Markku Alén

Markku Alén
University of Oulu · Institute of Health Sciences

MD, PhD

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176
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Publications (176)
Article
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Introduction: High-load, high-speed and impact-type exercise may be an efficient way of improving bone strength even in old age. We evaluated the effects of combined strength and sprint training on indices of bone health in competitive masters athletes, who serve as a group of older people who are likely to be able to participate in vigorous exerc...
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Introduction High circulating non-esterified fatty acid (NEFA) level is an independent risk factor of type 2 diabetes and cardiovascular diseases. Recent study showed that sleep restriction elevated morning fasting NEFA among healthy adults, which implied a link between impaired sleep quality and NEFA. We investigated whether morning fasting NEFA l...
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BACKGROUND: The nature versus nurture debate is one of the oldest issues in the study of longevity, health and successful aging. OBJECTIVE: We present a 97-year-old man (I.K.) as an example of the effects of habitual exercise on the aging process. METHODS: Extensive assessments included medical examinations, interviews, musculoskeletal structure, p...
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Background: The nature versus nurture debate is one of the oldest issues in the study of longevity, health and successful aging. Objective: We present a 97-year-old man (IK) as an example of the effects of habitual exercise on the aging process. Methods: Extensive assessments included medical examinations, interviews, musculoskeletal structure, per...
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Context Serotonin plays a potential role in bone metabolism, but the nature and extent of this relationship is unclear and human studies directly addressing the skeletal effect of circulating serotonin are rare. Objective The study aimed to investigate the associations between serum serotonin and bone traits at multiple skeletal sites in women and...
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Background: Mental health problems of children are commonly treated by psychotherapy and other psychosocial treatments. Studies comparing different treatments in naturalistic clinical settings are few, however. Aims: We assessed the differences: 1) in symptoms and diagnoses; 2) in treatment outcome between psychotherapy and other psychosocial tr...
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Background The aim of this study was to compare 6 weeks short-term moderate intensity aerobic exercise and dieting on serum metabolomics and cardio-metabolic risk factors in pre-menopausal women. Methods Ninety previously inactive overweight and obese (BMI 25-35 kg/m2) women (age 41.5 ± 7.6 years) were randomized to either a 6-week Nordic walking...
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Osteoporotic hip fracture is a serious clinical event associated with high morbidity and mortality. Understanding femoral growth patterns is important for promoting bone health in the young and preventing fractures in later life. In this study, growth patterns of areal bone mineral density (aBMD) and geometric properties of the proximal femur were...
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Study design:Population-based prospective study.Objectives:To determine the incidence and evaluate the characteristics of newly injured patients with traumatic spinal cord injury (TSCI) admitted to two of the three national spinal cord injury (SCI) centers during the first year after the centralization of SCI care in Finland.Setting:Oulu and Tamper...
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Background & Aims Recent evidence suggests that in animals gut microbiota composition (GMC) affects the onset and progression of hepatic fat accumulation. The aim of this study was to investigate in humans whether subjects with high hepatic fat content (HHFC) differ in their GMC from those with low hepatic fat content (LHFC), and whether these diff...
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MiRNAs are fine-tuning modifiers of skeletal muscle regulation, but knowledge of their hormonal control is lacking. We used a co-twin case–control study design, that is, monozygotic postmenopausal twin pairs discordant for estrogen-based hormone replacement therapy (HRT) to explore estrogen-dependent skeletal muscle regulation via miRNAs. MiRNA pro...
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High impact loading is known to prevent some of the age-related bone loss but its effects on the density distribution of cortical bone are relatively unknown. This study examined the effects of age and habitual sprinting on tibial and fibular mid-shaft bone traits (structural, cortical radial and polar bone mineral density distributions). Data from...
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Quantitative ultrasound of the heel captures heel bone properties that independently predict fracture risk and, with bone mineral density (BMD) assessed by X-ray (DXA), may be convenient alternatives for evaluating osteoporosis and fracture risk. We performed a meta-analysis of genome-wide association (GWA) studies to assess the genetic determinant...
