Tobias Holmlund

I hold a PhD from Karolinska Institutet, completing my dissertation titled "Energy Expenditure and Accelerometer Cut-points for Sedentary Behavior and Physical Activity in Spinal Cord Injury – Implication for Guiding and Prevention." My research revolved around understanding the energy metabolism of individuals with spinal cord injuries during activities ranging from basic metabolism to maximum oxygen uptake. I analysed extensive data from approximately 700 measurements, including indirect calorimetry, heart rate,  and accelerometers. This data allowed me to establish intensity thresholds and describe energy expenditure patterns for wheelchair users with spinal cord injuries.

Following my PhD, I joined the Åstrand Laboratory at the Swedish School of Sports and Health Science (Gymnastik och Idrottshögskolan) as a  postdoctoral researcher in the HPI group. Here, I delved into investigating the relationship between changes in physical capacity and various
health-related risk factors within the field of public health. Throughout my academic journey, I have published several research papers.
Some of these publications explore the association between changes in cardiorespiratory fitness and incident hypertension, the impact of
cardiorespiratory fitness and lifestyle on severe COVID-19 risk, and the influence of changes in cardiorespiratory fitness on self-rated health. I
have also investigated the correlation between lifestyle habits, mental health, workplace sitting, and general health in the working populations,

My research includes several projects that examine how daily activity and inactivity are linked to cardiovascular risk factors in individuals with motor‑complete spinal cord injury. This includes studies on how activity patterns, intensity levels, and sedentary behavior relate to cardiovascular risk and secondary health complications. An important part of my research profile builds on my postdoctoral work at the Swedish School of Sport and Health Sciences (GIH), where I investigated associations between physical capacity and cardiometabolic risk factors in a working‑age population using data from approximately 500, 000 individuals. This provided me with a broad public‑health perspective and a deeper understanding of how activity levels influence key risk factors such as hypertension, obesity, stress, and self‑rated health—knowledge that now serves as an analytical reference point in my SCI‑related work.

The foundation for my current research direction was established during my doctoral studies, which included approximately 700 measurements of indirect calorimetry, heart rate, and accelerometry. These data enabled the development of SCI‑specific intensity levels and detailed descriptions of energy expenditure during various daily activities among wheelchair users. These reference values now underpin several of my ongoing projects. This work has led to the development of the WheelAbility app, now available for download on both the App Store and Google Play. The app connects to an activity wristband and uses heart‑rate and accelerometer data to estimate energy expenditure, activity intensity levels, and sedentary time. The physiological models used in the app are directly based on data from my doctoral research, making the calculations specifically adapted to individuals with spinal cord injury. AI Integration in WheelAbility In its latest development phase, WheelAbility has been enhanced with AI‑driven decision support and pattern recognition.

The AI component works by: analyzing the user’s combined activity and health data detecting patterns that may be difficult to identify manually generating personalized recommendations providing early warning signals when risk‑related behaviors emerge explaining why certain activity patterns may be unfavorable

The app integrates these analyses with self‑reported complications such as pain, urinary issues, pressure ulcers, and spasticity, creating a comprehensive picture of daily health status and risk.

The development of WheelAbility follows a co‑creation approach, in which individuals with spinal cord injury actively participate in the design, testing, and continuous refinement of the app to ensure that its functions meet real‑world needs and clinical requirements. https://hci.gu.se/wheelability).

Another ongoing project involves developing a submaximal arm‑crank test to predict maximal oxygen uptake in individuals with spinal cord injury. The test, named the Holmlund–Grooten Test, is included as part of the educational program Physical Capacity and Fitness Training After Spinal Cord Injury, designed for clinicians. https://ryggmargsskadecentrum.se/fysisk-kapacitet/)

Furthermore, I have taken on teaching responsibilities since 2021 within the physiotherapy program. I have the privilege of teaching and mentoring
students at both the undergraduate and advanced levels. As the course coordinator in semester four, " nerve system injuries and Diseases".
Additionally, I teach various subjects, including balance control,  somatosensory assessment, and pain physiology, within a clinical context. At
the advanced level, I delve into the intricacies of "Measuring Physical Activity with Focus on Wearable Monitors - Applications for Clinical and
Epidemiological Studies."