ijerph18031185. Full text in Research Archive Show summary

  Patient Activation Measure-13 (PAM-13) is a valid and widely used questionnaire that assess an individual’s knowledge, confidence, and skills for self-management of their chronic illness. Although there is some evidence regarding its reliability, the test–retest reliability has not been investigated among patients with substance use disorders (SUDs) or schizophrenia spectrum disorders. We investigated the internal consistency and test–retest reliability of PAM-13 in these populations. Test–retest reliability was analysed using data from 29 patients with SUDs and 28 with schizophrenia spectrum disorders. Cronbach’s α and Intraclass Correlation Coefficient (ICC) scores were used to examine internal consistency and test–retest reliability, respectively. Of the 60 collected test–retest questionnaires, 57 were included in the analyses. No mean differences between time one (T1) and time two (T2) were observed in either patient group, except for item 12 in schizophrenia spectrum disorders patients (p < 0.05). Internal consistency for T1 and T2 was 0.75 and 0.84 in SUDs patients and 0.87 and 0.81 in schizophrenia spectrum disorders patients, respectively. The ICC was r = 0.86 in patients with SUDs and r = 0.93 in patients with schizophrenia spectrum disorders. To conclude, PAM-13 showed good internal consistency and test–retest reliability in SUDs and schizophrenia spectrum disorders patients.

• Brobakken, Mathias Forsberg; Nygård, Mona; Guzey, Ismail Cuneyt; Morken, Gunnar; Reitan, Solveig Merete Klæbo & Heggelund, Jørn [Show all 8 contributors for this article] (2020). One‐year aerobic interval training in outpatients with schizophrenia : a randomized controlled trial. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 30(12), p. 2420–2436. doi: 10.1111/sms.13808.
• Nygård, Mona; Brobakken, Mathias Forsberg; Taylor, Joshua L.; Reitan, Solveig Merete Klæbo; Guzey, Ismail Cuneyt & Morken, Gunnar [Show all 10 contributors for this article] (2020). Strength training restores force‐generating capacity in patients with schizophrenia. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 31(3), p. 665–678. doi: 10.1111/sms.13863. Show summary

  Patients with schizophrenia spectrum disorders have impaired skeletal muscle force‐generating capacity (FGC) of the lower extremities, that is, one repetition maximum (1RM) and rapid force development, and poor functional performance. We therefore investigated whether 12 weeks of maximal strength training (MST) could (a) restore FGC and functional performance to the level of healthy references, (b) increase patient activation and quality of life, and (c) explore associations between symptom severity, defined daily dose of medication, illness duration, level of patient activation, and improvements in FGC and functional performance. Forty‐eight outpatients were randomized to a training group (TG) or control group (CG). TG performed leg press MST 2 day/week at ~ 90% 1RM. The CG received two introductory training sessions and encouragement to train independently. Leg press 1RM, rapid force development, a battery of functional performance tests, Patient Activation Measure‐13, and 36‐Item Short Form Health Survey were tested. Healthy references performed baseline tests of FGC and functional performance. Thirty‐six patients completed the study (TG: 17, CG: 19). TG improved 1RM (28%) and rapid force development (20%, both P < .01) to a level similar to healthy references, while no change was apparent in the CG. TG’s improvement in rapid force development was negatively associated with defined daily dose of medication (r = −0.5, P = .05). Both TG and CG improved 30‐second sit‐to‐stand test performance (P < .05) which was associated with improved rapid force development (r = 0.6, P < .05). In conclusion, 12 weeks of MST restored patients’ lower extremity FGC to a level similar to healthy references and improved 30‐second sit‐to‐stand test performance.