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To identify serum biomarkers through metabolomics approach that distinguishes physically inactive overweight/obese women with metabolic syndrome from those who are metabolically healthy, independent of body weight and fat mass. We applied nuclear magnetic resonance spectroscopy-based profiling of fasting serum samples to examine the metabolic diffe...
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Quantitative ultrasound of the heel captures heel bone properties that independently predict fracture risk and, with bone mineral density (BMD) assessed by x-ray (DXA), may be convenient alternatives for evaluating osteoporosis and fracture risk. We performed a meta-analysis of genome-wide association (GWA) studies to assess the genetic determinant...
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Context: Knowledge about the interrelationship between adiposity and systemic low-grade inflammation during pubertal growth is important in detecting early signs of obesity-related metabolic disorders. Objective: The objective of the study was to evaluate the developmental trajectories of fat mass (FM) and high sensitive C-reactive protein (hsCR...
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Objective. To determine whether categories of obesity based on BMI and an anthropometry-based estimate of fat mass percentage (FM% equation) have similar discriminative ability for markers of cardiometabolic risk as measurements of FM% by dual-energy X-ray absorptiometry (DXA) or bioimpedance analysis (BIA). Design and Methods. A study of 40–79-yea...
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Vitamin D is well known for its regulatory role in calcium and phosphate homeostasis, but its role in muscle mass and strength during growth remains inconclusive. We explored the association of serum 25-hydroxyvitamin D (25(OH)D) with muscle development in girls from 11 to 18-years old. Whole body lean tissue mass (LMWB), appendicular lean mass (aL...
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Inphase and out-of-phase magnetic resonance imaging is a robust and fast method which can provide similar vertebral bone marrow fat estimation as (1)H proton magnetic resonance spectroscopy, indicating that this technique is a potentially useful tool in both research and clinical practice. The importance of evaluating bone marrow fat lies in the fa...
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Exercise-induced positive changes in skeletal muscle properties and metabolism decrease the risk for disability, cardiometabolic diseases and mortality. Here, we studied muscle properties and glucose homeostasis in a non-exercise stage in twin pairs with co-twins discordant for physical activity habits for at least 32 years of their adult lives. Is...
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Dear Editor, Drs. Cure-Cure and Cure [1] have raised the important question of whether greater maternal bone size and bone strength due to prolonged lactation protects women from fragility fractures in the long run. We cannot answer this question at this time since the majority of the women in our study [2] were pre-menopausal. We will explore this...
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Purpose: This study was undertaken to examine bone properties in masters sprinters of different ages and younger reference subjects. In addition, the association of sport-specific ground reaction force, muscle, training, and hormone characteristics with the bone parameters was evaluated in the athletes. Methods: Bone densitometric, structural, a...
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In this cross-sectional study, 95 postmenopausal women, with and without fracture history, were measured by low-frequency axial transmission ultrasound. The measured ultrasound velocity discriminated the fractured subjects from the nonfractured ones equally or better than peripheral quantitative computed tomography (pQCT) and dual energy x-ray abso...
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The global epidemic of chronic non-communicable diseases is closely related to changes in lifestyle, including decreasing leisure time physical activity (PA). Physical inactivity is a major public health challenge. To respond to that challenge, it is essential to know which personal and environmental factors affect PA behaviour. Certain life events...
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Bone mineral density (BMD) is the most widely used predictor of fracture risk. We performed the largest meta-analysis to date on lumbar spine and femoral neck BMD, including 17 genome-wide association studies and 32,961 individuals of European and east Asian ancestry. We tested the top BMD-associated markers for replication in 50,933 independent su...
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To examine effects of 21-week twice/week strength training (ST) period followed by an additional 21-week twice or once/week ST period on force production, walking and balance in aging people. Seventy-two women (58 ± 7 years; W) and 63 (58 ± 6 years) men (M) were randomized for the first 21-week ST period: STW and STM, control (C) CW and CM. Trainin...
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Bone mineral density (BMD) is the most widely used predictor of fracture risk. We performed the largest meta-analysis to date on lumbar spine and femoral neck BMD, including 17 genome-wide association studies and 32,961 individuals of European and east Asian ancestry. We tested the top BMD-associated markers for replication in 50,933 independent su...
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Hip fracture is a common trauma in older people, and often leads to decreased muscle strength and increased physical disability. This randomized controlled trial examined whether three months of progressive resistance training (PRT) can reduce physical disability among older people with a history of hip fracture. A population-based sample of 60-85-...
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Long-term persistent physical activity is important in the prevention of chronic diseases, but a large number of people do not participate in physical activity to obtain health benefits. The purpose of this study was to examine the motives and perceived barriers to long-term engagement in leisure time physical activity. Same-sex twin pairs (N=16, m...
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Postmenopausal monozygotic twin pairs discordant for hormone replacement therapy (HRT) provide an advantageous study design controlling for genetic background for elucidating the relationships between aging, sex hormone levels, muscle strength, contractile capacity, and fatigability. Thirteen postmenopausal monozygotic twin pairs discordant for HRT...
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The association between lactation and bone size and strength was studied in 145 women 16 to 20 years after their last parturition. Longer cumulative duration of lactation was associated with larger bone size and strength later in life. Pregnancy and lactation have no permanent negative effect on maternal bone mineral density but may positively affe...
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A better understanding of how bone growth is regulated during peripuberty is important for optimizing the attainment of peak bone mass and for the prevention of osteoporosis in later life. In this report we used hierarchical models to evaluate the associations of insulin-like growth factor 1 (IGF-1), estradiol (E2), and testosterone (T) with peripu...
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Im Rahmen der Bewertung von lumbalen Rückenschmerzen ist Schmerzzentralisierung ein spezifischer Befund. Ein dynamisches internes „Bandscheibenmodell” mit hoher positiver Korrelation mit Schmerzen während der Provokationsdiskografie wurde als ein der Schmerzzentralisierung zugrunde liegender Mechanismus hypothetisiert. Zwar ergibt die MRT häufig au...
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Both strength and endurance training have several positive effects on aging muscle and physical performance of middle-aged and older adults, but their combination may compromise optimal adaptation. This study examined the possible interference of combined strength and endurance training on neuromuscular performance and skeletal muscle hypertrophy i...
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Bone adapts to mechanical loads applied on it. During aging, loads decrease to a greater extent at those skeletal sites where loads increase most in earlier life. Thus, the loss of bone may occur preferentially at sites where most bone has been deposited previously; ie, bone loss could be the directional reversal of accrual. To test this hypothesis...
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Although postmenopausal hormone-replacement therapy (HRT) is known to prevent fractures, knowledge on the influence of long-term HRT on bone strength and its determinants other than areal bone mineral density is scarce. This study used a genetically controlled design with 24 monozygotic female twin pairs aged 54 to 72 years in which one cotwin was...
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The purpose of this 7-yr prospective longitudinal study was to examine if the level and consistency of leisure-time physical activity (LTPA) during adolescence affected the quantity and distribution of lean mass (LM) and fat mass (FM) at early adulthood. The study subjects were 202 Finnish girls who were 10-13 yr old at baseline. LM and FM of the t...
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Exercise is thought to increase the diameter of the conduit arteries supplying the muscles involved. We studied the effects of a physically active vs inactive lifestyle on artery diameters in monozygotic (MZ) twin pairs discordant over 30 years for leisure-time physical activity habits. In a population-based co-twin control study design, six middle...
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In this study self-reported ability to walk 2 km and six-minute walking test (6MWT) performance were examined as predictors of all-cause mortality in 434 women, aged 63-76 years. The primary outcome measure was all-cause mortality (follow-up: 8 years). Predictors were self-reported difficulties in walking 2 km and 6-min walking distance tertiles of...