• Nygård, Mona; Brobakken, Mathias F; Roel, Ragnhild Bjerkem; Taylor, Joshua L.; Reitan, Solveig Merete Klæbo & Guzey, Ismail Cuneyt [Show all 10 contributors for this article] (2019). Patients with schizophrenia have impaired muscle force-generating capacity and functional performance. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 29(12), p. 1968–1979. doi: 10.1111/sms.13526.
• Brobakken, Mathias F; Nygård, Mona; Guzey, Ismail Cuneyt; Morken, Gunnar; Reitan, Solveig Merete Klæbo & Heggelund, Jørn [Show all 8 contributors for this article] (2019). Aerobic interval training in standard treatment of out-patients with schizophrenia - a randomized controlled trial. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 140(6), p. 498–507. doi: 10.1111/acps.13105.
• Brobakken, Mathias F; Nygård, Mona; Taylor, Joshua L.; Guzey, Ismail Cuneyt; Morken, Gunnar & Reitan, Solveig Merete Klæbo [Show all 9 contributors for this article] (2019). A comprehensive cardiovascular disease risk profile in patients with schizophrenia. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 29(4), p. 575–585. doi: 10.1111/sms.13371. Show summary

  Patients with schizophrenia are physically inactive and have high prevalence of cardiovascular disease (CVD). Peak oxygen uptake (V̇O2peak) is one of the strongest predictors for CVD, yet is rarely investigated in this patient population, and how V̇O2peak relates to other conventional CVD risk measures in this population is unclear. We measured treadmill V̇O2peak along with daily physical activity assessed by triaxial accelerometry, body mass index (BMI), waist circumference, blood pressure, lipid profiles, and glucose in 48 outpatients (28 men, 35 ± 10 (SD) years; 20 women, 35 ± 12 years), diagnosed with schizophrenia, schizotypal, or delusional disorders (ICD‐10; F20‐29). The patients were compared with 48 age‐ and sex‐matched healthy references (±2 years) and normative data from the population. V̇O2peak was 34.5 ± 8.7 mL/kg/min (men) and 26.4 ± 7.0 mL/kg/min (women), which was 27% and 30% lower than healthy references, respectively (both P < 0.01). V̇O2peak was not associated with daily physical activity in men while a weak association was seen in women (steps per day: r2 = 0.26; counts per minute: r2 = 0.25; P < 0.05). BMI (26.0 ± 6.1 kg/m2) revealed that patients were moderately overweight with a waist circumference of 103 ± 17 cm. Lipid‐ and glucose levels, and blood pressure were all within normative range. Our data advocate the utilization of V̇O2peak assessment for CVD risk profile determination in patients with schizophrenia. Daily physical activity was poorly and inconsistently related to V̇O2peak, suggesting increased daily physical activity might not translate into improved V̇O2peak and CVD risk reduction. Keywords: accelerometry, aerobic power, cholesterol, obesity, physical activity

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• Helgerud, Jan; Brobakken, Mathias Forsberg & Fossen, Dennis (2024). Slik bestemmer du hvor på kroppen du forbrenner fett. [Internet]. ABC Nyheter.
• Nygård, Mona; Brobakken, Mathias Forsberg; Taylor, Joshua Landen; Reitan, Solveig Merete Klæbo; Guzey, Ismail Cuneyt & Morken, Gunnar [Show all 9 contributors for this article] (2020). 12 Weeks Of Maximal Strength Training Restores Muscle Force-generating Capacity In Patients With Schizophrenia. Show summary