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Body weight and lean mass correlate with bone mass, but the relationship between fat mass and bone remains elusive. The study population consisted of 396 girls and 138 premenopausal mothers and 114 postmenopausal grandmothers of these girls. Body composition and tibial length were assessed using dual-energy X-ray absorptiometry (DXA), and bone trai...
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During growth bone increases in length and width as does the body size. The aim of this paper was to examine the growth pattern of body height and weight, and the width and length of various body segments, and to establish the timing of peak growth velocity (PV) in relation to time of menarche in a cohort of Finnish girls followed from age 10 until...
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Bisher ließ sich vom in mehreren aufeinanderfolgenden Untersuchungen bestimmten Zentralisationsphänomen eine gute Prognose ableiten, wohingegen eine Nichtzentralisation chronische Kreuzschmerzen und Behinderung vorhersagte. Diese Studie ging der Frage nach, ob bei der Erstuntersuchung festgestellte zentralisierende Rückenschmerzen in der LWS (LBP)...
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Aging is accompanied by inexorable loss of muscle tissue. One of the underlying causes for this is the massive change in the hormonal milieu of the body. The role of a female sex steroid - estrogen - in these processes is frequently neglected, although the rapid decline in its production coincides with a steep deterioration in muscle performance. W...
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Familial resemblance and diversity in bone structure and strength in adulthood are determined in part during growth. Whether these characteristics are established during gestation or shortly after birth is not known. Total-body, lumbar spine, and femoral neck size and mass and indices of tibial bending strength and distal radial compressive strengt...
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Our purpose was to examine if adults with centralizing pain might achieve better treatment outcomes when treated by individually designed therapy than “given advice only to stay active”. One hundred and nineteen working adults with first or a recurrent episode of low back pain (LBP) were classified as centralizers and were randomly allocated to ort...
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Previous studies have shown that athletic training or other physical activity causes structural and functional adaptations in the heart, but less is known how long-term physical activity affects heart when genetic liability and childhood environment are taken into account. The aim of this study was to investigate the effects of long-term physical a...
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We investigated whether the myosin heavy chain (MyHC) proportion and androgen receptor (AR) concentration in skeletal muscle differ following 21 weeks of strength, endurance and combined training in untrained older men. Strength (S) and endurance (E) groups trained twice per week and combined (S+E) group trained four times per week (two strength an...
Article
The purpose of this 7-year prospective longitudinal study was to examine whether the level and consistency of leisure-time physical activity (LTPA) during adolescence affected the bone mineral content (BMC) and bone mineral density (BMD) attained at early adulthood. The study subjects were 202 Finnish girls who were 10 to 13 years of age at baselin...
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The purpose of this study was to examine how resting electrocardiographic (ECG) and other clinical variables, which can be included in a routine clinical examination, predict walking ability in older women. Three hundred and twenty women (63-75 years) without overt cardiac diseases and apparent mobility limitations were studied. Measurements perfor...
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Exercise is thought to reduce high-risk body fat, but intervention studies are frequently limited by short follow-ups and observational studies by genetic selection. Therefore, we studied the effects of a physically inactive vs active lifestyle on high-risk (visceral, liver and intramuscular) fat in twin pairs discordant for leisure-time physical a...
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Both left ventricular hypertrophy (LVH) and repolarization phase (RP) are known to be attributable to genetic influences, but less is known whether they share same genetic influences. The aim of this study was to investigate to what extent individual differences in electrocardiographic (ECG) LVH and RP are explained by genetic and environmental inf...
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This study was designed to assess the effects of strength training on work capacity and parasympathetic heart rate modulation during exercise in physically inactive men. Seventy-four men aged 20-45 were randomly assigned to training (n=52) and control (n=22) groups. Training groups underwent 10-weeks of progressive strength training. Body compositi...
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Limited data exist on the associations between muscle performance and work ability measures in working age adults. To evaluate how the results of simple muscle performance tests correlate with self-reported work ability and physical functioning in middle-aged men. Muscle performance was measured with handgrip, sit-up, arch-up, squatting and lifting...