  Patients with schizophrenia spectrum disorders (ICD-10) suffer from impaired muscle force-generating capacity (MFGC) and functional performance of the lower extremities. PURPOSE. To investigate if 12 weeks of maximal strength training (MST) would restore MFGC and functional performance. METHODS. Forty-eight outpatients (28 men, 35±10 yrs; 20 women, 35±12 yrs) were randomized to a training group (TG) or control group (CG). Forty-eight age and gender matched healthy controls (28 men/20 women, 35±11 yrs) were tested to establish reference values. TG performed leg press MST (4x4 repetitions) 2d/week for 12 weeks at ~90% one repetition maximum (1RM). CG received two sessions of MST and encouragement to follow traditional physical activity guidelines. RESULTS. 17/24 patients in the TG (12 men/5 women, 34±11 years) completed 79% of training sessions and 19/22 patients in the CG (9 men/10 women, 37±12 years) completed the study. TG improved 1RM (28%, 12.6±4.1 to 16.2±5.0 Kg·mb -0.67, p<0.01) and rapid force development (20%, 18.6±8.6 to 22.4±10.8 N·m·s-1·mb -0.67, p<0.01), reaching 106% and 85% of healthy reference values, respectively. TG improvements differed from CG (p<0.01) where no changes occurred (1RM; 11.4±3.0 to 12.0±2.7 Kg·mb -0.67, rapid force development 16.4±6.9 to 17.3±6.5 N·m·s-1·mb -0.67). Both TG and CG improved 30-second sit-tostand test (30sSTS) performance (15±3 to 17±4 stands and 13±3 to 14±3 stands, respectively, p<0.05). Changes were not apparent as between group difference nor close the gap to reference levels (27±5 stands). CONCLUSION. MST restored the patients’ lower extremity MFGC and improved 30sSTS performance. Supported by grants from the Norwegian ExtraFoundation for Health and Rehabilitation, The Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology, and The Norwegian Directorate of Health.

• Brobakken, Mathias Forsberg; Nygård, Mona; Guzey, Ismail Cuneyt; Morken, Gunnar; Reitan, Solveig Merete Klæbo & Heggelund, Jørn [Show all 8 contributors for this article] (2020). Aerobic Interval Training Integrated In Collaborative Care Of Outpatients With Schizophrenia: One-year Outcomes. Show summary

  Although aerobic interval training (AIT) is recognised to attenuate the risk of cardiovascular disease (CVD) and premature mortality, it appears that it rarely arrives at patients’ doorsteps. PURPOSE: This study investigated 1-year outcomes when AIT was integrated with municipal and specialised health service in collaborative care of outpatients with schizophrenia. METHODS: Forty-eight outpatients (28 men, 35±10 (SD) years; 20 women, 35±12 years) with schizophrenia spectrum disorders (ICD10) were randomised to either a collaborative care group provided transportation and training supervision and walking/running 4x4-minutes at ~90% of peak heart rate (HRpeak) 2 d·wk-1 (TG), or a control group (CG) given 2 introductory AIT sessionsand advised to continue training. RESULTS: Directly assessed peak oxygen uptake (V̇ O2peak) increased in the TG (3-months: 2.7±3.1 mL·kg-1·min-1; 6-months: 3.2±3.0 mL·kg-1·min-1; 1-year: 3.3±3.1 mL·kg-1·min-1; all p<0.001; different from CG: p<0.05-0.001). In contrast, V̇ O2peak remained unchanged (3/6-months) and decreased (1-year:-1.8±3.8 mL·kg-1·min-1, p<0.05) in the CG. One-year cardiac effects revealed increased HRpeak (3±7 b·min-1, p<0.05; different from CG: p<0.01) in the TG and decreased HRpeak (-3±7 b·min-1, p<0.05) in the CG, while peak stroke volume tended to be higher (0.87±2.15 mL·b-1, p=0.12) in the TG compared to the CG. Conventional risk factors (body weight, waist circumference, blood pressure and lipids/glucose) were unaltered. One-year regular AIT rates were 15/25 (TG; different from CG: p<0.0001) and 0/23 (CG), respectively. CONCLUSIONS: AIT was successfully integrated in long-term collaborative care of outpatients with schizophrenia, advocating this model for aerobic capacity improvement and CVD risk reduction in future treatment.

• Brobakken, Mathias F; Nygård, Mona; Guzey, Ismail Cuneyt; Morken, Gunnar; Wang, Eivind & Heggelund, Jørn [Show all 7 contributors for this article] (2017). Cardiovascular Disease Risk Profile in Patients with Schizophrenia. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 49.
• Nygård, Mona; Brobakken, Mathias F; Guzey, Ismail Cuneyt; Morken, Gunnar; Vedul-Kjelsås, Einar & Wang, Eivind [Show all 7 contributors for this article] (2017). Strength Training In Patients With Schizophrenia: Effects On Muscle Force Generating Capacity. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 49.

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