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Balance dysfunction and loss of balance confidence have been associated with functional limitations and loss of independency in daily tasks. This study examined various aspects of postural balance and balance confidence between older adults with a hip fracture history and their non-fractured counterparts. A comprehensive assessment of balance capac...
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To evaluate the effects of a low-frequency sound wave therapy programme on functional capacity, blood circulation and bone metabolism of the frail elderly. Single-blind, randomized, controlled trial. Two senior service centres. Forty-nine volunteers (14 males and 35 females) aged 62-93 years with up to 12 diagnosed diseases were allocated in either...
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Aging diminishes the ability to run fast, but the specific mechanisms responsible for this deterioration remain largely unknown. In the present study, we investigated the age-related decline in sprint running ability through a cross-sectional examination of biomechanical and skeletal muscle characteristics in 77 competitive male sprinters aged 17-8...
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The growth of lean mass precedes that of bone mass, suggesting that muscle plays an important role in the growth of bone. However, to date, no study has directly followed the growth of bone and muscle size through puberty and into adulthood. This study aimed to test the hypothesis that the growth of muscle size precedes that of bone size (width and...
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Previous studies in young and middle-aged men and women have shown that resting electrocardiographic (ECG) variables are influenced by genetic factors. However, the extent to which resting ECG variables are influenced by genetic factors in older women is unknown. Thus, the aim of this study was to estimate the relative contribution of genetic and e...
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The physically active lifestyle is associated with low future morbidity and mortality, but the causality between physical activity and health is not always clear. As some inherited biological characteristics and childhood experiences may cause selection bias in observational studies, we sought to take them into account by identifying 16 twin pairs...
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Bone must be rigid for leverage yet light for mobility. We studied how bone modeling and remodeling fashioned differences in bone size, shape, and mass during growth to achieve these properties in adulthood. We measured the structural features of a tibial cross-section using quantitative computed tomography and markers of remodeling in 258 10- to 1...
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The Work ability of ageing work force is a matter of major concern in many countries. The aim of this study was to examine the relationship between perceived work ability and health-related quality of life (HRQoL), and to investigate their associations with age, physical activity and physical fitness in middle-aged men working in blue-collar occupa...
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To examine the effectiveness of concurrent strength and endurance training on muscle strength, aerobic and functional performance, and symptoms in postmenopausal women with fibromyalgia (FM). Randomized controlled trial. Local gym and university research laboratory. Twenty-six women with FM. Progressive and supervised 21-week concurrent strength an...
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This study aims at examining the effects of progressive strength and sprint training on regulation of muscle contraction at the whole-muscle and single-fibre levels in older sprint-trained athletes. Eleven men (52-78 years) were randomized to a training (EX, n = 7) or control (CTRL, n = 4) group. EX participated in a 20-week programme that combined...
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The purpose of this study was to investigate if strength training affects red blood cell variables in physically inactive men when taking into account seasonal variations. Seventy-four men aged 20-45 were randomly assigned to training (n = 52) and control (n = 22) groups. Training group underwent 20-week progressive strength training. Body composit...
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The effects of 18weeks’ intensive strength and endurance training on fibre characteristics of the vastuslateralis muscle were studied in 76- to 78-year-old women. Type I and type IIa fibresconstituted over 90% of the cell population and were almost equally represented. Nochanges were observed in the proportions of the different fibre types. When co...
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The purpose of this study was to compare physical fitness and health-related quality-of-life between twenty-three postmenopausal women with fibromyalgia (age 58 +/- 3 years) and eleven healthy women (58 +/- 5 years). Aerobic fitness and isometric force of different muscle groups were measured. Functional performance was assessed by walking and stai...
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This study evaluated to what extent dual-energy X-ray absorptiometry (DXA) and two types of bioimpedance analysis (BIA) yield similar results for body fat mass (FM) in men and women with different levels of obesity and physical activity (PA). The study population consisted of 37-81-year-old Finnish people (82 men and 86 women). FM% was estimated us...